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On this page:
Ι Demonstration at the Senedd 24th October Ι Pembrokeshire County Council Debate 18th October Ι other Council responses Ι
Ι Public Meeting 20th September and associated press coverage Ι 3 new anaesthetists at Glangwili. Why? Ι
Ι Hips and Knees to stay Ι Withybush Consultants write again: "no confidence" in consultation Ι SCBU protest starts Ι
Ι Doctor shortage in Neath Ι Ten statements that show the Health Board's intentions for Emergencies - or do they? Ι
Ι The Consultation Document - a confidence trick Ι Outrage! Withybush response ignored by Health Board Ι ... and more. Browse !
24th October demonstration at the Senedd.
14000 signatures on petitions were handed in. We understand there were 10500 signatures against closing our SCBU, and 3500 from SWAT. We are also aware of at least 1800 signatures on a SCBU ePetition, and 1200 on a SCBU petition organized by our local politicians. That makes about 13500 signatures total against closing the Withybush SCBU. There is also a Withybush SCBU
A couple of
personal stories that illustrate what SCBU means locally.
(click here) with over 8000 members.
The Health Board issued a response, published in
Wales Online. Here is what they said:
"We will not take risks with - nor compromise - the safety of our children and babies. However, currently none of our Special Care Baby Units fully comply with British Association for Perinatal Medicine guidelines and All Wales Neonatal Standards. There is a need for a single compliant unit for the Hywel Dda Health Board area.
"It is also important to stress that Withybush Hospital will retain the ability to stabilise and transfer mothers and babies. There will still be obstetric doctors for mothers and paediatric doctors and highly trained paediatric nursing staff for babies at
Click for our response to the Health Board's response - and how our fears are being realized as we campaign. the hospital. In addition local people will have access to an overall higher level of care than they currently have through the new units.
More on SCBU "We will also be actively seeking to improve to the CHANTS transport service as the current hours of operation is too limited. The skills to safely look after babies prior to and during transfer will be given prominent importance. None of the proposed changes will take place until safe replacement services are in place."
18th October 2012. Pembrokeshire County Council Debate. Pembrokeshire speaks!PCC site: Older Persons meeting.
Full Council meeting.
See other councils' responses.
A motion was unanimously passed with applause, vigorously opposing any removal of key services at Withybush Hospital. Healthcare proposals had also been discussed at the Older Persons committee on 5th October; they voted to strongly disagree with Health Board proposals. This was also endorsed at the full Council meeting. There was a friendly atmosphere at the demonstration, councillors stopping to talk. The Cabinet of the Council agreed to submit both a questionnaire completed by them, and the result of this debate in their response to the Health Board consultation. The PCC passed another resolution on 28th February 2013. Click here to see that too. Click here to see what was debated, and a report of it.
The current situation regarding Core Services.
Click to watch the debate.
From the point of view of Core Services we now have promises to retain hip and knee
* actually they refer to "admission" and do NOT commit themselves to "treatment", at least not in writing. This needs clarifying too.
See below ...
... look at the
Health Board's flyers
issued at their drop-in sessions. Cleverly worded. Can you spot the deliberate omissions?
How Core Services may be
replacements, and a "full" *
emergency surgery and trauma service.
But there is as yet
no written confirmation, so we must demand it.
As for Obstetrics/Neonatal and Paediatrics, we also have promises that a Consultant service will be retained. But if the plans are allowed to proceed as documented, then these will be unsustainable despite the Health Board's promises.
So we must demand an explanation as to exactly what they will do to retain the numbers of patients and the consultant service.
Start of the SCBU protest.
A letter from N.Wales neonatal nurses makes arguments relevant to us.
Welsh Assembly debates neonatal services
A motion was passed to "Ensure that none of the current neonatal services in West Wales are downgraded". Many fascinating comments. The government side refused to vote! Click for a summary.
Pembroke Town Council have written a hard-hitting letter making absolutely plain the dissatisfaction of the Council. Likewise Haverfordwest TC and the Pembrokeshire Association of Local Councils (PALC). We thank them for allowing us to publish their documents on our website. Milford Haven TC have debated their response, some councillors criticizing the questionnaire, and the questionnaire responses from the County Council; Neyland TC have also held a meetng. Click here to see the Councils' views.
20th September Public Meeting. Can we believe the Health Board? press coverage (lots of it!).
Pembrokeshire Passion! There were ladles of it, including from our AM's and MP. A huge amount of distrust was expressed, based not only on the last two years, but also on the events of six years ago and the "Designed to Deliver" debacle. People are puzzled as to why we have had to go through the same process again. Our paediatrician disagreed with their paediatrician. Many but not all topics were covered, from Community Care and Minor Injuries through SCBU and Maternity to Emergency Services. So what answers did we get? Well, some of them were rather fudged. Here is a selection, with follow-up questions in italics.
