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, 01.04.18
Dear Mr Rowlands,
We thank you for this further opportunity to respond to BCUHB Chief Exec’s latest claims regarding healthcare provision at what is now referred to by the Board as the Ffestiniog Memorial Centre.
Judging from the arguments that he has presented, it is patently obvious that the Betsi Cadwaladr Health Board remain in a state of denial as they stubbornly try to justify past and present failures.
There are several points in his letter that need to be challenged:-
1. His claim of ‘35 new, increased and existing regular services’ now being provided in the Ffestiniog Welsh Uplands.
In July 2017, the Board was listing those same 35 services as ‘new services’, a definition that, at the time, could only have been intended to deliberately mislead the public. In fact, of the 35 services listed in that newsletter, as many as 23 were already being provided, whilst others on the list included what can only be described as non-essential group sessions such as ‘Community Wellbeing Group Mindfulness Courses’, ‘Job Centre Plus’, ‘Walking Sessions’, ‘Disability Employment Advisors’, ‘Stop Smoking Wales Clinic’.
Professor Longley in his study of healthcare services in rural mid-Wales, used a proforma to list the comparative healthcare services available in various wellbeing community. The healthcare services promised by Betsi Cadwaladr in the Welsh Uplands around Ffestiniog fall far short of those listed as suitably comprehensive for the Tywyn and the Dolgellau well-being areas, a fact Betsi Cadwaladr has never denied. Mr Doherty’s argument seems to be that he cannot afford to provide more than the primitive service, by international measures, that he has planned to supply, in the Welsh Uplands and the residents there will have to tolerate a service far less comprehensive than provided in places like Tywyn, Dolgellau and Pwllheli.
When eventually an independent assessor examines the service in the Ffestiniog area, that assessor will use a comparative method to illustrate the difference in healthcare services provided betwen wellbeing areas and demonstrate by epidemiological analysis of patient outcomes the impact of the service downgrade that Betsi Cadwaladr has imposed on the Welsh Uplands residents.
2. The paragraph on page 2 of his letter (‘The Health Board is also pleased ...’) is typical of the sort of bluster to which we have become so accustomed. For example:-
i) The so-called ‘new appointments’, that Mr Doherty takes such pride in, are not new positions at all, but mainly replacement appointments. For example, the recent need to appoint a new Practice Manager arose out of the hush-hush sacking of a predecessor in the post, one who had also been appointed by the Health Board!
ii) When applauding the appointment of the ‘second salaried GP’, Mr Doherty should surely have clarified that the only other salaried GP in the Practice has been semi-retired since January 2014, having postponed full retirement in response to an earnest request from the Health Board itself!
3. Like his predecessors in the post, Mr Doherty seems intent on presenting a case that the Ffestiniog area actuallydeserved to lose such crucial services and that the region is adequately provided for under the terms of the 2014/15 Well-being Acts.
This is far from being the case and his claim that ‘the catchment area for FMH [i.e. Ffestiniog Memorial Hospital] was confined largely to Blaenau itself, with a low level of admissions from the area to the west and little or no activity from the east or the “rural uplands” area’ is a blatant misrepresentation of the facts.
For instance, in 2015, Dolwyddelan Community Council (to the north-east) felt the need to call its own referendum, in which the residents voted 99%+ in favour of a return of the services that are listed in our Petition. A similar referendum held in Blaenau Ffestiniog and its surrounding villages, produced an almost identical result, and for Mr Doherty to claim that residents are now satisfied with their lot is disingenous to say the least.
In fact, in his letter to you, dated 2nd March 2018, he admits, albeit inadvertently, to the Board’s true intentions in closing the Ffestiniog Memorial Hospital when he refers to what he calls BCUHB’s two key principles. i.e. :-
(i) ‘Focusing our resources on providing reliable healthcare services at fewer hospitals to make sure that the services provided are consistently available.’
(ii) He then compounds his argument by quoting the second of those key principles: ‘Providing the same Healthcare services with the same opening times within 40 minutes drive for as many people as possible in North Wales.’
Mr Doherty should be asked to explain the source of his 40 minute criterion. In fact, such a time scale was pure invention by the Health Board itself, during the period when Mrs Mary Burrows was the Chief Executive, and it is surprising, to say the least, that someone in Mr Doherty’s exalted position hasn’t yet realised that fact. The World Health Organization makes no reference whatsover to such a 40 minute timescale in any of its guidance. 40 minutes does not appear in any Welsh or UK regulations.
The last “Profile of rural health in Wales” conducted for the Welsh Government includes on page 20 a “time and distance analysis to hospitals in Wales”. It uses the internationally deployed bandings of 0-10 mins, 11-20 mins 21-30 mins and “greater than 30mins”. We include the map below. You will note that without a hospital in the Ffestiniog locality, a wide area of the Welsh Uplandss is now without the 30 minute zone.
Mrs Burrows was formally censored by the Welsh Assembly Public Accounts Committee in its Decemebr 2013 report on “Governance Arrangements at Betsi Cadwaladr University Health Board”. While the report was being prepared Mrs Burrows left the employ of the Wales NHS.
We feel that Mr Doherty needs to specify his source in this respect.
4. The Chief Exec presents other so-called ‘facts’ to strengthen his argument, but none as banal or as clichéd as where he claims that Blaenau people have said that they prefer to die at home rather than in hospital. To seriously present such an argument in support of the decision to close our Memorial Hospital, or any other hospital for that matter, is an insult to any person’s intelligence, leave alone yourselves as members of the Welsh Government’s Petitions Committee.
5. Over the past five years (ever since the hurried closure of our memorial hospital in March 2013), we have presented BCUHB with several examples where patients from the Welsh Uplands have been sent (and are still being sent) from Ysbyty Gwynedd to step-down hospitals and into the care of other unfamiliar doctors many miles distant from their homes - egs. Alltwen (up to c. 20 miles), Bryn Beryl Pwllheli (up to 32 m.), Dolgellau (c. 24m.). In most of those instances, patients will have been out of the care of their own GP for many weeks, if not months, at a time.
Mr Doherty needs to explain whether that is in line with his Health Board’s ‘Care Closer to Home vision’ (see penultimate sentence in his letter to you.)
We know of other instances, where pressure has been brought to bear on families to transfer their relatives out of those step-down hospitals and into private nursing homes, as a means of alleviating bed-blocking brought about by hospital closures.
In respect to the letter from the Cabinet Secretary, we feel that we should draw to the Committee’s attention that on his visit to Blaenau Ffestiniog, the Cabinet Secretary made no effort to meet with the many residents displeased with the downgraded healthcare services that we now have and that the timing of his visit was withheld from us until very late. Clearly the Cabinet Secretary is not very comfortable with meeting with the public.
We thank you again for giving our Petition the continued consideration that it merits.
Yours very sincerely,
Geraint V. Jones (Chair of Ffestiniog Memorial Hospital Defence Committee)