Monday, December 01, 2008

A Difficult Year for City Hospital

As we enter the last month of 2008 it is worth reflecting on where City Hospital stands.
Internationally and nationally there have been seismic changes in the economic and financial situation. The very foundations of capitalism have been shaken to the core. The nation, heavily in debt, is being exhorted by the government to spend its way out of recession as people struggle to pay their bills. Get yourself more in debt to save the nation seems to be the plan.

Is this going to make building a new hospital easier or more difficult? The government at one time talked about trying to avoid unemployment by proceeding with more public building projects. However all public building projects costing more than £1 million have to be funded by the Private Finance Initiative. I may have missed it, but I do not think PFI, surely one of the greatest follies of both Tory and New Labour governments has been suspended temporarily or permanently. Therefore the Sandwell and West Birmingham Hospitals NHS Trust needs a commercial enterprise to loan them the £350-400 million required so that they can waste taxpayers money paying 6% interest to fat cats. How likely is this to happen in the present climate as many of the fat cats have gone to ground? The Strategic Health Authority has asked the Trust to delay the new build once this year so that the putative date is now 2015. However after what has happened recently that date seems overly unrealistic. There is of course outline planning permission from Sandwell Council for what it's worth.

The construction of a 24 hour Surgical Assessment Unit by refurbishing a ward is under way at City Hospital, and when it is complete we will see acutely ill surgical patients needing longer than 24 hours in hospital bundled off to Sandwell. It is clear that this is no short term arrangement. The local people will have to live with it for a long time. Meanwhile we still wait patiently for the Equality Commission to say something meaningful about the question they were asked by City Hospital Supporters back in the Spring of 2007. Perhaps somebody can explain to me the point of having an organisation with an impressive name like the Equality Commission? When asked to adjudicate on an important question of racial equality affecting the lives of many people it takes 18 months and appears to have got precisely nowhere. The matter has been passed on to some other individual. The workings of this organisation as far as City Hospital Supporters are concerned have been totally opaque. I fear the only conclusion to be drawn is that England has an Equality Commission so that we can say we have one. The box has been ticked, but in reality nothing is being done, at least for the citizens of West Birmingham.

The Sandwell and West Birmingham Hospitals NHS Trust has a very important campaign running at the moment. It is called "Listening into Action." I think I can hear your hollow laughter. I believe management consultants have been involved with this exercise and now every member of staff has been sent a DVD on the subject which apparently only cost 40p per person! The thrust of Listening into Action is that managers should take note of what front line staff are saying and incorporate their ideas into management decisions. This was applied to a ward and apparently it made a big difference. Gosh isn't that truly amazing! Perhaps a Nobel Prize for management is in the offing. It would not surprise me in the upside down world that is England in 2008. Any manager worth his/her salt knows that it is essential to listen to the people working at the coal face and the customers.

What a pity the Trust were not prepared to implement Listening into Action over their consultation questionnaires for the Interim Reconfiguration. Local people rejected their plans resoundingly as did the consultant medical staff at City, but the only action that followed was implementation of the plans regardless of the views expressed.

Interestingly some planning towards the new hospital has been taking place but Listening into Action has not been applied to consultant medical staff once again. Apparently there will be no room for offices for consultants if and when the new hospital is built. This is another stupid short-sighted decision. The consultant medical staff of a hospital are fundamental to its success. You need to attract the best calibre candidates to look after the local population. You need to encourage doctors to stay on site and be available to support junior and nursing staff. They need somewhere to have one to one meetings in private. They need somewhere to hang a coat and a desk to sit at. Somewhere to work on case notes, referrals and all the activities that go with being a consultant. No office sends the message to them that they are not valued and their role is not understood. It will encourage them to leave the premises as soon as they have completed their contracted hours. I would suggest that if accomodation is tight because the new build is on a shoestring, they should make managers not involved directly in providing or supporting clinical care redundant, especially those on the higher payscales. This would save valuable revenue for more important activities and free up offices for consultants.

Talking about saving revenue I note that the Trust's Communications Team or should that read Propaganda Team consists of ten individuals plus a chief! Wow big bucks there, it must be costing a fortune and think of all those offices. If we had fewer propagandists could we afford more nurses? Now that would be putting Action into Listening!!

And so another year draws to its close. What is in store for the NHS? In one word AUSTERITY. Literally millions and probably billions of pounds have been wasted pouring money into an NHS fundamentally badly managed. It is not in good shape to withstand the cold wind of the new economic climate we are now facing.

The number of emergency medical admission at City continues to rise inexorably. The Accident and Emergency Department is doing a fantastic job under enormous pressure. In my PERSONAL view the best Christmas present for the people of West Birmingham and Smethwick would be a sudden change of tack, with agreement to build a new hospital on the existing Dudley Road site. Sandwell Hospital would be welcome to join in.

I do not believe this would delay the new hospital because I do not believe the present plan is viable. Is it possible for us to see a change of plan? Anything is possible. Maybe a change of government would help. Undoubtedly City Hospital Supporters need to start making their views known in no uncertain terms.

Happy Christmas to you all. Ken Taylor

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