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Health

Withybush woes as new consultation launched

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• Health Board says coronavirus has had a major impact on services • New hospital could be built between St Clears and Narberth
• It’s a similar plan which led to protests involving thousands of locals in 2018

MORE than 18,000 people have signed the petition opposing the decision to downgrade Withybush General Hospital, but that was three years ago, and it seems that the health board may have forgotten the locals’ anger.

The health board is launching a consultation exercise to “deliver on our long-term commitment for a healthier mid and west Wales”

Steve Moore, Chief Executive of Hywel Dda UHB, said: “The global pandemic has had a major impact on all areas of our lives so it’s crucial that the health board considers, reflects and learns from this extraordinary period. This engagement exercise will allow the public to tell us in their own words how COVID-19 has affected their health and care, and access to it.

“I would encourage as many people as possible to participate.” 

Under similar proposals to those first unveiled in 2018 a new district general hospital would be built on the border between Carmarthenshire and Pembrokeshire providing A&E services, while in some of the options Carmarthen’s Glangwili hospital would also lose services, including A&E.

The people of Pembrokeshire protested. They protested outside the hospital, they marched through Town, they took their placards to the Senedd.

There was no one, it seemed, who wanted a new super hospital ‘up the line’.

Save Withybush Hospital protests back in 2018 in Haverfordwest

Ten months ago, the First Minister and Health Minister of Wales were united in their decision not to offer any reassurances to the safeguarding of A&E services at Withybush Hospital.

With the July 2020 u-turn of Cwm Taff health board not to remove services at Royal Glamorgan Hospital, the ministers have come under pressure to offer reassurances to the future of Withybush services.

Mark Drakeford said last summer that the decision was down to local health boards, with Vaughan Gething, Health Minister taking a similar stance.

Withybush has already seen the downgrade to its maternity services, with it now being a mostly daytime service with expectant mums with pregnancy complications or those giving birth after 5pm mostly having to travel across the border into Carmarthenshire to give birth. Other departments have also been shrunk on what locals call “a salami slicing away of local services”

Speaking at a Plenary last year Vaughan Gething, was asked by Pembrokeshire MS Paul Davies, the Welsh Government’s position on the delivery of A&E services at Pembrokeshire and if they would remain at Withybush.

Mr Davies said: “You’ll be aware, there is a strong campaign to retain A&E services at Withybush General Hospital.

“Given the recent news that Cwm Taff health board has decided to retain A&E services at The Royal Glamorgan Hospital, the people of Pembrokeshire are now looking at that decision and, quite rightly, asking for the same safeguards.”

The Health Minister said that the decision to overturn the removal of services at Royal Glamorgan Hospital, was made after they were able to recruit more staff which would help them safely deliver that service. Recruitment problems have often been cited as a key problem at Withybush Hospital in recent years.

Mr Gething said, “The member will also know, over a long period of time, the challenges that have been faced in delivering healthcare across Wales and the plans for the future delivery of healthcare.”

He added “The health board is now planning for the continued provision of essential and key services alongside caring for patients affected by Covid-19.”

However, although the Welsh Government is desperately trying to distance itself from its unpopular decisions on local health provision, the buck stops with it.

In November 2018 hundreds of people took to the streets to oppose the downgrading of Withybush. But now it is clear that the plan of a new hospital further away from Pembrokeshire’s population centres and industrial complexes is still on the cards.

Surprisingly, the exact cost of the new hospital, and its exact location, is yet to be determined but the health board is hoping to finalise a ‘programme business case’ in the coming weeks which will then be submitted to the Welsh Government this summer.

A full business case can be signed off by March 2024, The Pembrokeshire Herald understands.

Protestors outside Withybush at the 2018 protests

The health board has said the plan to reshape the way people receive medical treatment in west Wales is part of the “ongoing process” that is now under way with an engagement exercise running until June 21.

According to a new eight-page document published by Hywel Dda entitled ‘Building a Healthier Future After Covid-19’ the pandemic has been a “big challenge” which created an “extremely difficult” period.

