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New hospital for west Wales faces delays due to funding issues

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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.

There have been protests over the years as Withybush was slowly downgraded, and people have been skeptical about the plans for a new hospital.
Where the Health Board says the new hospital is likely to be situated, and where existing hospitals are (Image: HDUHB)

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.

There were protests in Cardiff ten years ago, in 2014 (Image: Herald)

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.”

Health

Local nurse awarded by The Queen’s Nursing Institute

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MEGAN WARE, a Learning Disability Children’s Community Nurse in Hywel Dda University Health Board, was recently awarded the ‘Dame Elizabeth Fradd Memorial Prize for Outstanding Achievement’ by the Queen’s Nursing Institute.

This prestigious award was presented to Megan in recognition of her hard work and achievements across Carmarthenshire, Ceredigion, and Pembrokeshire.

Megan was nominated by one of her lecturers in the University of South Wales. There were many reasons that helped influence her nomination for this award. She has enthusiastically embraced the opportunity to gain experience, develop and achieve. She helped with teaching year one community children’s nursing students in the Specialist Practitioner Qualification (SPQ), sharing her own learning from her clinical practice.

Her innovation and encouragement have inspired others to feel confident within their future specialist practice and she has excelled clinically, achieving all the elements of the course to a high standard.  

Megan said: “I have always been passionate about making a positive difference to people’s lives and I feel so privileged to be in the position I am as a nurse working with children with learning disabilities and complex needs. I was completely shocked to have won this award but feel proud at the fact that I have been recognised for my work and efforts in completing the course.”

Megan is also the first learning disability nurse in Wales working within a community children’s nursing team to complete her SPQ in children’s community nursing. The course prepares nurses to become a specialist practitioner following the Nursing and Midwifery Council’s standards of proficiency for community nursing specialist practice qualifications. The skills taught involve health education and health promotion, how to improve quality in healthcare settings, leadership, and management and more.

Sharon Daniel, Interim Executive Director of Nursing, Quality and Patient Experience at the health board praised Megan’s achievement, saying: “I am proud of Megan for obtaining this award and for being the first learning disability nurse to study for the Specialist Practitioner Qualification in Wales. It is testament to all her hard work and commitment to extending her knowledge as a nurse working with and benefiting children in our community.”

Megan plans on finishing her dissertation and completing her Masters degree, which will help further her career.

This annual award is for the most outstanding student in the Specialist Practice Qualification in community children’s nursing across universities in Wales, England, and Northern Ireland. The Dame Elizabeth Fradd Memorial Prize was established in 2024 to honour the legacy of Dame Elizabeth Fradd, a Fellow of the Queen’s Nursing Institute and a distinguished children’s nurse.

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Health

Pressures remain high despite the end of ambulance ‘critical incident’

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AMBULANCE service pressures remain high despite the end of a 48-hour critical incident declared by the Welsh Ambulance Service.

The incident, triggered by overwhelming demand and a backlog of 340 emergency calls on Monday, was formally stood down after significant strain on resources.

Judith Bryce, assistant director of operations, said: “While the critical incident is behind us, significant pressures remain, and it’s really important that the public play their part to protect our precious resources for those who need them most.”

Ambulance chiefs have urged the public to use the service responsibly, advising people to only dial 999 in life-threatening emergencies and consider alternatives such as NHS 111 Wales symptom checkers, pharmacists, minor injuries units, or GPs.

“For anyone under the weather after New Year’s Eve celebrations, consider what you can do at home to self-care, including for common ailments like coughs, sore throats, and diarrhoea,” Ms Bryce added.

She also warned the public to take extra care while yellow weather warnings for heavy rain and high winds remain in place, highlighting the risk of accidents on the road and injuries from slips, trips, and falls.

The pressures extended beyond the ambulance service, with health boards including Cwm Taf Morgannwg, Hywel Dda, Aneurin Bevan, and Cardiff and Vale reporting increased demand. These boards introduced mask-wearing measures last week due to rising flu cases.

Jason Killens, chief executive of the ambulance service, described the critical situation as “very rare” and stressed the importance of using emergency services wisely.

This is not the first time a critical incident has been declared during winter pressures. In December 2020, south Wales experienced a similar crisis, while an extraordinary incident was declared in 2023 after an ambulance waited over 28 hours outside a hospital.

The Welsh government acknowledged the ongoing pressures on urgent and emergency care services and urged the public to carefully consider their options before seeking care.

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Health

Critical incident declared by Welsh Ambulance Service due to demand

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A “CRITICAL INCIDENT” was declared by the Welsh Ambulance Service on Monday (Dec 30) evening due to significantly increased demand and extensive handover delays.

The service, which covers more than three million people across Wales, reported over 340 calls waiting to be answered at the time the incident was declared.

More than half of the ambulance vehicles were stuck outside hospitals waiting to hand over patients, resulting in some people waiting “many hours” for an ambulance and delays in answering emergency calls.

Ambulances outside Withybush Hospital in Haverfordwest (Image: Herald)

Welsh Conservative Shadow Cabinet Secretary for Health and Social Care, James Evans MS, said: “Another critical incident declared by the Welsh Ambulance Service with over 340 calls waiting, ambulances stuck outside hospitals, and patients waiting hours for care.

“This is not just a winter crisis, it is a symptom of long-term failures in Labour-run Wales. Patients and frontline workers deserve better.

“It’s time for real leadership to fix this problem once and for all.”

The public has been urged to call 999 only in the event of serious emergencies.

The Welsh Ambulance Services University NHS Trust said it had implemented additional measures to ensure services could continue.

Stephen Sheldon, Head of Service, said: “It is very rare that we declare a critical incident, but with significant demand on our service and more than 90 ambulances waiting to hand over patients outside of hospital, our ability to help patients has been impacted.

“Regrettably, this means that some patients will wait longer for an ambulance to arrive and for their calls to be answered.

“For that, we are very sorry because this is not the level of service we want to provide.

“We understand that this is frustrating for patients, but can assure them that we are doing everything we can to relieve the pressure on our service.”

A critical incident is the highest alert level used by the NHS, allowing management to take immediate steps to create capacity.

Sheldon added: “The public can help by only calling 999 in the event of a life-threatening emergency – that’s a cardiac arrest, chest pain, breathing difficulties, loss of consciousness, choking, or catastrophic bleeding.

“If it’s not a life-threatening emergency, then it’s important you use one of the many alternatives to 999, starting with the symptom checkers on our NHS 111 Wales website, as well as your GP, pharmacist, and minor injuries unit.”

Earlier on Monday, Walsall Healthcare NHS Trust, which operates Walsall Manor Hospital, also declared a critical incident due to rising numbers of people needing urgent and emergency hospital care, predominantly for respiratory conditions.

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