City Hospital Supporters Appeal to New Prime Minister.

A letter was dispatched to Mr. Gordon Brown on the day he became Prime Minister. The idea to write to him was inspired by his declaration that he intended to make the NHS and listening to local people his top priorities. Undoubtedly he has the chance to do so right here in Birmingham with the City Hospital Reconfiguration debacle.

Dear Mr. Brown,
Firstly I am writing this open letter to you on behalf of the City Hospital Supporters Group in Birmingham and we would like to congratulate you on becoming the new Leader of the Labour Party and Prime Minister. We were delighted to hear this most welcome news. We were also very pleased to hear that you were to make the NHS one of your top priorities and were particularly delighted that the views of local people were to be listened to.

City Hospital is the hospital closest to Birmingham City Centre. It serves the 4th most deprived district in England with wards such as Ladywood, Handsworth, Soho and Aston. Its A&E Department saw some 103,000 referrals over the last year with approaching 20,000 children. The hospital has an excellent A&E Department that has developed special expertise as it sees more penetrating injuries from gunshot and knife wounds than any hospital in the Midlands and probably the whole country.

City Hospital Supporters is a recently formed group consisting of members of the community served by the hospital and members of staff of every occupation. We are committed to ensuring that the community continues to receive the same high quality of care they have been used to, provided by City Hospital. This hospital had its own Trust Board until a few years ago and it then merged with Sandwell Hospital NHS Trust. The long term plan is to replace the two existing hospitals with a single hospital in Grove Lane Smethwick that will serve a combined population of 500,000. City Hospital Supporters endorsed this development when it went out for consultation in November last year. The new hospital is but a plan at present at a very early stage. Finance has to be organised throught the Private Finance Initiative, the land purchased and the building plans produced. The new hospital will not open its doors before 2013/14 assuming no slippage.

Our major concern is the Interim Reconfiguration Proposals recently approved by the Trust Board. These proposals would see inpatient Paediatric and Emergency Surgery beds moving from City Hospital to Sandwell Hospital with 24 Hour Assessment Units being established in these specialties at City Hospital. City Hospital is the larger hospital with 1100 beds compared to 400 beds at Sandwell. It serves a socio-economically deprived population and one with a very high concentration of the ethnic minorities. Some 50% of families are without their iwn car and public transport links are not good.

If the Trust's proposals were implemented about six of the children admitted and about 12 of the adult surgical patients who were admitted via the 24 Hour Assessment Units each day would need to be moved to the beds at Sandwell because they needed to stay in hospital longer than 24 hours. These journeys would not be medically necessary as they would not be moving patients to higher levels of care such as Intensive Care or High Dependency beds, they would be moved to ordinary ward beds. This has to be unacceptable care in the 21st century for the hospital at the centre of England's second city.

The actual formal consultation was flawed because the ethnic minority population was not effectively addressed. However those who returned consultation forms rejected the Trust's proposals for Emergency Surgery 47.2% to 31.4% and for Paediatrics 45.6% to 29%.

As if this were not bad enough these proposals fly in the face of the Trust's own Racial Equality Policy. This is because from data provided by the Trust on their website City Hospital has an inpatient population consisting of 45.9% ethnic minorities against Sandwell 13.4%. Thus ethnic minority patients at City would be unfairly disadvantaged and put at greater risk. A complaint has been made to the Commission for Racial Equality and I understand that it is being investigated.

Last week a secret ballot of all the consultants at City Hospital drew to a close. 97% of those retuurning ballot papers supported the prospect of the new hospital but opposed losing the Paediatric and Emergency Surgery beds. Only two ballot papers were received voting the other way and we had an overall majority of 57.9%. No previous ballot had been conducted by the Trust.

I am sure you will agree that this is a totally unacceptable situation, particularly as the Trust did have options on the table that would have preserved Emergency Services at both hospitals until the new hospital is built. These options would have been perfectly acceptable to City Hospital Supporters. The good news is that the Birmingham City Council Health Scrutiny and Overview Committee has referred the Emergency Surgery proposals to the Secretary of State for Health who has to decide if referral should be made to the Independent Reconfiguration Panel. However Paediatrics has not been referred.

