 The next item of business is a debate on motion 14405, in the name of Richard Leonard, on keep the Monklands in Monklands. Can I ask those members who wish to speak in the debate to press the request to speak buttons now? I call on Richard Leonard to speak to and move the motion for up to eight minutes. Mr Leonard. Thank you, Deputy Presiding Officer. We are forced to bring this motion before Parliament because we fear that a great injustice may be served on the people of Lanarkshire. We bring this motion before Parliament because we believe that it is the job of this Parliament and the elected representatives in it to speak up to stop a grave error, a grave error that would be felt for generations to come if we sit back and allow it to be made. The decision to build a new hospital, a state-of-the-art hospital for present and future needs, and to replace and not simply upgrade the existing Monklands University hospital has been widely welcomed, but the health board consultation, which closed last week over what form and critically where the new hospital is to be built, has been roundly condemned. The health board plead that what it has done is simply to follow Scottish Government guidance. In that guidance, it clearly states that, and I quote, the Scottish people and the staff of the NHS are co-owners in the NHS. It clearly states that the health board has a duty to ensure that information presented to the public must be, and I quote, balanced. That is why we have brought this motion before Parliament today, because the health board has undertaken a flawed process with flawed logic. It is true that the people of Lanarkshire have been informed, but they have neither been meaningfully engaged nor genuinely consulted. I would go further. There has been nothing less than a cynical attempt to railroad through the board's preferred option of closing the Monklands hospital down and relocating its services to a new site in the village of Garkosh in the teeth of widespread public opposition. Public meetings were not meaningful consultations, but one-sided presentations on the case for Garkosh. People left those meetings angry and frustrated. Before that, we had in June of this year an options appraisal process, in which there was a desperate shortage of patient and public voices. The people who took part in this options appraisal have been described by NHS Lanarkshire as, and I quote, delegates. My question to the health board is if there were delegates, who delegated them? Were they mandated in advance and have they reported back on their decision? According to the guidance that they were supposed to be, and I quote again, health service users, patients, staff, members of the public, carers, volunteers and the voluntary organisations that represent them. However, the composition of the people involved in this options appraisal appears to have been dominated by NHS Lanarkshire employees and senior ones at that. So, whilst the surgeons and the consultants may have been consulted, what about the porters? What about the domestics? What about the catering workers? What about the lowest paid workers? Many of them shift workers, most of who live and work locally. What about the patients? What about the service users and what about the carers? My question to the minister is if this exercise is in line with Scottish Government guidance, when the guidance is so much waste paper. If it is, isn't it about time that the Scottish Government started laying down some tougher rules that ensure that the democratic will of local communities is respected? Or, on the other hand, if this exercise is not in line with the guidance, then surely the time has come for the Government to swiftly and directly intervene. As a member of this Parliament for Central Scotland, in August, I initiated an online petition. The petition called on the Scottish Government to step in to ensure that the new hospital is built on the site of the existing hospital. To date, it has gathered over 5,000 signatures. This is the option that the majority of the people want. What is the health board's response? They say, and I quote, that there are significant challenges in delivering key adjacencies within the identified expansion zone, and the guidelines stipulate that everything is meant to be easy to understand. They also say that there is potential for complex wayfinding that is associated with building over different levels. This is not transparent, this is opaque. We are told, time and time again, that construction work on the current site would lead to the temporary loss of parking spaces. Of course, that is a consideration, but surely our commitment to public health and the great legacy of anir and Bevan and the founding principles of our national health service demands that we look beyond short-term car-parking difficulties. What about the long-term health benefits for the people of the Monklands and a health service that is accessible and free at the point of need? At a public meeting that I attended in Airdrie Town Hall, the audience faced such a hard sell to close down the Airdrie Town Centre hospital and moved to the village of Garkosh that, at one point, we were told that it took less time to get from the Monklands to Garkosh than it took to get from the Monklands to the Monklands. Do the health board take the people as gullible? Why on earth, if the Queen Elizabeth University hospital, newly built in Glasgow, can be built on the sites of the southern general hospital in Glasgow, why on earth can't we build the new Monklands hospital on the site of the old Monklands hospital? The health board accepts that this is possible. The people now want them to make it happen. The Maggie's Centre, the Lanarkshire Beatson, is co-located on the existing site in Airdrie. Both state-of-the-art, both less than five years old, both are good reason to stay. The town centre first principle, which is supposed to inform decisions like this, has not been factored in by the health board, and that is another good reason to stay. The outline business case for the project will be considered by the board of NHS Lanarkshire at its meeting next month, so time is running out, but there still is time for the Scottish Government to intervene. The Government's own guidance says that the consultation process needs to demonstrate that the NHS listens, is supportive and genuinely takes account of views and suggestions. Let us hear that this Government is prepared to step in, to stop this closure before it is too late, before a great injustice is committed, before a grave error is made and instruct the board to keep the new Monklands hospital in the Monklands, in the name of the people we are here to represent, I move the motion in my name. I now call Claire Houghy to speak to and move amendment 14405.1 for up to six minutes, please minister. I welcome this debate on an important issue for the many people who use and value the services that are delivered by Monklands hospital. I recognise that there is the strength of feeling in the local Airdrie community about the future access to and provision of hospital services. I want to make one point absolutely clear to members and to local people who use the highly valued services at Monklands hospital. No final decision has been taken by the NHS board on their preferred option for a new or refurbished Monklands hospital. We recognise that the hospital is more than 40 years old. Whilst there has been and continues to be significant investment in the hospital to maintain high-quality patient care, the current facilities do not have the right layout to ensure an ideal model of care, in line with best modern clinical practice. That is why the Government has been clear that we support NHS Lanarkshire in bringing forward the proposals to replace or refurbish Monklands hospital for the benefit of local people. We note that those plans will ensure that the new hospital will have state-of-the-art facilities and provide a range of specialist services for patients across Lanarkshire, as well as continue to be the local hospital for the people living within the Monklands catchment area. It is also important to note that the new hospital will retain an A&E department for the benefit of local people, along with its key support services. Any decision on the