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Society Fights Against Threatened Hospital Closure |
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Medical Society Fights Against Threatened Hospital Closure
At the end of the Society's annual general meeting there was a long and fruitful discussion on the subject of the Health Authority's threat to our hospital. There was unanimous agreement that the Health Authority's proposals were totally unacceptable and that they would return local medical services 'to the dark ages'. It was agreed that a letter should be sent to the Health Authority with copies to all with all vested interests including MPs and Press. In the rush to meet the deadline not all members were able to sign the letter, but even'~o a gratifyingly large number of members (70+) of all disciplines did append their signatures in a single day. The text of the letter was as follows :-
Strategic Framework Document
Worcestershire Health Authority 23rd October 1997
The undersigned are members of the Kidderminster Medical Society which consists of all hospital doctors, general practitioners, veterinary surgeons
and dental practitioners in Kidderminster and District. The Society was founded over a hundred years ago to promote understanding and cooperation between
all members of the medical and allied professions and has been closely involved with the development of the Kidderminster General Hospital.
We unanimously wish to condemn the process and management of the Acute Services Review, the options it has prepared (A - DJ and so ultimately Worcestershire Health Authority itself for agreeing to fulther consider these entirely unacceptable, i/l thought-out, destructive and unnecessary proposals. Concentrating first on option A which already seems to be the option preferred by the Health Authority; we find that far from improving the safety of secondary care within the county, this option undeniably suggests an unsound and even dangerous model of care for general medicine and midwife led maternity services at Kidderminster General Hospital. It would be categorically unsafe to admit patients as general medical emergencies to the hospital in the absence of an on-site general surgery service and full anaesthetic facilities. We can not and will not accept, for example, that conditions such as gastrointestinal bleeding, severe respiratory failure or indeed any critically ill patient could be safely admitted to a general medical service without essential back up facilities.
We also deplore the suggestion that a midwifery led unit could operate without back up obstetric and gynaecological facilities; it cannot be
challenged that a midwifery service without such vital backup facilities is inherently unsafe. The
plans outlined by the Health Authority therefore mean not only substantial downgrading of a District General Hospital but the subsequent complete
closure of a/l in patient services. Option B in the Strategic Framework Document is also completely unacceptable to us for the same reasons which
have been outfinedabove. We firmly believe that there would be insufficient capacity for all the---~ ( Ietter continued) secondary (hospital) care services which are planned for the new Worcester
Royal Infirmary Private Finance Initiative (PFI) hospital. This hospital was planned to take the current workload of Worcester Royal
Infirmary for the catchment population of South Worcestershire and not for the county as a whole. By closing the majority
of Kidderminster General Hospital in-patient services and transferring much of the Alexandra Hospital emergency
services to the new Worcester Royal Infirmary, the capacity of the new hospital to cope with such a workload, which was
already previously in doubt, will be completely overwhelmed. We do not accept that the 390 beds which are
proposed by the health Authority will be adequate to provide a safe and comprehensive service for the entire population of
Worcestershire County.
The proposed options relating to medical manpower and sub-specialisation as outlined by the Worcester Health
Authority we consider to be both destructive and unnecessary. The Authority is over-reacting to long-term 'vision
statements' of the Royal College of Surgeons and ignoring contradictory and conflicting advice and views being offered by
other authoritative bodies. Whilst we accept that certain complex conditions and
medical procedures need to be carried out by specialists in specialist centres, we do not accept that basic emergency surgery and medicine should be removed
well away from Kidderminster General Hospital and its local catchment area population. We do not accept that wholesale
closure of services and relocation of facilities is the answer to the relevant clinical issues. The alternatives have been
clearly enunciated by our members within the Health Authority Acute Services Review Working Groups but have been
consistently ignored. We wholeheartedly support clinical partnerships and collegiate working in the provision of specialist
services but these must evolve rather than be imposed. Appropriate investment can then be made to develop specialist
centres within the county. Premature closure before there is a superior and viable alternative is profoundly unacceptable.