This is a very clear example of the local community not being effectively consulted about a major change to the provision of their hospital services. In spite of the flawed consultation they have rejected a reduction in services at their local hospital, but they have been ignored by the Trust. The senior doctors at the hospital have spoken with one voice on the Trust's proposals but to date it has had no effect.
Referral of both the Emergency Surgery and the Paediatric plans to the Independent Reconfiguration Panel would at least give us a chance to present the facts to an independent and external group of people, so that the case for preserving effective emergency services at City Hospital until the new hospital opens could get a fair hearing.
With kind regards and good wishes for the future.

Yours sincerely.

Dr.K.G.Taylor

On behalf of City Hospital Supporters Group.

Media Cover Ballot Results

There was plenty of coverage of the results of the recent ballot on Friday, with both the Evening Mail and the Birmingham Post running the story. The ballot was also reported on Midlands Today during the 6.30pm News and on News Bulletins on Radio WM. Our very own Ken Taylor did a 10 minute slot on New Style Radio 98.1FM on Saturday evening at 8.40pm with Marie Welch, a mother and very active member of the City Hospital Supporters Group. For those of you who are unfamiliar with the station, it is based at the Afro-Carribean Millenium Centre where the big debate took place earlier this year.

The Birmingham Post coverage has some excellent quotes from an unnamed City Hospital consultant. In contrast, the Birmingham Mail's coverage contains some ridiculous quotes from a spokesman for the Trust.

"We accommodated the work of the group during the consultation. Now the board has made its decision, it is no longer appropriate for the group to continue using trust facilities and premises to try and force the board to reconsider its proposals."

said head of communications, Jessamy Kinghorn. It is really a sad state of affairs when staff are banned from using Trust premises while attempting to maintain high quality care for their patients if it goes against Trust Board Policy.

Who exactly do you think is guilty of a conflict of interest? Leave your answer in the comments below.

Informing the Trust of the result.

Today a letter should have reached the Chief Executive and I copy it here for all to see:

Mr. John Adler Chief Executive,
Sandwell&West Birmingham Hospitals NHS Trust

Dear John,
I am writing to formally let you know the method and result of this ballot. The list of consultant staff ballotted was the current list used by the Medical Staff Committee. Each consultant was allocated a number which appeared on the ballot paper and also on the envelope in which the paper was returned. I enclose a copy of the ballot paper. These were sent out the week commencing the 4th June and the closing time was 5pm on the 20th June.

The count took place at the Afro-Caribbean Millennium Centre and the Independent Referee was Mr. XXXXX of the Birmingham Council Health Scrutiny Committee. All the ballot papers received were in envelopes. The envelopes were opened and the ballot papers arranged in numerical order. A check was made to ensure that there was only one ballot paper with each number, and there were no papers without numbers. All the ballot papers had the preference clearly marked.

The number of ballot papers returned was 98 giving a percentage return of 59.7%. 95 of those papers were in favour of the motion i.e. 96.9%. There were two papers cast against the motion and one abstention. The votes in favour of the motion expressed as a percentage of the papers sent was 57.9% this being the overall majority. Thus in the event of all the non-voters having voted against the motion those in favour would still have carried the day.

This is a very clear cut result with good participation, an almost unanimous result on the votes cast and an overall majority.

The message from the consultant staff is absolutely clear. It is that they supported the prospect of the new hospital on the Grove Lane site, but rejected the current interim reconfiguration proposals to move Paediatric and Emergency Surgery and Trauma beds from City to Sandwell Hospital.

In the light of this result I call upon the Trust to reconsider the options available for any interim reconfiguration and select one that does not impact upon the emergency service provision of City Hospital.

Yours sincerely,

Dr. Ken Taylor

On behalf of City Hospital Supporters Group.

cc. Secretary of State for Health and others.

I am sending a copy of this letter to all members of the senior medical staff at City Hospital and no doubt they will be discussing the situation in the near future.

It's Almost Unanimous!!!