location of the new hospital's location must also, as a priority, help to reduce the level of health inequalities within the Monklands area and across Lanarkshire. In terms of the strategic context, the Monklands of the future will support the required clinical model to meet the objective set out in the board's healthcare strategy achieving excellence, which is consistent with the ambitions and aims of the Scottish Government as set out in the national delivery plan for health and social care. Sustained investment in our health infrastructure is vital to ensure that Scotland's health service can continue to provide a high standard of care. In the Government's forthcoming capital investment strategy, which will be brought to Parliament before the end of the financial year, we will set out the further steps that we will take. I would like to offer members a brief update on NHS Lanarkshire's progress with the important Monklands replacement or refurbishment project. In June, local stakeholders took part in an appraisal of the non-financial benefits of the following options, on-going maintenance of the current hospital in Airdrie, a refurbishment of the current hospital and a new build on the existing site, or a new building at Garkosh or Glen Mavis. In line with national guidance on informing and engaging local people on potential changes to their healthcare services, NHS Lanarkshire then conducted formal public consultations on the above options between 15 July and 15 October. NHS Lanarkshire has assured us that it will carefully consider all the responses to the consultation and rigorously evaluate all the options before the board decides on a preferred option. In just a moment, NHS Lanarkshire's consideration will be informed by a report on the public consultation from the independent Scottish health council. Elaine Smith. I thank the minister for taking the intervention, so perhaps she can tell us why she went out so vigorously promoting Garkosh, which is not in the Monklands area, as her preferred option. Perhaps she can tell us that, and perhaps she can also tell us who those stakeholders were, because they weren't the public. I do not know whether Elaine Smith is aware, but there were actually public engagement events, including one-on-one constituency. The role of the Scottish health council in this instance is to quality assure the board's public consultation process, in line with the national guidance issued in 2010 on informing, engaging and consulting people in developing health and community services. The council's report will be published in due course, and it is incumbent on the board to demonstrate that it is properly dispensed its statutory duty under the 2004 NHS Reform Scotland Act to involve patients, carers and the wider community in developing the healthcare services that they provide for them. The board must be able to demonstrate that any decision on a preferred option has been meaningfully informed by the views of patients, carers, staff, elected representatives and other local stakeholders. The choice of location must also take full account of other factors such as the view of staff, accessibility, transport links, travel times and the best return to the NHS in terms of patient care. Ministers are aware of some of the concerns that have been raised by elected members and local people about the quality of engagement and involvement activity that is undertaken by the health board. In particular, concerns have been expressed about the quality of information and analysis undertaken by the board and about the robustness of their options appraisal process, which led to Gart Cosh being identified as the highest-scoring option for the site of the new-build replacement hospital. I can assure members that we have noted those concerns. We are clear that it is critical that the health board comes to a robust, evidence-based decision in such cases, in line with national guidance and practice, and as meaningfully informed by the views of local stakeholders. We agree that all efforts must be made to move work on this important development forward, while meaningfully engaging with and ensuring the confidence of local people and their representatives. That is why, on the completion of the formal consultation process, the health secretary asked the director general of health and social care to liaise with the chief executive at NHS Lanarkshire to discuss the need for the board to undertake further analysis and engagement with local stakeholders to explore the concerns that are raised in more detail, and that discussion will take place by the end of the week. I have set out ministers clear expectations that NHS Lanarkshire's choice for a preferred option for the location of the replacement of Munkland hospital must be based on a robust evidence in line with national guidance and best practice, and is meaningfully informed by the views of local stakeholders. I move amendment S5M-1445.1, in my name. Thank you, Deputy Presiding Officer. I am pleased to speak in today's debate about what is a major issue for residents across Lanarkshire, and I was pleased to visit Munkland hospital in May of this year to meet staff and management at the hospital. I was hugely impressed with the hard work, enthusiasm and dedication of all NHS staff working there. It was clear to me that the hospital enjoyed widespread and deep-rooted community support, and that is something that we should all be working to protect and take forward. What really struck me and has stayed with me since on that visit to Munkland was a nurse I met who just finished her shift and was staying on to be with her mother's elderly friend who was expected to die that evening, for me that really showed how those who work in our NHS in Munklands really put the community first. Deputy Presiding Officer, it is this sort of love and care which I think we don't often have the opportunity to highlight in Parliament and which I think is important when we take any opportunity to actually do so. The news, as Richard Leonard has said, that Munklands is to be rebuilt or modernised as a hospital building is, of course, hugely welcome, but it is vital that the choice of location for that replacement building is backed by local people who will be using their hospital facilities for decades to come. Having spoken to a number of council colleagues in North Lanarkshire and members representing the area, I fully recognise the significant public concerns about the highest-scoring option site that has emerged at Garkosh and growing concerns around the consultation process that saw that option emerge as the likely preferred site. It is important to note that those serious concerns are being expressed by local elected representatives from across the political spectrum and, perhaps more importantly, by local residents in Lanarkshire. Many local people feel very strongly that this, and understandably, they want to see a new hospital building that is both locally accessible as possible and therefore constructed within the Munklands. Many people believe that the Garkosh site is too near Glasgow and has not enough has been taken to consider the current Munklands site itself. Public transport links from Airdrie and other nearby villages to Garkosh are very poor already and too much important seems to have already been attached to rail services to Garkosh when a mere 4 per cent of people used the train to get to Munklands hospital at present. The consultation also provided very little information about the Glen Mavis option, even though the option clearly has local support and clear local strengths. It is the responsibility of NHS Lanarkshire to address those concerns and, most important, the concerns of local people and their elected representatives. I thank the member for taking the intervention. He will be aware that there was a complete cross-party campaign to keep the A&E from being downgraded and to keep it in the Munklands community, so we do now agree with me that it would be absolutely outrageous if the SNP Government were to sit back and allow the whole hospital to move out of the Munklands area. I think that what is key in this debate is that we can all accept and welcome the fact that this hospital needs to be upgraded, and that is something that we should look forward to. All