In early May of this year, we wrote to the Committee with an update of the healthcare provision situation in Ffestiniog and the Welsh Uplands. We pointed out that the state of the healthcare provision in Ffestiniog and the Welsh Uplands can only be described as ‘dire’. The plans that have been submitted to the Minister and to which our petition relates do not contain healthcare services beyond an unacceptably basic provision. The Betsi Cadwaladr UHB business case plan falls far short of the goal described in the Welsh Government’s ‘Rural Health Plan’ as adopted by the then Health Minister. It makes a mockery of the Welsh Government’s claim to seek to provide “world class health care in rural areas.”
We also provided detailed evidence to illustrate the state of disarray amongst the Betsi Cadwaladr UHB Board and senior management in addressing the provision of adequate healthcare in a major rural area. The Petitions Committees Members will know that this disarray has extended to other areas of healthcare in North Wales, recently, including maternity and other women’s services, Out of Hours Doctors provision, food hygiene in a major acute hospital and manpower planning and recruitment leading to a chronic shortage of GPs.
One month after we sent that letter to you, on June 9th, the Minister finally reacted to the lack of competence of Betsi Cadwaladr UHB, recognised the patient care damage being caused by Betsi Cadwaladr UHB and signed an intervention order placing the Board into “Special Measures”. The Minister replaced the Board’s Chief Executive with the Minister’s own representative, Mr Simon Dean.
Our original petition requested that the business case plan prepared by Betsi Cadwaladr UHB and submitted to the Minister be not approved until Prof Marcus Longley had completed his study of the healthcare provision in rural mid Wales. Prof Longley found the provision of healthcare in the Welsh Uplands to be at the most basic level of any rural community in Wales, and in most urgent need of addressing. The proposals contained in the Betsi Cadwaladr Business Case do not plan to provide an acceptable level of service and have been rejected firmly by the population of the Welsh Uplands in formal local community referendums.
In May, we asked the Petitions Committee to propose to the Minister that his officials involve us directly in discussions on improving the business case for the provision of enhanced healthcare services to this large and important, if sparsely populated, rural area.
Although we have had one meeting with Mr Simon Dean at our request, Betsi Cadwaladr UHB continues to proceed with service dismantling actions in isolation from the public that it is charged in serving.
Following Prof Longley’s report, the Minister established the Mid Wales Healthcare Collaborative charged with seeking to improve healthcare services in rural areas covering a wide area of Wales, including Ffestiniog and the Welsh Uplands. We have met more than once with the Joint Chairs of that Collaborative and also discussed the issue with Dr Sue Fish, Clinical Programme Director Mid Wales Healthcare Collaborative. Their understanding of the means of providing effective healthcare in rural areas appears much enhanced over the level of understanding demonstrated by Betsi Cadwaladr UHB management.
We would ask the Petitions Committee now to remind the Minister that he has found Betsi Cadwaladr UHB to be so defective in their planning and delivery of healthcare services, as to require, uniquely in Wales, Betsi Cadwaladr UHB to be placed in special measures. It is right and proper that the Minster should arrange for decisions taken by such a recognised defective healthcare organisation to be reviewed before they deliver irreparable patient harm. An appropriate body to be charged with reviewing the healthcare plans for the Welsh Uplands could well be the Mid Wales Healthcare Collaborative. We would be more than willing to co-operate with such a review.
Geoff Lang’s correspondence to the Petitions Committee (07.10.2015) on behalf of BCUHB
(see ‘P-04-564 Restoration of Inpatient Beds, Minor Injuries Cover and X-Ray Unit to the Ffestiniog Memorial Hospital’)
OUR RESPONSE
First of all, may we remind the Committee of the background to the Business Case which you have been asked to consider. In 2012, both Tywyn and Blaenau Memorial Hospitals were allocated £4m capital spend by the Welsh Government. The Betsi Cadwaladr Health Board then decided to provide Tywyn with a brand new extension to house a 16 bed ward and an equally new X-ray department whilst at the same time, in its supposed wisdom, taking immediate steps to remove all such facilities from the Ffestiniog Memorial Hospital and to use the £4m capital spend simply to refurbish the building so that all services from the current health centre [one that was purposely built less than 30 years ago!] can be re-located there. By its own admission (see evidence already submitted), the Board took that decision for purely mercenary reasons. (If proof were needed, it can easily be found in the Board’s Planning Committee Report for January 2015: ‘Building the new centre on the site of Ffestiniog Memorial Hospital will mean that there will no longer be a need for the current Health Centre or the physiotherapy building. This will result in substantial savings in the cost of maintaining services in the area and the financial rewards of such actions will become obvious within the next 2 – 4 years.’)
Mr Lang’s paragraph relating to Minor Injuries cover at Tywyn merely corroborates our allegation of discrimination by the Health Board. We have maintained all along that BCUHB decisions have favoured the more affluent coastal areas, to cater for the influx of summer tourists, and that they have done so at the expense of the more deprived rural population of the Welsh Uplands. The Betsi Executive have consistently denied the claim whilst at the same time ignoring the overwhelming evidence being presented to them. But Mr Lang himself, in his reply to you on behalf of the Board, now confirms our stance when he says:- ‘With regard to the minor injuries service at Tywyn, the opening hours were set to reflect the demand for the service, including the increase in activity during the summer months.’ And he has the confidence (or perhaps the arrogance) to affirm: ‘I would wish to clarify that the Board has no plans to reduce the opening hours of this facility.’
He then continues, somewhat convolutedly, to tell you: ‘With regard to the impact of the current opening hours upon demand in other sites, this has not an impact which we have observed since the changes were made.’ What ‘other sites’ is he referring to, if not Blaenau Ffestiniog and the Welsh Uplands? And why would he avoid referring to it by name, if not to avoid the issue as best he can?
He then goes on to say, ‘We continue to monitor access to local minor injury services and discuss this with the Community Health Council and we shall ensure that the issues raised are reflected in our ongoing monitoring arrangements.’
Since the Board offers no meaningful Minor Injuries cover in the Welsh Uplands, then we would suggest that Mr Lang be challenged on this issue as well, and be asked to produce the results of such ‘monitoring’ in the Welsh Uplands.
We recently provided you with proof of the numbers who visit the Blaenau Ffestiniog area annually. Those statistics far outweigh anything that the Tywyn coastal tourist belt witnesses from year to year. Around 230,000, this year alone, have come to experience the thrills of extreme downhill biking, zip wire rides, underground trampolining, caving experiences etc in this immediate area (i.e Welsh Uplands). And as we have also proved to you recently, such interests often result in accidents requiring ambulance and air ambulance call-outs, leading to subsequent A&E treatments in Ysbyty Gwynedd. But the BCUHB Executives are content to ignore such facts when they are presented to them and this leaves you, as members of the Petitions Committee, to draw your own conclusions.
On 28.09.2015, we copied you in with our response to Simon Dean’s email to us. Hopefully, you will take account of its content, as well, during your deliberations.
We thank you again for giving of your time to consider our ongoing concerns.
Yours, most sincerely,
Geraint V Jones (On behalf of the Ffestiniog Memorial Hospital Defence Committee)