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Health

Chair’s reflections and focus on recovery one year on

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MARIA BATTLE, Chair of Hywel Dda University Health Board, which plans and delivers the majority of NHS care in Carmarthenshire, Ceredigion and Pembrokeshire, is reflecting on the last year as we reach the anniversary of the first UK stay-at-home instruction in response to the COVID-19 pandemic:

“The day of reflection planned across the UK on Tuesday March 23 2021 will be a poignant day.

Families who have suffered the loss of a loved one either directly from COVID-19, or during the pandemic, are living every day with their personal grief and loss. In Hywel Dda University Health Board alone, 474* people have died from COVID-19 since the start of the pandemic.

Loved ones lost before their time.

Our thoughts and sympathies are first and foremost with people who are grieving at this time. The hope is that this day of national reflection will demonstrate that their loved ones were seen and are remembered. Our thoughts are also with our staff who cared for those lost so lovingly at the end of their lives.

In Hywel Dda University Health Board, we will join others across the UK in a one minute’s silence at 12noon on Tuesday, to remember those lost. Care will continue to be provided, but what can be paused will be paused. We will take those moments privately, or collectively with our colleagues, to remember in peace and to pay tribute.

An online remembrance service has been organised for our staff on this day, so those who wish to come together have a place to do so, although not physically but in the spirit of togetherness.

As always, staff can attend our hospital chapels if they need a place for rest or recuperation, and are invited to light battery operated candles, funded by Hywel Dda Health Charites, and distributed across our sites and community services.

As we know, the simple act of lighting a candle can help the emotions we may experience from continued pain, suffering and anxiety become a tribute to hope and thankfulness for the heroic response by many people in our communities.

We are also invited to shine a beacon into the night sky at 8pm by using our phones, candles or torches; and we thank our partners in local authorities in Carmarthenshire, Ceredigion and Pembrokeshire who will light up landmark buildings in our area for this day of reflection.

But alongside remembrance and reflection, in Hywel Dda University Health Board, we have also turned our attentions to the recovery and learning that is necessary as we start to emerge out of the pandemic.

I am so very proud of the sacrifices made by our staff (frontline and support), their families, our partners and our communities during the past year.

I have been awed by how our communities have rolled up their sleeves. Whether that has been other key workers, people staying at home, those shielding, home schooling, or in support of neighbours by volunteering and carrying out heart- warming acts of human kindness.

The hope and the light that came when we received the first batch of vaccines on December 8 2020 grows daily and shines more brightly. Our staff, volunteers and partners have worked so hard together in recent months to deliver vaccines to those most at risk, to save lives and protect us all.

And people have come forward for their vaccinations in numbers we daren’t imagine were possible, to protect themselves and their loved ones and their communities.

As of March 17 2021, we have given 175,893 vaccinations in total, representing 39.5% of our population (more than 50% of eligible adult population) having received their first dose and 5.9% receiving the full course (2nd dose).

We are on target to offer vaccination to all adults in West Wales by the end of July, subject to supplies being received as planned.

This extraordinary achievement opens up hope for the future as we continue to work towards our vision for a healthier mid and west Wales. But we have a lot of work to do to re-build and a lot of learning to take stock of.

We are all acutely aware of the detrimental impact on people waiting for planned operations far longer than we would like. We have written to all patients who have waited more than 52 weeks to say how sorry we are, to explain why and to ensure our waiting lists are correct to help clinical decisions as we re-start non-urgent care. You can keep up-to-date on the re-starting and expansion of planned care services here: https://hduhb.nhs.wales/healthcare/covid-19-information/restarting-services/

We are about to offer a single point of contact and additional support to some patients. We are starting with a group of orthopaedic patients, so they are supported to look after themselves and be ready for surgery, and are able to recognise and report any significant changes to their clinical condition. We want to eventually roll this out to everyone on the waiting list.

General advice to people on how to remain well whilst awaiting surgery, which can improve outcomes after surgery, is available here: https://hduhb.nhs.wales/healthcare/covid-19-information/preparing-for-treatment-lifestyle-advice/

Without the pandemic however, we would unlikely have seen the speed of the digital roll out and community based care that we have been able to provide in people’s own homes, or closer to them.

For example, in March last year only 1% of outpatient appointments were carried out online, but as of January this year, 28% of outpatient appointments were carried out in this manner, with really good feedback from patients.

We are also continuing to support staff with their own health and wellbeing with a range of psychological and wellbeing services. Many are exhausted and they and their families have made great personal sacrifices. It has been humbling and inspirational to listen to their experiences and see how they have looked after each other as well as their patients. They need some time to rest and recover before the full resumption of all services.