the services that have been retained there are transferred to the new site, be it at Munklands or a new preferred option, when that is taken forward. However, I totally accept that it is clear that serious questions are now being asked around the consultation process, particularly the removal of potential other location options that were made available. I believe that those issues need to be addressed, but we are talking about a major investment of perhaps around £400 to £600 million for a major new-build hospital that will serve the area for decades to come. It is vital, therefore, that a new hospital is developed on the best site available, and that that choice enjoys as much public support as is possible. I know from other decisions taken in the past, in other health boards, including my own, that it is important that we future-proof the site as well. Potential future NHS developments and investments is important in developing a site that cannot provide flexibility. I do not think that it is good for patients or the future sustainability of our NHS. To conclude, I hope that NHS Lanarkshire will be listening closely to today's debate in Parliament. I thank the Labour Party for bringing it forward. What is important now is that NHS Lanarkshire will take on board and respond to all the concerns that are being raised by members of all parties in this debate, and decide whether it needs to pause and reconsider the consultation process to date. We need to get the location of the new Monklin's right, and, above all, we need to make sure that the needs and interests of all the people of Lanarkshire are put at the heart of this decision. It is important that we come to this debate and consider those proposals with an open mind. We cannot always allow the history of service changes in a particular place to shape our future decisions, although I appreciate that that is easier said than done. I also appreciate that colleagues across all parties have, at different points and in different ways, fought hard to maintain and protect the Monklin's and the excellent local health care people benefit from that. Looking at the information outlined in the consultation on those plans, it is clear that a total rebuild is needed to provide the high-quality facilities people deserve. It would be unthinkable for people to lose such quality of service. I am extremely conscious that we spend a significant part of our time in Parliament scrutinising service change proposals and that, time and time again, patients and residents are forced to point out that longer journey times are one of their main concerns. Getting to hospital by public transport can be painfully difficult. Even small relocations can cause communities real problems when they do not line up with decent transport routes. The process also speaks volumes about the generally inadequate state. If a lot of public transport in this country is how slow it is to change to people's needs and, frankly, how low our expectations are of what it should provide, so it is crucial that we get the sight of our hospitals right, that, when new facilities are developed, they have the space, as Miles Briggs pointed out, and the capacity that they need with room to expand if necessary, and that they offer a good environment to patients and their families and, of course, the NHS staff who work within them. New public transport routes and other planning decisions should then fit around that. It goes without saying that it would be unacceptable for any aspect of the current service at Monklands to be downgraded in any way, whatsoever, as part of that process. I am glad that the Government's amendment speaks directly to those concerns, reiterating commitment to its A&E department and specialist services. I thank the member, but I want her to agree with me that committing to any A&E department and then moving it right out of Monklands is no commitment at all for the people of Monklands. Alison Johnstone It is clear that people in the wider area need access to a top-class, first-class A&E department, but there is further information that I would like regarding future plans for the existing hospital site. If new facilities were to be built elsewhere, could the minister please address that in closing? How could that site be used to the best effect for people in the local area? Today, Parliament surely would be offering its judgment on the service change without sight of a report on the public consultation, which ended just 10 days ago. The report has not been published yet. Apparently, I believe that there have been over 600 responses to the consultation. I personally would prefer to be able to take those views into consideration, because rightly we criticise the Government, as we have criticised health boards in the past, when consultations have been flawed and people's views and responses have not been given appropriate regard, so we cannot rush past that consultation process, which is in train at the moment ourselves. The board has not met to decide on a preferred option for the outline business case. That is not due to happen until next month. I appreciate that my colleagues are acting out of genuine concern for people and patients in this area, but I am mindful too that the longer timescales that are anticipated for rebuilding on the existing site would leave patients without a viable local service for longer, possibly many years longer, as well as putting more pressure on other hospitals in that time, since they would have to absorb displaced demands. It is crucial that the very best decision is made for the long-term future of this hospital, and that can only be achieved with a clearer, more detailed view of the potential advantages of building on all sites and by taking the views of patients and residents into proper account. The Government's motion does not make any determination amendment, I should say, on the ultimate location for the hospital, and it does stress that the views of patients and other factors such as travel must be taken fully into account. For that reason, I am minded to support the Government's amendment today. Thank you very much, Deputy Presiding Officer. I am grateful to the Labour Party for bringing this motion to Parliament today. Monklands general is not a hospital, I know well. I have never used its services, but its reputation very much precedes it. It has been the subject of many heated debates, questions and campaigns in this place. I think that that is testimony to how well-regarded it is by the communities that it serves and the calibre of its excellent staff. But above all that, I understand the drivers behind both the reasoning for the Labour Party bringing this today and indeed the depth of feeling that exists in the community about the location of this hospital. I see it resonate with many of the campaigns that I have been involved with around health services in the areas that I represent. I understand that very much. It is a dynamic and well-regarded institution. It has substantial throughput. One of the things that resonates with local people who have backed the campaign is not just the certainty that it provides of where it is but the heritage that it has and its place in the local firmament. It speaks this process so far, and we have heard a lot of that already in the debate this afternoon. It speaks to a wider catalogue of decisions in major service redesign, both by territorial health boards and by Scottish ministers, which might well be underpinned by theoretical arguments, spreadsheets and arguments around economies of scale, which look good on paper but fundamentally fail to carry with it the support of the communities that they serve and are wholly adrift of the views of those local communities that they serve. I remind Parliament of what happened with the service redesign around cleff services, which Felicity Mahendale lost to the profession as a result of that. It has diminished our offer to patients in that regard. Hospitals will always evin strong emotions locally. They are, in many cases, central to the fabric of the communities that they serve. That is because they do not exist in isolation. Many local businesses and voluntary groups have very close ties with those hospitals and depend on their location for their viability. They define public