Thursday, January 18, 2007

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.

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