An Open Letter to the SHA

The following letter regarding moving Paediatric and Emergency Surgery and Trauma beds from City to Sandwell Hospital as part of the interim reconfiguration plans was sent to the Strategic Health Authority, the Birmingham Mail and to all staff at City Hospital. A copy was also sent to the Commission for Racial Equality today. The document referred to in the letter can be found here. The Birmingham Mail's coverage of the letter is available here.


Ms. Elisabeth Buggins,
Chairman West Midlands Strategic Health Authority,
St. Chad’s Court,
213, Hagley Road,
Birmingham B16 9RG. 20th May 2007.


Dear Ms. Buggins,

Re: Sandwell and West Birmingham Hospitals NHS Trust’s Interim Reconfiguration Proposals - Shaping Hospital Services for the Future.

I am writing to you on behalf of the City Hospital Supporters Group and this is an open letter that is being simultaneously passed to the Birmingham Mail. You may know that we are a group composed of members of the community served by City Hospital and also members of staff from across all the staff groups of the hospital. The one commitment we all share is to ensure that local people can rely on continuing to receive a high quality hospital service. We support the 2010 proposals for the new hospital combining both City Hospital and Sandwell Hospital on the Grove Lane site. We are only too well aware that this exciting new development is still only at the very early planning stage, and many things could happen in the next few years that could jeopardise or delay its opening. At the moment it is not projected to open before 2013/14.

City Hospital Supporters feel very strongly that patients at both City and Sandwell Hospitals should continue to receive the same quality of service while they await the new build. The Trust’s Interim Reconfiguration Proposals do not threaten the services provided for the population of Sandwell Hospital, but unfortunately they do threaten those services for the population served by City Hospital. The Trust’s initial proposals that went out to consultation would have moved Emergency Surgery and Trauma beds to Sandwell and Paediatric beds providing only a 12 hour Paediatric Assessment Unit at City Hospital. As a result of our campaign on behalf of local people the consultation period was increased by a month, the 12 hour Paediatric Assessment Unit became a 24 hour unit and finally they decided to provide a 24 hour Surgical Assessment Unit. However these proposals are still fundamentally flawed.
I believe you will find that the Trust’s Reconfiguration Proposals conflict with their own Race Equality Scheme May 2005-April 2008 which is easily accessible on their website. The following data have come from this source. It states that 20% of Sandwell residents and 30% of Birmingham residents are from Black and Minority Ethnic groups. Ladywood, Handsworth, Soho and Aston have significantly higher proportions of Minority Ethnic residents: 49%, 81.5%, 76.2% and 70.6% respectively. They go on to look at the percentage of Black and Minority Ethnic inpatients by hospital in 2004-2005. The figures for Sandwell Hospital are Black and Ethnic Minorities 13.4%, White 70.5% , Unknown 16.1%. For City Hospital the figures are very different: Black and Ethnic Minorities 45.9%, White 45.4% and Unknown 8.7%. They admit that Sandwell’s data is not as good but even if we were to assume that all the unknowns at Sandwell were Black and from the Ethnic Minorities there total figure would only be 29.5% compared to 45.9% for City. If we exclude the Unknowns it is Black and Ethnic Minorities at City Hospital 45.9% against 13.4% at Sandwell Hospital! A more than threefold difference!

In paragraph 4.1 the policy states and I quote “Equality for Sandwell and West Birmingham Hospitals NHS Trust means that all members of our community and workforce must have equal access to the services and opportunities offered by the Trust regardless of gender, race, ethnic background, disability, religion, sexual orientation or age.” In the paragraph under Meeting the Specific Duties it states in 6.1 “To assess its existing policies and service delivery for any adverse impact on the promotion of race equality. Crucially under paragraph 6.2.3 it says and I quote “if impact assessments show that a current policy, service or function results in greater adverse impact, or if opportunities arise which allow for greater equality of opportunity to be promoted, the Trust will ensure that the policy, service or function is revised and targets are set to reduce or eliminate disadvantage.”

Now I can hear you asking where is this all leading? Well it is very simple. If the Trust were to implement its plans for moving inpatient Paediatric and Emergency Surgery and Trauma beds from City Hospital to Sandwell Hospital and establishing 24 Hour Assessment Units in Paediatrics and Surgery at City, we would argue that they would be treating the City Hospital patients that have a different ethnic balance to Sandwell in a different way. In particular they would be exposing two thirds of the Emergency Surgical patients and two thirds of the children brought to City Hospital A&E and needing admission, to transfer by ambulance to Sandwell Hospital or if no bed were available there, to another hospital. The ambulance journey would not be to better care i.e. an ITU or HDU bed, but simply for managerial and financial convenience. It would be an ambulance journey not for the benefit of the patient but for the benefit of the Trust and would undoubtedly put City Hospital patients with their higher Black and Minority Ethnic mix at greater risk than the patients with a different ethnic mix admitted to Sandwell Hospital. We believe that this conflicts with the Trust’s Racial Equality Policy and we presume the Commission for Racial Equality would be of the same view. The Trust did consider five options before selecting one that impacted on Emergency Services producing a differential effect on the two hospital populations. City Hospital Supporters believe that now is the time for the Trust to choose an option that does not impact upon Emergency Services at all, and does not involve moving significant numbers of ill patients, children or adults unnecessarily.

Needless to say this will form part of the evidence we will be giving to the Independent Reconfiguration Panel. Under the circumstances we feel that there should be no move of Inpatient Paediatrics from City Hospital to Sandwell Hospital while the situation is being satisfactorily resolved. I would appreciate an early reply on this most worrying situation.
With kind regards,

Yours sincerely,


DR. K.G.TAYLOR

City Hospital Supporters Group.

cc. Cynthia Bower
Sue Davis
John Adler