Jacqui challenges report into maternity services - where is the medical justification?

Mr Michael O'RiordanWorcestershire Acute Hospitals NHS TrustChairmanWRI SiteRonkswoodWorcesterWR5 1HN 17 October 2006 Dear Michael Thank you for taking the time to receive my petition opposing the loss of birthing services at the Alex. I hope that you recognise that there is significant public concern about these matters. I am very concerned about the justifications that the Trust are relying on to inform their decision making process. We have discussed before the issue of key staff recruitment. I was pleased to hear that there are no vacancies for neonatal nurses at present. However, I was disappointed to learn that the Trust were “forced” to recruit at Trust level rather than to the Alex alone and of the inference that this was a less than ideal solution. In fact, that attitude is at the heart of the difficulties that the Trust has now and has faced time and again in the past. The Trust was established to enable it to share resources (including staff) to the benefit of patients. It already recruits staff in several disciplines to work in more than one hospital and quite right too – it seems for the maternity unit inter hospital working remains a problem. My constituents shouldn’t have to pay the price for that failing. We have also discussed the cost of the PFI hospital at WRI. You referred in your letter of 8 September 2006 to an excess cost to the Trust of £5m. Yet the attached letter from the Department of Health indicates that the WRI PFI costs 9.3m compared to a publicly financed alternative of £9.8m. How do you reconcile these two views? I would welcome your comments and some details about how the £5m is calculated. Finally, I have read Mr Naftalin’s report into the possible reconfiguration of services. I find it wholly un persuasive. First he says, in relation to the possibility of a regional distribution of maternity services that “there is no indication that such a wider reconfiguration is being discussed”. And yet there are changes being proposed and discussed in most of our neighbouring Trusts. I think that there are very good possibilities for increasing the numbers of births at the Alex that we should not turn our back on by taking a pre emptive decision.

The report contains no medical evidence supporting the removal of births from the Alex. There is no evaluation of the benefits of a “local” service or the safety implications for travel time to WRI or other hospitals for mothers and babies during labour.

In fairness, the report does say that there will be economies of scale arising from a single unit. However, there would be even bigger economies of scale if a single unit were developed for the whole of the West Midlands or even England. Such statements about economies of scale must be balanced by an evaluation of the accessibility to services too! This report does not mention increased travel times, access for families, public transport links and their implication at all! Despite Mr Naftalin interviewing many staff no decisive case was made by anyone about the best way forward. No one could identify a medical imperative for the changes and no one could say how the changes would be financed in the short term or what the costs might be in the future. Nor does Mr Naftalin. Mr Naftalin says that the quality of care remains good and relies on the same gloomy predictions that there may be recruitment problems in the future to justify his agreement with the Trust’s favoured option for change. However, it simply isn’t good enough - with record numbers of doctors and nurses available to the NHS - to cut services using this as the justification. The final recommendations within the report highlight the importance of communication, leadership and clarity. Please please don’t make the mistake of making a change simply to appear decisive – particularly when the evidence you are relying on to make such changes is so flimsy and marginal. Make a decisive commitment to mothers and babies in Redditch and I will back you all the way!

Yours sincerely

Jacqui Smith MP

Re-elect Jacqui Smith