New Year's Demo at City

Despite the best attempts by the powers that be to bury the bad news, demonstrators turned out yesterday to campaign against the downgrading of City Hospital's A&E service which was recently rubber stamped by the government funded "Independent" review panel. This article in the Stirrer implies that it is a stitch-up by Sandwell, but I am not convinced; this whole episode is just another example of the incompetence of the Trust board that happens to be less worse to Sandwell than it does Birmingham. After all, as the article points out, if the new hospital ever gets built, Sandwell effectively loses its hospital, despite claims to the reverse of the Trust Board.

Well done to all those who turned up. The fight is not over.

A Very Constructive Meeting

Thursday 4th October finally arrived. Bringing the City Hospital Supporters team together did give me moments of anxiety, but we made it in the end with four members of the local community, two GPs from the area, two Acute General Surgeons, two Trauma and Orthopaedic Surgeons, a Senior Physician, a Senior Paediatrician, a representative of all the non-medical staff at City Hospital and yours truly.

We met four Panel members with two from their Secretariat. The IRP arranged to record everything that was said so the Anne Gibson Room was wired for sound. The Panel arrived promptly at 2pm and there were introductions all round. The Panel began by explaining to City Hospital Supporters what they had been doing so far. I then began our presentation using Powerpoint and after about half a dozen slides handed over to the members of the local community and the GPs.

Members of the community stressed to the Panel the importance of having City Hospital providing a comprehensive range of Emergency Services that were fully supported. They stressed the terrible problems the locality faced. They spoke from first hand as either their families or their friends had needed care at the hospital. They spoke very highly of the care that they had received there.

One lady had thoughtfully travelled from City Hospital to Sandwell Hospital on the bus and back again. It had taken 1 hour and 35 minutes, excluding waiting time and cost £4.80. She had also tried it by car on two occasions, considerately avoiding the rush hour. The mileage for a single journey varied between 5.1 and 5.9 miles depending on route, and the time taken had varied between 20 and 35 minutes. On arriving at Sandwell a very real problem was the parking. For completeness our thoughtful member enquired about the cost of the taxi fare from City to Sandwell and it was £8 each way. During the presentation it was pointed out to the Panel that 50% of our population relied on public transport.

The GPs just could not understand why the Trust wished to lose Emergency Surgical and Children's beds and they felt it was quite unacceptable. They were very complimentary about City Hospital saying that it was the hospital that accepted emergency referrals with alacrity and without question. They also both made the important point that GPs on the patch had not been consulted. Perhaps one or two GPs with management roles in the Heart of Birmingham Primary Care Trust had given their views on the Trust's proposals, but it would seem those views were not aligned with their colleagues at the coalface. Prior to the meeting the most senior GP had confided to City Hospital Supporters that he did not wish to be identified because he was concerned about the possible consequences and he felt the same applied to many GPs in the area.

The Panel went on to hear about City Hospital Supporters concerns about the failure of the Trust to conduct a proper Impact Assessment of their proposed changes to the service on the different ethnic groups served by the Trust. The absence of any mention of the problems of going out to consultation with such an ethnically diverse and socio-economically deprived population in the specification for the contract for the consultation process.

It was a long list of problems which included a failure to mention in plain language of any description that the important consequence of implementing the Trust's plan was that sick children and surgically ill adults needing longer than 24 hours in hospital would face a further journey by ambulance for no medically justifiable reason.

Further problems with the consultation that were touched upon included a failure to circulate the document to the target population, a need to be able to leave a message on an Answer Phone in English or navigate a website in English to be able to download a version in the relevant language. A lack of awareness that an inability to read in that language is not uncommon. City Hospital Supporters had looked into the English reading age required to comprehend the document Shaping Hospital Services for the Future. It was in excess of 17 using the Fry Readability Graph which is the reading age required for a newspaper such as the Times. Using the Frisby Formula the Reading Ease Score was 27 indicating 4.5% of an average population would understand it and the IQ required for comprehension was 126+ which is superior and required for reading a scientific magazine.