transport links, and, in many ways, they impact on the roads and traffic profiles of the communities that they serve. I support the Labour motion tonight, which would be harder, where those communities are pitted against one another, but they are not. In fact, many residents in Garkosh have already voiced concerns about pressure on parking and traffic flow and other issues. Some elected members have also cited things such as proximity to gas mains and the rest of it as aspects of the unsuitability of the Garkosh site. As I said at the start of the debate, this is not a hospital that I use. It is not something that I am very familiar with, but I have absolute solidarity with the community campaign that has sprung up around it and its perseverance in this locale. I think that it speaks to the much wider problem that we have in Scotland right now, in the delivery of our health services, where we locate services and how we design and redesign services to answer the needs of the citizens that we all are elected here to serve. It is fundamentally flawed because it is focused very much on what looks good on paper and what does not work necessarily for communities in the areas that they are there to serve. I welcome the Labour motion today and assure it of our support for it tonight. We now move to the open speeches of up to four minutes. We are tight for time with our second debate this afternoon. I call Elaine Smith to be followed by Alex Neil. Over a decade ago, I campaigned with colleagues from across the political spectrum to stop NHS Lanarkshire downgrade in our local A&E at Munklands general hospital. The first thing that I did when I was re-elected in 2007, straight after being sworn in, was to go out of here and to lodge motion S3M 0002, calling for a reversal of the decision to downgrade Munklands. As it is fond of reminding us, the SNP Government then instructed NHS Lanarkshire to do just that. At that time, Nicola Sturgeon MSP, health minister at the time, concluded that the health board did not give sufficient weight to the concerns expressed by local people. Fast forward to the present, and Munklands hospital is now facing a much worse threat, the removal of the whole hospital from the Munklands area. I can assure the First Minister that, yet again, sufficient weight has not been given to the concerns of local people. The so-called consultation, which closed a week past on Monday, whilst the Parliament was in recess during the school holidays, and to make matters worse, an additional paper suddenly appeared with a week to go until the closing date. The whole process has been flawed from the start, with NHS Lanarkshire heavily promoting the preferred option of building outwith Munklands at Gat Cosh. Even the option of appraisal exercise was weighted in favour of Gat Cosh and involved far more staff and professionals than patients are public, and it was also very clear from the public presentation—not meeting—that I attended that the Gat Cosh site was being heavily promoted with the other sites, in particular the current location, being negatively portrayed. I have to say to the minister that they were not inclusive public meetings. They were a PR exercise and they were designed to promote the Gat Cosh option and to undersell the other options. I am sorry, but no one in my community in Munklands is going to believe the minister that the decision has not already been taken. Of course, the minister can overturn that. Indeed, on the actual site, building has happened in recent years. We have heard that. We have got new theatres. We have got the Beatson and Maggie centres, and we have got investment in the A&E. The current site has many advantages. It is in a very central location. It is embedded in the Munklands community. It has access to well-established transport links, car, bus and train. We also know that far more staff live closer to the current hospital. That is not only an important factor in issues such as childcare and additional travel costs, but it raises issues around providing services in bad weather. During the heavy snow of last year, we should commend the many staff who walked into their work, something that is not going to be possible if the hospital is moved out of its central location. Over the years, Munklands residents have lost acute medical services such as pediatrics, inpatient dermatology beds, gynaecology and orthopedics. Living in the community, I have no doubt that the people of Munklands are deeply concerned about losing their local hospital provision in the heart of our community. With the closing of the so-called public consultation, it is time for this Parliament to step in and show support for the people of the Munklands. By the way, we understand that the contributions are not being made public by the health board, so we will just put that on the record. Last week, during the Co-Bridge advertiser, Alex Neil MSP quoted as saying, we must ensure that Gartcosh gets the Kiwbosh, but Fulton MacGregor is not publicly supported in keeping the Munklands in the Munklands. Both of them can show support today by voting against this Government's anti-Munklands amendment and for Labour's motion. Let's just be very, very clear. Any MSP who supports the Government amendment, which talks of the catchment area, is giving a green light to Munklands hospital being removed from the Munklands. Of course, a new or substantially upgraded hospital is needed, but I believe that it should be on the current site. The Scottish Government is going to have the final say, or indeed they can call it in. They are investing heavily in the new provision, but the amendment today is worrying. It does not support keeping the Munklands in the Munklands, so I call on them having previously stopped the removal of A&E services from the Munklands to now step in and stop the removal of the whole hospital from the Munklands. If members want that too, they need to vote against the amendment and vote for Labour's motion. Alex Neil is followed by Alison Harris. Thank you very much indeed. I speak as a local MSP for Ayrdrian shots, which includes the Munklands hospital. As well as myself, Neil Gray, the MP for Ayrdrian shots, we have spearheaded the campaign against what I regard as a stupid decision by NHS Lanarkshire to make Gart Cosh the preferred site for the new hospital. Unfortunately, that is not a sentiment that is universally agreed. I am delighted that Gart Cosh has been shortlisted for a proposed new build of Munklands hospital. Gart Cosh is a good choice. Hugh Gaffney, Labour MP for Colbridge. The Labour Party needs to sort out its position, as usual, is trying to face two ways at once. I speak as a local member and I am only facing one way. That is no to Gart Cosh and no on a number of points. First of all, the option appraisal has been referred to. I say that as a former health secretary with the greatest respect for those people who work in the Munklands hospital, but, at that appraisal, there were 53 people at it. 34 of them were senior employees of NHS Lanarkshire. Only 16 of them were patients. Five of those 16 came from South Lanarkshire, the other 11 from North Lanarkshire, but the health board can only identify one patient who lives in the Munklands catchment area. One patient out of 255,000 patients living in the Munklands area and the only identified one to turn up at the scoring event. Then they have the cheek to say that they have stuck by the process laid down by the Government. There is no way that they have stuck by the process. It is not just the participation, Presiding Officer. It is the way that whole scoring system was rigged to get the answer that the senior people in the health board wanted against the wishes of the majority of people in North Lanarkshire and the vast majority in my constituency. The information on which they scored was inaccurate, misleading, unbalanced and very often bordering on deliberately being economical with the truth. There is no way that it could be described as a fair and objective exercise. The top priority for the health board in its own document is reducing health inequalities in Lanarkshire. If the hospital goes to Gat Cosh, far from reducing inequalities, it is going to make them much worse than what they are. That is why Neil Gray and I have submitted a