The document, seen by The Pembrokeshire Herald, states: “We are progressing plans for a new hospital in the south of the area, somewhere between and including the towns of St Clears, Carmarthenshire, and Narberth, Pembrokeshire. At this early stage, we would welcome site nominations you may have and your views on how we compare possible sites.”

The health board is inviting people’s opinions on a post-Covid future in general and how healthcare is provided across the region today and in the future – pointing out that health and wellbeing centres have been opened in Aberaeron and Cardigan while plans are in the pipeline for similar facilities in Llanelli and Cross Hands.

While many aspects remain uncertain at this stage one thing that has been decided is that the new hospital is to be built between St Clears and Narberth because “this location is the most central to most of the population in the south of the Hywel Dda area”. The site will also have at least 35 acres of “developable land” with “appropriate transport infrastructure”.

A spokesman for the health board said: “The new hospital will be our main site for the network of all our hospitals, providing both urgent and planned care. It will enable us to have more consultants in permanent posts being available more of the time and specialising in areas of care. Consultant-led services will be available 24-hours a day seven days a week.

“We will provide rapid access to specialist assessment and treatment, discharging people as soon as possible so they can receive rehabilitation closer to home. Emergency and unplanned care will be provided in a different building to planned care therefore avoiding the disruption or delay that can occur from high volumes of emergency cases.”

The public is also being asked to nominate sites for a new hospital based on four criteria: (1) The nominated site must be within the zone between and including St Clears in Carmarthenshire and Narberth in Pembrokeshire. This location is the most central to most of the population in the south of the Hywel Dda area. (2) The nominated site should be a minimum of 35 acres of reasonably developable land. (3) The nominated site should have realistic prospects of obtaining planning permission for a new hospital. (4) There should be appropriate transport infrastructure for a major hospital site.

The health board said: “Anyone can have their say on the plans by emailing the health board at [email protected] or by calling 01554 899056.”

Health

Doctors to enter pay negotiations with the Welsh Government

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BMA CYMRU Wales has suspended forthcoming industrial action for Consultants and SAS doctors following a constructive meeting with the Welsh government to resolve its pay disputes.

As a result of sustained pressure, including three rounds of industrial action by junior doctors in Wales, the Welsh Government has made a significant proposal to form the basis of talks to end the pay disputes with all secondary care doctors including Consultants, SAS and Junior doctors.

Since the meeting last week, the committees representing doctors from all three branches of practice have voted to enter pay negotiations based on this proposal.

The planned 48-hour strike by Consultants and SAS doctors due to take place from 16 April will now be suspended.

Junior doctors have paused plans to announce more strike dates whilst they enter negotiations with the Welsh Government.

The Welsh junior doctors committee, Welsh SAS committee and Welsh consultants committee will now each engage in pay negotiations, with the aim of reaching deals which can be taken separately to their respective members.

Dr Oba Babs Osibodu and Dr Peter Fahey co-chairs of the BMA’s Welsh Junior doctors Committee said:

“This is a significant step forward. It is sad that we had to take industrial action to get here, but we are proud of members for demonstrating their resolve in pursuit of a fair deal for the profession.

“Whilst we are optimistic and hope to quickly resolve our dispute, we remain steadfast in achieving pay restoration. Until we reach a deal, nothing is off the table.

 “We will continue to work hard to reach an offer that is credible to put to members who will ultimately have the final say.”

Dr Stephen Kelly, chair of BMA Cymru Wales’ Consultants committee said:

“The Welsh Government’s recent efforts to reach an end to the pay dispute are encouraging and so we have called off our planned strike for now whilst we allow time and space for negotiations to take place.

“We’re hopeful that we can reach a deal that sufficiently addresses years of erosion to our pay to help retain senior doctors in Wales but remain ready to strike if we’re not able to do so during negotiations.”

Dr Ali Nazir, chair of BMA Cymru Wales’ SAS doctor committee said:

“As a committee, we felt that this latest development goes someway to understanding the strength of feeling of our members. We will work hard to reach a settlement that sufficiently meets the expectation of our colleagues who have faced real terms pay cuts of up to a third since 2008/9.”