● Yes, progress is being made on community centres ● Yes, we will maintain hip and knee replacements and a full trauma service at Withybush (see below) ● Yes, we need a neonatal level 2 unit somewhere in Hywel Dda ● No, no decisions have been made ... "then why have you just advertised for 3 new anaesthetists at Glangwili, two with an Obstetric interest?" ● ... well, er, we need them. ● Yes, there will be consultant paediatricians and obstetricians covering Withybush 24/7 ... if you have only 400 - 500 deliveries a year, how can you maintain a consultant obstetrician presence?" * ● ... well, er, we don't recognize those figures, and obstetricians will rotate through the complex unit to maintain skills ● Yes, we will maintain full Emergency Surgery and Core Services at Withybush ● We are working on a rota of consultants across the hospitals ... "How can you maintain a rota across two hospitals 33 miles apart with only 9 miles of dual carriageway, not to mention Bronglais?" ● ... well, er, networking ● (final comment from the Chairman, paraphrased): We need to earn your trust ... we guarantee that in five years time the full Core Services at Withybush will remain unchanged.
Fact !! hip and knee replacements to stay at withybush
You know how we have been banging on about this for many months. Well, as of 13th September, we have it from a Look at our campaign to preserve Orthopaedics earlier this year. reliable Health Board source, who also revealed it to the local press, that they have performed a volte-face.
Contrary to what is said in their Consultation Document, they are now intending to maintain the hip and knee replacement service at Withybush "for the vast majority of cases".
It looks like a victory from where we are sitting - but there's lots more to do, with the other specialties.
Promotion of Obstetrics at Glangwili
We are repeatedly being told by the Health Board that they have listened, we have been consulted, and that "no decisions have been made".
Yet there are clear signs that they are already making preparations to develop their so-called "Complex Obstetrics Unit" at Glangwili.
● There is a job embargo in Withybush - so why have there been advertised three new See other evidence of surreptitious upgrading of Glangwili. Consultant Anaesthetist posts at Glangwili, two of them with an Obstetric interest? ● And ... look at the " Did We Deliver?" scheme at Glangwili. Nothing wrong with trying to improve the service, but there's no news yet of a similar scheme at either Withybush or Bronglais Hospital.
● Health Board dropping hints about going elsewhere. Following a referral for a joint replacement to a named surgeon in Withybush, a patient received a letter saying he may go to another hospital. We have a recommendation. If you have been referred to Withybush and want to be treated there, reply to any such letter refusing to go anywhere else. Exert your people power. ● Were the Health Board a little sparing with their information about Ward 12 (see below)?
Poor Mr Purt. PHC have written to him too to explain the adverse effects of Health Board proposals.our comments on the Con Doc.
Feeling strong? Then download our 11-page 'Consequences' document (pdf).
It's not rocket science to detect from our page that we are not exactly impressed with the Consultation Documents. We think there is lack of clarity, various ambiguous or downright misleading statements, failure to describe evidence for the proposals, failure to consider cautions about rural hospitals in the various guidelines, failure to consider consequences, and of course failure above all to bring neighbouring Swansea into the equation for Carmarthenshire. It's quite clear for example that, even though they say they wish to retain a so-called '24/7 full emergency service', they actually intend to develop services in Carmarthen at the expense of Withybush. We have stated this view to the media, the Health Board and ORS in our response to the consultation.
To be fair, the Board have stated they will account for any potential adverse impacts of their proposals - though you have to look jolly hard to find where they say that. It's in technical Document 12, pages 28-29.
Withybush Consultants write again to Mr Purt: they have no confidence in the consultation.
It is a short but hard-hitting document. They highlight inaccuracies in the Health Board's data, their
failure to account for the proximity to Carmarthenshire of the Swansea Health Board ABM, the failure to consider the effect
of removing services from Withybush and the need for proper infrastructure.
Study their previous response and its omission from the ORS report.
Look at previous evidence of consultant discontent. They point out that the Health Board ignored the previous Withybush response. They state they have no confidence in the consultation process and that it will result in worse services for Pembrokeshire. Read their new letter here (pdf). It has at last elicited a Follow this even further, to the ORS Final Report and see our comments on it (rather damning). response from Mr Purt (pdf), containing protestations that the Health Board are listening, but not telling us exactly how.
And now the Llanelli physicians too have written with specific criticisms of the Health Board plans.
SCBU: latest developments SCBU. Right on, Linda!Welsh Assembly neonatal debate
A letter is described from N.Wales neonatal nurses, making many points relevant to our area too,
with a follow-up here.
Western Telegraph of 12th September has a double page spread of questions about SCBU and the Health Board's answers.
