Sending in a 'hit squad' of clinicians to help sort out the problems at the beleaguered Victoria Infirmary trust in Glasgow 'is like shutting the stable door after the horse has gone', says one observer. 'It is window dressing. The Victoria Infirmary's problems are far greater than the recent unfortunate incidents there - they go way back.'
Scottish health minister Sam Galbraith has ordered Greater Glasgow health board to set up a support group to move into the hospital to review its general surgery and accident and emergency services.
Public concern escalated after the deaths of three people who were treated at the hospital. Imran Khan, aged 15, was stabbed during a clash between white and Asian youths in Glasgow. He died of multi-organ failure caused by blood poisoning eight days after being admitted to the intensive care unit of the Victoria Infirmary. An inquiry into his death has been called for.
Ellen Carroll, aged 83, died of undiagnosed tuberculosis a month after being admitted to the hospital. Her son, a Glasgow councillor and lawyer, has called for a public inquiry, arguing that a fatal accident inquiry or an inquiry into clinical competence at the hospital would not explain why her TB was not diagnosed.
The third case relates to 16-year-old Gordon Niven, who died in September 1997 after doctors at the Victoria Infirmary failed to diagnose that he had a fractured skull after falling off his bike. His parents are calling for a fatal accident inquiry.
But health service observers in Glasgow say the standards of clinical care at the hospital are no better and no worse than at any other hospital in the city. 'It is a case of there but for the grace of God go any of us,' says one.
The British Medical Association in Scotland says that if the support group of doctors finds that clinical practice at the hospital is falling short, there should be immediate action.
'But while we believe in good quality patient care, we also believe the media in Glasgow has whipped up a huge amount of public hysteria about these incidents,' says a spokeswoman. 'It seems as if people are looking for the Scottish equivalent of Bristol.'
She suggests that the support group also needs to look into the morale of hospital staff, the environment in which clinicians work and the pressures they are under.
Glasgow health council chief officer Danny Crawford welcomes the clinical support group being sent in. 'It is important that the quality of care at the hospital is looked at thoroughly if there is any doubt at all in the public's minds,' he says, 'although most people who use the Victoria Infirmary are well satisfied.'
But he adds that the health council has received more complaints about the Victoria Infirmary over the past year than about any other hospital in Glasgow. 'The number of complaints there does stand out,' he says, but counters this immediately by saying this is not necessarily because services there are poorer than elsewhere. 'It may just be that our publicity is more effective at the Victoria.'
The hospital is known to have had financial difficulties for years. 'There were grave doubts about its viability when it became a trust in 1993,' says one observer. 'It has a declining population base and a declining income. It has never got out of debt and never met its financial obligations as a trust.'
The axe has been poised over the hospital for years, adds another. 'The permanent threat of closure has had a huge effect on staff morale and means that people tend not to stay there.'
Unison's Glasgow regional officer Jim Devine says that there was a very macho management culture at the hospital until a couple of years ago. 'It takes a hospital time to recover from that,' he says. 'The morale of staff at the hospital has been very low. The Victoria Infirmary always seems to bear the brunt of any allegations within the health service in Scotland.'
Others agree that there has been little stability at the top of the organisation since it became a trust - chairs and chief executives have moved on rather rapidly, raising questions about its long-term future.
Most welcome the forthcoming merger of the Victoria Infirmary with the Southern General Hospital trust, also on the south side of Glasgow. The Southern General's chief executive Robert Calderwood is now also at the helm of the Victoria Infirmary, although the new merged trust will not be officially launched until next April.
'Bob Calderwood is an excellent choice as chief executive,' says Mr Devine. 'He has got a good track record in the NHS.'
He will need it, some suggest. 'I cannot see how both these hospitals can continue to provide the whole range of district general hospital services,' says one observer.
Meanwhile, Unison is backing the calls for a fatal accident inquiry into the death of Imran Khan. 'Things will come out at an FAI that have not been able to be revealed so far,' says Mr Devine. 'But to look at these incidents in isolation is wrong. We believe there are wider issues to be resolved at the Victoria Infirmary and these have got to be taken into consideration.'