At last the senior doctors at City Hospital have expressed their verdict on the Trust's proposals for a new hospital on the Grove Lane site, and in the interim moving inpatient Paediatric and Emergency Surgery and Trauma beds to Sandwell.

95 out of 98 effectively said YES to the new hospital and NO to moving the beds. For the mathematically inclined this is a 96.9% majority of the votes cast. 164 ballot papers were issued using the current medical staffing list for City Hospital giving an absolute majority of 57.9% or in other words if all the non-voters had voted against the motion it would still have been carried. The count today was supervised by an independent referee.

We now have a situation where however flawed the consultation, the proposal to move the Surgical beds was rejected 47.2% to 31.4% and the Paediatric beds 45.6% to 29% by those in the community consulted. In view of the very obvious ethnic issues the Commission for Racial Equality is involved. The Emergency Surgical proposal has been strongly criticised by the City Council Health Scrutiny committee and referred to the Secretary of State, and now the consultants at City have spoken with one voice endorsing the view of those consulted.

Can there be a louder or clearer message to those managing the Trust?

Would the majority of senior doctors have rejected the interim reconfiguration proposals if they had felt there were essential reasons for moving the beds to Sandwell?

Now is the time for the Trust to be reviewing the situation. There ARE other options. PROTECT the emergency services to the local community. The people NEED them.

Can somebody, anybody tell me why oh why are we having to fight to prevent something really important being taken from those with the greatest need?

I now understand what Julian Tudor Hart meant. He is an eminent and greatly respected Welsh GP. He is a youthful octogenarian but an angry one who invented the" inverse care law" back in 1971.

This law states that "those people most in need of health care tend to receive the poorest service."
This must not happen in this great City of Birmingham to our people, and we must do all in our power to prevent it happening.

A final point, it would be good to hear from some of you reading this blog. If you click on comments at the end of this piece you can have your say. I know people are worried about identifying themselves, so just adopt a pseudonym or perhaps use a christian name. This website is for all those people who wish to stand up and support good hospital care for the people local to City Hospital.

Fears About Confidentiality of the Ballot

As the ballot of senior medical staff reaches its final day tomorrow I have been talking to colleagues and urging them to vote. The ballot closes at 5pm so if you have not voted take your envelope to the Postgraduate Centre in person please.

There clearly are concerns about confidentiality. I must emphasise that the ballot papers must be numbered so we can prove to the independent referee that nobody has voted twice. We can tell who has voted but assuming everybody puts their ballot papers in sealed envelopes with numbers on the outside we simply tick off the list that they have voted and do not open the envelopes.

The count will be held at the Afro-Caribbean Millennium Centre on Thursday 21st June at 11am. The independent referee is Mr. Darren Wright the Principal Officer of Birmingham City Council Health Scrutiny Committee. The Trust have been invited to send a representative but they have declined. The list of names will be sealed away before the envelopes are opened and I will store them safely just in case an independent review were demanded. I would ensure that no member of Trust management ever had sight of these lists.

Trust Board Decide to Engage Consultants

Ken Taylor's ballot of the Consultants at City regarding the interim reconfiguration plans really seems to have got the wind up the Trust board. The following letter went out to all consultants on the 13th June 2007 (click here for original copy).

Sandwell & West Birmingham Hospitals NHS
NHS Trust

Chief Executive
': 0121 507 4847
Fax: 0121 507 5636
Email: john.adler@swbh.nhs.uk


To: All SWBH Consultants
cc: Executive Team, DGMs


13 June 2007


Dear Colleague

Shaping Hospital Services for the Future

Those of you based at City Hospital may have received a letter from Ken Taylor proposing a ballot of City consultants on the Trust’s plans for service configuration change in advance of the “Towards 2010” plans for a new hospital. In the light of this I am writing to remind all consultants whether based at City or Sandwell where we are in the process with these important plans.

Our plans for change in pathology, paediatrics, neo-natal care and surgery have been developed over the last 18 months following extensive discussion with clinicians from the services involved. As this work has proceeded there have also been many opportunities for the wider clinical body to contribute to the discussion which many of you have taken. Finally, as you will be aware, we carried out a four month formal public consultation on the plans that concluded in mid-March 2007.