In August last year, the BMA’s committees representing secondary care doctors in Wales voted to enter into separate trade disputes with the Welsh Government after being offered another below inflation pay uplift of just 5% for the 23/24 financial year. SAS doctors on some contracts were offered as little as 1.5%. This was the lowest pay offer any government in the UK offered and less than the DDRB, the pay review body for doctors and dentists, recommended last year.

As part of their disputes, SAS doctors, consultants and junior doctors carried out successful ballots for industrial action. Since then, junior doctors have taken part in 10 days of industrial action since January this year.

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Health

BMA pay disputes – Junior Doctors, Consultants and Specialist Doctors

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THE WELSH Government and BMA Wales’ three national committees representing consultants, SAS doctors and junior doctors have today agreed to formal negotiations about pay.

Planned industrial action will be suspended during the negotiations.

A mandate is being developed for the talks with all three BMA branches of practice with the aim of resolving the disputes over pay for 2023-24.

In the context of the most challenging financial position the Welsh Government has faced since devolution, a significant amount of work has been undertaken to identify funding to support the negotiations.

First Minister Vaughan Gething said: “We recognise the strength of feeling among BMA members and that industrial action is never taken lightly.

“This is a government that listens and engages to find solutions. I prioritised a meeting with the BMA directly alongside the Cabinet Secretary for Health to reinforce our commitment to that partnership approach.

“We currently face the most severe financial situation in the devolution era which makes our task far harder. Despite this backdrop, we have worked to identify a way forward that I hope will lead to the successful resolution of this dispute and ensure that doctors can return to work in NHS Wales.”

Cabinet Secretary for Health Eluned Morgan added: “Even in these very challenging circumstances, we have worked in social partnership with the BMA and NHS to maintain patent safety during industrial action.

“But the strikes have been very disruptive to the delivery of NHS services – none of us want to see doctors on strike. I am pleased the three BMA committees have agreed to pause further industrial action and begin formal talks with Welsh Government and hope we can bring an end to this dispute.”

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Health

NHS dental charges in Wales to increase from April

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THE COST of NHS dental treatment in Wales will increase from 1 April 2024.

The increase in dental charges is the first since April 2020 and are overall still lower than in England. Any revenue generated from the increased charges will be re-invested back into NHS dentistry services.

From April 2024, the three standard charges will increase to between £20.00 and £260.00 depending on the treatment required, and urgent treatment will increase to £30.00.

Around 50% of people receive NHS dental treatment for free in Wales. Those eligible for free treatment include children under 18 or those aged 18 and in full time education, pregnant women or those who have had a baby within the 12 months of treatment starting, anyone who has dentistry treatment carried out in a hospital or people on certain benefits.

Additionally, the low-income scheme provides full or partial help with health costs, depending on individual circumstances.

Despite pressure on budgets the Welsh Government has increased investment for dentistry, with funding £27 million higher than it was in 2018 to 2019. Included within this increase is an additional £2 million a year to address local access issues.

Changes to the dentistry contract in Wales include a requirement for NHS practices to see new patients. Since this was introduce in April 2022, 312,000 people who couldn’t get an appointment before have now received NHS dental treatment.

Cabinet Secretary for Health and Social Care, Eluned Morgan, said: “Because of the extreme pressure on our budget we have had to consider if additional funding should be raised by increasing dentistry charges.

“This is the first increase we have made to dentistry charges since 2020. Around half of patients don’t pay for their NHS dental treatment and we will continue to protect those that are least able to afford to pay.

“It is vital we all keep our teeth and gums healthy. This is why we are working to make it easier for people to see an NHS dentist by increasing the number of new NHS places and helping dentists to focus on those who need help by changing how often we see a dentist for routine appointments.”

Commenting on the announcement Russell George MS, Welsh Conservative Shadow Health Minister said: “Vaughan Gething’s arrogant choice to hike up dental charges for the people Wales, rather than cut his Labour Government’s wasteful spending is wrong.

“All standard charges are being increased for dental services by the Labour Welsh Government, including for urgent treatment, which will add to cost-of-living pressures.

“While Welsh Conservatives agree that dental services require greater investment after years of Labour underfunding them, ministers should look at cutting vanity projects like their plans to create more politicians before passing on the cost to patients.”

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