P-04-564 Restoration of Inpatient Beds, Minor Injuries Cover and X-Ray Unit to the Ffestiniog Memorial Hospital – Correspondence from the Petitioner to the Committee, 03.05.17

Dear Kayleigh,

We would be obliged if you bring the attachment to the notice of members of the Petitions Committee. It contains our recent email correspondence (dated 01.03.2017 and 04.04.2017), with Dr Peter Higson, Chair of BCUHB,together with his interim response of 21st March. 

All three emails relate to  Betsi Chief Exec Gary Doherty's  letter to Mr Hedges on 6th January, which the Petitions Committee discussed at their last meeting. Appendix 1 in that letter was penned by Dr Whitehead, lead practitioner for Meirionnydd, some of whose statements are challenged in our emails to Dr Higson.

Hopefully, the members will see once again how disingenuous and intentionally misleading the Board's argument continues to be. Since the Betsi was formed in 2009, Mr Doherty is the FIFTH chief exec. that we have had to deal with, the others being Mary Burrows, Geoff Lang (in office during Mrs Burrows' prolonged absence), David Purt and Simon Dean (Mark Drakeford's 'trouble-shooter!), all in the space of seven years. And yet the Board is still being kept under special measures! And as if that fact alone hasn't made it difficult for us to hold meaningful discussion over the years, we have also had to correspond with as many as FOUR different Health Ministers, all of whom have refused to involve themselves in the argument, implying that the buck stops with BCUHB, which is surely an uncommon stance for any Minister to be taking.

We thank the members for respecting our petition and hope that they will continue to seek a full and honest response from BCUHB to the true level of healthcare  now being delivered in the Welsh Uplands.

Diolch yn fawr,

Geraint V Jones (Chair of Ffestiniog Memorial Hospital Defence Committee)

01.03.2017

Pwyllgor Amddiffyn Ysbyty Coffa Ffestiniog

Dear Dr Higson,

On behalf of the above Committee, I wish to issue a formal complaint about comments made by Dr Bill Whitehead in Appendix 1 of Mr Doherty’s recent response to the Petitions Committee.

There are several issues that we could challenge even in Mr Doherty’s own e-mail but, for the present, we will confine ourselves to pinpointing misleading and blatantly inaccurate statements by Dr Whitehead that could only have been intended to mis-inform the Petitions Committee. In fact, what Dr Whitehead sets out to prove in this Appendix is that Blaenau Ffestiniog actually deserved to lose its services, simply because some villages ‘along the coastal strip’ don’t have them either, and he applies a rationale that could just as easily apply not only to Tywyn and Dolgellau but also to most other parts of Gwynedd. In fact, his whole argument seems to be based on astounding geographical ignorance when he claims that ‘Blaenau Ffestiniog is clearly rural’ whereas, in fact, Blaenau is still recognized as the third largest town in Gwynedd, behind Bangor and Caernarfon.

Dr Whitehead claims that ‘Blaenau has as good access to health services as anywhere else in Meirionnydd and has much better access to a wide range of primary care services.’ Such a statement is both incorrect and clearly intended to misinform Members of the Petitions Committee. For instance these words – ‘The surgery in Blaenau is fully manned by doctors, most of whom have a regular committment to the practice, some of whom have salaried posts and are not simply locums.’ Dr Whitehead knows full well – or at least he should know, being the lead practitioner for the area! – that our only salaried doctor is semi-retired (working 3 days a week) and that all others are locums who, bar one, have to travel 30 miles or more to attend daily surgery. The gist of Dr Whitehead’s reasoning, however, is that the people of the Welsh Uplands should be thankful for what is now on offer to them!

In fact, his arguments are more in keeping with those of the hard-nosed businessmen running the health board than those of a medical practitioner whose main concern should be to prioritize patient care. He must surely know that his views are at odds with those of his colleagues on the north Wales LMC? Some might even argue that he was appointed chair of the Project Board merely as a stooge to ensure that BCUHB’s wishes were carried out! 