I have recently set up a group of experts, including the Military, to advise on how we best support staff coming out of the pandemic. To rebuild stronger, we need a solid foundation and that is our staff who deliver or enable the care we provide

Following the Senedd elections, we will also ‘check in’ with our communities and open up a conversation about the pandemic and what it has meant for you and your experience and access to health and care. We want to consider any new information you have that we need to take into account when planning your health services for the future.

So next week is for reflection and remembrance. But it is a not a one day event for us in Hywel Dda UHB. We will use what we have learnt and all our experiences to inform what we do and how we do things moving forward to hopefully, make things better for our communities, our staff and our patients.

 

Health

Medicine shortages now ‘most severe on record’, health leaders warn

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PATIENTS are facing some of the worst medicine shortages ever seen in the UK, with pharmacists warning the situation now poses a serious risk to safety.

The National Pharmacy Association said shortages affecting commonly used medicines are becoming more frequent, lasting longer, and causing increasing disruption for patients, GP surgeries and pharmacies.

The warning comes as Serious Shortage Protocols for Creon, used by people with pancreatic cancer and cystic fibrosis to help digest food, have been in place since May 2024 and have now been extended until July 10, 2026.

HRT treatment Estradot has also been under a Serious Shortage Protocol since December 2024, with the current extension also running until July 10.

Patients travelling between pharmacies

A survey by the National Pharmacy Association found that 98 per cent of pharmacies had encountered patients who had visited several pharmacies in one day to find a prescription.

It also found that 96 per cent of pharmacies believed the current situation posed a serious risk to patient safety, while 89 per cent said they had been unable to dispense a medicine at least once a day because of supply problems.

Some pharmacy teams have also faced anger and abuse from patients unable to obtain medication.

Olivier Picard, Chair of the National Pharmacy Association, said: “Medicine shortages are becoming more frequent, lasting longer and causing increasing disruption for patients.

“These shortages are some of most severe the UK has experienced.

“It is deeply distressing to find patients who have travelled from pharmacy to pharmacy to find the medicines they need without success.”

Calls for urgent taskforce

The NPA is calling on the government to convene an emergency taskforce involving manufacturers, wholesalers, clinicians and pharmacists.

It also wants changes to rules which currently stop pharmacists from making simple substitutions, such as changing a tablet to a capsule or a cream to an ointment, even where a safe alternative is available.

Professor Victoria Tzortziou Brown, President of the Royal College of GPs, said medicine shortages were frustrating for patients, GPs and pharmacists, and added pressure to already stretched services.

She said the College supported pharmacists being able to make limited changes to prescriptions where a medicine is unavailable and a safe alternative exists.

She added: “The most important thing is that patients are able to access the medication they need safely and without delay.”

The Cystic Fibrosis Trust and Pancreatic Cancer UK have also raised concerns about the impact of shortages of pancreatic enzyme replacement therapy, including Creon, on people who rely on the medication to digest food, maintain weight and stay well enough for treatment.

 

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Health

Woman jailed assaults on police, harassment and XL Bully possession

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A CARMARTHEN woman has been jailed after admitting a lengthy catalogue of offences including assaults on police officers, harassment, breaching a Community Protection Notice, shop theft, possession of an XL Bully dog and assaulting a paramedic.

Tilly Rees, 25, of Llys Caermedi, Carmarthen, appeared before Llanelli Magistrates’ Court on Wednesday (Jun 18).

The court heard that Rees admitted multiple breaches of a Community Protection Notice issued in 2025, including incidents in which she shouted abuse in public, caused distress to residents and repeatedly targeted individuals named in court proceedings.

Harassment campaign

Among the offences was a harassment charge relating to a course of conduct against a Carmarthen man between March and May this year.

Prosecutors said Rees approached him on multiple occasions, shouted abuse, called him a paedophile and video-recorded him and his home.

She also admitted a series of Community Protection Notice breaches linked to the same behaviour.

Police assaults

The court heard that Rees assaulted a number of police officers during incidents in Llanelli on May 1 and May 5.

Several assault charges against serving police constables were taken into account by the court when sentence was passed.

A further charge of assaulting a paramedic at Dafen Police Station on June 12 was also admitted.

Shop theft and XL Bully

Rees also admitted stealing items including sanitary products, deodorant, skincare products and reading glasses from a Carmarthen pharmacy.

In a separate matter, she admitted possessing an XL Bully dog contrary to the Dangerous Dogs Act. The court ordered the dog to be forfeited and destroyed after Rees relinquished her rights to it.

Restraining orders imposed

District Judge M Layton imposed a number of restraining orders preventing Rees from contacting named individuals or referring to them online.

The orders prohibit direct or indirect contact and restrict social media activity relating to those protected by the orders.

