Alan MacDermid, Medical Correspondent
A case of mistaken identity adds to tension at Glasgow Royal
Infirmary.
THE man accused of running a ''regime of fear'' at Glasgow Royal
Infirmary is 34, with a boyish countenance that might almost qualify him
for a job in the casualty department.
Nigel Clifford joined the Royal as unit general manager after 11 years
with British Telecom, latterly in charge of developing their mobile
services.
He was kept on the move yesterday as the flak came in from one
direction after another -- the accusation that staff are being gagged,
and the revelation that two fourth-year pupils on work placement were
mistaken for medical students last week and invited to help stitch up
accident patients.
Staff who feel that they -- and their patients -- are being stitched
up as the Royal gets into trim for trust status in April will still be
there after yesterday's embarrassment has faded.
Mr Clifford, aided by his top aides, tried to set their minds at ease
in the course of a lengthy interview yesterday, but there is no escaping
the fact that the Royal, like other hospitals in the city, faces a
squeeze as they compete with each other for business from a health board
with a shrinking budget.
''An atmosphere of fear is not the kind of thing I want to exist
here,'' he said. ''Certainly there is trepidation about what trust
status is going to mean. When I came in here I asked what staff morale
was like and got a mixed response, so we ran a census. We asked about
everything from communications to car-parking.
''I found that people felt far more positively about their jobs than
you would find in an internal industrial environment. They thought their
job was worthwhile. But there are concerns about what trust status will
mean.
''Since then we have run a series of presentations by heads of
departments. A lot was unknown about what a trust would be like. We have
done a lot of communicating.''
He added:'' We have addressed a lot of concerns. People will remain
concerned but it would be the same if we remained a directly-managed
hospital.
''I hope the atmosphere is such that people can raise issues. I have
written to Mike Watson [MP for Glasgow Central] to say I am very
concerned and would like to meet him to hear his reasons for making
these complaints. We do not wish to gag people.''
His emphasis, however, was on official channels -- the nursing and
medical hierarchies, and the clinical directorate structure.
''I also meet union representatives on a quarterly basis; and once or
twice a week I take a walk round and drop in on various areas to give
people the opportunity raise what they want. I want everyone to feel as
if they can talk to their line manager if they have a problem.''
These concerns centre on the changes that are taking place in the way
the 850-bed Royal treats patients -- fewer beds, faster turnover, more
patients treated at home -- and the effect this will have on jobs, wages
and conditions.
Details about the infirmary's bed-closure plans have leaked out
piecemeal until now. The new configuration means that three wards -- 29,
35, and 36 -- are closing, a total of 62 beds.
As a result general surgery will be located in the new block,
alongside the hospital's 16 operating theatres, ending the regular
trolley trip -- for surgery patients at least -- through the long
connecting corridor. Net reduction, 16 beds; paediatric cases -- largely
ENT -- will be handled by the Royal Hospital for Sick Children (18
beds); oral surgery (six beds) will be transferred to Canniesburn.
Other specialties to be cut are gynaecology (seven beds), medical
investigation (nine), vascular medicine (four), and urology (two).
Professor Ross Lorimer, the Royal's medical executive, insists: ''It
gives us space to redevelop in the fullness of time. The reduction in
surgical beds is compensated for by the increase in day surgery. It is
not that there will be less done; more and more is being done on a day
basis.''
The patients, he says, are happy to sit at home if they are re-assured
that there is continuing care -- in the form of visits from liaison
nurses and other back-up staff -- and that if they need to come in, they
can.
The move to trust status in other hospitals has already been marked by
skirmishes with the unions over attempts to change wages and conditions,
with threats of legal action. There is no assurance that life at the
Royal will be any different in the long-run.
Meantime, however, Nigel Clifford said: ''The 3900 whole-time
equivalent staff we have at the moment will move into the trust on the
same terms and conditions they have at the moment. Any change will have
to be negotiated.
''For those who come in after April, we will have the opportunity to
offer something different, but we have not got any plans in that
respect.
''The health board will be seeking to place business with the most
cost-effective trusts. Each of the trusts is going to be taking a view.
We have to have a cost profile which is competitive. The GP fund-holders
are going to have to be very sharp on this too.''
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