Wednesday 30 May 2018

Future Wales NHS (3) Plans and shams - Consultation Time


In Carmarthenshire and Pembrokeshire  a "consultation" is in full swing as to the futures direction of the Hywel Dda University Health Board,which covers the 3 counties of Dyfed.

In the words of the Hywel Dda Executive:

We have an ambition for our local NHS and a once-in-a-lifetime opportunity to work with you to make it better for everyone. We want to provide the highest quality care, with excellent outcomes that improve your health and well-being and provide you with a good experience wherever you live and receive your care. We want to help you maintain your health, well-being and independence, recognising that good health is much more than living longer; it is living healthier lives, from before birth to older age"

There are 3 proposals:  A, B, and C

In all cases Bronglais in Aberystwyth remains as it is now, a General Hospital. In all cases Withybush hospital, near Haverfordwest, is downgraded to a community hospital. In 2 scenarios West Wales General Hospital also becomes a community hospital but in option C is a "planned care" hospital which sounds better. None of these hospital descriptions are clearly defined in the consultation questionaire.

Currently West Wales General Hospital on the outskirts of Carmarthen is a district general hopsital and provides basic emergency care via an Accident and Emergency department and has the best range of services in the board area. Hywel Dda "University" Health Board intend to downgrade this hospital to a "Community" hospital in options A and B or to a "planned care hospital" in option C in the consultation.

 In all options the A & E and urgent care at WWGH is replaced it with a brand new  "urgent care"hospital on the Carmarthenshire/Pembrokeshire border described as "somewhere between Narberth and St Clears". The build will take 5-10 year.

East Carmathenshire and Llanelli itself will need to be serviced for most urgent/emergency treatment by the nearer Morriston Hospital as the travel distance will be too far to the new emergency unit. Abertawe Bro Morgannwg University Health Board will be able to bill Hywel Dda for the cost of treatment of Carmarthenshire based people, so the money "follows the patient".  

Also included in all options are 10 "community hubs" across the region. 

They include the current community hospitals of Amman Valley, Llandovery, South Pembrokeshire and Tenby. Also there are 5 units currently in the planning stage at Cardigan, Cross Hands, Tregaron, Aberaeron and Delta Lakes Wellness Village. Llanelli. Aberystwyth Health Hub is just labelled as "New". The community hospital exist already but the building of the rest of the hubs is likely to take several years.

A view of Delta lakes site where the Llanelli Hub has not yet been started

These community hubs will deliver preventative medicine, community based care for those with chronic illnesses and early help and treatment to prevent hospital admission. They will work hard to prevent anyone getting too ill and having to go to hospital. They may contain local GP surgeries and be able to perform diagnostic tests currently available in hospitals. 

The "choices" are whether or not the 3 existing southern hospitals, Prince Philip Hospital, Llanelli, West Wales General hospital, Carmarthen,and Withybush Hospital, Haverfordwest, are designated as "General Hospitals" or "Community Hospitals". At the moment PPH and Withybush are designated "General" , a vague term not to be confused with the term "District General Hospital" which refers to a hospital with a wide variety of specialities which can treat most medical conditions. A "General" hospital seems to be one with limited emergency medical care, diagnostic and clinic faciities and day treatments with a minor injuries unit, such as PPH is now.

In all 3 scenarios WWGH is downgraded and presumably its major emergency functions transferred to its successor new hospital. 

The timescale of building the new facilities (5-10 years) means that the desired result of attracting and retaining medical staff to the new look Health Board and the newly built units is a long way off. In the current NHS staff market, jam tomorrow is unlikely to attract new staff until the units are not only completed but shown to be working well. Reputation is the strongest factor for recruitment in new systems and how long this one will need to be up and running to gain that is not clear.  The plans may even encourage workers to move to other areas from those likely to be downgraded.

So it is very simple. Select the least worst option. (Similar to voting for your MP)

If you live in Llanelli or Carmarthen East this is probably proposal C (although some in the extreme north of the County have pointed out that Prince Charles hospital in Merthyr could be quicker for them to get to than Morriston  where the real serious emergency stuff will be provided to this area)
If you live in Carmarthen town area you will want to keep the downgrade at WWGH Carmarthen to a minimum and accept proposal C as your local hospital downgrade will be to "planned care" rather than a "community" hospital, 

If you live in Pembrokeshire  all the proposals are equally poor in that your hospital is downgraded into a community hospital in all options. Only worth filling in the "consultation" if you go for your own personal 4th box of "another alternative".
The proposals are to be marked 1.2 and 3, with no 4th vote option so it obviously a wasted vote to use the 4th box as no-one knows what you are voting for - unless everyone in Pembrokeshire writes in the same thing and only votes for that choice? 

Its not a true consultation, just a manipulated endorsement of plans already made. It is not sensible to make plans about the Welsh health service in isolation and surely all the Health Boards should be involved and co-operating?

In  June 1970 the new box girder Cleddau Bridge collapsed killing 4 men, injuring others working on the bridge, and narrowly missing most of the village beneath. It was rebuilt, and the delay in the injured getting help drove the desire for a proper emergency hospital in the area. The replacement bridge may well last far longer than the district general hospital the local community fought to get built and more recently to keep.  
The Cleddau Bridge

  Siân Caiach

If you would like to contribute:

consultation ends 12th July

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