History is expected to repeat itself and the campaign that took place eight years ago to retain surgical facilities at the Princess Alexandra Eye Pavilion// in Lauriston looks set to repeated again. NHS Lothian has again proposed plans to transfer eye operations to St John's in Livingston, a situation that would force Edinburgh people to make a round trip of about 40 miles for treatment.

In 1998, about 100,000 people signed the petition to save the Eye Pavilion forcing the then health board chair Margaret Ford intervened to shelve the plan to move inpatient treatment out to West Lothian. Although the move was estimated to save the board ￡200,000 it was deemed that the effort was not worth the detrimental effect on patients, most of them elderly. Senior clinical sources have confirmed that NHS Lothian has already had several discussions regarding this.

As in the previous occasion the arguments put forth by some health professionals claim that expertise centralised in one site produces better results while the others say that this must be balanced by the likely inconvenience to patients, especially those who are vulnerable.

Gathering expertise in one place is an important argument when a pool of knowledge is essential for the most critical and cutting-edge procedures, such as cancer care, and where acknowledged expertise helps recruit the very best practitioners.

Eye Pavilion's former clinical director, Dr Hector Chawla, remains as opposed to moving surgery to Livingston now as he was in 1998 stating that only if a massive benefit was there would it go against such eminent opinion. However presently saving a few pounds hardly counts when NHS Lothian's total budget of ￡870 million only suggests there are several other places to look for efficiencies which do not adversely affect acute services.

What is obvious however is that the health board has a fight on its hands just as in 1998.

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