Health Plans Defended on Doolan Show

On Friday at 11am, Ed Doolan welcomed John Adler (Chief Executive of Sandwell & West Birmingham Hospitals NHS Trust), Hugh Bradby (Medical Director SWBH), Jackie Chambers (Heart of Birmingham PCT) and Di Reeves (Sandwell PCT) into his studio to explain the two consultations currently going on to the listeners of his show.

The four guests were given some time to explain the proposals. When Jackie Chambers was asked to explain the interim proposals, she said she wanted to talk about the Towards 2010 proposals and was allowed to unopposed. After Hugh Bradby said the proposals would allow the Trust to recruit and retain staff, Ed picked up on the fact that the Trust had recently just lost a lot of staff presumably referring to the 560 posts removed by the Trust in the Autumn. Hugh Bradby's reply was that there was a lot of turnover in staff in the NHS and astonishingly Ed let this statement go without question. (Incidentally later Ed asked John Adler again whether or not a lot of nursing posts had been removed. John replied that it was mainly administration, managerial and support staff whose posts had been removed. If Ed had been on the ball, he would have asked how they managed to close so many wards and reduce so many bed days without sacking a single nurse or doctor). Di Reeves managed to explain that as a mother she supported the proposals on paediatrics; she would as she represents Sandwell PCT, and the interim proposals are a bad deal for City. The only time she even attempted to acknowlege the other side of the argument was when she spoke about Michel Platini's election as UEFA president, an issue she regarded as "very important" (even when compared to childrens health in the heart of Birmingham?).

Before the show, Ken Taylor (spokesman for the City Hospital Supporters Group) had campaigned hard to get an equal footing on the show and have a proper debate on the interim plans. He was told (as was mentioned twice on the show) that there would be a full debate at a later date, but was invited on to this show by the editor Robyn Dangerfield. According to the e-mail I have seen, she hoped to call Ken at the "beginning of the phone in... so that the key issues and concerns are flagged up early".

Over ten minutes into the show, Ken was introduced by Ed and brusquely asked "What's your question". Ken started to explain how the City Hospital Supporters Group was formed but was cut short by Ed who insisted "Ken, do me a favour, instead of making a point ask a question"

Ken pointed out he had been invited onto the show with the understanding that he would be able to make points pertinent to the debate, but was continually interrupted by Ed who pushed him to make a question. He did finally get a minute or two to make a point after which the Trust was able to respond. Hugh Bradby replied with the following:

"Ken has illustrated quite well that he doesn't understand the case for change"

and

"things have moved on quite a lot from when Ken retired"

He then goes on to explain why the European working time directive (EWTD) has forced the Trust to reconfigure its services in the medium term. Ed does not intervene, but asks Ken to respond. Ken points out that he still works for the Trust and that the has been told by the relevant doctors that the EWTD is not a problem and is being used as a smokescreen by the Trust. Hugh dismisses the point that Ken has not retired by saying he only works in one outpatient clinic and again claims he does not understand how a modern general acute hospital works. Ed again lets this personal attack go and asks Ken to respond. Ken again points out what he has heard from his fellow medical professionals and calls Hugh Bradby's attempts to rubbish their views "very, very poor". Ed now decides to intervene and tells Ken there is no need for any personal attacks from him, or anyone in the panel.

After this exchange, John Adler acts as peacemaker and says there are no personal issues, that the Trust has talked to Ken and understand his concerns. Some more points are made and responded to by both sides. Ken, who was invited onto and called by the show is then cut off.

Even in Ken's absence we still got some choice soundbites from the studio. John Adler complains near the start of the show that the term "downgrading the A&E" with reference to the plans for removing emergency general & trauma surgery and paediatrics at City is very misleading. Is this any more misleading than many of the statements made by the Trust regarding both the interim and Towards 2010 proposals on the Birmingham Mail's Big Debate or on the Radio Five Live debate? Why don't you click on the links and decide for yourself.

While the City Hospital Supporters Group is concerned in particular with the interim proposals for City A&E, it would be fair to say we do not represent all the opposition to the Trust plans. Time and time again on this show people from Sandwell rang questioning the location of the new hospital, which would be just a stone's throw away from the current City site just inside the border of Smethwick with Birmingham.

John Adler spent a lot of time justifying the location of the new hospital, and I must admit despite spending a lot of time pouring over the Towards 2010 proposals, he came out with a lot of reasons I had not heard before. The main reason for the location of the new hospital I had heard previously was that it was the most central location to the population being served. On this show he added that it was on the dual-carriageway Black Country spine route so it would be easy for ambulances to access, it would help regenerate an economically deprived area, and that there would be minimal disruption to the surrounding area as it is not a residential area. He did not mention the other (and arguably main) reason for the location of the new hospital; that its location was a political decision based on the fact that it will still serve Birmingham City Centre, but is just inside the Sandwell boundary so that technically it can be said that Sandwell will not be losing a hospital.