The Panel heard that of the consultation forms returned only 15.6% were from the Black and Ethnic Minorities, whereas they represent 45.9% of City Hospital's inpatient population. It was also pointed out to them that the Black and Ethnic Minority population of Sandwell Hospital is 13.4% and all these figures are either the Trust's own data or from QUAD RESEARCH who conducted the consultation. A key issue that emerged here was that City Hospital patients containing three times the Black and Ethnic Minorities attending Sandwell would be the ones to receive an inferior quality service. The Panel were reminded that a complaint has been made to the Commission for Racial Equality. This is currently being processed although it is delayed because the CRE is changing to become the Commission for Equality.

At this stage the Panel were reminded that in spite of all the problems with the consultation the Emergency Surgical plan had been rejected by 47% to 31% and losing Inpatient Paediatrics at City by 46% to 29%. The margins were likely to have been wider if the target population had been properly consulted.

We moved on to the Consultant Ballot that rejected the proposed changes to Emergency Surgery and Children's Services by a majority of 97% of those voting, where the turnout was 60% and the overall majority 58%.

Subsequent meetings of City Hospital's Medical Staff Committee rejected the concept of sick patients of any specialty arriving at City Hospital and having to be moved to another hospital for non-medical reasons, putting them at increased risk and the whole family to enormous inconvenience.

We went on to consider the reasons that the Trust had chosen Sandwell Hospital as the site for concentrating Emergency Surgery. City Hospital Supporters were perplexed that no single reason was put forward about any benefit for Emergency Surgery patients and indeed the last reason put forward by the Trust was that if patients were really stuck there were other hospitals in Birmingham that they could go to such as UHB or Heartlands!

We then looked at the reasons put forward by the Trust for proposing the changes, and then went on to hear from the doctors directly concerned. These reasons were rejected quite emphatically. It was at this point that the Panel invited the surgeons to come forward with their plan ensuring that they were able to meet the necessary requirements. Our surgical colleagues have accepted the challenge and have gone away to commit their plan to paper and present it to the Panel in the near future.

The Children's doctor present handed to the Panel a document setting out the plan from the Children's doctors at City Hospital that would retain some beds at the hospital, meet all necessary requirements and save the Trust £500,000 a year.

Nearly two hours had passed remarkably quickly. It had been a very good meeting. The Panel had been extremely attentive and had asked some searching questions. There was good interaction between the Panel and City Hospital Supporters. We thanked each other and then thankfully retired for tea and Panel members then faced the long journey home. We were most grateful for their time and trouble.

There is one very troubling issue, and that is Children's Services. Unfortunately the Birmingham Council Health Scrutiny Committee did not refer Paediatrics to the Secretary of State for Health back in May this year just Emergency Surgery. It is City Hospital Supporters belief that the Scrutiny Committee may have been misled and this is being pursued. It would appear from everybody but the Secretary of State that the IRP are not able to consider Paediatrics. This seems to be a remarkable example of where due process is getting in the way of doing the right thing. It is clear to City Hospital Supporters that a grave injustice is being done to the people served by City Hospital. Emergency Surgery has the chance of reprieve, but the little children are condemned to an inferior service. Can that be right?

After this meeting I went home and had another look at the letter from the Secretary of State for Health to the Chairman of the IRP Dr. Peter Barrett. I am reproducing it here because I feel it is important for others to see it:

From the Secretary of State for Health Alan Johnson to the Chairman of the IRP Dr. Peter Barrett.

