FOLLOWING loud public protests about the Local Health Board’s plans for the future of Withybush Hospital, local media were invited to meet with Health Board Chair Trevor Purt for interviews in the Board’s offices at Merlin’s Court, Winch Lane, Haverfordwest.

The Herald put questions to the Health Board chief which our readers and correspondents raised with us about the decision to close the Special Care Baby Unit at Withybush and transfer services elsewhere and about the future of health care at the Haverfordwest site.

Polite but firm, Trevor Purt did not allow much of the exasperation he must undoubtedly feel spill over into his answers. When it did, he was clear and forthright. To be sure, he was eager to get his message across and – in terms – that message was that changes to service provision in Pembrokeshire have not been driven by a determination to cut costs but in order to ensure quality of care.

We asked him first about the announcement of the “safety net” made by Health Minister Mark Drakeford in the Senedd on January 21. Did the announcement of the “safety net” mean that the arrangements announced in September were incomplete?

“We had put a safety net in place. It was never going to be the case that we would shut the provision at Withybush down on one day and shift it over to Carmarthen the next. That would be impractical and illogical. There are twelve months while we examine the progress of the service change and that will be done by a panel drawn from the Community Health Council and other stakeholders.

“Not even our sternest critics suggest that the model we propose is wrong: the dispute is about the location of the unit at which we will deliver centralized services for complex births. As a board we have to look beyond parochial concerns and deliver the best possible outcomes for the whole of the population the Board serves.”

But why Glangwili?

“We chose Glangwili ahead of Withybush because it has better links to Morriston Hospital and the wider Health Board area. I have heard the suggestion that we have not discussed our plans with Abertawe Bro Morgannwg Health Board. We have considered developments at Morriston very carefully indeed and been in close communication with our counterparts there. People should not let rhetoric get in the way of the facts.

“Plans are not made in isolation, we have a range of considerations to take into account. If we had chosen Withybush, we would be facing the same protests in Carmarthen as we are in Haverfordwest. I understand people are angry and frustrated but I believe that is because there has been a lot of misunderstanding and misinformation.

“I want to make a couple of things very clear: the Royal College of Midwives has told us that in order for a junior doctor to get sufficient expertise in obstetrics they need to be exposed to a range of types of case. They have said that the range required means that a unit has to have 2,500 births annually. That is the position of the professional bodies as well. The Deanery and the GMC require doctors to be fully accredited and to maintain that accreditation. If we have insufficient accredited doctors, all complex births would be taken to Morriston and none would take place in the Health Board area.

“This is not about money. This is about delivering a safe and sustainable future for obstetric provision across the Health Board’s area. In many respects, we are suffering from a long term structural problem. It is a numbers game, but the number is not money: it is about attracting, training and retaining staff.

“Secondly, we announced our plans last January. The CHC did not raise any issue about switching to a midwifery led obstetric service. Its objection only related to SCBU. The idea that this is a sudden change or shock announcement is wrong. We made our plans clear last year.

“The experience in Powys, where there has been a midwife-led obstetric service since 2001, has been that that service has been effective and safe. We anticipate that the majority of expectant mums will be able to choose where to give birth and most births will take place where they are planned to take place. It will be mum’s choice in the overwhelming majority of cases.

“In addition, the Emergency Medical Response Service – which is being planned for the whole of Wales – will ensure very quick access to emergency care. When there is an emergency, patients will be stabilized locally, where possible, and then taken to the appropriate unit for specialist care, whether that is at Glangwili or Morriston.”

But what about the decision on paediatric care? Is the health board “salami-slicing” services as critics have claimed?

“No. I want to make it as clear as possible. Our plans for obstetrics were announced last year at the end of the consultation. This is not new and, again, our plans for paediatric care were not criticised by the Community Health Council. They did not form part of the referral to the Minister and were not considered by the expert panel on the future of the Special Care Baby Unit.”

What about A & E at Withybush? Part of the rationale in closing the Minor Injury Units at Tenby and Pembroke Dock was that this would preserve services at Withybush. Is A & E safe?

“I want to make this as clear as I can: I do not foresee that we will not continue to provide an emergency 24/7 service at Withybush.“That service configuration might be with middle grade staff or a GP service, but we will maintain a 24/7 A & E service at Withybush.”

Our interview ends. Our friends at Radio Pembrokeshire are waiting with a large microphone outside. We will be meeting again with Trevor Purt in March. Let us know what questions you want to put to him and we will do our best to work them into our meeting.