As a result of ongoing work with clinicians and in the light of the outcome of the consultation the final proposals recommended to the Trust Board incorporated a number of important changes:

· the Paediatric Assessment Unit at City Hospital will be open for 24 hours a day;

· there will be a 24 hour Surgical Assessment Unit at City to increase support for A&E and reduce the numbers of patients needing transfer to Sandwell;

· elective colorectal surgery will be retained on both sites to ensure there is support for gynae-oncology at City Hospital.

The Trust Board approved the plans for change at its meeting in May. The Birmingham local authority scrutiny committee referred the proposals for emergency surgery only to the Secretary of State and we are waiting for confirmation of the next steps in this process. The rest of our proposals were not referred and can therefore proceed. The ballot that Dr Taylor is seeking to organise does not have any formal status as part of the Trust’s decision making on these plans.

For those of you who have received Dr Taylor’s letter, there are two particular points that I would like to stress.

Firstly, the Trust has strong support for the plans for a new hospital and is moving rapidly in developing these further. In addition to longstanding support from our PCTs, and public support shown through the consultation, we have also recently had renewed confirmation of SHA and DoH support for the programme at their latest review of the plans. I am also pleased to be able to tell you that the Trust Board approved the business case for the purchase of the land on which the new hospital is to be built at its meeting last week. This business case will now go to the SHA for their approval. Work on the detail of the plans for the new hospital is also well underway as part of the process of preparing the hospital outline business case for submission in March 2008.

Secondly, the steering groups and the executive team carefully considered the range of possible options for change in both paediatrics and neo-natal care and in surgery before deciding to proceed with these plans. We are clear that we have identified the best options available to us. The plans for a single paediatric inpatient unit at Sandwell have been developed alongside the plans for developing the neo-natal unit at City and taken together include significant capital and revenue investment in these services. The plans for emergency surgery were developed alongside plans for bringing elective surgical services together and are designed to make the best use of the theatre capacity available to us at each of our sites. We believe that the proposals approved by the Board provide the best way forward for our services and now want to focus on planning for implementation so that we can get on with developing our services for the future.

The proposition on the ballot is essentially for the status quo. It is of course entirely up to each consultant whether you wish to participate in the ballot at all and if you do, which way to vote. I trust, however, that this letter has helped ensure that you remain up to date with our progress on these plans and are presented with a full and accurate statement of the position. As always throughout this process, if you have any questions or wish to discuss further please do not hesitate to contact me,

With best wishes.

Yours sincerely,

John Adler
Chief Executive


Isn't it amazing what it takes for a Trust Board to engage its consultants?
*******************************
I am going to respond to some points in John Adler's letter:

In his second paragraph the Chief Exec. talks about extensive discussion with clinicians from the services involved. He is presumably referring to the Sandwell-based Medical Director and Sandwell-based Clinical Directors in Paediatrics and Sandwell-based surgeons? I have been getting a very different message from the City-based clinicians. At no time has the Trust balloted the senior medical staff at City on their proposals.

The consultation was fundamentally flawed. It did not address the multi-ethnic population served by City Hospital. It did not tell the community that if they had an ill child or a surgically ill adult although they would be assessed at City Hospital, if they needed to stay in hospital longer than 24 hours they would need to be moved by ambulance to Sandwell Hospital. This would be the only population in Birmingham subject to this inferior form of care, and it would not be suffered by people going to Sandwell Hospital with the same problems. Are these plans really tenable expressed in this way?

However in spite of consulting the wrong population and not providing them with the full facts, the proposals were still resoundingly rejected.

The Chief Exec. omits to mention that the Commission for Racial Equality are now involved in the reconfiguration plans.

How the Executive Team have concluded that they have the best options for Paediatrics and Emergency Surgery is a complete mystery. The best options for whom? Not for the poor people of West Birmingham. Not for City Hospital.
I think it means the Trust has a very different agenda. and the sooner we understand what that agenda is the better.

