A LONG-PLANNED new hospital for west Wales faces significant delays due to funding challenges, Hywel Dda University Health Board’s chief executive, Phil Kloer, has revealed. Originally slated for completion by 2029, the project may now take at least a decade—or longer—to materialise.

The proposed hospital, intended to serve as part of a wider transformation of healthcare in the region, had two potential locations identified after extensive public consultation: St Clears and Whitland in Carmarthenshire. However, the rising cost of construction, driven by inflation, has forced the health board to revisit its strategy.

Rising costs and strategic reassessment

A report presented by the health board highlights that the estimated costs of the original strategy—outlined in a request for £1.3 billion from the Welsh Government—have surged significantly. The strategy aimed to overhaul healthcare services by developing community hubs, refreshing Prince Philip Hospital in Llanelli and Hospital in Aberystwyth, repurposing Withybush General Hospital in Haverfordwest and Glangwili General Hospital in Carmarthen, and constructing the new hospital.

Acknowledging the impact of inflation and other factors, Mr. Kloer told a health board meeting: “It would be wrong to plough on with the same thinking.” He cited the effects of Covid-19, demographic shifts, and climate change as additional reasons to “refresh” the health board’s approach.

Phased implementation to manage costs

Executive Director of Strategy and Planning Lee Davies presented a paper indicating that while a phased implementation might increase the overall costs of the programme, it could make the project “more affordable for the Welsh Government” over time. The health board also acknowledged that reviewing the hospital’s location could be necessary, despite previous public consultations narrowing options to two shortlisted sites.

Financial struggles and politics compound challenges

The health board’s financial difficulties add another layer of complexity to the hospital’s future. At the same meeting, it was confirmed that the board is grappling with a £64 million deficit, despite delivering £32.4 million in savings.

The delay raises questions about the future configuration of health services in west Wales and underscores the financial and logistical hurdles facing ambitious infrastructure projects in the region.

The delays have reignited political tensions in June this year, with Welsh Health Minister Eluned Morgan (as she was then) laying blame on Conservative politicians for obstructing progress. During a Welsh Parliament session she accused the Conservatives of leading a campaign against a new hospital years ago, which she claimed delayed its construction.

Speaking in response to a question from Pembrokeshire’s Sam Kurtz MS about the ongoing delays, Baroness Morgan said: “If you [the Conservatives] hadn’t led a campaign against the West Wales hospital, it would’ve been up and running by now. The Conservatives must take their share of responsibility for the fact there is not already a West Wales hospital.”

Morgan’s remarks were met with sharp criticism from veteran campaigners and opposition politicians. Dr Chris Overton, a prominent campaigner for Withybush Hospital, called the comments “rubbish,” pointing out that the campaign to save services at Withybush Hospital drew support from across the political spectrum, including members of the Labour Party and non-affiliated community members.

“The reality,” Dr Overton said, “is that Labour has been in power in Wales for 25 years. They’ve had plenty of time to build this hospital. Instead, they’ve salami-sliced services at Withybush to the point where trust in their promises is completely eroded.”

At that time Plaid Cymru candidate Cris Tomos and Liberal Democrat candidate Alistair Cameron both called for greater clarity and transparency from the Welsh Government. Tomos emphasized the need for genuine consultation with communities, while Cameron pointed out that residents face uncertainty about accessing services during the decade-long delay.

Covid an issue

Executive Director of Strategy and Planning Lee Davies said: “The pandemic and subsequent programme delays have meant the timescale for delivery of the programme, in particular the new hospital network, is substantially longer than originally anticipated. It is now highly likely that the new hospital would not be operational for at least a decade.

“In accepting that a new hospital will not be operational in the near future, it follows that the key service changes unlocked through a new hospital will now need to be considered ahead of a new facility and within existing hospitals.”

“Work to support fragile services in the interim of a new hospital has already begun through a programme of work called the Clinical Services Plan.”

“Staff, including clinicians, working with stakeholders and patient representatives have reviewed issues and challenges faced, agreed minimum standards, and developed draft options for nine fragile services.

“The nine services are Critical Care, Emergency General Surgery, Stroke, Endoscopy, Radiology, Dermatology, Ophthalmology, Orthopaedics and Urology. They are services which need change and support to continue safely providing care in the medium term.”

Board agreed that the programme prepares for a public consultation to involve further staff and communities in this work. The scope and matters for a future consultation, including the options, will be prepared for the next Health Board meeting at the end of January 2025.

Lee Davies added: “In the absence of a new hospital in the south of our area to address challenges, we need to consider other options to bring together some of our services. We anticipate the emerging model, informed by work on the Clinical Services Plan, will seek to build on the strengths of each of the hospital sites in a way that builds complementary areas of expertise.”

PEOPLE living with the effects of brain injury and neurological conditions have praised the positive impact of Pembrokeshire’s first therapeutic neurorehabilitation gardening group.

The group is run by Hywel Dda University Health Board’s (UHB) community neuro-rehabilitation service, an inter-disciplinary team always looking at ways of improving a person’s health, recovery, and rehabilitation.

In a partnership between Scolton Manor Park and the community neurorehabilitation service, the group provides adapted gardening and outdoor activities for eligible patients as part of their community neurorehabilitation.