petition with 6,000 people to NHS Lanarkshire. Unfortunately, NHS Lanarkshire acts as though they are deaf. They are not listening to the people. The people told them that the A and E closure was the wrong thing to do. The people are telling them that putting the new hospital in Gat Cosh is the worst thing to do. I agree with the people and that the evidence agrees with the people. I say that it is time for an independent review of the protest, the information and the decision to make Gat Cosh the preferred site. That cannot be allowed to stand. It would be a betrayal of the people of the mountains if Gat Cosh was a site for the new hospital. Unlike the Labour Party, I can say that on behalf of all the SNP representatives for Airdrie and Schott's. Monklin's and Airdrie was the first new hospital built in Scotland in the post-World War 2 era. The hospital's routes go back to 1887, when Sir John Wilson, a late 19th century businessman and local politician, bought the Airdrie house estate. He then went on to bequeath the land to the people of Airdrie, became the local maternity hospital and later what was to be known as Monklin's hospital. After some 40 years, there has been a significant increase in the number of people living in the Monklin's area, so it was undoubted that at some stage, Monklin's hospital would become no longer totally fit for purpose. It is fair to say that the hospital currently has become less fit for the modern day. Emotions and feelings do run high. Hospitals belong to communities, not only the patients who attend those hospitals but the staff who work and dedicate their lives to looking after our sick. It is no small wonder that emotions in Monklin's are running high about the potential closure of its hospital and reciting. I welcome this debate today, and whilst I am led to believe that the health board has not yet fully made up their minds regarding the location of Monklin's, there is significant evidence and other factors that now must be taken into the overall consideration for its future. There is no dispute that there should be a new modernised Monklin's hospital. I do not agree with Richard Leonard and Elaine Smith that by simply building on the current site of the hospital that the problems will be solved. Apart from the considerable length of time to dismantle the old hospital and rebuild a new one, whilst currently operating an efficient hospital on the same site, which already lacks space, in my view, is simply not practical. I appreciate the passion surrounding the current location and logically why people think that it makes sense to take out the old and bring in the new. Forth Valley hospital in Falkirk had a very similar experience. There was Falkirk royal and there was Stirling royal, yet you were either a Falkirk bairn or a son of the rock, and discussions about what was the best site to replace those two hospitals went on for 25 years. The new Forth Valley hospital has now been there for, well, I think, about eight years now. Personally, where I do agree is that the Monklin's is an air-dry and to start looking at a site in Gartcosh sees the potential move to a G postcode. There is an argument that Gartcosh could technically be in Glasgow and not North Lanarkshire. Therefore, a move of this nature would and could benefit the people of Glasgow, but be of a huge disadvantage to those who live in the Monklin's. Not only would travelling be problematic for a lot of the elderly and infirm in the local area, but we have to consider the emergency ambulance transfer times and the additional travel time that this would impose on an already long hours that staff actually do work. If you just let me finish this, it's in my region and I want to try and finish it, but at the end, as I was going to be speaking— No, I'm afraid you can't. You're in your last minute. I looked back to find out when the hospital was originally opened. It was then that I discovered the story behind Sir John Wilson bequeering land to the people of air-dry for what would become the Monklin's hospital as we know it. How fitting was it to learn that some 130 years later, a similar gesture from a local air-dry businessman to sell a suitable location in Glen Mavis for the potential to build a new Monklin's hospital for the princely sum of £1? That huge gesture should be given serious thought. Glen Mavis is a more central location, it is local, it keeps the hospital within the heart of the community. That is a serious alternative and one that I would urge the health board to take on board. Now is the time to go back and have a significant rethink. Don't take choice away from local people. Thank you. Neil Findlay, followed by Fulton MacGregor, and his four-minute speeches have taken intervention. I'm afraid you have to absorb it. Mr Findlay. Monklin's is not in my region, but I have had constituents make representations to me as they work there, and some have indeed been treated there. It's a hospital like so many across Scotland that was built by the Labour Government to serve the health needs of growing communities, and in that particular area, a grown industrial town, yet the recent history of the hospital has been one of insecurity and indecision that has left local voices marginalised by the health board, a very familiar tale indeed. There are many reasons why that is the case, but we today have to concern ourselves with how we answer the question of where the new hospital will be located. The people in that area have had to put up with repeated instability in recent years, not least when services have been taken away from the hospital forces and patients to travel further afield for treatment. A serious problem, especially for those who are reliant on public transport, is a situation that has been reflected in my area, where the same is happening at St John's hospital, where families and children are having to travel up to 30 miles because the service is not on a 24-7 basis. All too often, those decisions are made with no prior consultation with staff or the people who fund the NHS, the taxpayer, the patients, the people. In Monklands, as people have said, we have seen dermatology, gynaecology and pediatrics lost. We have seen beds cut from 527477, despite population growth and despite the population getting older. At what point does the downgrading of a hospital end, and when will certainty over the future be settled? I hope that we are all agreed that the community needs a new and well-resourced hospital and that the location has to reflect the concerns and wishes of the local population. It is not the role of Government nor NHS boards to dictate to communities when they have shown a clear and strong preference. Indeed, I would suggest that that goes against the various essence of the chief medical officer's principle of realistic medicine. A new hospital must continue to serve the people of those communities and be built where the community wants it to stay. That is the site where it has always been. I think that it is a bizarre argument from the Green Party. Who is arguing for a hospital to build on a greenfield site when it could be built on an existing brownfield site? That makes no sense to me whatsoever. We should also remember that Monklands is the largest employer in an area of multiple deprivation, providing an economic boost to the community that needs it. That is a very important thing. Richard Leonard has secured a petition with over 5,000 signatures. I am delighted that I, like Neil, have done the same. That is good that people are making that point. Those must be taken into account over and above the so-called local consultation, because it is clear that people have a clear preference. My Labour colleagues have been pressing the issue for many years, and it is concerning that we have spent so much time deliberating those matters, rather than getting on with the job of creating an NHS fit for the 21st century, not just in Lanarkshire, but across the whole of Scotland. Hospital instability has become a common problem in Scotland. It is only too well in my area, and it is unacceptable. Absolutely unacceptable. People in Lanarkshire deserve certainty about the situation, just as the people in West Lothian deserve certainty about the earth. With the future of their hospitals secured, they can start