One of Tayside’s three adult psychiatric facilities is to close and NHS Tayside has refused to rule out the prospect of a second unit following.
The health board is suffering from a crippling lack of doctors and junior medical staff with specialist psychiatric training, leading to concerns over the future safety of services.
With no breakthrough on the horizon and the cost of hiring expensive locum staff becoming unsustainably high, a reform of mental health provision is under way.
NHS Tayside has decided that one of the acute psychiatric units at either Stracathro Hospital, in Angus, Carseview in Dundee or Murray Royal Hospital in Perth must go.
It is understood the Mulberry Unit at Stracathro is most likely to face the cut, with services transferred to the other two hospitals.
A review has controversially identified the unit, part of the £20 million Susan Carnegie Centre, as the most suitable target for closure.
With the financial savings that would be made by closing one unit not yet made public, the board has decided to keep its options open by calling for senior staff to consider a move to one facility.
That, although unlikely, could impact upon the acute admission ward at Murray Royal and the intensive psychiatric care unit at Carseview, based at Ninewells Hospital.
The board has stressed that the quality of treatment at each hospital remains high and staff have been praised for their excellent work.
Chairman, Professor John Connell, however, said changes were needed to ensure that matters do not deteriorate.
He said: “As a board we must provide safe and effective care for patients and we do no-one any favours if we cannot provide properly staffed services.
“The reality is that we cannot staff our facilities at the present time and I can see no sign of that changing in the near future.
“In the meantime we have services that are in danger of collapse.
“Moving to a two service system will not happen overnight it will take a very serious period of time but it is a move in the right direction.”
A Tayside-wide consultation will now take place before the NHS board takes a final decision on the future of services at the three hospitals.
There has been criticism of the consultation to date and some board members raised concerns that many Angus residents considered the closure of the Mulberry Unit “a done deal”.
The board has also been made aware that a significant number of staff do not favour a closure, while additional travel times may impact upon service users and families.
Nonetheless, Professor Connell stressed the need for urgency.
Tayside currently spends more on general psychiatric care per head of population than any other health board in Scotland and among the least on community care.
Professor Connell said that balance needed to be addressed.