"TERMS OF REFERENCE
The Panel is asked to advise the Secretary of State by Friday 30 November 2007:
(a) whether in the light of the grounds of referral as set out in the correspondence from the Birmingham Health Overview and Scrutiny Committee to the Secretary of State of 18 May 2007, it is of the opinion that the proposals to consolidate emergency surgery provision at Sandwell Hospital, as set out in the decision of Sandwell and West Birmingham NHS Trust Board on 10 May 2007 will ensure safe, sustainable and accessible services for the people of Sandwell and West Birmingham, and if not, why not;
(b) ON ANY OTHER OBSERVATIONS THE PANEL MAY WISH TO MAKE IN RELATION TO THE PROPOSALS FOR CHANGES TO EMERGENCY SERVICE PROVISION AND IMPLICATIONS FOR ANY OTHER CLINICAL SERVICES;
(C) IN THE LIGHT OF (A) AND (B) ABOVE ON THE PANEL'S ADVICE ON HOW TO PROCEED IN THE BEST INTEREST OF LOCAL PEOPLE."

Now if that does not apply to Paediatrics I do not know what else it can be. I have written to the Secretary of State pointing out my concerns that his letter is being misinterpreted somewhere, I suspect in the Department of Health. I did get a reply to my letter not from the Secretary of State, but from a Mr. Alan Addison in the Customer Service Centre of the Department of Health. He closed the door firmly on the little children citing the Birmingham Scrutiny Committee as the reason.

The question is should we just accept the word of somebody in the Customer Services Department of the Department of Health. I am not their customer. City Hospital Supporters are not their customers. The children of West and Central Birmingham are not their customers. They are potential patients needing high quality patient care when it is required by their local hospital without facing any increased risks or inconvenience. City Hospital Supporters is going to continue to fight for them and for their right to TRUE EQUALITY OF ACCESS TO HIGH QUALITY HOSPITAL CARE.

DO YOU THINK WE ARE RIGHT OR DO YOU AGREE WITH MR. ADDISON IN CUSTOMER SERVICES AT THE DEPARTMENT OF HEALTH?

WE NEED YOUR SUPPORT ON THIS ONE AND THE CHILDREN CERTAINLY DO!
LET US HAVE YOUR COMMENTS PLEASE.

A Very Good Meeting.

Last Tuesday 4th September the City Hospital Supporters Group had one of its regular meetings
We learned that we have over 200 members and we are about equally balanced between members of the local community and members of staff.

Members heard from Ken Taylor a detailed report of all the activities since the last meeting at the end of April.

They took careful note that the Trust's Interim Reconfiguration plans have been referred to the Commission for Racial Equality.

They were very pleased at our success in persuading the Health Overview and Scrutiny Committee to refer the Emergency Surgery proposals to the Secretary of State and his subsequent referral to the Independent Reconfiguration Panel (IRP.)

There was great disappointment that Children's Services had not been referred but everybody felt we must do all that we can to stop City Hospital losing its Children's beds. The members felt that local people would get a much poorer service for their children as a result. We will continue to press for children to be included in the IRP review. Everybody agreed that if it was poor patient care to make adult patients travel on unnecessary ambulance journeys to Sandwell or elsewhere, why is it OK for the children. Have people taken leave of their senses? A referral to the Health Service Ombudsman on the Children's issue could be the next step.

Since last week's meeting we have heard that City Hospital Supporters will be meeting the IRP on the afternoon of the 4th October. We will be fielding a strong team of people from the local community, some patients and doctors and a staff representative.

Members deplored the fact that Postgraduate Centre staff had been cautioned by management for helping the Group to communicate with staff. They also heard about the problems with staff accessing the website from some computers within the Trust. The two questions everybody asked were do we still think we are living in a democracy, and is it right that those paid their wages out of tax payers money can treat fellow citizens in this way?

We heard the good news that we continue to maintain a satisfactory financial position and members were impressed at the value for money they had been getting.

It was agreed to meet again when we have the result of the deliberations of the IRP to decide our next actions.

The Holidays Are Over!

September is here already and the new term is almost upon us. A fateful few weeks lie ahead for City Hospital its patients and staff.

The key event this week is the meeting of:

CITY HOSPITAL SUPPORTERS GROUP ON TUESDAY 4TH SEPTEMBER AT 12.30PM IN THE ANNE GIBSON ROOM AT CITY HOSPITAL.

