Letters to the editor – January 8, 2021

The now-disused Argyll and Bute Hospital.

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Past achievements squandered by health board

Sir,

I thought your article on the disappearance of the Argyll and Bute Hospital was excellent (Argyllshire Advertiser, December 18), written around Gillian Hogath’s photographs and remarkably perceptive comments on the demolition of the hospital.

Among other things, she regrets an apparent lack of any historical accounts of the hospital and its social significance. Some do exist, however, and while not attempting to be a comprehensive history, there is a nicely illustrated booklet about the hospital and its past entitled ‘Up The Brae’, produced a few years ago by Brenda Bratt, Jess Grant and my former colleague Dr Grace Fergusson (MacLeod).

These photographs are a reminder of the loss of a significant social and economic element in the fabric of Mid Argyll, where for generations it would have been difficult to find a family without some connection to ‘the A&B’. For those who worked there, myself included, any sadness however is much more about the loss of a self-sufficient and widely respected mental health service.

I was a late participant in the story of the A&B, being appointed physician superintendent in 1980, a post I held in addition to that of clinical director for mental health services for Argyll and Bute and West Dunbartonshire until 2004, and I feel a duty to the many splendid colleagues with whom I worked to comment on the loss of the service in which the A&B served as the nucleus.

During the course of 1989/1990 the hospital was awarded the accolade ‘Best Mental Illness Hospital in Britain’ as the result of a national competition launched by the King’s Fund and sponsored by the Sunday Times. This was a recognition of the multi-disciplinary spirit and enthusiasm for innovation that characterised the service, and the ethos of best clinical practice being led by academic excellence. The service went on to be recognised as a centre of excellence by many visiting accreditation bodies.

My reason for making these points has nothing to do with nostalgia.

The past has no utility in the present or the future except as a source for learning how best to proceed.

The ingredients for a good mental health service are the same today as they were in 1989 and they have little to do with buildings or even location. Staff have to feel they ‘belong’ to something; there must be a collegiate spirit binding together the various disciplines; shared professional development and peer support; and clear lines of accountability. It is frankly hard to see any such features in the current delivery of mental health care.

Someone once said ‘psychiatry isn’t sexy’, meaning that in any competition for resources with other clinical specialities, psychiatry will always lose, and so to get the best out of the NHS for folk with psychiatric disorder, exceptional effort is required. The achievements and values of the past can act as a springboard for such effort, but here they seem to have been squandered by a distant and disinterested health board.

It is all too easy to avoid investing in a service by reorganising it into invisibility, but the people who pay the cost are those who deserve the best of specialist professional help.

So I am certainly sad at the disappearance of the old A&B, because it is symbolic of something having been lost that is much more important than stones and mortar.

Professor Angus Mackay OBE FRCPsych, Ardrishaig

 

Staying ahead online

Sir,

Scots have taken to online technology like never before to keep in touch during this difficult time.

When we first went into lockdown, there were concerns over whether our networks would cope with this big increase in online traffic. But though customers’ usage of data more than doubled, our networks were able to stand up to the demands.

I’m immensely proud of the role my colleagues have played in keeping the country connected during this crisis. From the engineers who keep our broadband and mobile networks connected, to the vital contact centre staff in Glasgow, Dundee, Greenock, Edinburgh and Thurso, helping people when they need it most.

I’m also proud of the role our people played in supporting the NHS in Scotland during the crisis, including working with Scottish Government to quickly provide communications to the temporary hospitals.

The pandemic has shown the vital role digital technology and internet connectivity now plays in all our lives. If all homes and businesses are going to stay ahead, we know that fast and reliable broadband and good mobile coverage is going to be essential for the post-Covid recovery.

We’ll continue to work with governments and local authorities to make sure that no areas are left behind.

Jane Wood, BT Group Scotland Director, Alexander Graham Bell House, Edinburgh