Ms J Smith
Member of Parliament for Redditch
The House of Commons
London

Dear Ms Smith,

In the Worcestershire Acute Hospitals NHS Trust's Annual Report and Accounts 2004/05, Michael O'Riordan, the Chairman, states:-

'We still face a considerable challenge in securing the future of safe, affordable hospital services in Worcestershire. A major clinical service and financial review is already under way. We have pledged that the process will be open and transparent throughout.'

He goes onto write:-

'We are making efforts to engage with the communities we serve, so that they can help shape hospital services of the future.'

He continues:-

'(Our staff) are our greatest asset, and I am proud to be part of an organisation which boasts such an outstanding team, working in facilities that are the envy of many other parts of the country.'

I should therefore appreciate being told by Mr O'Riordan how I, as a member of the Redditch community, am going to have the opportunity to discuss the proposals when they are finalised in order that I can help shape hospital services. At the moment, I am left with many questions since the only information I have is what I have read in the newspapers.

1. Some of us will remember the strategy in the late 1990's called 'Investing in Excellence.' Despite widely reported protests from the Kidderminster community their hospital was closed as a general hospital. Also in this strategy, as I can remember, the A&E at the Alexandra Hospital would have closed, with a nurse led Minor Injuries Unit put in its place. In-patient maternity, gynecology and pediatrics would also have been transferred to Worcester . This strategy was reviewed because Worcester did not have sufficient capacity; indeed, many hundreds of thousands of pounds were subsequently spent upgrading the A&E at the Alexandra Hospital . Before I left the Trust as Chaplain Team Leader on 31 March this year, part of my role was listening to the concerns of staff. I was frequently told that patients had been transferred to the Alexandra Hospital from Worcester because Worcester was full. Bed Managers were often hard pressed to find beds for patients, in some cases leading to operating lists being cancelled. In the Critical Care Unit at the Alexandra Hospital I once worked with a family from Hereford . A member of their family had been transferred from Hereford to Redditch as there was no critical bed free mere, nor at Worcester . What has changed so that a previously rejected strategy is being proposed again? How has capacity increased? Would any extra capacity mean a Privately Funded Initiative development with its extra costs, or would it be in an existing publicly owned building? Would any additional capital costs be incurred? If so, to the detriment of what other areas?

2. Where is the financial deficit occurring? In senior managers' meetings details used to be given of each directorate's (both clinical and non-clinical) under or overspend, and whether at Worcester or Redditch . To have such figures would help us understand more deeply where difficulties lie and how they have occurred, how they have been addressed in the past and why this has failed.

3. Some people have commented that the county's financial difficulties lie at the door of the PFI Hospital in Worcester . How much does the private company charge for the lease of its building? How does this relate to a publicly owned building? What is the comparative maintenance cost per square metre between the PFI building and the Alexandra Hospital ? Is the 30 year contract with the private company such that the Trust cannot afford to review its services there and so has to make savings at the only publicly owned general hospital in the county?

4. Comments have been made about a future midwifery led birth centre in Redditch . Not long ago, following unexpected baby deaths, a report was published into such a centre at Kidderminster . My understanding is that part of the reason this birth centre was closed for deliveries was that there was no emergency paediatric cover on site. If Worcester is to be the only paediatric in-patient site, how can there be a midwifery led birth centre in Redditch which is 'safe'? If there is to be one, what has changed from when that report into the Wyre Forest Birth Centre was published?

5. If there are proposals to transfer some services to Worcester , and the number of orthopaedic operations, already agreed with a private company using the Kidderminster site, is carried out, would this have a further impact on the Alexandra Hospital ?

6. Would there be other uses for the vacated areas? Would there be any cost implication and how would this fit in with the savings needed to be made? If our 'working facilities.. .are the envy of many other parts of the country', why close them?

7. The proposals I have read in the newspapers deal only with clinical areas. What other options are available, including a review into senior and middle management structures?

8. Even the proposed closure of the general hospital at Kidderminster had a demoralising effect on staff, and many members of staff, some highly skilled, found jobs in other Trusts which paid at a higher grade, or in other areas of the local economy. If the Trust does value its staff, how is it going to prevent this happening? Or are there planned job losses?

9. The government has a commitment to reduce carbon emissions. Can Mr O'Riordan advise me how more traffic movement caused by decisions to end local services is going to help this? Doesn't the need to travel and the extra traffic increase health risks?

10. At present, as part of cancer services, if specialist treatments are needed, such as radiology, people in Redditch may have to go to the Walsgrave Hospital in Coventry , as the Alexandra Hospital is part of the Arden Cancer Network. This is inconvenient enough, but if Redditch patients are treated in Worcester and then need specialist services, where will they go? Is it to Cheltenham or Gloucester since Worcester is part of the Three Counties Cancer Network?

These are some of my questions. I hope mat in any future meetings you may have with Mr O'Riordan you may have the opportunity to raise these and other people's questions. I hope, too, that Mr O'Riordan will make his answers public in order to honour his commitment to openness and transparency, so that the true 'stakeholders', we who live in this area, will have a better understanding of the issues facing the county. I also hope that senior managers, not only local, but also at strategic health authority and ministerial level realise that health is not just a medical procedure, but also has to do with patients not being isolated many miles from home, but having easy access to the support of their family, friends and community. It is essential that managers find ways to maintain and improve our local services using the 'facilities that are the envy of many other parts of the country' both in Redditch as well as in Worcester .

Yours sincerely

cc. Mr M O'Riordan, Chairman, Worcestershire Acute Hospitals NHS Trust. Ms J Kirkbride, MP for Bromsgrove. The Rt Rev Dr P Selby, Bishop of Worcester The Rev D Rogers , Rural Dean, Bromsgrove and Redditch Deanery. The Editor, The Redditch Advertiser. The Editor, The Redditch Standard