At this meeting members will be able to hear about all that has been happening with the campaign over the summer. Additionally there will be the opportunity to approve the thrust of our proposed presentation to the Independent Reconfiguration Panel when it visits Birmingham during September and October.

Please do your best to attend this important meeting.

YOU KNOW IT MAKES SENSE!!!!

It is turning out to be quite a week. There has been the excellent paper from the people at Sheffield showing that the further seriously ill patients are transported to hospital, the greater the risk and the higher the mortality.

Why is this so amazing I can here everybody asking? We all knew that, it's only common sense! Yes but nobody has done a careful study and proved it to be a fact until now. Now it has been done and the results are unequivocal.

Now we have the evidence it should influence policy. As a physician I always try to practise evidence-based medicine. Surely the organisation of care should be evidence-based? Indeed one of the great causes that I believe the entire medical profession would unite behind is that government should use available evidence as the basis for all its health policies and plans.

I suspect the profession would also agree that there are serious issues with the advice that government receives. This should be about "horses for courses." If you want advice on emergency medical care, ask a doctor who has a great deal of experience in that area.

Another pitfall is building your plans around a collection of individual professional perspectives. The Cancer Tsar will have one set of recommendations, the Heart Tsar another and so on. They could well pull in quite different directions. Add in various statutory requirements such as the EWTD and MMC and you have all the ingredients for a complete shambles.

Common sense and talking to patients over many years brings out the really important themes. Patients want to see their GP when they are ill. When they are acutely ill they would also like to see the GP, preferably the usual GP. Patients think continuity of care is quite important. They like doctors and nurses that understand them. People they can trust. How can you trust anybody when you have only just met them once? Trust is built over time. They do not want GPs masquerading as Consultants or vice versa. They do not want nurses replacing doctors or health care assistants replacing nurses. Informed patients understand the "concept of dumbing down" and the affluent and insured consult the internet and find their specialists.

When patients are really ill they want to go to their local hospital until they are better. They would like their common serious illnesses managed under one roof but appreciate they may have to be moved for something very clever. They do not believe that closing or downgrading their local A&E Department is an improvement and suspect ulterior motives quite rightly in my view. They are also quite rightly extremely suspicious and sceptical about treatment in or nearer their own homes. They also find this difficult to equate with losing services from the local hospital.

Now how does all this bear on City Hospital. Well under current plans the sick children and surgical adults would have to face that additional ambulance journey of six miles minimum, more if Sandwell had run out of beds. Current plans clearly do not make sense.

Lastly I hear from Louis that the Sandwell and West Birmingham Hospitals NHS Trust has blocked this website for the staff at City Hospital. I wonder why? Has hospital productivity fallen because everybody is so busy eagerly scanning this website? I doubt it. Could it be something to do with preventing the staff hearing the other side of the argument? When an organisation blocks freedom of communication warning bells should be sounding. It suggests they are on the wrong course. A healthy organisation is one open to and welcoming of criticism and confident enough in its own evidence-based decisions to allow all its staff access to all the arguments. I suspect banning us will lead to more hits than ever so we must watch the website monitor most carefully. (Update 29/08: The website appears to be accessible from Trust premises again. Someone must be paying attention!)

ANOTHER REMINDER.

CITY HOSPITAL SUPPORTERS GROUP MEETING TUESDAY 4TH SEPTEMBER 12.30PM ANNE GIBSON ROOM CITY HOSPITAL.

Next Meeting of City Hospital Supporters

Will be on Tuesday 4th September at 12.30pm in the Anne Gibson Room close to the Postgraduate Centre. It is a meeting open to all members of the Group and I hope as many as possible will attend.

It will be an opportunity to hear about all the activities over the summer, and discuss the imminent visit of the Independent Rconfiguration Panel to Birmingham to review the Trust's plans for Emergency Surgery. We have not received any dates as yet but understand it wil be during September and October.
Please do your best to join us.