There has to be a very real concern after what has happened in Coventry with the Walsgrave PFI. The local health economy is going to have to find many millions of pounds and there will be severe cutbacks at the hospital. One has to ask the question well what about the new University Trust PFI here in Birmingham? It is a bigger project than Walsgrave. How will that black hole be financed? Could it be at the expense of City Hospital and the population it serves? What chance of another big PFI happening in the near future in the Birmingham area? Can anybody answer these questions please? Would it not be sensible to maintain the status quo at City Hospital until that new PFI happens as the Executive Team try to assure us it will?

Ken Taylor. Posted 00.15hrs 19th June.

Vote, Vote, Vote!

This is a timely reminder to all the senior doctors at City Hospital to make sure that they vote in the secret ballot and return their voting papers by next Wednesday 20th June.

The Motion is lengthy for good reasons but the message is very simple:

We are FOR investment in a nice new hospital on the Grove Lane site.
We are AGAINST moving the Children's beds and the Emergency Surgical and Trauma beds from City to Sandwell Hospital while we wait for the new hospital.

There is a simple choice for voters, IN FAVOUR or AGAINST.
There is no option for those who are undecided except perhaps not to vote. I would like ALL those eligible to vote. Naturally I would prefer them to vote in support of the motion. However actually voting is the most important thing. Disagreement among human beings is essential for progress. We learn from different views being expressed. It is a great strength of the human race. It is how we resolve our disagreements that is important. Letting people decide at the ballot box recognises that the majority must determine what happens in a fair and free vote.

Why a secret ballot? It takes all outside pressures off the voters. Each individual can follow his/her conscience without fear of peer pressure or reprisals from any quarter. No names are required just a cross on the paper.

The ballot papers are numbered to ensure no duplicates. The sealed envelopes are numbered so they can be ticked off from the list to ensure people have voted. These lists will not be available when the sealed envelopes are opened and will be destroyed when our independent assessor from outside the Trust is content all is in order.

DO MAKE SURE YOU VOTE!!!

Adler Anger at (Genuine) Consultation

Ken Taylor has been organising a ballot for the Consultants at City on whether or not they support the Trust's interim reconfiguration plans. This seem to have put the wind up the Trust Board a little, as can be seen in the following letter to Ken Taylor from the Chief Executive (click on the letter to enlarge).

Ken has responded to the letter in the following fashion (a printable copy is available here):

Mr. John Adler,
Chief Executive,
Sandwell and West Birmingham Hospitals NHS Trust,
Trust Headquarters,
City Hospital,
Dudley Road,
Birmingham B18 7QH. 11th June 2007.

Dear Mr. Adler, Re: Ballot of City Hospital Consultants.

I was really disappointed to receive your letter today, both with regard to its content and its tone. In organising the ballot, City Hospital Supporters are giving the consultant medical staff at City Hospital the opportunity to express their opinion on the plans for the new hospital and the service reconfiguration in a truly democratic, fair, private and time-honoured way. We have done our best to make sure the doctors are aware of all the new developments such as Race Equality issues and the matter of the Birmingham City Council Health Scrutiny Committee’s response to your proposals, as well as the resounding rejection of the reconfiguration plans by the consultation process flawed as it was. There are ethical issues here for doctors who do have a wider responsibility to all members of the community served by the hospital. We also pointed out to them that apparently the West Midlands Strategic Health Authority is already under the impression that your proposals have clinical support, although admittedly they do not state where that support is based, and how it was obtained. Surely some clarification now would be most timely?

I would like to reassure you that Trust resources are not being squandered by City Hospital Supporters. The cost of materials such as paper and envelopes is being borne by Unison or City Hospital Supporters. This was made clear to ***** at the start of the campaign. I am sure ***** has only done things for us in her own time, because I know she comes into the hospital very early at around 7am. If we owe any money to the Trust, it will be reimbursed.

This ballot could go either way. We have given the consultants a choice. It was our intention to ask you to nominate a person to represent the Trust at the count to ensure that all was in order. This offer still stands. However if you do decline to nominate somebody we shall identify an impartial and respected individual to perform this task.

Your letter to me is very clear indeed. In response to your final paragraph I would simply say that when the Trust produces plans that address the health care needs of all of the populations of both City and Sandwell Hospitals in a fair and equitable manner, we will be able to campaign for the Trust and not against it. I look forward to that time.

