Jackie Baillie (Dumbarton) (Lab): I congratulate Jim Hume for securing this important debate.

We have heard from local members about NHS Dumfries and Galloway's consultation on three options for service change, which would lead to varying degrees of change on the ground. I will concentrate on the board's preferred option—option C—not least because it is the most radical and involves the closure of five community hospitals. Option C also involves the creation of four community rehabilitation units, but the proposal is not gaining widespread support in communities in Dumfries and Galloway.

I appreciate that the decision is ultimately for the cabinet secretary and the minister and that, therefore, the minister's ability to comment is severely constrained. However, the Government has stated its intention to keep service delivery as local as possible, so I have no doubt that members will seek to test that commitment against the proposals that emerge from Dumfries and Galloway.

It is important for us to take a step back and to consider the context in which the cabinet secretary will operate. We have a current strategy for development, not closure, of community hospitals—"Developing Community Hospitals: A Strategy for Scotland", which the previous Scottish Executive published in 2006. It envisaged a new model for community hospitals, which were to fit into the vision of much more community-focused health services, as laid out in "Delivering for Health". That vision of "Delivering for Health" was based on the Kerr report, which talked about reconfiguration of services and helpfully tried to provide a sensible framework for service change that—if my memory is correct—the whole Parliament accepted.

In addition to that, the current Scottish Government produced a valuable report called "Delivering for Remote and Rural Healthcare: The Final Report of the Remote and Rural Workstream". It was published in May 2008 and specifically built on the agenda and model for community hospitals, but recognised the challenges of delivering health care in a rural setting.

We need to set what NHS Dumfries and Galloway proposes within that robust framework in considering how we move forward. Does its proposal sit comfortably in the policy context that we created? The jury is certainly out on that and local communities are possibly arriving at decisions about people's intentions in Dumfries and Galloway.

I value the work that the independent scrutiny panel did. I will raise three issues that it highlighted. It was sad that the panel had to remind the health board that it needed to set out a compelling vision for the changes that it wished to make. I would have thought that the first thing that the health board would do would be to set that vision out—to understand what it was trying to achieve and then follow through on it.

The other issues were transport in the context of geography and the financial assumptions. I will focus on them. I understand absolutely that the area is rural and that transport connections are challenging; the independent scrutiny panel also recognised that. From my experience at the Vale of Leven, I understand that sometimes—as Derek Brownlee said—a hospital's appearing to be geographically close takes no account of transport connections. Not everybody these days has a car, so some people rely on public transport. I am clear about the need to resolve such issues well in advance, otherwise we will find that people will not travel for hospital appointments, which is not what members would want.

I am also genuinely concerned about the financial assumptions.

The Deputy Presiding Officer: The member is on a four-minute speech. I hope that she remembers that.

Jackie Baillie: Indeed. I will be quick.

There are significant challenges in the NHS capital budgets. My understanding is—I would appreciate the minister's response on this—that funding for projects is being approved only when the business case has been finalised and there are no commitments to anything else, so I am curious as to how NHS Dumfries and Galloway intends to fund its proposal.

I am sure that there will be a very good turn-out in the health board election pilots in Dumfries and Galloway and I will be happy to visit the area to hear first hand from the board and, particularly, the local community how they want health services to be provided in their area.

Official Report Wednesday 20 January 2010 - Community Hospitals (Dumfries & Galloway)