planning for the future and feel confident that they have their services protected. That is why I will be supporting the position put forward by Richard Leonard today. Thank you very much. I call Fulton McGregor to follow by Graeme Simpson. Mr McGregor, please. I thank you for the opportunity to speak in this debate. As someone who grew up in the area of Coltbridge right next to where the Monkland sits, it really is a privilege to speak in a debate about a hospital I know well and its future in serving my constituents in a wider area. Because of the unique position of my constituency, I have taken extra time to listen to the differing views of people and communities within my constituency before expressing any outright opinion. I have attended the NHS public meetings, met with constituents at stakeholders, held street surgeries and engaged in various forums to gather opinion. My consultation response was balanced and tried to reflect those issues. Generally speaking, people from Coltbridge want it to remain at the current site or nearby, and those from the Christen area, which encapsulates the various villages in the north of my constituency, and areas that have been fighting for a health centre to be fair, are comfortable with a move to Gatcosh in the main, although there were some exceptions. The most important and wider issue that the consultation raised was about health inequalities, which is why the Government motion is so important, and it shows the Labour motion for what it is—shallow, simplistic and scaremongering. In Coltbridge and Airdrie, the two Monklands towns have some of the most deprived areas in Scotland. Between them, they have nine areas and the most deprived 5 per cent by SIMD statistics. Will the member listen to this statistics across Scotland? Four of those on Coltbridge. If that is then increased to the most deprived 10 per cent— Just a wee minute, just a minute, please, Mr McGregor. I want to hear what Mr McGregor has to say. You've got a chance and you're summing up, Mr McGregor. Thank you, Presiding Officer. If that is then increased to the most deprived 10 per cent, the figure rises to a staggering 28 areas, 14 in each. That poverty and deprivation that resulted from de-industrialisation in the 1980s under Conservative Governments and which is being perpetuated by current failed UK Government austerity policies has brought with it a whole host of health inequalities, from high rates of heart disease and other long-term health conditions to significant drug and alcohol-related harm. Monklands has been known as the sick man of Europe, a term that will be familiar to many of us. It may not be the intention, but removing a well-established hospital with an A and E from an area with such health inequalities and where people who have less access to private cars would be regarded as elitists and decision makers giving a hammer blow to those communities. That's not what I commit to politics to do and I know it's not what MD here commit to politics to do. As the motion outlines, the hospital needs to serve the Monklands area and it's got to continue to be part of a plan to address those health inequalities where slow but sure progress is being made by this Government. The board and the engagement process have the duty to instill confidence that that will be the case and, as others have said, that generally has not been the case. Some aspects of the consultation were relatively good and the meetings were responsive and professional. However, there was a waiting towards Garp Glosh as a preferred outcome and I was disappointed to hear that only one Monklands resident was involved in the scoring. There should have been more information on the other central Monklands sites, for example at Gersherry, which was rejected due to poor road access, but those same roads would be the main ones to get folk from Coabridge to Garp Glosh, so I ask you how that makes any sense. Similarly, the current hospital has many positives such as location and transport links and I would like more information on other options around the land nearby and on building up the way. This seemed to be dismissed too easily. Presiding Officer, this is a major decision and I believe that it would be best to start again and take into account all of the options, including looking at Garp Glosh again but dealing with the concerns raised. However, I will finish on this point. In 2007, it was the SNP that saved the Monklands A&E from closure by labour. Shameful proposed closure of an A&E in one of Scotland's most deprived area. It has been this Government that has invested heavily in the site since. It was this Government under Shona Robinson as health secretary that agreed the funding for a new hospital to be built. It is politicians such as Alex Neil, Neil Gray and myself and our councillor colleagues who are scrutinising the proposals of the board and holding it to account. It is our candidate in the Coabridge South by-election who is standing on a strong platform to keep the Monklands central. People aren't filled by labour speakers or anything more. They know that the Monklands is safe in the hands of the SNP. Sit down. If you overrun your time, you cut other people out no matter your passion. Mr Simpson followed by Emma Harper, who will be the last speaker in the open debate. I was thinking that this was a very considered contribution from Fulton McGregor until the end. It is an important debate for the people that I represent in central Scotland. For those of us who live in Lanarkshire, Monklands is one of our hospitals. I live in East Kilbride. Hairmayers is my local A&E, so when I fell off my bike a few years ago, that's where I went. Monklands is just as much my hospital as Hairmayers because there are specialisms there, like ear, nose and throat, and radiotherapy that aren't available closer to home. It's Airdries hospital, but it's Lanarkshire's too. First of all, do we need a new hospital? No-one's really arguing that the current one fits the bill for the 21st century. Second question is, where should it be? Now when you propose to build a new hospital, there are always going to be strong views on where it should be, so it's vital that there's a robust evidence-based process and that people's views are taken into account. There's been a consultation that's now closed. The health board say the process was in line with Scottish government guidance. They say the process to select those taking part in the consultation was formally agreed with the Scottish Health Council. There have been 13 public meetings attended by around 600 people. That's an average of 46 people a meeting. Now I can guarantee that any of us here could rustle up more than 46 people to a public meeting around something so important. It doesn't sound very many people to me and I have to wonder how well publicised these meetings actually were. I think the minister should be taking a very close look at the consultation process that's been followed because we need to be absolutely certain that it was done the correct way. 37 sites were initially considered. Various criteria were looked at. They had to be within North Lanarkshire on an area of at least 40 acres within the existing catchment area, suitable access, et cetera. Any new hospital could not be built in a location that would mean that Monkland's patients would choose to go to another hospital like Wishaw or Forth Valley. Really there are only three options. We've heard it. Building on the existing site, I personally think that's problematic and it would take 13 years. I don't think people would really want to wait that long. Or Garkosh or Glen Mavis. Now Garkosh is further away from the current site than Glen Mavis. It's got a railway station but if you live in Airdrie you'd have to travel into Glasgow and back out to get there. It takes about an hour. Glen Mavis doesn't have a station but there are a couple of nearby which shuttle buses could easily connect to. To me it's more convenient and there's going to be a plan new link road. Thousands of houses are to be built in the area. That's why local politicians including Airdrie's three Conservative councillors support that site. I think it's sensible but we're in an ongoing process. No decision has been made. The health board will meet at the end of