December 2003

Welcome to the Christmas Edition of the Med Chi website. We continue to highlight matters of importance for the Bristol Health Care Community and beyond. Again, we discuss good things and not such good things.

The Bristol Community Health Council has done an enormous amount of work over the last years. Details of some of their publications are given in this edition of the website. The Council is about to disappear. Whether or not there will be an official thank you is doubtful.. We would like to express thanks for their efforts on the behalf of patients in Bristol.

The new arrangements for public involvement in the NHS of the future are described in this issue of the newsletter. So far the arrangements are almost totally untried. They are certainly ambitious but will they work? It seems that the Bristol City Council will now have a major overseeing view. It also seems that the new arrangements may well be cumbersome. They seem likely to slow down major decisions. This is not necessarily a bad thing. The local trusts are already feeling the cold wind of change witness the vigorous public objections to the partial closure of Keynsham Hospital and the reduction in the number of beds at Blackberry Hill Hospital.

One of the most worrying characteristics of the Bristol Health Care scene is that at present there seems to be no one who can take an overview of the whole of the Bristol area. This task cannot be left to Hugh Ross alone. The Strategic Health Authority seems too remote an organisation to do this. It might have been hoped that some form of patient-centered organisation might, at any rate partly, fill the gap but this seems unlikely to occur unless the Bristol City Council becomes, unexpectedly, incisive. What does seem to be clear is that the public voice in planning is unlikely to be well coordinated for the next 2-3 years because the relevant organisations have only just been set-up. This is particularly unfortunate bearing in mind the melting pot to which Bristol health care planning has been plunged.

We report the findings of a recent survey of MRSA infection rates across the country including Bristol. As might be expected in an old building that is difficult to keep clean the BRI does not do well. The question arises as to whether or not it will ever be possible to reduce the rates to acceptable levels unless new, and more hygienic, buildings become available. However getting doctors and nurses to wash their hands between patients would help!

We are pleased to feature the latest version of the Bristol Health Services Plan. The essential features appear to be that some of the health centres are to be expanded and developed, that the Bristol General Hospital will probably close, there will probably be a South Bristol hospital, and there will be 2 acute hospitals in Bristol one of which will be the BRI and the other will be somewhere in North Bristol. So far the published thoughts of the planners regarding acute hospitals are vague and remarkably uninformative considering the fact that the matter has been discussed for several years.

Poor public transport. No light railway. No major Bristol Conference Centre. Two football teams both of which usually lose! State education. The Centre. The bus station. No high quality symphony orchestra. Bristols problems seem endless. Even "@Bristol" is struggling to keep going. The question for us is Can the NHS in Bristol do better and could it even set an example to other organisations developing really high quality services over the next 10-15 years? The auguries are not promising but the health care establishment in the City needs to unit around this defined objective. The Med-Chi intends to play a full part in the debates that are now pendingadopting a non-partisan, constructively critical, approach.

Some of the plans for Bristol are tentative and a timetable for the others has not been given. (The Health Services Journal recently identified new 100 hospitals in England which are in the pipeline and are due to be opened within the next few years. The cost of these is in excess of £10 billion. None of these hospitals is in Bristol. It is hardly surprising that the Bristol population is getting restive!). There are many questions that need to be answered. We have identified 3 particular ones:-

How is the financial shortfall to be dealt with? What changes in service provision are planned as direct result of the deficit? What effect will the financial situation have on the plans for the development of Bristol hospitals and other facilities?

What timetable for the major developments, including particularly the South Bristol hospital and the acute hospitals is envisaged?

How can the BRI be brought up to acceptable structural/design/environmental standards to render it suitable for the next 50 years or so? What new buildings are planned? What plans are there for dealing with the road that bisects the hospital?

Because the situation is so serious and so fluid we plan to organise a combined meeting of the Med Chi and the BMA to discuss the situation. The meeting will probably have the overall title The future of Bristol medicine promise or threat? We hope that the meeting will occur in March 2004. Details will be posted on this website and elsewhere as soon as the preparations have been made. The meeting will be open to all members of both organisations. A summary of the discussions will be posted on this website.

In the meanwhileforget the problems of the NHS and have a really happy Christmas!

RLH