When Dr Whitehead argues against having ‘isolated’ branch surgeries, then he should list those that come within his definition. For instance, is Trawsfynydd an isolated branch surgery despite it being open four days a week? Can we please be given the health board’s official definition of an ‘isolated branch surgery’ and perhaps be told how many others are being targetted for closure by the likes of Dr Whitehead on the excuse that they are not adequatedly staffed or don’t have the necessary facilities? By implication, Dr Whitehead’s definition leads us to believe that the Blaenau GP Practice, before it was taken over by BCUHB, acted irresponsibly for over 60 years in maintaining ‘inadequate’ and ‘isolated’ surgeries in Dolwyddelan and Llan Ffestiniog!

He goes on to claim that ‘Full MIU services are provided by the practice in Blaenau during surgery hours’. Let him therefore respond professionally, if not to the numerous examples that we have already provided but at least to the case of the 87 year old pensioner living alone in Llan Ffestiniog who fell on her garden path last year whilst hanging out her washing. Dr Whitehead’s so-called ‘full MIU services’ in Blaenau wanted to send her on to Alltwen (14 miles distant), and Ysbyty Alltwen on from there to Ysbyty Gwynedd! Fortunately, an off-duty district nurse took pity on her and attended to her injuries at her own home. When we sent in details of her case, BCUHB refused to respond, preferring instead to hide behind the old excuse of ‘patient confidentiality’. But I have the elderly lady’s permission to attach a photograph of her that was taken at the time, but with name with-held. Are the Health Board and Dr Whitehead, our so-called lead practitioner, honestly of the opinion that a woman of her age should be expected to find her own way to a hospital 35 miles from home, simply because the MIU at her own surgery, or that in Alltwen Hospital, weren’t prepared to do what an off-duty district nurse was perfectly capable of doing? In the light of this case, it would be interesting to hear Dr Whitehead’s definition of ‘full MIU services’ as provided in Blaenau.

There are several other of his statements that need to be challenged but we take particular offence when he makes the spurious claim of ‘a clear perception that some individuals are constantly searching for examples of care ... in order to generate political ammunition’. How dare he make such an accusation! We challenge him to name the ‘individuals’ that he has in mind! In fact, our Committee was presenting Blaenau’s case well before he ever arrived on the scene; otherwise he would not show such ignorance and would know that we have sought the backing of all political parties over the years. The newly elected Petitions Committee, in its response, already respect that fact.

We have always maintained that Dr Whitehead had a vested interest in seeing the Blaenau Memorial Hospital closed in order to safeguard and to enhance services at Dolgellau Hospital. That claim has never been challenged by anyone in authority. Some of Dr Whitehead’s tenuous arguments in Appendix 1, recently sent by Mr Doherty to the Petitions Committee, give further credence to our claim.

You will know better than anyone, Dr Higson, that we have asked consecutive Chief Executives, as well as both yourself and your predecessor as BCUHB Chairs, not to mention the Health Minister himself, the following questions regarding Dr Whitehead’s appointment as chair of the Project Group that decided on the future of health services in the Rural Uplands – (i) ‘How ethical was it for the health board to place him (i.e. Dr Whitehead) in such an influential position? And also (ii) How ethical was it for Dr Whitehead himself to accept the responsibility? Should he not have declared a vested interest and refused to take part? Why is it that we still await answers from every single one of you?

Another question that was put to you several times (albeit in Welsh) was this -

‘Os na ddangoswyd ffafriaeth i un ardal mwy nag arall, ga i ofyn sut yr aeth BIPBC ati i bwyso a mesur rhwng gwahanol ardaloedd yng ngogledd orllewin Cymru. Roedd rheidrwydd ar y Bwrdd i gynhyrchu dogfen yn cloriannu’r sefyllfa, nid yn unig yma yn Stiniog ond hefyd yn nalgylchoedd Tywyn, Dolgellau, Alltwen, Pwllheli a Chaernarfon. Carwn wneud cais am gopi o’r ddogfen honno, ... er mwyn gweld beth yn union oedd y dadleuon dros roi gwell gwasanaeth i drefi llai poblog ond mwy Seisnig y glannau.’

I wonder why that request was also ignored at every asking?

In the meantime, the Betsi Cadwaladr University Health Board, with the blessing of a dispassionate Labour government, has seen fit to completely desecrate a war memorial to the sacrifice of 353 young men of the Welsh Uplands who lost their lives in the Great War; a war memorial that the people of this area have held in high esteem for the best part of a hundred years. Rather than taking pride in the new construction, successive BCUHB executives, plus Dr Whitehead, should be hanging their heads in shame.

