THE sad, sad thing about the drastic downgrading of Kidderminster General Hospital is that now, when it is being openly admitted that such changes demand a re-think, Alan Milburn MP has matters of crucial national and international importance on his hands.

These make it difficult for the Secretary of State for Health to consider the plight of people in Worcestershire and surrounding counties.

Make no mistake, the downgrading has been a disaster, as most patients and staff in the remaining acute hospitals in Worcestershire will agree, regardless of what managers, drowning under a flood of their own making, may say.

Complaints have risen according to the Comm-unity Health Council.

Staff complaints to the media are rubbished by management but not extinguished.

Long waits in A&E and medical admissions units still occur.

Shortage of beds has been at last admitted by managers - "...reductions (in bed numbers) previously planned as part of the PFI proposals are unlikely to be deliverable in the light of demand for emergency and elective services". (Trust Brief, July 2001).

Men with severe prostate troubles and patients in pain awaiting joint replacements are desperate as they have little hope of relief soon.

Some of the problems facing Wyre Forest and South Shropshire patients include:

- Patients from the minor injuries unit are told to go to Worcester carrying their own x-rays. Much-vaunted telemedicine was supposed to stop the transfer of x-rays, let alone patients.

- Patients sent to Worcester at night have to pay £32 for a taxi home when found not to need admission.

- Elderly people say they are frightened to visit their GP in case they are sent to Worcester - impossibly far away if no car is available.

- Wyre Forest waiting lists have deteriorated from previously good levels to unacceptable countywide levels. Comparisons are now impossible following the merger of the acute hospital trusts.

Recent specific cases include:

* A patient with chest pain referred to Ronkswood, arrived at mid-day, not seen by a doctor until 10pm then transferred to Newtown and admitted to psychiatric ward where the patient maintains he was only seen by psychiatrists.

* A patient admitted at 7.45am for an operation was told to go home at 12.56pm as no bed was available.

* A knee replacement patient writing about ward experiences said: "The noise was dreadful, the standard of nursing care very poor when one is so utterly dependent on help. We were kept waiting for bedpans, medication etc, no chance of being offered a bowl at night for a wash or cleaning teeth."

* A long and complicated case where the communication to knowledgeable and well-informed relatives about a critically ill patient was felt to be lamentable and allegedly inadequate treatment possibly led to avoidable brain damage in a previously fit patient.

Solutions are still possible to rescue hospital services for the whole county.

Despite the pre-election urgency for the Darzi Report, which was duly handed in on July 31, action has been delayed by ministerial holidays. I have not yet received a meaningful response to a letter to Mr Milburn, stressing the urgency of the situation.

If the report recommends brief in-patient stays it could, for example, shorten the wait for non-emergency waterworks operations. If it supports slightly longer stays, joint replacement operations could become possible here with immediate benefit to waiting lists across the whole county.

Secondly, urgent local action on the Royal College of Physicians and NHS Confederation re-think of the delivery of acute hospital services is essential.

Any logical solutions depend solely on Mr Milburn. No-one else can sanction them even though they are so obviously needed by people and supported by the silent majority of staff.