Following a successful six-week pilot in 2021, participants named themselves the Heads-Up Gardening Group – or HUG – with further seasonal groups continuing throughout 2024 with varied gardening activities.

Occupational therapy staff from the community neurorehabilitation service have been pivotal in initiating and developing the therapeutic gardening group, alongside invaluable input and support from Scolton Manor Park staff and the wider multidisciplinary team.

This has included physiotherapy, neuropsychology, speech and language therapy, Neuro nurse specialist and therapy assistant practitioners and the head gardener at Scolton Manor Park.

The pilot project in 2021 was led by Phillippa Lee, Clinical Lead Occupational Therapist at Hywel Dda UHB, who said: “It has been an absolute pleasure and privilege to be able to facilitate a local therapeutic group, bringing people together to develop themselves, learn to self-manage their symptoms and support each other’s rehabilitation journey.

“The team felt people’s needs and rehabilitation goals could be met in a therapeutic group setting, which had proved successful in other counties.

“We work as a team with a shared purpose, modifying therapeutic activities within a nourishing environment, to work on individual needs and goals as part of their community neuro-rehabilitation plan.

“We have seen positive patient outcomes, with people moving on from the HUG group to voluntary roles, returning to work and embarking on other life goals.

“We are now in the process of evaluating the impact on people’s recovery and rehabilitation as HUG approaches its eleventh cohort and is due to restart again in spring 2025.”

The gardening group activity is led by Scolton Manor Park’s head gardener, Simon Richards, alongside occupational therapists and therapy assistant practitioners, with support from the community neurorehabilitation service.

Participants of the group have opportunities to become mentors or move onto the voluntary roles and opportunities at Scolton Manor Park, such as being part of the ‘Green Team’. These opportunities can then lead to paid employment.

Here is some feedback from people who have attended the group, highlighting the positive impact HUG has had on their lives:

“When I first went to the group, I felt a bit nervous and awkward to meet new people and I didn’t know what we were going to do. But it only took a few sessions to feel at ease. The staff were very helpful, and it was great to meet people that understand similar situations.”

“Such a brilliant group to be involved with. It’s so helpful to spend time with people who have similar issues. I’ve learnt a lot about gardening and moved forward a lot as a person.”

“I have enjoyed the group very much; it has helped me with my confidence. Thank you all so much for giving me my life back and all the support everyone has given me. A big thank you to Simon for all the help he has given me on this journey of life.”

“Positive supportive environment to learn more about nature and how to manage fatigue and other symptoms of brain injury. Great way to meet and enjoy time with others affected by Brain Injury and make new friends. Diolch o’r galon to Simon and the neurorehab team for great outdoor experiences.”

Phillipa concluded: “We hope to be able to continue this joint venture with Scolton Manor Park and would like to thank all those involved for making this rehabilitation opportunity possible.

“A special thanks to our partners at Scolton Manor Park, Mark Thomas and Simon Richards, and to all the staff working within the community neurorehabilitation service for their enthusiasm and commitment to continuing with this valuable group.

“We would like to especially thank our patients for inspiring us to develop HUG, for all their hard work, dedication and creativity.”

A SENEDD Member called for reform of the way the Welsh Parliament handles backbench legislation after pulling a mental health bill that received cross-party support.

James Evans announced the withdrawal of his standards of care bill, which aimed to replace outdated mental health legislation, in a statement to the Senedd on November 27.

The Conservative called for change to processes for backbench bills, which are proposed by Senedd Members who are not part of the Welsh Government.

Mr Evans, who represents Brecon and Radnorshire, won a ballot to introduce the legislation and Senedd Members unanimously backed the bill at the first stage in December 2023.

But, withdrawing the bill, he warned backbenchers face extremely difficult challenges in introducing legislation that is fit for purpose and serves people across Wales.

He said: “A guiding principle for me, since I’ve come here, is that we shouldn’t introduce legislation … that is defective and that I don’t think meets the needs of the people we serve. So, for that reason, I’ve decided to withdraw my bill.”

The Senedd has not passed a backbench bill since legislation on safe nurse staffing levels, which was introduced by the Liberal Democrats’ Kirsty Williams in 2013.

Warning the bill would take two years or more to develop, Mr Evans said: “Not many of us come into the Senedd with fully fledged law written, done, and all the regulation-making done around it – it simply doesn’t happen ….

“We’re not the government, we don’t have all the civil servants and the expertise but I do think it is something … we really do need to look at – how we improve this process.”

Mr Evans also pointed to the new UK Government bringing forward a mental health bill, saying it is important that parts of the legislation work on a Wales-and-England basis.

He urged the new “future Senedd committee”, which is examining reforms for the next term from 2026, to look into greater opportunities for backbench legislation.

Sarah Murphy, Wales’ mental health minister, was disappointed by the withdrawal of the bill but hopeful many of its aims will be achieved through the UK legislation.

Plaid Cymru’s Mabon ap Gwynfor similarly regretted withdrawal of the Welsh bill, saying it was a significant step forward in addressing serious deficiencies in mental health law.

Warning the Senedd too often falls short in living up to the promises of devolution, he added: “It shouldn’t be the height of our ambition here to simply wait for Westminster.”

Elin Jones, the speaker or Llywydd, said the Senedd’s business committee will be beginning a review of legislative processes at its meeting on December 3.