17. MATERNAL AND CHILD HEALTH

The Yorkhill NHS Trust comprises Scotland’s biggest children’s hospital (Royal Hospital for Sick Children), one of Glasgow’s principal maternity centres (Queen Mother’s Hospital), and the community child health services for Glasgow. In addition Yorkhill is the site of highly specialised services such as Fetal Medicine (babies before they are born), Bone-Marrow and Kidney Transplantation and the National Centre for Paediatric Cardiac Surgery.

The Health Board has decided to take the opportunity to explore the provision of a new Maternity and Children’s Hospital as part of the reconfigured health service in Glasgow. There would be a period of 7 – 10 years before building was completed.

Why is this worth thinking about now?

• By 2010 most of the buildings at Yorkhill will be 40 to 50 years old. We would need to be thinking then about how to create a "new Yorkhill". Failure to do that then would mean that the next generation of children would be condemned to using buildings that had been designed in the 1960s – an era when hospital services were very different from what they will be in the future.

• The Yorkhill site is cramped. The hospitals on it cannot be replaced there properly without knocking them down first!

• Piecemeal replacement of parts of the hospitals on the small Yorkhill site would condemn staff and patients to being among a building site for many years...... and it would be almost impossible to produce a highly effective modern design in a piecemeal development.

• So – why not think about creating a fully up-to-date replacement with stronger links with other services in one single building contract and with no building site disruption to the Yorkhill site itself?

 

The Yorkhill NHS Trust welcomes the opportunity to investigate the option of relocating to a new site in Glasgow.

Staff within the Trust will work with patients and their families and all other interested parties in considering this and other alternative options. We can then start to set out in more detail how we feel health needs of children and mothers can best be provided for in the future.

As Yorkhill currently provides many national and regional services for mothers and children we are aware that any proposals for the future will also be of widespread interest to the public throughout Scotland.

Medical care is continuously developing and this has implications for where and how mothers and children are treated. Our vision is to deliver the best health care in the most appropriate setting. Patients and their families tell us that where it is safe to do so they would like to be cared for in the community, close to where they live, or better still in their home. However, there are patients who require access to more sophisticated investigation or surgical or medical treatment that can only be provided by a concentration of highly trained staff and resources in a hospital setting. Such care should be provided in modern, fit for purpose facilities equipped and designed to meet the challenges of leading-edge clinical care in a safe child and family-friendly environment.

The proposal contained in the modernisation plan is to transfer all services provided by Yorkhill into a first class new children’s hospital in association with an adult hospital service on the same site within the next 7 – 10 years. Further work needs to be done to consider whether it would make sense to create a new maternity hospital at the Southern General as part of that scheme or whether the service can function satisfactorily with the maternity service remaining elsewhere on the Southern General Hospital sit in its existing relatively modern accommodation (which would be big enough).

Some advantages of locating these services on the same site will be:

Any option for the future location of the services currently provided by Yorkhill must ensure that:

The Yorkhill Trust provides a mixture of local, regional and national services. Greater Glasgow NHS Board residents are the major users – around 43,000 (in-patients, day cases and new outpatients) in 1998/9 (67% of total activity). The next biggest numbers of users are around 9,000 from Lanarkshire (14% of total activity) and 5500 from Argyll and Clyde (9%). Other Health Boards’ numbers are:

Ayrshire and Arran - around 1700 ) 10% of

Forth Valley - around 1300 ) total

All other Health Boards - less than 600 each. ) activity

Accessibility to Yorkhill at present is reasonably straightforward by car (but car parking is limited) or else involves combinations of trains (via Partick), underground (via Kelvin Hall) or bus. Accessibility to the Southern General will not be significantly more difficult for those travelling by car (and car parking will be easier). Public transport access via the underground (to Govan and then short bus ride to the Southern General) will, for very many people, be no more difficult than current access to Yorkhill. The present in-patient attendances at Yorkhill by Glasgow residents show that most people are already used to travelling from widely around the Greater Glasgow area, using several bus routes and changing buses to complete their journey.

An ‘Evening Times’ story on 21st March, 2000 identified that the bus journey from the City Centre to the Southern General (mid-morning) was 23 minutes, which is no more than 15 minutes longer than it would take from City Centre to Yorkhill (where the journey would conclude with a walk up the hill from Argyle Street).

Initial reaction to the suggestion of building a new Children’s Hospital at the Southern General has – very understandably – emphasised the supreme importance of retaining the spirit and child-centred focus that the Royal Hospital for Sick Children provides. We absolutely agree. What is proposed is the same set of services, provided by the same staff but in a completely new children’s hospital building better connected to some services where the child-centred focus is currently weak (such as neurosciences, Southside ENT and services for children who currently attend an adult Accident and Emergency Department). Residential accommodation for parents wanting to stay near their children will also be provided on site to ensure continuation of the excellent support currently provided by Ronald McDonald House.

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