ACUTE CAPACITY Birmingham campaign groups demand answers

Published: 24/03/2005, Volume II5, No. 5947 Page 8

Senior NHS managers from across Birmingham have reassured local campaigners that they will not impose a 20 per cent cut in hospital beds until replacement capacity is available elsewhere.

They were called to a meeting of Birmingham City Council's health overview and scrutiny committee last week to defend proposals from Birmingham and the Black Country strategic health authority that could mean the loss of 1,405 beds.

Campaign group NHS Concern is angry because it believes that the proposal was hidden away on page 61 of SHA strategic framework document A Wider View, published last May. Spokesman Gordon Will told the meeting he was outraged that the SHA plans to make the cuts while handing 15 per cent of elective work to the independent sector by 2008, in line with government expectations.

'This is a plan for 1,405 beds to go without any indication of where staff are going to come from or how primary care improvements are going to be delivered, and It is happening at a time when untested private sector organisations are being proposed to replace the NHS.' Representatives from the city's four primary care trusts, the SHA and a medical director from Birmingham Heartlands and Solihull trust tried to reassure campaigners that services would not be cut.

SHA director of health policy and strategy Peter Spilsbury was at pains to stress that acute bed numbers would only be cut when community services were operational.

He said A Wider View envisaged a move away from hospital care using proactive ways of limiting emergency admissions in line with the government target of a 5 per cent cut in emergency bed-days, improving primary care diagnostics and developing community strategies for chronic conditions.

South Birmingham PCT chief executive Graham Urwin pointed out that the SHA was ahead of elective admissions targets.

The next day, the Commons' public administration select committee (see story, right) quoted Mr Urwin's evidence, pointing out that, because Birmingham had not introduced private sector capacity in the past, it now faced 'a challenge in catching up'.

In the evidence, he said this meant capacity would be replaced by use of the private sector: 'There is not sufficient growth money. . . so we will have no choice but to look at opportunities for substitution, to look at current NHS work being carried out within the independent sector.' On the question of shifting care from acute sites to the community, Sparkbrook GP Bidhu Mayor told the scrutiny committee that locally intermediate care had not 'worked as well as we wanted'. But he said practice-based commissioning would encourage GPs to find ways of getting patients out of hospital into suitable settings more quickly.

But Mr Will was not convinced: 'We are expecting a mass wave of GP retirements and you talk about 40 per cent increase in spending [in primary care] by 2010. How will you recruit 40 per cent more staff?' East Birmingham PCT chief executive Sophia Christie told Mr Will that 40 per cent rise in activity did not require 40 per cent more staff.

'It is about new ways of prescribing, new ways of tracking patients and intervening.

'I would be very wary of measuring efficiency by the number of beds - That is a very 1950s model.'