• Health Board cancer service ‘propped up’ and ‘unsustainable’

• Will cancer care be cut and moved to Carmarthen?

“HYWEL DDA do have a serious problem with their oncology services. They currently employ two oncologists to serve a population of 250,000 persons. 

“They rely on visiting Swansea consultants to prop up their service. This is unsustainable. “Furthermore oncology has become so specialised that it is no longer possible to be a general oncologist treating all types of cancer. “It is my view that Hywel Dda should employ sufficient oncologists to allow patients with common cancers to be treated at one hospital in the Health Board. “Patients with rarer cancers will need to travel to Swansea to a consultant who is sub specialised in the rarer cancer types. This is the way that oncology is developing across Europe.” The words of Professor John Wagstaff, the Programme Director in Medical Oncology for the Wales Deanery, the Postgraduate School for Medicine and Dentistry and the body responsible for commissioning, quality assurance and supporting the education and training of trainees, hospital doctors, GPs, dentists and DCPs throughout Wales. We asked the Health Board to respond to Professor Wagstaff’s views and we were directed to the comment it had already made about cancer services in Pembrokeshire last week: “Hywel Dda University Health Board is fully committed to the achievement of a new Chemotherapy Day Unit for Pembrokeshire which will realise the time, effort and investment that has been made by those fundraising in the county. The capital build is only part of the challenge as all service/units that we provide require a review of staffing to ensure that they are sustainable in the long term. “We continue to work hard with colleagues, partner organisations and stakeholders, including our charitable fundraisers, to ensure we provide the best care possible for cancer patients and will continue to work closely with them on the development of the new Chemotherapy Day Unit.” That response does not, however, address one inconsistency in the Health Board’s approach. The head of oncology at the Wales Deanery says that the current service model cannot be sustained and that services need to be centred in one location in relation to cancer services. Taking the Board’s press statement above at face value, it contemplates ignoring Professor Wagstaff’s view, albeit one expressed in a personal capacity. However, the Board continues to press ahead with its even more controversial plans relating to the SCBU, which it claims it is obliged to carry out due to Deanery advice on service provision. Most tellingly, it appears that the advertisement for a cancer specialist doctor at Withybush will be precisely the type of general post that Professor Wagstaff states is no longer appropriate. A Health Board spokesperson also said: “We are currently undertaking a review of Oncology Services which about strengthening and modernising local services providing high quality, safe, effective treatment and care as close to patient’s home as possible. “The review board includes in its membership oncologist from ABMUHB with whom we have a long standing contractual relationship to deliver oncology services. The board will consider a range of views from different clinical staff. The board also includes members of the CHC. “This process is not about reducing the service we offer but is about creating a more sustainable, high quality service. This may mean the way we deliver cancer services may change.”