Yours sincerely,



Dr.K.G.Taylor MD.,FRCP
On behalf of City Hospital Supporters Group

Ken and I would be very interested to here your opinion on these matters. The use of the comments facility below is positively encouraged.

Information or Propaganda?

I have just been reading the June copy of Heartbeat which is apparently the pulse of Sandwell, City and Rowley Regis Hospitals. The editorial team are certainly not short on hyperbole when it comes to reporting progress on Towards 2010 and the Interim Reconfiguration proposals. The story is only from one side, with no reference to opposition or indeed facts that inconveniently do not fit the party line.

Would staff have been interested in a few pertinent facts? I can think of a few examples: Such as how does the population affected by the Interim Reconfiguration relate to the population responding to the Shaping Hospital Services for the Future paper that sets out how services would change in the interim. Well only 15.6% of respondents were from the ethnic minorities, whereas the inpatient ethnic minority population at City from the Trust's own data on its website is running at 45.9%, a threefold difference! No comfort for the Trust here. The best way to have targeted these people would have been to consult them as patients on the wards, in outpatients, and in their general practitioner's surgeries. This did not happen.

Interpreters would have been needed and instead of talking about concentrating inpatient Children's services and Emergency Surgery services at Sandwell Hospital they should have explained that if they had needed to remain in hospital more than 24 hours they would face being moved by ambulance to Sandwell Hospital or elsewhere. I cannot visualise them lining up to say yes to that proposal!

How about one or two more consultation facts. When people were asked about whether they agreed with the proposed changes for surgery 47.2% said NO and 31.4% said YES. The NOs have it in spite of consulting the wrong population. Interestingly there were very similar figures for the proposed changes to children's services, 45.6% said NO and 29% said YES. Do you think it is just remotely possible that if they had consulted the right population even more would have said NO?

I looked very hard in Heartbeat to see if they had included a mention of the Birmingham City Council Health Scrutiny Committee decision on the Interim Reconfiguration plans, and the fact that the committee had referred the Emergency Surgery proposals to the Secretary of State and proposed that an Independent Reconfiguration Panel is convened. No that has not reached consciousness either, or if it has, it has been conveniently airbrushed away.

Heartbeat cannot claim to have the pulse of City Hospital until it accurately presents the facts whether they are palatable or unpalatable. I suspect an independently minded editorial team is needed. I would welcome the opportunity to write the front page for the July edition? Is anybody listening out there?

Finally I received another glossy brochure about Towards 2010. today. It presents an analysis of the public consultation, (I wonder how much this little lot has cost?) There were some additional papers entitled Public Consultation on the 2010 Proposals. There is a section "Service Transition" and it states and I quote "It has been a longstanding principle for the 2010 Partnership that the proposed new acute hospital needs to be almost the final element of the system to be put in place . This is based on the recognition that any other sequencing could mean that the new hospital was too small to cope with demand in the absence of the proposed community services."

Well what do you make of that? I am trying to get my mind around the timescales. Presumably the idea is that all the health centres, community facilities and community hospitals will be built and up and running by 2010 giving 3 years to build the new hospital so that it could be open by 2013??? Does this sound realistic? It sounds as if the money for the new hospital will be raised later, as you would not want to raise PFI money until you actually need to spend it. What happens if we cannot afford the last stage at all, or can only afford half a hospital??

Why not keep what we've got, ensure that the developments in the community go together with the new hospital build simultaneously, and work our socks off to achieve this as soon as possible?
I suspect people would feel that this a plan we could all get behind!

Medical Director Misleading Everyone?

When Dr Hugh Bradby was being interviewed on The Politics Show on Sunday 3rd June I believe that he misled the viewers. The piece opened with a brief interview with a gunshot victim that had been successfully treated at City Hospital. The patient made the point that City Hospital had saved his life. It moved on to a view of the A&E Department at City as the commentator said the management wanted to move the main Emergency Surgery Service to Sandwell Hospital while establishing a 24 Hour Surgical Assessment Unit and management maintain that this is an improvement. They then cut to Dr. Bradby being interviewed at Sandwell. He said "I would want treating where the best facilities were and all the evidence shows that you are far better off travelling further away to the best resourced department than you are to a local department that perhaps does not provide you with as good a service."