Jailed for 26 weeks

Magistrates concluded that only an immediate custodial sentence could be justified.

Rees was sentenced to a total of 26 weeks’ imprisonment.

The court heard that some of the offences were committed while she was already subject to a suspended sentence, while others involved assaults on emergency workers carrying additional aggravating factors.

 

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Education

Senedd Members walk out after Reform MS’s comments

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COMMENTS made by a Reform MS led to a walkout in the Senedd during a debate on the Welsh Government’s international spending.

A Reform motion, calling for an end to all Welsh Government international spending, was rejected by Senedd Members on Wednesday June 17.

Wednesday’s plenary opened with Llywydd Huw Irranca-Davies reminding members to mind their language and tone when contributing, following clashes between Reform UK’s Joe Martin and the First Minister in Tuesday’s proceedings.

Mr Irranca-Davies said: “Robust disagreement is part of democratic debate, but it must always be grounded in respect and we must avoid using language that has the potential to inflame debate or to increase tensions.”

The debate was opened by Reform’s shadow minister for finance and government efficiency, Cai Parry-Jones, but it was the contribution made by Caerdydd Penarth MS Joe Martin which sparked the most controversy.

Reform MS Cai Parry-Jones
Reform MS Cai Parry-Jones

Announcing to his colleagues that he had “good news”, Mr Martin began his statement by sharing that he had “found the £9 million” needed for Plaid’s “childcare idea”.

However, Mr Martin then added that the “bad news” was to get the money the government would have to stop funding “some of the most pointless schemes known to man”.

One example Mr Martin gave of these so-called “pointless schemes” was a beekeeping scheme in Uganda designed to advance gender equality.

The scheme, run by Bees for Development and their partner organisation, The Uganda National Apiculture Development Organisation, aimed to enhance women’s economic empowerment through beekeeping.

It challenged gender norms in the industry, increasing the visibility of women in technical and policy leaderships roles.

Mr Martin then suggested Wales had won the “Who can find the stupidest use of taxpayer money?” competition because of a scheme supporting tree planting in Uganda.

He said: “We actually asked some Ugandan people what they thought about Wales’s scheme to send them money for trees and they said, ‘Why are you sending us money for trees?’

“We then asked the same question to some Welsh students who had been through our underfunded education system, but we didn’t get a reply because we had e-mailed them and they couldn’t read.”

Mr Martin went on to criticise the money spent on mini embassies abroad.

He said: “In India, one of the functions of those mini embassies is to recruit nurses to come and work in our NHS, which is great because it means that the Welsh people who would have otherwise become nurses can instead go on universal credit.”

The Reform MS then added: “I have enquired as to why we can’t just have an enormous pit where we burn all the money, but apparently that’s not compliant with net zero.”

At this point in Mr Martin’s statement Plaid Cymru’s Zaynub Akbar, of Caerdydd Ffynnon Taf, announced she was going to leave the Siambr.

She said: “I don’t accept any of this and I don’t want to be a part of it, so I’ll be leaving the chamber.”

Plaid Cymru MS Zaynub Akbar
Plaid Cymru MS Zaynub Akbar

She was followed by numerous other Senedd Members, including Trefnydd and chief whip Heledd Fychan.

Mr Martin was then reminded by the Llywydd of Senedd rules, which mandate respect in the chamber, before he could continue his contribution.

He concluded his speech to the Senedd by saying: “In Westminster, the Tory party doubled foreign aid whilst imposing austerity. There are now only seven of them in this chamber. The same fate awaits any party that insults taxpayers by frittering money overseas on feel-good vanity projects.

“So, I want to encourage the Party of Wales to be nationalist, to put Wales first. Spend your constituents’ money on your constituents. That way, when someone is lying in a hospital corridor and they ask you, ‘are you really the Party of Wales?’, you’ll be able to say ‘yes’.”

At the end of the debate, the Llywydd directly addressed Mr Martin calling for him to “reflect” on his remarks and contributions, noting that it was “not in line with [his] expectations”.

Mr Irranca-Davies described it as “particularly disappointing” given the comments he made at the beginning of plenary.

Senedd Llywydd Huw Irranca-Davies
Senedd Llywydd Huw Irranca-Davies

He said: “Going forward, I think we all need to reflect on this and make sure that we comply with our conduct within this chamber and the way we comport ourselves in light of my remarks.”

Welsh Conservative leader Darren Millar expressed his support for the Reform-backed motion, saying it is a debate about where responsibilities lie.

He said: “It’s very clear that foreign relations, international development are matters for the UK Government, not the Welsh Government, and as a result of that, I believe that we respect devolution and can expect respect for devolution back when we respect the boundaries of our legislative competence and the competence of the Welsh Government’s position as well.”

