The gift of a new computerised axial tomography imaging scanner to an Edinburgh hospital has ignited calls for a debate on business donations with strings.

The Royal Bank of Scotland has given a CT scanner worth £4 million to Edinburgh Royal Infirmary, with the proviso that RBS employees will have access to the machine for 25% of the time. Edinburgh and Queen Margaret Universities will also share in the use of the scanner for research to improve the diagnosis and treatment of a range of heart and cancer illnesses. As well as funding the purchase, RBS will contribute to the scanner’s ongoing operating costs. It aims to be operational by January 2009

The scanner will provide an additional 4,000 patient scans a year to the current NHS provision. Its innovation over previous scanners means that it can capture entire organs such as the heart or brain in a fraction of a second, and radiation exposure is reduced by approximately 80% compared with conventional CT scans.

Critical voices
Independent MSP Margo MacDonald has indicated her intention to raise the issue of conditional gifts in the Scottish Parliament, and has called for guidelines on donations with conditions.

Ms MacDonald said, "I'm putting a motion down for the parliament, suggesting that before we stray into this territory of conditional charity or gifts to the NHS, we should debate what the ground rules are going to be. It's not that I think that the Royal Bank means to be anything other than charitable and look after its own staff, perhaps give something back to the community, it's just that I wish this had been talked about first of all."

Professor Allyson Pollock, head of Edinburgh University's Centre for International Public Health Policy suggested that this agreement undermined the equitable principles at the NHS’s core. Professor Pollock – an outspoken critic of the Private Finance Initiative and other forms of private sector involvement in the NHS – termed the gift "philanthropy with conditions”, telling BBC Radio's Good Morning Scotland: "The whole point is that we have equal access on the basis of need. Introducing this system of public private partnership actually undermines that because some people are going to have better access with lesser needs than others." She also speculated whether a commercial contract might underpin the gift.

Edinburgh Royal Infirmary is under the regional control of NHS Lothian health board, whose medical director Charles Swainson denied that there was any contract, saying there was merely an agreement about how the scanner would be used. He described Professor Pollock's concerns as "nonsense".

Swainson added,"the fact is we don't have waiting lists or waiting times for these kind of investigations and the really important point is that this new scanner is completely additional to normal NHS services. This is really good news for the NHS and for patients because after all 75% of the time it is being used for them. It is excellent news for the region as it will allow our clinicians to diagnose life-threatening illnesses within a matter of minutes and will also pave the way for quicker treatment."