We therefore unanimously demand that the financial recovery plan is separated from the above clinical
issues and that the ill thought out proposals of the Health Authority be dropped. The financial recovery plan itself is
undeniably tainted by the Health Authority's desire to sign a long term contract to guarantee the funding of the new
Worcester PFI hospital at a level which it cannot itself afford. There is no question that we support the need for a new
hospital in Worcester but feel that the PFt plan, as currently proposed, will place an unacceptable demand on the
resources of the whole county. The knock on effect on Kidderminster General hospital is therefore unjust and deplored by
all signatories. In this open letter, the Kldderminster Medical Society therefore unanimously condemns Worcestershire
Health Authority and it's Strategic Review options.
For the past 30 years that I have been in Kidderminster, the local medical
community - GPs and Consultants - have worked hard to improve the medical standards and
facilities in Wyre Forest, ably assisted by nursing and administrative staff. The result of their endeavours are
clear for all to see both in terms of the health of the local community outside of hospital; exceptional general
practice facilities with well above average immunisation and other parameters within general practice;
and equally in terms of Kidderminster General Hospital, which is the result of many hours of work by former and
present medical and surgical staff most notable being the late Robert Gibbins. All of our achievements were
based on the strengths of a united local medical community personified by the Kldderminster Medical Society.
As we all know, the hospital as we know it Is now under threat, being threatened by a Health Authority
bureaucracy, much more concerned with money and administrative tidiness than standards and
convenience to our local population. The Society has already acted by writing to Member of Parliament,
Community Health Council etc., but much more will need to be done to ensure survival of our local hospital. I
implore all Society members to do all in their power to change the thinking of the Health Authority.
If we lose the hospital we shall lose many excellent colleagues and eventually I fear for the Society itself.
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SAVE KIDDERMINSTER GENERAL HOSPITAL CAMPAIGN.
It is hard to write about the Campaign to save KGH as not only the goal posts but the playing field change
frequently. The Worcestershire Health Authority (WHA), having passed on 27th November six options for Formal
Consultation to start in December, without warning in mid December changed their mind and delayed consultation until
February. This made a nonsense of all the previous claims of urgency and the impossibility of delay, and emphasised the
incompetence of a Health Authority which cannot have produced realistic or complete financial details for the NHS
Executive (West Midlands) to sanction such a postponement. The tremendous pressure from the public including the dramatic march to the Town
Hall, hundreds of letters and over 66,000 signatures on the Shuttle's petition must have had some effect also. Mrs. Archer-Jones is on record as
saying that the amount of resistance to the WHA'S proposals surprised her - not altogether unexpected from someone
who has only worked within the NHS for a short time and in Worcestershire since 1 st October 1997.
Even though six options have been approved for Formal Consultation, 1 think that we will only know the final form
and details of these proposals when we see the actual option paper in February. At the meeting of the WHA on 27th
November both the Chairman and Vice-Chairman amazingly admitted that they did not know what form the final proposals would take.
Three facts are certain:
i) The WHA has a huge financial deficit. . .
ii) Worcester city needs a new hospital and the only way it can get it in the present1il'!8ncial and political climate is
through the Private Finance Initiative (PFI). This has recently been examined and reported upon very
critically by Declan Gaffney and Allyson M. Pollock working for the BMA'S Health Policy and
Economic Research Unit.
iii) The Royal Colleges, especially of the surgical specialties, are opposed to small hospitals on the grounds of
inadequate sub-specialisatjon and junior doctor training and supervision. They feel that the minimum size of a DGH
should be that required to serve a population of 500,000 people.
The only hope of preserving anything at KGH more than out-patient and day case work, with perhaps some
convalescent or recovery beds, is by : a) Persuading the Royal Colleges that their current recommendations for junior doctor training can only apply to large
urban areas and not to semi-rural counties like ours where the needs of widely spread and separate concentrations of
population must be balanced more reasonably with those of training.
b) Presenting an absolutely united front to the WHA and NHS Executive (West Midlands) from all GPS and all
consultants across all specialties about what must remain at KGH and what partnerships can be developed with other
parts of the county.
c) Mobilising "people power" to exert pressure at the highest levels possible to convince the authorities that the unique
excellence of KGH, that is neither sufficiently recognised or valued outside Kidderminster, has to be retained to provide an
adequate range of services for the 100,000 people who live within four miles of the hospital and for the more isolatedcommunities to the West who have
no acceptable alternative for hospital services.
