Madam,

The members of the Ceredigion Labour Party who are seeking guarantees from the Welsh Government and the health board that savings made by virtue of the ‘Big NHS Change’ will be spent within the Hywel Dda area to build up community services have clearly missed a few salient points.

Perhaps the most important of these is that the strategy to place healthcare away from hospitals and embed it further into the community is not a local initiative developed by Hywel Dda or their staff in order to overcome financial pressures. The strategy has been in place across the UK for some years, although it has become more apparent in the last five years.

Most of the health board deficit occurs through the need to resort to locum staff in order to ensure safe care and to meet performance targets. Recruitment and retention of trainees and experienced staff in west and mid Wales is a problem that cannot be resolved with extra money from savings or allocations.

It is clear that doing nothing is not an option.

Whilst there are those that believe a new hospital and the opportunity for more staff-friendly rotas will help to recruit and retain staff, I do not think, in view of the competition in Wales, throughout the UK, and the rest of the world, this notion will add much to the justification of a new hospital, which at the very least is seven years away.

We are told that people wish to stay in their own homes for as long as possible and recover better at home. You do not have to be a great thinker to realise that much depends on the level and quality of support available to them as well as the suitability of their home as a surrogate care home or ward.

Now it has to be admitted that many patients are already being cared for at home. In 2015 a joint project by Carers UK and Sheffield University put the number of informal carers in West Wales at 47,000. Research from 2011 suggests a very conservative estimate of a further 15,000 informal carers being needed to be added In the Hywel Dda Area between the end of 2017 and 2030.

Above and Beyond (Care & Social Services Inspectorate Wales, October 2016) referring to the availability of domiciliary care workers states: “There is a serious lack of care and support capacity and the market is very fragile”. These truly enormous shortages are currently affecting services across the UK.

Figures from the Census held in England and Wales in 2011 estimate that there were 4,205 informal carers aged 85 and over in the Hywel Dda area. Whilst no-one would suggest that they should be prevented from caring, anything short of immediate support and/or full respite replacement as required, on demand, I feel should be totally unacceptable.

Extra cash will not solve the problem in west Wales or in many other places.

Yours etc,

Bill Parker, Llanfair Clydogau, Lampeter.

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