Madam,

Bill Parker (Letters, 2 August) suggests that Ceredigion Labour Party has called for “extra cash” for the local health service – but we have done no such thing.

What we do call for is a commitment from all concerned that existing funding levels (current and planned) will not be reduced. Because that is what we see coming, if Hywel Dda Health Board is allowed to proceed with its proposals to shift patient services out of hospitals into the community.

We have consulted the academic literature on large-scale health service reconfigurations, and we can find no instance where financial savings were claimed.

What we did find were warnings: “The evidence did not suggest that reconfiguration, including moving to a more community-based model of care, will deliver significant savings” (King’s Fund, 2014); “There is little evidence to show that community-based alternatives to hospital care will cost less” (Nuffield Trust, 2015).

So whatever else the HDHB proposals may achieve, they will not solve or mitigate the board’s continual overspending/underfunding problems. Unless of course the replacement patient services in the community are reduced in capacity and/or in quality, which would not be acceptable.

Ceredigion Labour Party does not want to see financially-driven cuts to patient services introduced by stealth through the use of some magic formula about community care – that is our argument.

Bill Parker makes some good points about informal caring in an ageing population, and rightly calls for more support and respite provision for elderly carers. But we wonder how he expects those things to happen without money being spent?

Yours etc,

Tony Geraghty, chair; Dave Bradney, executive committee member, Ceredigion Labour Party.

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