Scotland needs a bed inquiry

BMJ 1999; 318 doi: https://doi.org/10.1136/bmj.318.7184.668a (Published 06 March 1999) Cite this as: BMJ 1999;318:668
  1. Matthew G Dunnigan (le2r{at}clinmed.gla.ac.uk), Senior research fellow
  1. University Department of Human Nutrition, Royal Infirmary, Glasgow

    E—The National Bed Inquiry for England is welcome, especially if the remit extends to issues of accuracy and definition.1 My experience suggests that a similar inquiry is required for Scotland.

    On 27 October 1997, in reply to a parliamentary question, Tam Dalyell was informed that with the completion of Lothian Health Board's acute services strategy there would be 2042 acute hospital beds in the board's three acute hospitals.2 These figures were grossly inaccurate, relating to a superseded 1993 strategy document. The true number of projected acute beds in the three hospitals is 1413 (31% fewer) in 2003. I obtained these numbers from the board with considerable difficulty.

    In October 1997 I sent a paper to the board's area medical committee expressing reservations about the large projected loss of acute hospital capacity in Lothian's hospitals (available from MGD). In November the British Medical Association held a press conference to highlight the concerns expressed in my “BMA paper.” In response the board issued rebuttals in a press statement and in a paper (subsequently shown to contain serious errors) which was sent to all general practitioners in Lothian.3 The paper was used to reassure local councillors and members of parliament that the projected bed numbers in the BMA paper were misleading and inaccurate. In August 1998 Lothian Health Board signed a contract for the largest new hospital financed through the public finance initiative in the United Kingdom.

    Publicly available documents relating to the acute services strategy contain no hospital activity data. My subsequent access to the board's database, negotiated by the BMA, and an independent review by the Information Services Division of the NHS in Scotland4 showed that the data in the board's rebuttal paper had departed from conventional definitions of acute specialties beds and inpatient activity. These departures resulted in substantial differences in historical and projected bed reductions (table), case load, and throughput between the BMA and Lothian Health Board.

    Number (percentage) of acute bed reductions in Lothian Health Board hospitals according to various sources

    View this table:

    Publicly accountable bodies should be required by statute to provide current and future projections of activity data and beds in a standard format and to make these data publicly available in all documents relating to new hospital planning developments. The Accounts Commission for Scotland have been given relevant documents relating to the issues discussed above.


    aI am a member of the NHS Consultants' Association and the BMA. I thank Dr Brian Potter, Scottish BMA secretary, for help in obtaining the data discussed above.


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