It also has large-scale deprivation among its citizens which imposes great strains upon hospital services. Undoubtedly, it is not receiving fair and adequate funding to meet its needs. My main concern tonight is that there is no overall strategic authority to direct the thinking and decision making that is vital to the future of the service. There is no meaningful public consultation before decisions are taken, or not taken, and there is little involvement of the general practitioner in what planning there is. The trust system is failing because there is no such overall authority.
Trust competes against trust.
The purchasing authority, Birmingham Health Authority, controls the funds but does not have the authority for any hospital development programme. A classic example of all this confusion has recently come to my notice and caused me to initiate this debate. I informed my noble friend of the circumstances. I know that she has made inquiries, which I much appreciate. The document that I obtained was a set of minutes of a meeting held on 19th February this year of the Birmingham Health Authority Consultants' Committee which was attended by Mr. Brian Stoten, chairman of the health authority.