The Campaign Committee has commissioned the King's Fund Management College to address the
first point (a) by designing a model for hospital services in a shire county that will meet with approval
from the Royal Colleges. The second point (b) has to be resolved by the local medical profession and,
to me, is the 'sine qua non' of success. The third point (c) can only be successful on the back of (a) and
(b) as demonstrated by the recent (justified) changes to paediatrics and obstetrics at
KGH.
Richard Taylor
OBITUARY
Harry Buchannan
It is with great sadness that I have to report the death of Harry Buchanan. Harry was a well loved
Kidderminster General Practitioner whose surgery was in lower Mill Street until the whole area was razed
to the ground by road developments after which his practice moved to the Health Centre in Bromsgrove Street.
My one abiding memory of Harry was at a Christmas party at the Croft in the late 60s when he
entertained us with superb aplomb on the piano to add sparkle to an otherwise dull party.
I hope to have a full obituary in the next edition of the Newsletter
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With something of a sigh of I relief I put pen to paper at the end of an unexpectedly enjoyable year as
president. Thanks in the main to David Malcomson my fears surrounding the organisation of the
social calendar proved much less of an ordeal than expected. We started with the mountain
bicycle ride through the Wyre Forest, exploring areas of the forest far from the usual signposted paths. The nice
thing about it was that everyone let
me win, but perhaps I was the only one treating it as a race. The day proved to be
unforgettable for a much more unfortunate and macabre reason, the discovery of a body
hanging from Arley bridge as we arrived shortly after dawn. The next event appealed to a
minority of the society, but identified
those who wasted hours of their childhood on station platforms or standing with their Ian Allan train
spotting note book by the line side. Colin Garret was an unusual man expressing political views which
bordered the extreme right wing to say the least but he he is a remarkable photographer
recording an extraordinary series of pictures of the last days of steam from numerous
countries of the world, I think that most of us enjoyed the annual dinner at Spring Grove i
House in May. We were ably: entertained by Phil Hammond the well known medical television and radio
personality. I have to say that I do not remember too much of the speeches; but perhaps that is a good
thing from what I have been told. The final event of the year was the garden party. the weather was
somewhat unkind but in fact the drizzle accentuated the scents and made everything look much better
than it had the week before after a period of drought. Maggie Herbert won the quiz. displaying an expert
knowledge of horticulture. 1 So my year as-president has ended, but with the worrying news of:
a threat to the viability of the hospital.: At-the AGM it was reassuring to i witness the strength of the society:
united in the determination to maintain an acceptable hospital
Steve Booth
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I am grateful for the honour of becoming President of the Kiddeminster Medical Society this
year and would immediately wish to pay tribute to the outgoing President Steve Booth, in whose footsteps I will
follow with some trepidation. His skilful and amusing introductions of the Years guest speakers has left me
in no doubt that his will be an impossibly hard act to follow" For my part, I would like to attempt some new
and innovative ideas, details of which will be circulated as soon as possible. Little did I realise when
accepting this years Presidency, that the most pressing issue at the time would be the Health Authorities
proposals - .. for" the future of Kidderminster General Hospital itself! My personal feelings on these issues
are very strong as are those or my Partners. I am gratified that there is also an abundance of commonsense
and clear thinking being expressed by other local colleagues on these important proposals"
Suffice it to say that the provision for GOOD SAFE MEDICAL PRACTICE is the bottom line - we
have it now and must strive to safeguard it for all our patients for the future.
Christopher Smith
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PLANNING FOR POSTGRADUATE CENTRE TO CONTINUE
It was agreed at the Annual General Meeting that we will press forward with our planning for the multi-
disciplinary postgraduate centre. An
architect has been appointed and plans are now proceeding for a 2 storey building.
The Health Authority's recent paper will not be allowed to put "planning blight" on the new centre,
reported appeals committee chairman
Paul Newrick.
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