A couple of callers picked up on the point that the traffic on these dual carriageways leading onto junction 1 of the M6 can get pretty crowded, particularly on Friday afternoons or when West Bromwich Albion are playing. These were dismissed by the Trust, and on the second occasion Ed actually fielded the question, saying that when ambulances had the blue lights flashing and the siren on it would not pose a problem. Unfortunately the caller did mention ambulances, but perhaps instead of answering the question Ed should have asked the studio how people with a sick loved one in the back of their car were supposed to get to A&E in such circumstances.

Another caller made a point that Sandwell would be losing an A&E. John Adler's response was that "it was a statement of fact that there will still be an A&E in Smethwick, which is in Sandwell". This completely ignores the point that it is not as central a location in Sandwell as the current A&E, and that when the new hospital is built, many people in Sandwell will find it easier to get to Manor Hospital in Walsall. If John Adler knew anything about the population he was serving, he would realise that it fair to say that for most people in Sandwell a hospital in Smethwick might as well be a hospital in Birmingham as far as they are concerned.

Another listener sent a comment to Ed asking why the people of West Brom do not matter. Sandwell residents may have been heartened when Hugh Bradby later mentioned that he "supports West Brom". To avoid Trust accusations against us of misleading the public, I must point out however that he was referring to the football team and not the town.

The ugly question of whether the consultation really is a consultation was again asked. It is not a referendum warned Mr Adler, but denied the Trust was trying to keep people in the dark after someone mentioned they knew nothing about these plans. Mr Adler replied the Express & Star had covered this, there had been almost saturation coverage in the Birmingham Mail, they were having 100 public meetings and the consultation on the interim plans had been extended, as well as coverage on programmes such as the Ed Doolan show proved the Trust was not trying to hide this from the public. While the Trust have made some moves to involve the public further, I think it is fair to say a lot of this coverage (in particular the Birmingham Mail's) has been a result of campaigning by the City Hospital Supporters Group and other opponents of the plans, and the Trust have been pushed into extending the consultation on the interim plans after an outcry by the local community.

The most telling statement on the consultation was by John Adler when he said

"before we went out to consultation we looked at a number of options"

Perhaps this is the point. If this was a genuine consultation the Trust would have presented a number of options and let the public decide. When the Trust presented these proposals to the staff over a year-and-a-half ago, they were supposed to be consulting on four options, two of which kept the general acute hospitals we have now. In the time it actually took the Trust to go public with the consultation it changed and is now being presented as the building of a new hospital, which further is being used as a Trojan horse to get through some decidedly questionable interim plans.

The reality is that if even if the spokesman for many staff and patients at City Hospital is being dismissed by the medical director with ad-hominem personal attacks, someone who is part of the medical profession and who has worked at City Hospital for many years, who knows the issues involved and has asked for some sensible compromises, what chance has the community got to make its point heard in this consultation?

Consultation taken to Birmingham News

It appears that the Trust has taken out a two-page advert in the Birmingham News, the free newspaper that is dropped through doors across Birmingham on Thursdays, regarding the proposed changes to healthcare in Sandwell and the West of Birmingham. The article gives a brief explanation of the two consultations that are currently taking place, Towards 2010: Investing in a Healthy Future and Shaping Hospital Services for the Future on the first page (page 24), with the actual consultation documents printed on page 25.

Whilst these efforts to raise awareness of the proposed changes should be applauded, it is worth noting that at the meeting organised by the Birmingham Mail many people said they had seen the consultation documents before but were unsure what the implications were.

Those of us who are concerned in particular with the interim plans proposed in Shaping Hospital Services for the Future should consider writing to the Birmingham News outlining the potential problems with the plans to remove emergency general & trauma surgery and paediatric beds from the City site. Their e-mail address is birmingham_news@mrn.co.uk, or they can be snail mailed at The Birmingham News, Letters, Weaman Street, Birmingham, B4 6AT.

E-mail to CHSG Members

The following letter was sent out today to members of the City Hospital Supporters Group via e-mail with details of the next meeting.

CITY HOSPITAL SUPPORTERS GROUP

Dear Member

There will be a meeting of the City Hospital Supporters Group next Wednesday 31st January from 1245-1345 in the Coffee Lounge, Postgraduate Centre. Tea and Coffee will be provided.

Come and hear of the progress made so far, the positive feedback, and plans for future events.