This is an outrageously misleading statement. What better resourced department is he talking about? Is he talking about the A&E Department at Sandwell? He cannot be because the patients referred to would be sorted out in City Hospital's A&E Department and the 24Hour Surgical Assessment Unit. If the plans go through they would then move to a ward bed at Sandwell if they needed longer than 24 hours in hospital. Currently patients are admitted to a bed at City. Is he telling us that Sandwell Hospital has better wards, more and better nurses, more and better doctors, less infection on the wards than City Hospital? If he is where is the evidence?

In fact patients moved to Sandwell Hospital will receive similar care to that delivered at City but they will have suffered the risks and inconvenience of an additional ambulance journey with all the attendant problems for their relatives. This extra journey would be occurring because the Trust has decided to make changes to emergency services that are not in the best interests of patients. This will not be better care but worse care that is why City Hospital Supporters are so opposed to it.

SWBH Plans Featured on The Politics Show

The Politics Show had a piece today about the controversial plans being considered at Sandwell & West Birmingham Hospitals NHS Trust. If you missed the program do not worry; you can watch the programme by clicking on this link and pressing the latest programme button on the right hand side (this should be available for the next week). The article starts 10 minutes 20 seconds in, although you may be interested in the piece on euthanasia which precedes it.

The programme started by interviewing an anonymous man who had been treated at City A&E for gunshot wounds, underlining the point that we are moving away emergency general & trauma surgery beds from an area with a high gun crime and stab wound incidence rate. When added to the fact mentioned by Councillor Deirdre Alden that when the General Hospital closed, Dudley Road Hospital was renamed City Hospital and we were told it would be the hospital for Birmingham City Centre, we have the main reasons why the interim reconfiguration proposals are so ridiculous. We reiterate again that we are not against the building of the new hospital and the investment outlined in Towards 2013/14 2010. We simply want to ensure that until the new hospital is built, and we have some proper plans for it instead of just spin and conjecture, services should remain at the same high quality they are now.

When Sue Davies, Trust Chair, responded to this point she said that Birmingham had three hospitals and so there was a choice where you can go. This completely misses the point. If you are being admitted for emergency surgery, you do not choose where you go. The Ambulance service takes you to the most appropriate local hospital. At the moment they can take you to City, which is roughly 10 minutes away from the City Centre. In future, they may decide to spend another 15 minutes taking you further down the road to Sandwell Hospital, or more likely take you to Heartlands or University Hospital. Either way, whether you are the victim of gun crime in Winson Green or have an accident in Birmingham City Centre, it will take the Ambulance longer to get you there.

Hugh Bradby, the medical director at SWBH, again used the argument that one is better off travelling further away to the best services rather than being treated locally in poorer facilities!!!! I have pointed out on this blog before in a previous post that I believe this statement is misleading. 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 then having to move them to a new site after an arbitrary period of time.

Another quote, this time from the programme was by Marie Welch, a mother of four who has two children with special needs. In response to the replacement of emergency paediatric beds with a 24 hour PAU at City she said to the Trust:

"If you lived my life, walked in my shoes you wouldn't do what you're doing. It would stay."

Sue Davies' response to this was that more and more children are now being treated in the community rather than in hospital beds. However, there is currently a shortage of paediatric beds in Birmingham which will be made worse by these proposals. We already see children being transferred to hospitals outside the City due to paediatric beds being at full capacity.

I must be honest that I felt a bit sorry for Sue Davies. The lady did not look comfortable defending the indefensible.

The presenter finished by pointing out that there is another Dr Taylor in the region who is an MP as a result of plans to change the local hospital services. Would Ken consider running for MP, he asked? Dr Ken Taylor replied that he was ruling nothing out!

I guess we will have to see what the outcome is of the referral of the surgical plans to the Secretary of State and the overall proposals to the Commission for Racial Equality.