Cutting emergency services in the west of Scotland is still the best plan, according to new health board reports - despite SNP promises to save A&E departments.
Proposals which would downgrade the treatment available at Ayr Hospital and Monklands Hospital, Airdrie, come out on top in the latest analysis published by NHS managers.
Despite being told by Health Secretary Nicola Sturgeon to revise proposals and being told by a new scrutiny panel that the case for cuts was weak, the two health boards are still pressing for change.
NHS Lanarkshire, which runs Monklands Hospital, has listed a plan - known as option B - where it would lose intensive care, emergency medicine and surgery as their "preferred scenario".
NHS Ayrshire and Arran, which runs Ayr, rated a scheme which would axe emergency surgery from the hospital and reduce the level of critical care, top of their list.
Dr Robert Cumming, chairman of the Scottish Health Campaigns Network, which unites groups fighting hospital service closures, said: "I think the health boards are trying to stick to their guns no matter what. They seem to be going through all the right processes but maybe coming out with the answers they want in the end. Hopefully they will not get away with it."
After Ms Sturgeon announced she was reversing the Labour government's decision to downgrade the two A&Es, she ordered the boards to bring forward new proposals.The results are revealed in final reports which are being sent to the panel set up to scrutinise the process.
In their document NHS Lanarkshire say option B is their preferred scenario, but admit it "does reduce access for patients in the Monklands area for emergency care and this is likely to be less favoured by the public".
However, they also give a second option, G, which keeps much of the existing front line at Monklands but allows centralisation of specialist medical fields in future.
Alex Neil, SNP Central Scotland MSP, said he fundamentally disagreed with their first choice. "I think option G is the only one that fulfils both the letter and the spirit of the commitment to keep an A&E in Monklands," he said.
Alec Clark, chairman of Girvan Community Council and an opponent of the cuts, said: "When they (the SNP) said the A&E would remain open, we expected it meant open with full back-up services and I think that is crucial."
The public representatives involved in the scoring in both Lanarkshire and Ayrshire backed the options which ultimately came out on top. However Dr Cumming said: "There were thousands of people who signed petitions asking to keep the A&Es. There is no question the status quo is what people want."
Timeline
- JANUARY 2006: NHS Lanarkshire launches public consultation which includes downgrading A&E in either Monklands, Airdrie or Hairmyres, East Kilbride.
- JUNE 2006: Board agrees to downgrade Monklands A&E.
- AUGUST 2006: Lewis Macdonald, deputy health minister, announces Monklands will be downgraded.
- JUNE 2007: New SNP health secretary Nicola Sturgeon says she is reversing decisions to downgrade Monklands and Ayr Hospital.
- DECEMBER 2007: NHS Lanarkshire's final submission to a scrutiny panel is published, listing an option which would remove acute medicine, surgery and intensive care from Monklands.
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