Good News and Bad News.

The combined Health Overview and Scrutiny Committees for Birmingham and Sandwell Councils met at the Sandwell Council House at 10am today with representatives of the Sandwell and West Birmingham Hospitals NHS Trust.

The Trust had arranged for their appointed medical experts all Sandwell based doctors to be there with one very notable exception, Mr. Peter Ahee the Director of A&E at City Hospital. Dr. Ken Taylor was present representing City Hospital Supporters and he was permitted to contribute to the meeting.

The QUAD team again presented their data on the consultation. There was some discussion on the Towards 2010 proposals but there was general support for the new hospital but concern about how the proposals for the community component would function with the hospital.
The reconfiguration proposals were then discussed after the QUAD team had again presented the consultation results demonstrating very significant opposition to the Trust's proposals on Emergency Surgery and Paediatrics at City Hospital. Great concern was expressed that the data indicated that there had been inadequate participation by the ethnic minorities in the consultation process. It was appreciated that had more of this population expressed their views it would have made opposition to the proposals even more overwhelming.

The debate that followed on reconfiguration was extremely lively with the Chair of the Birmingham Committee Deirdre Alden expressing the very great concerns her councillors had about both Emergency Surgery and Paediatrics. Peter Ahee the Director of A&E at City once again made clear to Councillors that two thirds of the children, and two thirds of adults with surgical illnesses brought to City Hospital A&E would have to move by ambulance to Sandwell or elsewhere because they needed to stay in hospital longer than 24 hours. This is a key point as these patients would be subject to unnecessary ambulance journeys that would put them at increased risk.

I spoke briefly at the end of the meeting making clear City Hospital Supporters were fully supportive of the new hospital on the Grove Lane site. Our concern was to ensure no deterioration to emergency service provision at either hospital while we awaited the new hospital which was no more than a preliminary plan at present. I made clear that unnecessarily moving patients in ambulances and exposing them to increased risks was not acceptable especially as the Trust had rejected options that would preserve fully supported emergency services on both sites. I pointed out that however flawed, the consultation had roundly rejected the Trust's plans. I also mentioned that our petition had supported 24 hour Assessment Units in Paediatrics and Surgery and opposed moving beds in these specialties from City to Sandwell.
This meeting ended shortly afterwards at about 12.10pm.

The Birmingham Councillors then met until about 1.10pm and I was fortunate to be present when Councillor Alden announced the results of their deliberations. Emergency Surgery was to be referred to the Secretary of State for Health. The Scrutiny Committee were very concerned about the proposals for Paediatrics and she would be writing to West Midlands Strategic Health Authority to express her concerns. I believe there was mention of some monitoring and also some conditions. I will be seeking early clarification on these issues.

We now have a further great opportunity to influence the debate in the interests of patients. We will make sure that we present evidence to the Independent Reconfiguration Panel that will presumably be convened by the Secretary of State. The decision on Paediatrics is a setback but there are several avenues to be explored in this area, and this you can rest assured, we will be doing. Watch this space!

Trust Make Decision on Interim Plans

On an e-mail sent to staff on Friday, the Chief Executive announced that as a result of the consultation exercises held earlier this year there will be a 24-hour Surgical Assessment Unit (SAU) and a 24-hour Paediatric Assessment Unit (PAU) at city to support the A&E department on this site. This means that the petition we submitted to Birmingham City Council's Health Scrutiny Committee has been successful. However, it also means that emergency inpatient paediatric and general and trauma surgery beds will be removed from the city site. In other words, after 24 hours after being admitted in an emergency, children will have to be transferred to either Sandwell General or Birmingham Children's Hospital, and general and trauma surgery patients will be moved to Sandwell Hospital.

If you have issues with this I suggest you turn up to the public Trust Board Meeting at the Wolfson Lecture Theatre in the Postgraduate Centre at City on Thursday 10th May 2007 at 2.30pm and make your feelings known.