Some of those answers might make your skin crawl. Click here to take a look and see our comments.
Senior Sister on the Special Care Baby Unit has the courage to
speak out despite pressure from the employers, and a Consultant Paediatrician points out that it doesn't make sense to try to get back Llanelli patients into Hywel Dda who traditionally go to Swansea.
Join the SCBU Facebook page Look at the press items here.
Give Linda and her colleagues your support and join the e-petition here.
And here is an extract from the BBC report of a local paediatrician doing the same.
This is yet another example of the Health Board ignoring the knock-on effects of their proposals. They claim that consultant-led obstetrics will remain - but closing SCBU would cause it and inpatient paediatrics to become unsustainable.
Neath Port Talbot. Shortage of doctors. Relevant to us.
Big article and leader about this in the Western Mail of 25th August. 999 medical emergencies have had to be stopped at Neath Port Talbot Hospital following a decision by the Welsh Deanery to withdraw training posts (CT2), resulting in inability fully to staff the unit. The emergencies are being redirected to Morriston Hospital.
Our take on this? Well, for some time the hospital has not provided a full set of Core Services due to its proximity - along the M4 corridor - to other hospitals that do. These are Morriston Hospital (13 miles to the west) and Princess of Wales, Bridgend (16 miles to the east). Without a full set of core services each specialty is restricted in the conditions it can safely treat, and therefore the experience that trainees can obtain. This, no doubt, has led to the decision to withdraw training posts.
Does this matter? Well, for the population in the area, probably not too much as long as the nearby hospitals can take up the slack. Morriston is slightly nearer than Bridgend, and in the same Health Board (ABM). Hence, no doubt, the redirection there. But if Morriston cannot cope patients can be taken east to Bridgend, and maybe patients in the eastern part of the area go there anyway.
What are the implications for a hospital like Withybush? Well, if we were rendered without our full set of Core Services, ultimately the same would happen. Training posts would be withdrawn, and recruitment would become
How Core Services may be lost compromised. But in our case, the distance to an alternative facility would be prohibitive - 33 miles to Carmarthen from Haverfordwest, but 45 miles from St David's. Emergency medical care to the whole of Pembrokeshire's western area would be compromised. This simple fact is what so far has been ignored by Hywel Dda Health Board, and illustrates why we need to retain our Core Services in Pembrokeshire.
But what about the problems, so highlighted by the Health Board, of services being stretched over a wide area with a small population? Well, the obvious solution to that is to keep the Core Services where they are needed - Bronglais and Withybush Hospitals - and to restrict them where they are not - Carmarthenshire. See a letter pointing this out, also in the Western Mail of 25th August. Glangwili Hospital is only 27 miles from Morriston, all along dual carriageway, and the last eight miles along the M4. Llanelli, the densest population base, is only 12 miles from Morriston.
So we ask: Why are the Health Board so hell-bent on centralising services in Carmarthen, which may compromise the Core Services in Pembrokeshire and Ceredigion?
Emergencies. Ten statements from the Health Board.
The Health Board state that their 'preferred option' is 'Option B': a 'full emergency service' in each county. Hooray! you may say. Our fears are unfounded!
Are they? Here is a succinct explanation (a one page pdf).
Answers to questions.
We have correspondence which may give us some reassurance - or at least the Health Board can be held to the documentation.
See the full letter. First, Lesley Griffiths the Health Minister replied to a letter from a local citizen and acknowledged the rurality of our area. She stated "... any change ... must take full account of the distinctive characteristics of Mid and West Wales, in particular, its rurality and travel time to other centres.". I thank Mr Ian MacDonald for letting me see the letter.
See the full letter. Second, our Chairman Mr Chris Martin has responded to several questions put to the Health Board meeting on 6th August. In one of them he has acknowledged that a full emergency department requires backup from: "Medical Specialties, Surgical Specialties, Paediatric, Trauma, Gynaecology and Diagnostic Services.". I thank Heather Scammell for letting me see the letter.
It is the first time I have seen acknowledged in writing from either the Health Board or the Welsh Assembly Government that these requirements exist (except that it was on their DVD, seen only by a tiny number of people). But ...
We are not home and dry with this issue yet:
● "Surgical specialties" are not specified. Does Mr Martin include Orthopaedics in these? video clip from Health Board's DVD, descibing backup needed for A&E. It was certainly included in their DVD in the section on A&E by Dr Jeremy Williams. ● "Trauma" is mentioned. But, since the Health Board plans to take away major Orthopaedics from Withybush, who is going to be there to deal with Trauma?
We see nothing in their documents that addresses these vital questions on Orthopaedics and Trauma. They must be answered during this Consultation period.© Peter Milewski 2012