Welsh Conservative leader Darren Millar
Welsh Conservative leader Darren Millar

Mr Millar highlighted that his party has continuously argued against the development of “mini embassies” and “overseas offices”.

The Conservative leader did clarify however that he is not “anti-international aid”, and noted the “generous” nature of the people of Wales.

But he added: “I do not believe that when people are dying waiting for ambulances, when we’re at the bottom of the educational tree as far as the league table of the United Kingdom is concerned, and when our road infrastructure isn’t working, our transport infrastructure is creaking, that it’s right to spend those millions of pounds on those things, when the Welsh Government should be focused on the things for which it is responsible.”

Taking an intervention from Labour’s Huw Thomas, Mr Millar was questioned on whether he recognises that the majority of international spending is on economic development for Wales.

Labour MS Huw Thomas
Labour MS Huw Thomas

Mr Millar once again referred to the role of the UK Government, noting that it is their responsibility to bring inward investment to the UK as a whole.

He said: “We will always want to be an internationalist country, looking out and seeking to influence the world, but we do that as part of the United Kingdom, an integral part of the United Kingdom.

“And I’m proud to be a member not only of the Welsh Conservative Party, but of the Conservative and Unionist Party, and I believe in the union of the United Kingdom, and that these foreign relationships and international development are done better as a United Kingdom as a whole.”

Plaid Cymru’s Gwyn Williams shared a notably different perspective to that of his Conservative and Reform colleagues.

Prior to being elected to the Senedd, Dr Williams was a consultant ophthalmologist specialising in retina care at Swansea Bay University Health Board.

Plaid Cymru MS Gwyn Williams
Plaid Cymru MS Gwyn Williams

Speaking as someone who has worked within the Welsh NHS Dr Williams said: “Wales has long been a country that looks beyond our own horizons, looking to make a difference in the world and help where we can, but also we rely on help coming in to us as well.

“Many, many healthcare workers, of course, come from abroad, especially here in Wales, and every hospital in the country would crumble if all the international workers went home.”

He continued: “In Singleton Hospital in Swansea, in the eye department, I am the only Welsh-speaking, Welsh-origin consultant there, and much as I like to convince myself that I can do the work of ten people, I cannot, especially now because I am here.

“Chronic shortages in these sectors increase hospital discharge delays, reduce bed availability and create bottlenecks across the healthcare system.

“At a time when the NHS is struggling, we need the support from abroad as well, though we also, of course, need to grow our own ability.”

Concluding his statement Dr Williams said: “This whole debate tries to position international investment and domestic investment as a zero-sum game. It isn’t.

“Looking outwards does not come at the expense of looking inwards. I suggest that such a simplistic outlook condescends to the people of Wales and stymies science.”

Dafydd Trystan Davies, minister for government effectiveness and the constitution

The cabinet minister for government effectiveness, Dafydd Trystan Davies, called for reflection on the tone of the debate, suggesting that the “standard of this debate [had] descended to the level of a public house, not of a national Senedd”.

He said: “My friend the leader of the Welsh Conservatives made a speech, and I disagree with more or less all of it, and yet it was conducted properly and in line with the standing orders and the procedures of this Senedd.

“I think we should all take our duties properly as parliamentarians, whatever views we agree or disagree on.”

Dr Trystan Davies highlighted that international spending makes up just 0.03% of the Welsh Government’s overall budget, which he described as a “small contribution” to “building our prosperity, protecting our public services, strengthening our culture, and promoting our values”.

He said: “Our international work turns that belief into action, creating jobs and investment, exports and partnerships, life-changing experiences for students, new colleagues for our NHS and enabling communities in Wales and beyond to learn from one another.

“When Wales works internationally, Welsh people benefit. Our businesses reach new markets, universities build global partnerships, young people return home with skills and confidence, and Wales’s reputation grows.

“We should be proud of that, not in a narrow way, not with our backs turned to others, but proud to be generous and outward-looking, proud to share, proud to learn – internationalist, not isolationist.”

The motion to end all Welsh Government international spending, tabled in the name of Blaenau Gwent Caerffili Rhymni’s Reform MS Llŷr Powell, was rejected by the Senedd with 37 members for and 48 against.

The Siambr then agreed Plaid Cymru minister Heledd Fychan’s amendment, which proposed the Senedd “regrets Reform UK’s isolationist approach to Wales’s place in the world” and “celebrates Wales’ reputation as an internationalist, tolerant and outward-looking nation open for business, which is enhanced by its international engagement, including spending.”

The amended motion was agreed with 48 in favour and 37 against.

 

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