Come and share in the brainstorming session to offer your ideas of ways to reach more people in the hospital and the community, to inform them of the plans, and invite them to make a response.

One suggestion is for a leaflet drop in the area. Could you spare half an hour to push some Green booklets through the doors in a road where you live, or work? You may have other ideas. Every little helps and your contribution is important. The plans are not set in stone; if enough people stand together, the Trust will be forced to listen. We can make a difference – come along and show your support for City Hospital.

Ken Taylor, City Hospital Supporters Group

City Hospital Needs You Now

The following flyer is being distributed by the City Hospital Supporters Group. It contains a brief summary of the aims of the group and how you can help us achieve those aims. On the left hand side there are links on how to obtain a consultation document (see the link entitled How Can You Register Your Concerns), and links to either download a printable version of the petition or sign it online. There is an option on the petition to join the City Hospital Supporters Group.

C i t y H o s p i t a l N e e d s Y o u N o w

Keep the ambulances bringing the children, the seriously injured and those needing surgical care, to City Hospital

· What we want is:-

A 24 hour Children's Assessment Unit

A 24 hour Surgical Assessment Unit

· What you can do is:-

1. Complete and return a Shaping Hospital Services for the Future (green booklet) form now (consultation period extended until 15 March 2007)

2. Sign our Petition

3. Join the City Hospital Supporters Group

TOGETHER WE CAN MAKE A DIFFERENCE

Ed Doolan Show to Cover Health Plans

John Adler will be appearing on the Ed Doolan show this Friday (26th January 2007) just after 11am to discuss the plans for the future of healthcare provision in Sandwell and the West of Birmingham. Our very own Ken Taylor should also feature on the programme.

This is another great opportunity for the community to ask the Chief Executive of Sandwell and West Birmingham Hospitals NHS Trust important questions about the planned changes on a respected local forum. We urge you to phone-in or alternatively e-mail your questions to Ed and tell your friends to watch out for the show.

You can e-mail questions to Ed at ed.doolan@bbc.co.uk, or alternatively phone in on the number given out during the programme.

Campaign Goes National

On Friday, John Adler and Ken Taylor crossed swords again, this time on a national platform on the Matthew Bannister show on Radio Five Live.

The show should be available until Friday 26th January via the following link. The item starts 1 hour 19 minutes into the programme and lasts just over 10 minutes.

www.bbc.co.uk/radio/aod/fivelive_aod.shtml?fivelive/morning_fri

A particular highlight is when John Adler accuses Ken of intentional misrepresentation after it is claimed the doctors are not involved in the planned changes. Intentional misrepresentation? Why then have so many doctors from the affected departments joined the City Hospital Supporters Group? I have personally heard doctors say to me that they have told the Trust management of their concerns and have not been given acceptable answers. If by involved you mean asking them what they need and then ignoring what they say then I guess John is right.

Is this what the Trust plans to do with the public consultation?

Public Backlash at Interim Plans

If you were not present at the Birmingham Mail's Big Debate at the Afro Caribbean millennium Centre on Tuesday Evening you missed a treat. The public and staff who are served by and who serve City Hospital united to give the health managers responsible for the interim plans a grilling - so much so that yesterday the public consultation on Shaping Hospital Services for the Future has now been extended by a month to the 15th March 2007. Let us hope this is the first of many victories for those of us who oppose these plans.

A broad section of the public asked John Adler, Chief Executive of Sandwell and West Birmingham Hospitals NHS Trust some serious questions which he answered in true civil service fashion. For full coverage see the Birmingham Mail's coverage here - I understand they will be publishing answers to further questions asked at the end of the meeting over the coming days and weeks.

The opening question was a very sensible one about whether it is better for badly- injured trauma patients to be stabilised at City and then transferred to another hospital, or for them to be treated under one roof. This was followed up later on in the evening by an excellent point made by a nurse from City Hospital who said that the City A&E department would be crucial if there was a terrorist attack on the second biggest city in Britain. The fact that stabbings and shootings are common in the area surrounding City hospital has not been lost on anyone, except the Trust management, who have been deluded by their own spin. The answers of the representatives of the Trust seemed to be based on the idea that doing nothing was bad and not an option. The problem with this is the corollary - doing something must be good - does not hold either. We should only make changes which improve the situation and the problem is we do not believe the interim solutions offered by the Trust at present are good enough.

A point was then raised about the cost of travelling to visit patients transferred to Sandwell. A taxi would cost around £10, and the trip would involve changing two or three buses. Would the Trust be liasing with Centro? Of course we would implied John Adler, and let us remember low income patients can be reimbursed for their travel expenses.

