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Yet again, 'scrapped' hospital plans resurface
with Patrick O'Brien
IT WAS rubbish and we knew it and now it has been exposed.
They tried it on in 2006, and pretended to backtrack. They tried again last summer and gave us honeyed words of reassurance and said ‘don’t worry’, and told us that what we thought was current policy had in fact been abandoned.
But we – that is, those many people who by then had developed an unerring sense of when they were being conned over officialdom’s plans for the NHS in Ceredigion - knew not to believe them.
In 2006 it was Bronglais Hospital’s consultant-led maternity and paediatric teams that were threatened, basically to satisfy a mania for centralisation on Carmarthen, an obsession founded on a refusal to entertain any serious humanitarian or strategic challenge to the stale fiction that urban-based acute health-care is the one and only workable and affordable model. On an absolute refusal to consider the truly pressing argument in favour of moving towards the consolidation and development of Bronglais as a major hospital serving a vast chunk of rural Wales.
The public hit the roof and was told the proposals had been ditched. Of course, they hadn’t been.
Last summer a leaked confidential health board report served up more of the same. It promised a Bronglais without an intensive care unit and, once more, the scrapping of its consultant-led maternity and paediatric teams. In the wake of official apoplexy over the leak, we were asked to believe that the ambitions contained in the detailed 28-page report had amazingly become “out of date” within weeks of its completion. It had been withdrawn, it had been abandoned. Actually, it hadn’t been.
Now, as we all knew would happen, they’re at it again. Some of that report’s proposals are back on the table - and the rest will surely follow. Yet again, the future of the rural maternity service is under threat. Only this time there is none of the haziness about the extent to which Hywel Dda Health Board was running wild, and the extent to which they were working hand-in-glove with the Labour-Plaid Cymru coalition.
This time the risks that would be posed to women in labour in rural Ceredigion, Powys and Gwynedd are revealed in a draft document put out by the last Welsh government, the government of which Ceredigion’s newly re-elected AM was a member.
In a devastating analysis of its proposals, Gary Hicks, chairman of the community health council patient watchdog, precisely identifies the health board’s “current culture” as “one of centralisation of services to Glangwili Hospital in Carmarthen”. The proposed strategy, he says, “could lead to a midwife-only led service in rural hospitals such as Bronglais and Withybush, with acute services being available only at Carmarthen”.
“In rural areas with poor transport links”, he warns, “travelling any distance to obtain emergency acute treatment will certainly reduce the survival chances.”
Without any clinical statistics or professional arguments, he says, the document “suddenly” proposes that 80 per cent of maternity services in the Hywel Dda region will come under the “midwifery-led, and community and home-based care” heading, with only 20 per cent of mothers getting care in consultant-led units. Yet, Mr Hicks points out, currently only 30 per cent of pregnancies are completely midwifery-led and, in addition, up to 40 per cent of first-time mothers will need some help in labour, and up to 10 per cent of mothers having second or subsequent children will need assistance.
It is surprising that none of the Ceredigion or regional candidates in last week’s election gave any indication that they were aware of the existence of this document – A Strategic Vision for Maternity Services in Wales – still less of its potentially disastrous approach to rural maternity services. Part of the blame lies with the last Assembly government, which appears to have done little or nothing to actively draw the public’s attention to the report.
In particular, it would seem extraordinary if Plaid’s Elin Jones, now re-elected to a further term at the Assembly, was unaware of the draft strategy and its implications for mothers and babies.
What is now troubling is the establishment of a pattern: Bronglais-based patient services come under repeated threat by successive proposed strategies, plans which meet protest and are then supposedly scrapped, only to be revived in later reports. The policy-makers believe the public will eventually be worn down. Sooner or later, they reckon, resistance will fade, and centralisation on Carmarthen will be accomplished.
There have already been warning signs. The Liberal Democrats in Ceredigion came under fire in the final stages of the election campaign for sending out a ‘Save our local NHS!’ mailshot with the line ‘Going… Going... Gone? Mynd... Mynd... Wedi Mynd?’ over a picture of Bronglais Hospital. They were warning about cuts in beds and services, yet at the final hustings meeting in Aberystwyth Plaid Cymru supporters accused them of “scaremongering”. They weren’t. But the innocence of these Plaid activists will have delighted the health board.