Do your job Mabon!

We are all deeply indebted to Lisa Francis and the Protect Bronglais Services campaign that she leads. The ability of Lisa and PBS to get so many relevant players sitting down together in the same room (Mid Wales Health Summit, Saturday 17 October) is extraordinary. Welsh rural healthcare is under existential threat. It is clearly a very difficult issue for the Welsh Government.

Sadly, another event prevented me watching the live stream of this meeting. But I have seen some of the presentation papers. Dr Phil Jones’ paper on Stroke Care sums up how things have changed over the last few decades and highlights the significant challenges to providing good care in the rural environment. It’s totally different from a big urban centre.

He was Stroke Lead for Wales prior to his retirement, and led the Stroke Unit in Bronglais. To my certain knowledge he ran a world class service in one of the UK’s smallest acute hospitals; don’t believe “experts” who tell us it can’t be done. Whilst he looks at this through the prism of a Stroke Physician, his comments apply to all medical and surgical specialities. They are based on experience, wisdom, pragmatism and reality. Decision makers should read his paper carefully, and maybe talk with him further. There’s no need to waste money on outside reports and consultations. Welsh expertise is on hand in Ceredigion to advise on how to deliver a Welsh solution for a Welsh problem!

Tom Brooks’ (Community Hospitals Association) paper on the role of community hospitals is another important read. It has particular relevance for Powys but applies to all of rural Wales. One comment to highlight is “Secrecy is a major Powys Health Board problem”. (Ring any bells with Ceredigion County Council and Llettytwppa?).

Lisa’s own paper emphasised the very difficult issue of poor transport links. This means that acutely ill patients in mid Wales are at risk of slow and painful journeys to access care. A long term failure to invest in proper transport infrastructure holds mid Wales back badly in health care, as well as so many other areas. In medicine and surgery we often talk about “the golden hour” for starting treatment. We cannot have a Wales with no hospital between north and south.

Lisa goes on to expose all the issues surrounding “Centralisation” of Stroke Services, and the many unaddressed problems surrounding this Hywel Dda Health Board proposal. To judge it half-baked would be very generous indeed!

Finally she highlights the financial issues at HDHB. Pretty clearly there isn’t the money to implement their Stroke Services plan. Maybe that is underfunding or financial mismanagement or both, but unless this is gripped the future of Stroke and other services is grim.

The Declaration signed by all participants is self-explanatory. There is nothing in it that is contrary to what all political parties were promising us in the Senedd election. Whingeing arguments as to whether the Welsh Health Minister can take charge of Health Boards need to be set aside. We live in a democracy and they can’t spend our money without our consent and oversight via our elected politicians. End of!

It is disappointing that despite being invited Mabon ap Gwynfor wasn’t at the summit. He and other senior Plaid Cymru MSs campaigned on promoting Bronglais as a centre of rural health care excellence, and protecting rural services. Now it is time to start delivering. The Overton Window is shifting in healthcare. There is an opportunity for some radical long term thinking. It’s another litmus test as to whether Wales could possibly make independence work.

Diolch yn fawr Lisa and PBS for your sterling work on this; Mabon, please start doing your job!