We have been assured by a qualified architect that, even at this late stage, plans for the new building can easily be adapted without any significant extra cost to include those facilities that were stolen from us – namely an inpatient ward, X-ray equipment and a MIU worthy of the name.

There has to come a point, Dr Higson, where high-handed bureaucracy must answer to the democratic process, otherwise we might as well be living in a one-party state that is answerable to no one but to itself and where the wishes of the people can be totally ignored, even when expressed in a democratic referendum.

Is it too much to hope for a response to each of the matters that are being raised in this letter?

Yours sincerely,

Geraint V. Jones (Chair of Ffestiniog Memorial Hospital Defence Committee)

...................

21.03.2017

Final par. The Building Design is in line with the approved business case by Welsh Government and is on course to complete in the late summer and open following a short period of commissioning.

Yours sincerely,

Peter Higson, Chairman

………………….

04.04.2017

Dear Dr Higson,

Your response dated 21st March 2017 to my e-mail of the first of that month is again hugely disappointing, in that you yet again avoid most of the matters raised and persist in trying to defend the mistakes and the half-truths and the deceptions of past Health Board executives.

You further insist that Dr Whithead’s appointment as Chair of the Blaenau Integrated Health and Social Care Project Board was ‘entirely appropriate’. Of course, that was probably the case from the Health Board’s point of view, but ‘appropriate’ and ‘ethical’ are hardly synonymous, are they? As you well know, ‘ethical’ has direct moral implications which is why we again challenge not only yourself and the Board but also Dr Whitehead himself to argue the case that it was ethical for him to oversee the closure of essential services in the Ffestiniog Memorial Hospital whilst at the same time ensuring that those very same services were safeguarded at the Dolgellau-Barmouth Hospital that serves his own Practice. And for him to claim that ‘Blaenau has as good access to health services as anywhere else in Meirionnydd and has much better access to a wide range of primary care services’ is totally shameful, coming from one who is  professionally in a better position than anybody to know the true facts, should he choose to face them.

However, it has become patently obvious, that you have no intention of responding directly to matters that we have raised with you time and time again, not even to the case of the elderly lady who was refused minor injuries treatment both at the Health Centre in Ffestiniog and in Alltwen Hospital, only to be treated by a compassionate off-duty district nurse at the nurse’s own home. Are we to assume, therefore, that you and the BCUHB concur with Dr Whitehead’s biased opinion that such a case exemplifies the ‘good access to health services’ now being delivered in the Welsh Uplands and that we should be satisfied with our lot?

Finally, permit me to draw your attention to yet another example of undue hardship to elderly patients in the Welsh Uplands. It seems that BCUHB’s policy now is for patients needing longer-term nursing care to find alternative arrangements in private nursing homes, as a means of alleviating the bed-blocking dilemma created by the closure of community hospitals such as our own. With assistance from Cyngor Gwynedd, we now know that pressure is being brought to bear on patients and family members to make such arrangements. Does it, therefore, not concern the Health Board that, of the eight so-called ‘well-being areas’ in Gwynedd, the Welsh Uplands is the only area without a single nursing home? Compare that with the number of such establishments in the more affluent anglicized areas. For instance, Porthmadog and the small town of Cricieth between them can boast at least seven! Furthermore, Bryn Blodau in Llan Ffestiniog is the only care home for the elderly throughout the Uplands and that has a permanent waiting list.

Consequently, patients from this area, having spent time in Ysbyty Gwynedd or Glan Clwyd before being moved to Alltwen, and even Bryn Beryl or Dolgellau, are eventually expected to find alternative nursing care, if not at home then more often than not in a private and costly nursing home. To my knowledge, as many as NINE elderly patients, from  Blaenau and Llan Ffestiniog alone, are now permanent residents, through no choice of their own, in nursing homes in Llandudno (38 miles distant), Cricieth (17m.), Pentrefelin (15m.), Llanrwst (15m.), Porthmadog (13m) ... and that within the past twelve months a number of others have passed away in some of those same establishments, as also in Cartref Bryn yr Eglwys, Pentrefoelas (18m. distant).

