IN A hard-hitting interview with The Pembrokeshire Herald, a veteran health campaigner has revealed that the

Unable to cope: Glangwili Hospital

Board’s recruitment policy runs the risk of putting patients at risk as additional duties are placed on already overstretched staff. Retired surgeon, Peter Milewski calls the Board’s approach a “disestablishment policy” and said that services have been “pared to the bone.” He reveals that the Board deliberately delays recruitment, even when it knows well in advance of future vacancies. Last week, The Herald wrote about the way in which Glangwili Hospital is unable to cope with the influx of patients from Pembrokeshire. In the second of our two-part report on how local health services are coping with change, we turn to how staff at Withybush are coping with the strain.

In 2010, the health board introduced a formal policy that no vacancy was to be filled without jumping through lots of hoops. In practice the Board’s recruitment policy was found regularly to result in about six months’ delay, as shown by the gross delay this year in replacing Dr Anne Barnes MBE, with the result Dr Barnes had to come out of retirement to ‘hold the fort’ for inpatient cancer care. No advertisement was placed to replace Dr Barnes until after her departure, which was closely followed by the departure of the only remaining specialist doctor located permanently at Withybush. Health campaigner Peter Milewski told us: “I don’t know if the ‘disestablishment policy’ is still being applied across Withybush, but just before I spoke with you I heard that – certainly in theatre – people who leave are not being replaced, or if they are, only after a long interval.

“The Board even produced a flowchart showing all the stages to be followed before a recruitment advert could be placed.” Peter Milewski continued: “If, say, 50 posts a year have been managed like this for four years, and the result in each case is a delay of six months, how much money has been saved? Let’s say the relevant incomes were, as a conservative estimate, £15,000 – then you’re talking about 200×7500 = £1.5 million saved in four years. “Of course, it could be a great deal more than that. The saving on a consultant post, for example, would be £40-50k in six months. I think my own post wasn’t filled after I retired for about a year.” Meanwhile the remaining staff – already pared to the bone – have been placed under great stress.

The Herald understands that there are many examples of the stress under which frontline staff are working. One nurse has left a surgical ward saying she is so overworked that she is worried she will make a mistake and lose her registration. Theatre nurses are routinely told to work on the wards at night, though many of the more experienced ones have lost their familiarity with ward work. We asked Mr Milewski about these incidents and he confirmed that he had heard similar complaints from nursing staff: “One experienced nurse recently complained to the Nursing Council about this, and named those at the hospital who were ordering her to go to the wards. Another experienced theatre nurse has previously launched a grievance process about being ordered to work on Intensive Care when she had no intensive care skills, which would put her in a vulnerable position.

“The Nursing Council advice on this, I understand, is quite clear. That is, you should not undertake work for which you are not fully qualified.” Peter expressed his personal concern that if and when things do go wrong, it will be staff who take the blame: “I have become more and more convinced over the last few years that the basic strategy is to squeeze the system till it squeaks. When it squeaks is when mishaps occur. But they don’t care because those mishaps can nearly always be attributed to human error, and not systemic failure. “There is no acknowledgment that what they are doing increases the chance of human error. “The only thing that can then reverse the situation is if the failings are as grotesque as at Stafford in England: only then does an inquiry identify the link between system and humans.”