November to decide their favoured option and they'll then have to produce an outline business case. The board must follow due process. We have to be absolutely certain that due process has been followed. Enough serious concerns have been raised here today that we must question whether that has been the case. We must get this decision right. It's got to be the right decision for the people of Monklands and the whole of Lanarkshire. Thank you very much. I call Emma Harper, last speaker in the open debate, moving to closing speeches after that. I found it a bit difficult or a challenge to prepare for this afternoon's debate because I'm not a resident in the area and I'm not as familiar with the area but I was speaking this afternoon because we had a similar experience in Dumfries and Galloway when the new site was being chosen for the brand new fantastic facility that has been built near Dumfries. It's not very often that we're presented with a two-line motion for debate so I was pleased to see a significantly more substantive, informative and positive amendment put forward by the Government in the name of Clare Hockey. The Scottish Government has been clear that it remains committed to robust evidence-based policy making as set out in the national clinical strategy and I welcome plans to refurbish or replace the current university hospital at Monklands. I will take an intervention. I'm grateful to Emma Harper. The Government's amendment leaves the door open for the hospital to move out of Monklands. Is that the case? Emma Harper? Thank you for allowing me to clarify that. The motion does not allow any door to be open to allow the alternative site. I'm aware that NHS Lanarkshire has a process of consultation that is under way and the board must absolutely consult, engage and listen to the patients, the outpatients and all the people and service users who will be using the new state of the art facility. The Scottish Government, time and time again, has committed to the thinking that people should receive treatment as close to home as possible to promote safe, effective and person centre care. Indeed, in the Government amendment, this commitment is again reaffirmed. The consultation is on-going and the board is still going to evaluate all options and they are yet to decide on a preferred option, which will then be sent to the Scottish Government for ministerial approval. Once the board has gone through this process and when it has sent its final proposal to the Government, it will then be subjected to the national clinical strategy. The approach will ensure that all decisions are based on available evidence and will ensure that any decision is taken on the basis of proper and comprehensive public consultation. I echo the words today regarding concerns about certain aspects of the consultation. It seems that, on listening this afternoon, there may need to be a further review of the actual process and the scoring system and the engagement that has been undertaken by NHS Lanarkshire. I would ask the Government to consider whether the process might need to have some further investigation. Local people need to be assured that the Scottish National Party Government will always focus on providing as many services as possible, as locally as possible. I am sure that ministers will take into account all available information before coming to any decision. All are in agreement that the Monklands hospital needs to be upgraded. From my own experience, when I was working as a nurse in the old DGRI, I used to find it difficult moving around in rooms that were too small to manoeuvre. The equipment and supplies could not be accessed easily and we needed to carry out bedside care in a space that just did not work. The upgrading of the hospital or building a brand-new hospital will allow better modern patient care to be achieved. I absolutely recognise the need for hospitals to be upgraded and refurbished across the whole of Scotland when necessary to meet the state of the art needs of the 21st century. My colleague, Alex Neil, who is the constituency MSP for the area, has been proactive in his campaign to replace the current building. I would like to join him in expressing disappointment with the Labour Party, who have launched a separate petition on the matter, and I would like to support the best process that is moving forward. Thank you very much, you made your position clear. Closing speeches is tight for minutes. Mr Whittle, closing for the Conservatives. Thank you, Deputy Presiding Officer. I am pleased to be closing this debate on behalf of the Scottish Conservatives and thank Labour for bringing the debate to the chamber. As we would have expected, when it comes to health and the delivery of health services, there has been a passionate debate with MSPs, especially local MSPs, quite rightly rallying to the cause of their local constituents, and in some cases putting partisan politics to the side. However, it would be remiss not to mention the fact that there happens to be a local by-election tomorrow in the area. Call me an old sceptic, but perhaps politics is not as removed from this topic as perhaps it should be. Having said that, I often think that, in those debates that are often framed in the wrong way, we discuss bricks and mortar when we should be discussing delivery of services. However, what this debate highlights is that when it comes to bricks and mortar, it is crucial that, when we establish limit, it is in the right place for the good of the whole community that they serve, ensuring that no part of the community is disadvantaged. Alison Harris pointed out that Glasgow could benefit from a dark cost option to the detriment of those in Monklands. What has also been highlighted once again for me in this afternoon's debate is the NHS's continuing inability to engage in a satisfactory public consultation process. That has been brought to the attention of the health and sport committee again and again, and it is an issue that I think that we must address going forward. Changing the delivery of service is an inevitability and it would be much less of a painful process if proper protocols for open, transparent consultation were implemented from the outset, led by healthcare professionals focusing on service delivery. In this instance, from across the chamber, we heard from Miles Big, Neil Lane-Smith and Neil Findlay, a passionate address from Alex Neil, talking about a misleading and being economical with the truth. It is obvious that the consultation process relating to the sighting of the replacement of Monklands hospital has been at best flawed, as I say, according to some members. There is a significant conspiratorial element to the process where the outcome is predetermined, it seems, trying to lead the process to a specific conclusion. It leads me to the consideration, or otherwise, of the practicalities in accessing services. The Monklands situation is, by no means, unique in that. I fully accept that change is an inevitability as services develop, but, surely, as part of that study, it must be a cognisant of transport infrastructure and how moving a service may impact on those who rely on that service. In Ayrshire and Arn, for example, there is a plan under consideration to change the way in which certain cancer treatments are delivered. The basic plan has merit, and it is worth considering as a potential solution. Right up until you recognise, in some cases, that will mean changing from an air hospital appointment to one across-house hospital, and a journey by public transport in excess of three hours for some patients to get that treatment with the same journey on the return. I am glad that infrastructure has been raised in this debate, because considering and evaluating how we may better deliver service, we seem to be a core principle in that decision should be how those in need would access that service, and, as has already been said, we all need to be cognisant of those who deliver that service as well and their travel to work. After all, delivery of a public service, especially one as critical as the NHS, should have the service users as the key element of that decision. The question has to be asked. In the two decades that health has been devolved to this Parliament, how has Monklands been allowed to