CHSG Expands Campaign

At the meeting of the City Hospital Supporters Group on the 24th April 2007, it was unanimously agreed that the scope of the group should be extended to include the effects of the reconfiguration plans on Sandwell Hospital and the community it serves. There are many concerns among the Sandwell staff and community about the provision of acute healthcare in the borough when the two current acute sites are merged onto a single site, which will be close to the present City location.

The main role of the City Hospital Supporters Group until now has been to increase awareness and participation in the consultation process, and to present a petition opposing the interim reconfiguration plans to Birmingham City Council's Health Scrutiny Committee. This month the Trust will announce the results of the consultations and its plans for the interim reconfiguration plans and the Towards 2010 project. It will be doing this on Thursday 10th May 2007 at 2.30pm in the Wolfson Lecture Theatre in the Post Graduate Centre at City Hospital. We would urge everyone who can make it to be present at this meeting, because it is important that the Trust is reminded of the strength of opposition to these proposals should they decide to proceed with them. A large turnout from those of us opposed to the Trust's reconfiguration plans will be a timely reminder to the Trust board that they exist to serve us, the staff and community, and not the other way round. In the recent past, it is clear that the Trust board has expected the local community to change to accommodate their plans. This was unacceptable, and although some movement has been made towards more acceptable outcomes, we still need to remind them of our concerns to ensure that we maintain the best possible acute healthcare services for the local community in the short to medium term.

Letter to CHSG Members 11/04/07

The following letter was sent to City Hospital Supporters Group Members on 11th April 2007. If you wish to attend the meeting on the 24th April 2007 you would be more than welcome, even if you are not currently a member.

Dear Member,

The consultation period for the reconfiguration of services within the Trust ended on the 15th March. We marked this important milestone by presenting a petition of 1150 signatures opposing the Trust's proposals to Councillor Deirdre Alden the Chair of the Birmingham City Council's Health Overview and Scrutiny Committee. As you may know this important committee has rejected the reconfiguration proposals. As a result of public pressure so far, the Trust has changed its stance on Paediatrics and we believe they have opted for a 24 hour Children's Assessment Unit. This is better than nothing but it will not be as good as the present service. Ill children needing more than 24 hours in hospital will still have to be shipped elsewhere and ambulances may take seriously ill children elsewhere right from the start.
We await progress in surgery, and understand that the Trust is considering either a 24 hour Surgical Assessment Unit or maintaining the status quo. The latter would be infinitely preferable as the former would again mean that seriously ill people would have to be moved after 24 hours or once again the ambulance service may decide to take them elsewhere. Our goal has always been to ensure that local people do not suffer a worse service while they await the new hospital which at the moment is at least 6 or 7 years away. We are also concerned that if the new hospital either never happened, or was seriously reduced in size, services lost from the present City Hospital would never be regained for the people of Birmingham.
I believe that people within City Hospital and in the community realise that City Hospital Supporters have had an important influence on the consultation to date. I also believe that there is still a major job of work to be done (1) to ensure we get the best possible result announced in May (2) to ensure that all services continue at both City and Sandwell while we await the new hospital and (3) to ensure that the new hospital is delivered as promised. We have exclusively represented the interests of City Hospital over the reconfiguration because broadly it is the services at City Hospital that are in jeopardy. However now is the time for us to consider the full picture and I would like to see a City and Sandwell Hospitals Supporters Group. I know that many others at both hospitals share this view. In our small way we have demonstrated that ordinary people on the staff and in the community can influence events. Working together is the key. Do come to our next meeting when we will be very much considering the future.

