Friday, February 23, 2007

Ed Doolan Debate Proves Fruitful

There was an excellent debate on Friday's Ed Doolan show regarding the healthcare plans for Sandwell and the West of Birmingham. The panel was made up of six people, John Adler (Chairman Sandwell & West Bimingham Hospitals), Di Reeves (Sandwell Primary Care Trust) and Denise McKlellan(Heart of Birmingham PCT) who made the case for the proposals while Ken Taylor (Spokesman Ciy Hospital Supporters Group), Chris Rickards (Unison) and Judith Whalley (Royal College of Nursing) raised objections and concerns on the proposals. The panel was chaired by Ed Doolan himself and supplemented by an audience, many of whom were staff at the hospital and also some familiar faces from the Birmingham Mail debate which took place earlier this year.

Surprisingly the show started by discussing the longer term Towards 2010 proposals whose consultation finished last Friday, although John Adler assured Ed that points made today would be taken on board. As usual there was a general consensus among the panel that these proposals were a good idea although some concerns were raised over the number of beds and the standard of service that would be found in the planned community hospitals. This was unsurprising given that the debate took place at City because as mentioned before on this blog most of the opposition to the Towards 2010 proposals come from Sandwell residents who feel they are losing a hospital.

The debate then went onto the shorter term Shaping Hospital Services for the Future plans where I am glad to announce a victory for the City Hospital Supporters Group. For the first time John Adler gave a public commitment for a 24 hour Paediatric Assessment Unit, which was one of the main aims of the petition. He also said that the Trust were examining proposals for a 24 Surgical Assessment Unit, another aim of the petition, and would implement this if it was financially and logistically feasible.

A recurring theme in the debate was the climate of fear that exists in the NHS at the moment.
These accusations were not aimed at the senior management, but at "bullies at lower levels" as Judith Whalley put it. Ken Taylor pointed out that staff in the NHS are line managed, and are expected to follow the Trust line. Many doctors were frightened to speak up in opposition to these proposal because they were afraid of the consequences he said. Ed Doolan, who used to sit on the Trust board of the Children's Hospital, noted that this has been a problem in the NHS for years. In particular, Ken claimed that some doctors were even afraid to attend a meeting arranged with a local MP. John Adler stated that he was happy for this meeting to take place, and was happy for staff to say whatever they wanted about these proposals. I understand that since the programme a productive meeting between the group of doctors and the local MP has taken place.

A write-up on a debate like this would not be complete without me picking up Hugh Bradby on not one but two points he made on this show. The first one regarded his favourite excuse for the interim proposals, the European Working Time Directive (whose affect Ken Taylor assures us is being exaggerated). After spending a few minutes explaining how much more junior doctors we would have to employ to comply with this piece of legislation, and telling us how much it would cost if changes were not made, he concluded by claiming that the interim plans were being driven by clinical motivations and were not due to financial concerns thus contradicting everything he had just said! His other boo boo was as he pontificated that it would be better to stabilise a patient and move him to the correct facility rather than keep him at the wrong facility and try to manage the patient there. He seemed to completely ignore the point that currently we have acceptable facilities at both sites to manage emergency surgical and paediatric patients. It is the Trust that want to reduce these facilities at City and concentrate them at Sandwell, so the choice is really between being able to keep the patient at the same site where everything can be done or than having to move them to a new site after an arbitrary period of time. You do not need be medically qualified to realise that the former case here is preferable.

Some excellent points were made by the former chairman of City Hospital NHS Trust, Richard Steer, about the fact that whenever two Trusts merge the plan will always be to reconfigure services regardless of guarantees by the management and the Department of Health that services will stay the same during consultations on the merger. This was the case during the merger of Sandwell Healthcare NHS Trust with City Hospital NHS Trust five years ago, and is currently the case in the proposed takeover of Good Hope Hospital by Heart of England NHS Foundation Trust (if you want to take part in this entirely separate consultation, please click here). He also made an excellent point that since Birmingham Health Authority was split into four (now three) separate PCT's, there is no pan-Birmingham healthcare strategy, which is to the detriment of heathcare planning for the city.

Deidre Alden, chair of the Health Overview and Scrutiny committee on Birmingham City Council, made another good point that the healthcare proposals may affect people outside the Sandwell and West Birmingham area. If under the new plans the Trust fails to cope, ambulances could be diverted to Heartlands or Selly Oak which will have a knock-on effect on the services at these hospitals. Do not say you have not been warned - make sure wherever you live that you take part in the remaining consultation, Shaping Hospital Services for the Future.

Finally, on a lighter note I did chuckle at Dr Connolly's claim (did you know you have a 1-in-5 chance of seeing him if you have a heart attack in Sandwell or Birmingham City Centre?) that it took him 11 minutes to get from City to Sandwell. Not 15 minutes. Not 10 minutes. 11 minutes. Now I have done this route a lot and I would estimate it takes me a minimum of 15. Does anyone know what car he drives (in particular what is the size of the engine) and how on earth he managed so accurately to calculate this time?

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