Come off it! replied the crowd. It is not as easy in practice to reclaim these expenses because you often need receipts, not exactly the first thing you remember in an emergency. In any case, relatives visiting their children would not be reimbursed, pointed out one man. And does anyone really believe the Trust has enough sway over Centro to get the transport network overhauled to suit their own plans? I doubt it. Services may follow hospitals as the Chief Executive pointed out, but as he also pointed out earlier that 90% of patients would still be using the same hospital, will there be enough demand to make such services financially viable for the Transport Executive?

Someone then asked if the newly built Birmingham Treatment Centre would still be used if the new hospital was built. This and the new Emergency Services Centre (ESC) at Sandwell would continue to be used replied Mr Adler. What he failed to point out is that the ESC was designed to be used as an A&E. When the new hospital is built the A&E will move with it and the ESC will presumably be used in a way it not designed to as a planned operation centre, a fact pointed out previously by the Express and Star.

When asked if the plans would lead to further job losses John Adler's answer was (and I quote the Birmingham Mail):

"We have no job losses in the long term plans"

An astonishing answer given that the new hospital will only have half as many acute beds as the two it is replacing. Unless SWBH NHS Trust plans to become less efficient, it is a natural consequence that staff will have to go. Some of the clinical staff may be employed instead by Heart of Birmingham or Sandwell PCT, but there is no guarantee that support staff will have their jobs transferred to these organisations when the new hospital is built in 2013.

Some interesting points about community services were raised by Conservative councillor Deidre Alden, Midlands Today health correspondent Michele Paduano and local GP Niti Pall. The latter was rather unfairly heckled for apparently supporting Trust plans. I think she slightly missed the point of the City Hospital Suppporters Group campaign. Everyone in the room agrees that community facilities need to be improved so that stays in acute hospitals are reduced, but the problem many of us have is that the PCT's have failed to do this over the last eight years. Where is the evidence that things will improve in the next eight? Sandwell PCT is heavily in debt (although Heart of Birmingham PCT is sitting on a large surplus carried over from previous years); this will surely impact on the level of community provision they can provide even with a £700 million investment.

Khalid Mahmood, Labour MP for Birmingham Perry Barr, promised to send a consultation document to every household in his constituency and said he would stand by what his constituents think. It would be nice to see some of the other local MP's make this commitment - why not use the link in the bar on the left hand side to find out who your MP is and see whether they can help in a similar fashion.

The final question was the one that I think most of us have been thinking; is this consultation going to take on board the publics concerns, or is this a done deal, a bureaucratic box to be ticked before they can get on with the next stage. John Adler was asked this three time during the evening and his answer left us none the wiser.

The point is this. We have two consultations going on at the same time, in a three month period over the Christmas period. One is about whether a new hospital should be built. The other assumes we will be building a new hospital and asks how we should reconfigure services in the meantime. This hardly reassures us this is not a consultation in the sense "We will give the public their say, and then do what we were going to do anyway".

However, Shaping Hospital Services for the Future does now have an extended deadline as mentioned above. Towards 2010 will end on 16th February 2007 as before, because it is believed by the Trust that the public are broadly in favour of building a new hospital. At this meeting both sides of the panel were in favour of it but there was some discontent on the floor.

Have the Trust shot themselves in the foot by not heeding the warnings of the clinicians over the interim plans? Their arrogance over this issue could end up costing the community a new hospital if they are not careful. This is the reason the two consultations should have been done separately in the first place.

Trust Response to Question on Seriously Injured Patients Inadequate

Who is the Trust kidding? In this article in the Birmingham Mail 8th Jan. a Trust spokeswoman states:

"a surgeon would be on standby for City A&E who could be called in if anyone walked in needing immediate surgery"

How many patients who have been shot or knifed or have surgical emergencies are able to walk in?? Do these people live in the real world? We have one of the most experienced teams at dealing with surgically ill emergencies in the country at the moment. Having it downgraded will not improve the service to our patients.

The Birmingham Mail's Big Debate

The Birmingham Mail is organising a public meeting to debate the planned changes at City and Sandwell Hospitals. It will take place at 6pm on Tuesday 16th January 2006 at the Afro-Carribean Centre, 339 Dudley Road, Winson Green, Birmingham, B18 4HB (for a map of the area, please click here). This is a fantastic opportunity to quiz the healthcare bosses about the planned changes at City and Sandwell hospitals, and we would urge as many people as possible to turn up and make your views known in the presence of the local media (Midlands Today will probably also be covering this story).

To see an online version of the Evening Mail article, please click here.

The Website of the Afro Carribean Millenium Centre is http://www.acmccentre.com/acmc.shtml