deteriorate to such a poor state that it actually has to be replaced in the first place? I can assure members that the concerns raised today have been noted by ministers, and I want to reiterate ministers' clear expectations that NHS boards must come to a robust, evidence-based decision in such cases, in line with national guidance and best practice, and is meaningfully informed by the views of local stakeholders. We agree that all efforts must be made to move work on this important development forward, whilst meaningfully engaging with and ensuring the confidence of local people and their representatives. I have already explained that this is the reason that ministers have asked the director general for health and social care and the chief executive of NHS Lanarkshire to discuss the need for the board to undertake further engagement and consultation with affected communities on the proposed options for replacing or refurbishing Monklands hospital. On a wider point, local people can be reassured that this Government will always focus our approach on providing as many services as locally as possible. That is our record in Government, and it stands in stark contrast to that of the previous Labour-led administration. While Richard Leonard's motion calls on Parliament to build a new Monklands hospital, I think that it is appropriate to conclude by reflecting on what this Government has done for local people since 2007, in comparison with what Labour delivered when in power. In the 2007 SNP manifesto, we promised to keep vital health services local and reverse the decisions to close air in Monklands A and E, not a Labour Party manifesto commitment. The very first act of Nicola Sturgeon as health secretary in June 2007 was to come to this Parliament and announce that we were overturning the previous Labour-led administration's decision to close the highly valued A and E departments at Monklands and air hospitals. Since our decision to save the A and E at Monklands, it has provided much-needed emergency capacity, seeing more than 700,000 attendancies. We have not just maintained the service, we have invested in it and enhanced it. With emergency medical consultants up 300.1 per cent, from 8 to 32 whole-time equivalent posts in NHS Lanarkshire under this Government, support for NHS Lanarkshire includes an increase in the health board's budget and cash terms by £469.6 million. All staff up 16.6 per cent or 1,441 whole-time equivalents. With consultants up 81.4 per cent and qualified nurses and midwives up 19.3 per cent or 646.1 whole-time equivalents. In closing, as I have said, we welcome and are supportive of NHS Lanarkshire bringing forward proposals to refurbish or replace Monklands hospital for the benefit of local people. However, given the range of services required on-site to support a core A and E, one might wonder had the previous Labour-led administration's decision to close the A and E at Monklands not been overturned by this Government whether there would be a hospital there to refurbish now or not at all? I now call on if I could be heard over certain people. I call on Monica Lennon to wind up five minutes, please, I'm sorry. Thank you, Presiding Officer. There is a simple choice before us today. Support the Labour in motion to keep the University Hospital of Monklands in the Monklands community, or support the SNP amendment, which leaves the door open to take the hospital out of the Monklands community. I think that we all need to understand that. Scottish Labour is clear in welcoming investment in a new state of the art hospital for Monklands, and we will fight to keep the Monklands in the Monklands community. What an utter disgrace it is—hold on—is an utter disgrace that Fulton MacGregor, the SNP MSP for Cockbridge in Creson, has described the endeavour as shallow. He may have grown up next to the Monklands hospital, but I think that after today he will find it hard to look his neighbours in the eye, because we have heard that the public consultation process has been farcical. It has been heavily criticised by my good friend Alec Neill, who says that it has led to a stupid decision to make Gart Cosh the preferred site. I am happy to let Fulton MacGregor in at that point. Mr MacGregor. I described the motion as shallow because there was nothing to it. The Government motion has got a lot more to it and you should be supporting that. Chris Lennon. I think that we have heard enough. I will repeat again that the motion is simple. The motion is to keep the Monklands in the Monklands. Briefly, because I will have to make some progress. You have got to be called first, Mr Briggs. Thank you, Deputy Presiding Officer. I think that this is where we think that Labour is confused today. Are you saying that the only option is to rebuild on the current site? That is your policy, given the fact that we have just had a consultation on lots of other opportunities. That is too long an intervention. I want to make some progress. We have heard enough about the consultation. I think that the minister has plenty of notes to take away. However, in some serious points, moving the hospital away from Monklands out to Gatcosh will increase travel costs for many staff who live in the local area, especially those who are on the lowest wages. Alison Johnstone said helpfully that in general terms in Scotland we have inadequate levels of public transport. She also talked about the downside of longer patient journeys. Those are fundamental issues. There is nothing in the proposals to move the hospital to Gatcosh that would improve accessibility and journey times for patients. Alex Cole-Hamilton made some really good points when he talked about hospitals being central to the fabric of communities. What looks good on plan is not always best for the people in the area. That is not a paper exercise. We cannot afford to get this wrong. I support the Scottish Government's principles on town centre first. I hope that the Scottish Government will not abandon those principles over the Monklands. If the flagship Queen Elizabeth Southern General University hospital can be built on the site of the former Southern General in Glasgow, why is it not possible to build a new Monklands at the Monklands site? Rebuilding on the same site is not without its challenges, but it is entirely possible. We have the expertise and design teams here in Scotland to deliver state-of-the-art hospitals. There is no reason why we cannot achieve that in the Monklands. A lot of attention has been given to the cost savings, which could be gained from rebuilding or a new site at Gatcosh. However, not enough focus has been given to what would be lost by leaving the Monklands. Elaine Smith already mentioned the Maggie centre and the Lanarkshire Beats. For example, both state-of-the-art facilities are less than five years old and cost tens of millions of pounds and are co-located there. What about those facilities? We have heard a lot about health inequality, and that is important because in Monklands we have high levels of deprivation and some of the worst health inequalities and low levels of car ownership. Moving the hospital out of the Monklands will only make this worse. The long-term advantage of the hospital remaining in the Monklands is significant, and they have not been adequately reflected in the benefits and financial analysis. We are forced to bring this motion to Parliament today to speak out against the decision to move the Monklands out of the Monklands. The ramifications of which would be felt for years to come amid deep concerns and public criticism on where the hospital should be built. The choice before the Parliament today is clear. We either give support to the decision to move the Monklands hospital out of the community for decades, or we can give an unwavering commitment to the people of Lanarkshire that the current hospital should remain in the community where it belongs. That means keeping the Monklands in the Monklands area. Thank you. That concludes the debate. We will keep the Monklands in Monklands, and I am good of a terribly brief pause before we move on to next item of business. There is no time in hand. In those short debates, I have to ask members just to get their seats and get ready right away. No, we friendly chitchats, or unfriendly chitchats.