The most recent death was that of an elderly lady from Tanygrisiau who was moved earlier this year from Alltwen to a nursing home in Tywyn of all places, 42miles from home! Her partner had no car, nor could he drive, so please consider what a day visit entailed for him – clippa bus from Tanygrisiau to Blaenau (10 minutes), bus ride (hourly service)  from Blaenau to the Oakeley Arms in Maentwrog (20 + minutes) to catch a connection (two hourly service) to Dolgellau (c. 1 hour) and a further connection from there to Minffordd near Talyllyn for yet another connection to Tywyn (c. 1½ hours) and then an additional 10 minutes on foot to the nursing home, totalling over 3 hours one way!  Alternatively,  he could have used bus connections  from Tanygrisiau to Penrhyndeudraeth (10 + 35minutes) to catch a  less frequent railway connection (2-hourly service) on to Tywyn (1hr16m), totalling over 2 hours one way, provided of course that convenient connections were available  for outward and return journeys.

Within two months of being moved, the lady passed away with no family member  at her bedside and was buried in Ffestiniog a fortnight ago. The irony  and the callousness of such an example must surely be obvious to you all. 

So where does the blame lie, Dr Higson? Everywhere else but ... , presumably! In the meantime the discrimination and the injustice continues against the indigenous Welsh population of the Uplands!

 The Board’s publication ‘Health Care in North Wales is Changing’ promised ‘more care closer to home’ and claimed that its aim was ‘to improve health, not just extend life’. With due respect, successive BCUHB members, together with the lead practitioner whose views you so readily condone, should today be  hanging their heads in shame as far as the Welsh Uplands are concerned. But rather than do that, you will, no doubt, be reminding us yet again that we are getting a £4m  new building, to house not only the  few services that are left to us (see attachment), but also a very impressive Administrative Block and office accommodation overlooking the wonderful panorama that was originally intended for the benefit of inpatients of the Ffestiniog Memorial Hospital.

Yours, with increasing concern,

Geraint V Jones (on behalf of members of Ffestiniog Memorial Hospital Defence Committee)

03.05.17 – Petitioner to the Committee

Dear Kayleigh,

Thank you for confirming that our e-mail to Dr Higson (dated 1^st March of this year), in which we challenged claims made by Betsi Chief Exec Gary Doherty in Appendix 1 of his letter to the Petitions Committee, will be included on the agenda next Monday. Permit me also to remind the members of the following facts -

1.      In 2014, Blaenau Ffestiniog Town Council and Dolwyddelen Community Council instigated community polls calling for the return of inpatient beds, X-ray facilities and  minor injuries cover to our Memorial Hospital. Of the 52% turnout, over 99.6% voted in favour of restoration of those services. Dr Peter Higson’s response however was to say that the health board was not in any way obliged to take account of such a poll. (He had similarly rebuffed the results of an earlier petition that had over 4,000 signatories.). In other words, he was telling us that the health board is not obliged to respect any form of democratic process.

2.      Your members will be well aware that neither the community nor the various interested professional bodies support the Health Board’s discriminatory stance against the Welsh Uplands.

3.      The North Wales LMC opposed the closure of the services in 2013 (the original letter, which the LMC sent to every member of the Health Board personally, is attached) and have confirmed this view in the letter which the current LMC has sent to the Petitions Committee.

4.      The CHC did not originally refer the closure of the beds, X-ray and MIU to the Health Secretary having received assurances, statements and promises from the Health Board that proved totally false.  Since then the CHC has frequently complained about the on-going discrimination, as confirmed by correspondence already supplied to the Petitions Committee by the Chief Officer.

5.      A request from the MP for the area, first in person and then in writing, to the Chief Executive of Betsi Cadwaladr to initiate an independent enquiry into the inadequacy of the healthcare in the Welsh Uplands was rejected by Betsi Cadwaladr, thus again indicating that the health board does not consider itself answerable to democratic process. Meanwhile, people in the predominantly Welsh-speaking Uplands still have to suffer an unreasonably bad health service.

Given the impasse between the Health Board and the community and the reluctance of the Cabinet Secretary to take any personal interest in the residents’ plight, we wonder if the Petitions Committee would consider recommending to the “Health, Social Care and Sport Committee” that that Committee uses its scrutiny powers to examine the petitioners’ request and to report upon it?

Yours very sincerely as always,

Geraint