SERVICES at Glangwili are planned to be cut under proposals made by Hywel Dda University Health Board today (Apr 19).
The Board is consulting the public on plans to downgrade services at the Carmarthen Hospital as part of a major change to healthcare provision across west Wales.#
The new plans envisage a new major unit located between Haverfordwest and St Clears, probably at Whitland to take on all acute care and in some options also planned care.
However, in response to a question posed by a lay member of the Board, Chief Executive Steve Moore confirmed that there was ‘no firm commitment’ by the Welsh Government to any funding for any of the options upon which the Board is now consulting,
The only option which retains a greater number of services centred on Carmarthen is in an option which proposes that planned care for the Board be located at Glangwili.
In both other options, Glanwgili would be downgraded to a Community Hospital and lose its A&E provision, it being replaced by a minor injuries unit but would retain midwife-led maternity services.
Primary health care – apart from GP services – would be delivered at a series of community hubs.
The community hospitals will provide all of the care and support available in a community hub.
They will also have ‘step-up’ and ‘step-down’ beds (intermediate care) to provide an alternative to a hospital stay for people who need more care and treatment than can be provided to them at home, or to enable them to be discharged from hospital following an acute illness or operation if they need a period of rehabilitation.
The community hospitals will also have midwife-led units, where they currently exist, preserving the status quo as it is at Withybush.
Community hospitals will have facilities for undertaking tests such as CT scans and endoscopy. They may also provide day services such as renal dialysis and chemotherapy.
In Carmarthenshire, Community Hubs will be located at Llandovery (with beds), Cross Hands (no beds) Amman Valley (options presented with and without beds), Delta Lakes (no beds). They will offer some clinical services currently offered in hospitals (in some locations that will include x-rays) and also outpatient services.
Dr Owen Cox, Chair of the Local Medical Committee for Dyfed Powys, said that investment in primary care and community care had not been discussed and this was vital: “Having been a clinician here for over 30 years, and having heard lots of previous commitments to invest in primary and community care, it has, ever since I have been here reduced. To make this work; it needs the pre- investment in primary and community care – before new secondary care buildings are constructed.”
He added: “You have to do something you have never done before, put your money where your mouth is.”
Responding to the publication of consultation document on transforming clinical services, launched today by Hywel Dda University Health Board, Plaid Cymru politicians from across the region have said it is time for the Labour Welsh Government to properly invest in health and social services in west Wales.
The elected representatives said the health board had recognised all of the ingredients to make a successful and sustainable health and wellbeing service worthy of west Wales residents, but warned that promises of significant capital investment which is required for the health boards proposals “simply do not exist”.
The Plaid Cymru representatives reiterated their long held concerns with the Welsh Government’s failure to train and attract new medical staff, and called on residents of Carmarthenshire, Ceredigion and Pembrokeshire to speak out for their local services.
In a joint statement Assembly Members Adam Price and Simon Thomas, and Member of Parliament Jonathan Edwards said: “These transformation proposals come just days after the health board decided to support the establishment of a Major Trauma Centre in Cardiff over Swansea, which will now see residents of Hywel Dda endure incredible travel times to see their loved ones at a time of desperate need. It is not the best backdrop to launch a consultation in which the health board is asking residents to believe it is looking at their future needs.
“That said, we do appreciate the significant time and effort health board staff have invested in this project, and we know they have worked hard to try to produce a positive vision for a health and wellbeing service fit for the future.
“There are opportunities to radically transform health outcomes for patients, and the health board has recognised all of the ingredients to make a successful and sustainable health and wellbeing service worthy of west Wales residents. The plans deserve an open mind and an honest assessment about the services we need and where they should be located.
“But the stark reality is that these proposals will never see the light of day without the cast-iron guarantees of the Labour Government that it will invest substantial sums of capital monies in Hywel Dda.
“To date, the Health Secretary and First Minister which run the Welsh Health Service have been silent on whether the government will provide the funding required to properly realise any plans. The Labour Government has offered zero leadership and vision. If the status quo is not an option, what are the health board’s options when promises for investment simply don’t exist?
“We appreciate the need to separate planned and urgent care, but we will not support the removal of beds from community hospitals which already have them.
“Finally, whilst the proposals look at how an idyllic health and wellbeing system would work in the future, there is little indication as to how the decades-old distinction between health and social care, and the unnecessary delays and headaches this ludicrous division causes, will be consigned to history. Once again, unless this partition is addressed, these proposals are practically meaningless.
“Staff shortages and finance – the legacy of the Labour Welsh Government’s NHS mismanagement – are the overriding factors in these proposals. More doctors are needed – and Plaid Cymru has a long term health plan to retain, recruit and train more doctors and nurses.
“We will be engaging with local residents to seek their views, and urge them to also make their opinions known to the health board.
“In the meantime we will consider the proposals more closely and will carefully consider their affects – positively and negatively – on our communities. We’ll also be looking closely at how the health board uses these proposals to promote medical teaching and GP training, and develops the model for a rural health care.”
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