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"NHS Concern" raises Concern about NHS

I suppose the title is not surprising.

Birmingham NHS Concern are a lobby group that deals with matters relating to the NHS in Birmingham. They have written two public letters to the chair of the City Council's Health Scrutiny Committee and to the Strategic Health Authority (SHA).

The contents are important to anyone concerned about health matters.


Birmingham & Black Country SHA Strategic Framework ? A Wider View

Thank you for allowing Birmingham NHS Concern to participate in the Health
OSC meeting on 14th March.

I am enclosing a copy of our letter to Mr P Spilsbury of the Strategic
Health Authority, expressing our continuing concern about their plans.

It is worth emphasising our disappointment at the inability of the PCTs to
address the issue of recruitment of skilled health professionals in Primary
and Community Health to replace those staff who would be lost if 1405 acute
beds were to be lost. It continues to seem reasonable to us that the 40%
increase in funding for primary and community care by 2010 should be
reflected in a somewhat similar increase in staff. After all, if 1405
acute beds were lost, at least 4000 skilled professionals stand behind that
number of beds and their services would presumably be lost.

We understand the decision of your OSC to be that you will continue to
monitor the situation and in particular the PCT Local Delivery Plans
(LDPs), but would appreciate a copy of your minutes and to be placed on the
mailing list for future OSC papers.

We recommend and hope that your committee will request that staffing plans
be included in future PCT presentations.

We raised the issue of the government target of 15% of elective procedures
being carried out in the independent sector. We understand from press
reports that the government has dropped this ill considered policy.
Nevertheless, we hope that you will monitor the effects of the replacement
policy on existing NHS facilities, which we believe could well be


SHA Strategic Framework ? A Wider View

Thank you for your letter of 10th March, which our committee has
considered. We agree that we had an interesting and constructive
discussion on 22 February.

We think it necessary to record that you overstate our position somewhat in
the second paragraph on the second page of your letter, relating t possible
future bed cuts.

Whilst we note that Table 15 (p 61) is now described as "Summary of
scenarios for changes in general and acute hospital bed use", as opposed to
"Summary of capacity changes" in Table 18 of an earlier draft, the very
specific proposal for 1405 bed losses "20% reduction) remains in place.

We continue to be concerned about the extent to which primary and community
care can be improved by 40%.

Our concerns were unfortunately deepened by the PCT's presentations to
Birmingham City Council's OSC on 14 March. The formal presentations did
not include plans for the recruitment of skilled health professional staff,
such as GPs, district and practice nurses, physiotherapists, and the liked,
by 2010.

We also noted that the major presentations to the OSC were made by South
and Eastern Birmingham PCTs, but we believe that the greatest problems are
faced by Heart of Birmingham and Northern Birmingham PCTs. Their areas
incidentally also face the greatest difficulty in delivering existing acute
care. City Hospital currently faces a financial deficit and closure of
wards and Good Hope has had a troubled record for a number of years.

Of PCTs envisage a reduction of 20% in acute beds, an equivalent volume of
healthcare must be provided in primary and community care. Whilst IT and
drugs play a role in this, actual healthcare has to be delivered by health
professionals, just as acute care in hospitals is delivered by health
professionals using IT, drugs and all the equipment available. You and the
PCT representatives did not show how the PCTs can recruit sufficient staff
by 2010.

In relation to the 15% Independent Sector target for elective treatment, we
understand from press reports that the government has dropped this. We
note your responses to our questions 7, 8, and 9, and continue to have
doubts as to whether there are likely to be any patient and quality
improvements from expanding private sector provision, purely as a matter of


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