Sunday, January 28, 2007

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"
"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?

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