TUESDAY 24 APRIL 12.30P.M. ANNE GIBSON ROOM CITY HOSPITAL, NEAR POSTGRADUATE CENTRE.
Yours sincerely,

Ken Taylor

NHS Day of Action @ BTC

As part of the NHS Day of Action there was a small meet-up outside the Birmingham Treatment Centre to protest against the reconfiguration plans proposed by the Trust in the document Shaping Hospital Services for the Future. A small group turned out to hear from Chris Rickards (UNISON Branch Secretary, City), Esther Lowe (UNISON regional organiser), our very own Ken Taylor (Spokesman, City Hospital Supporters Group) and Malcolm Cantello (President, UNISON), as well as an impromptu speech by local resident Rageev Hassan on his successful efforts at door-to-door petition signing on behalf of the group. Ken Taylor claimed it was the first time he had ever got on a soapbox (which given the number of the campaigns he has been in over the years sounds quite surprising) and this indicated the seriousness of the current proposals. Entertainment was provided by a marvellous steel band, and there was some media coverage including a reporter from the Birmingham Post and a Midlands Today camera crew as well as yours truly of course.

A coach took most of the people on to the main rally in Victoria square that was part of the national day of action. I left with a copy of Socialist Worker, a RESPECT leaflet and a flyer for a trade union meeting. It was just like being a student again...

NHS Day of Action at City Hospital

Next Saturday (3rd March 2007) the City Hospital Supporters Group are holding a Day of Action at the front of the hospital on Trust property with the permission of the Chief Executive. There will be a marquee and at about 10am we will be joined by TUC members from around the Midlands on their way to the big Save our NHS Rally in the City Centre. Starting at 10.15am there will be some speeches, and we hope to have Khalid Mahmood MP among the speakers. There will be an opportunity for people who have not done so already to complete their consultation forms and the petition.

City Hospital needs you there to demonstrate your solidarity with our cause. The people who work there and the members of the community it serves have to be the ones that stand up and support it. Please come, even if it is for just a short time and bring your family, friends and anybody else that wants to support a great hospital doing a great job. The bigger our demonstration the more publicity our cause will receive giving us the best chance of being heard (you might even get a chance to be on TV!). Come and support City Hospital. You are needed now.

E-mail to CHSG Members

The following letter was sent out today to members of the City Hospital Supporters Group via e-mail with details of the next meeting.

CITY HOSPITAL SUPPORTERS GROUP

Dear Member

There will be a meeting of the City Hospital Supporters Group next Wednesday 31st January from 1245-1345 in the Coffee Lounge, Postgraduate Centre. Tea and Coffee will be provided.

Come and hear of the progress made so far, the positive feedback, and plans for future events.

Come and share in the brainstorming session to offer your ideas of ways to reach more people in the hospital and the community, to inform them of the plans, and invite them to make a response.

One suggestion is for a leaflet drop in the area. Could you spare half an hour to push some Green booklets through the doors in a road where you live, or work? You may have other ideas. Every little helps and your contribution is important. The plans are not set in stone; if enough people stand together, the Trust will be forced to listen. We can make a difference – come along and show your support for City Hospital.

Ken Taylor, City Hospital Supporters Group

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.

The Birmingham Mail's Big Debate

The Birmingham Mail is organising a public meeting to debate the planned changes at City and Sandwell Hospitals. It will take place at 6pm on Tuesday 16th January 2006 at the Afro-Carribean Centre, 339 Dudley Road, Winson Green, Birmingham, B18 4HB (for a map of the area, please click here). This is a fantastic opportunity to quiz the healthcare bosses about the planned changes at City and Sandwell hospitals, and we would urge as many people as possible to turn up and make your views known in the presence of the local media (Midlands Today will probably also be covering this story).

To see an online version of the Evening Mail article, please click here.

The Website of the Afro Carribean Millenium Centre is http://www.acmccentre.com/acmc.shtml

Public Meetings

Below is a link to a pdf document which contains times and dates of public meetings that are being attended by the the two public consultation teams. We encourage you to attend these meetings and make known your opinions regarding the interim reconfiguration plans for City Hospital.

www.swbh.nhs.uk/latest_news/documents/Consultationmeetings.pdf