The building of a new hospital in west Wales, which could result in around £1.3billion of investment into health and care will now be a choice of two sites, Whitland or St Clears, following a health board meeting today.

An initial 11 sites were nominated, which was reduced to five, and then three last year.

Members of Hywel Dda University Health Board, at an extraordinary board meeting, were asked to whittle down the three proposed sites of Whitland’s Spring Gardens – formerly site 12 – and Ty Newydd – formerly site C – sites and St Clears -formerly site 17 – to two.

A 12-week public consultation was held from February to May of this year, with 17 public drop-in events; more respondents rate all sites as poor, but of the sites, overall views are more evenly balanced in relation to St Clears.

A report for board members said there were widespread concerns raised about plans for a new hospital, primarily around geography/access, citing poor road infrastructure and traffic congestion, and a concern about ambulance response times, supporting refurbishing the existing Glangwili and Withybush sites and retaining services there but also recognising that a modern, fit-for-purpose hospital of sufficient size not possible on the existing sites.

Alternative sites were suggested – later rejected – included the showground in Nantyci, Canaston Bridge, and Penblewin, near Narberth.

The report also highlighted positive comments, saying those in favour felt it would be beneficial for the area economically/in improving health and wellbeing outcomes, help overcome the board’s staffing challenges, offer specialisms/up-to-date technology, and provide modern environments for patients and staff.

It said the St Clears site had drawn the most positive responses, but added: “However, it is important to note that views differ markedly by respondents’ geography/nearest current hospital.”

Of the three sites, Spring Gardens, the cheapest option, drew positives for being equidistant between Glangwili and Withybush, being closer to Pembrokeshire, and close to the A40 trunk road, but negatives were raised about poor road infrastructure, and the site being a complicated and costly sale due to multiple landowners, with limited room for expansion, and clinical/recruitment risks of siting a hospital further west.

Tŷ Newydd, the largest site, gained positives for its nearness to Pembrokeshire, the only site with potential for on-site renewable energy, the nearest to a railway station, and being owned by the county council.

Withybush Hospital Medical Committee stated: “To consider the other two sites when you have a perfect site in public ownership which can be expanded considerably is a no-brainer.”

However, negatives were raised about the lack of an access road, flooding potential, recruitment risks, and fears a large hospital in Whitland would destroy the character of the town.

Positives for the St Clears site – which has a single private landowner – included being geographically central and near large centres of population, no flood risk, easier to recruit/retain staff, less disruptive to local residents, but concerns were raised about the time taken to travel there from the west.

Summarising the lengthy meeting after a short break before a decision was made, Chair Maria Battle said: “Today is another important step to delivering our strategy of independent health and care centres, with investment in repurposing Glangwili and Withybush hospitals, bringing care closer to home.

“A vital part, now more than ever, is a new urgent and planned hospital fit for future generations. Based on the evidence we have been asked to consider reducing the shortlist from three to two sites.”

She said St Clears had the largest public support, other than residents to the west, but had commercial risks associated with it, while Spring Gardens had the highest commercial risk; Ty Newydd – the majority of the site proposed being owned by Carmarthenshire County Council -having the lowest commercial risk, but was the least liked by the public.

“I propose, taking all the evidence into account, that we take forward, as a board, the Ty Newydd site in Whitland and the St Clears site.”

Members backed this, and other recommendations, with the three suggested alternative sites of Canaston Bridge, Penblewin and Nantyci rejected.

The chair finished: “Never has it been more urgent that we in west Wales have a new hospital that is fit for purpose and fit for the future; let’s keep pushing forward to realise the vision that everyone in west Wales wants.”

THE WELSH GOVERNMENT raised the escalation level of all seven Welsh health boards on Wednesday, September 13, amid concerns about their extreme financial challenges.

Due to the incredibly tough financial climate, health boards have been unable to submit financially balanced Integrated Medium-Term Plans. Those health boards, which were not already in a form of intervention for planning and finance, will be escalated to enhanced monitoring.

Despite already being the subject of targeted intervention regarding finances and planning, Hywel Dda UHB is off target to come within its TARGETED nine-figure overspend.

Health Minister Eluned Morgan said: “It is disappointing that all health boards have been escalated to enhanced monitoring for planning and finance. We do not make these decisions lightly. Our decision reflects our very difficult financial position and the challenges affecting health boards.

“We are seeing operational pressures, long waiting lists, and an extremely challenging financial position in the NHS – but this is not unique to Wales.

“We will support health boards to improve their financial planning positions, but some difficult decisions must be made as we work through this tough financial challenge.

“In the coming weeks and months, together with the NHS, we will be working with the public to outline where savings need to be made to reduce these significant budget deficits.”

CYNICAL MINISTER CRITICISED

Plaid Cymru’s Health and Care spokesperson Mabon ap Gwynfor MS said: “All health boards in Wales are now in some form of escalated measures; this is serious.

“For the Government to publish this as a Written Statement with no opportunity for immediate Senedd scrutiny is a cynical move by a Minister that seems to have lost grip on the entire situation. It should not have taken until now for the Minister to realise the gravity of health boards’ situation and take action.

“The Health Minister must urgently address the implications of escalating intervention arrangements and provide both a clear picture of the financial wellbeing of Health Boards and a meaningful plan that gives confidence to patients, particularly with undoubted winter pressures approaching.”

Welsh Conservative Shadow Health Minister Russell George MS said: “This is a sad indictment of the state of our Labour-run Welsh NHS. After a quarter of a century of successive Labour Health Ministers, every health board in Wales is now at some level of government intervention due to poor performance.

“While it is positive that the Labour Health Minister is taking some action by acknowledging the dire state of our Welsh NHS, I have little faith, given the lack of improvements we are seeing in health boards already being monitored, that much will change in the coming months.

THE PUBLIC consultation period addressing the future of urgent and emergency paediatric services at Withybush and Glangwili hospitals has officially concluded. Organised by Hywel Dda University Health Board (HDdUHB), the consultation started on 26 May 2023 and ended on 24 August 2023. The consultation is an integral part of the health board’s broader strategy to enhance health and care in the region.

Following a number of temporary changes made to paediatric services since 2016, the health board needs a longer-term solution that will be in place until the proposed new urgent and planned care hospital is developed.

HDdUHB worked with its expert clinical and paediatric teams, staff, patients, parents and wider public and other stakeholders to identify options and evaluate them. A short-list of three options for future services were then shared to form the public consultation.

Professor Phil Kloer, Hywel Dda University Health Board Deputy Chief Executive and Executive Medical Director, said: “We would like to thank everyone who has participated in this consultation, whether that be attending one of our in-person or online events. We look forward to the next steps in the consultation process as we consider all the feedback received, to enable us to make the best decision on the future options for urgent and emergency services for children and young people at Withybush and Glangwili Hospitals.”

The health board will now begin considering the options and the consultation responses in a process called ‘conscientious consideration’. At this stage there is no preferred option for how urgent and emergency paediatric services at Withybush Hospital and Glangwili Hospital will be delivered.

For all three options, it is important to note that access to children’s emergency care will be retained at Glangwili Hospital’s emergency department, and minor injuries for children will continue to be treated at both Withybush and Glangwili hospitals.

Opinion Research Services (ORS), an independent social research organisation, has collected and will analyse the response to the consultation questions from staff and members of the public. This feedback has been gathered through online and paper questionnaires, and in-person and virtual consultation events and meetings.

As an independent and impartial organisation, ORS will present their report to the health board in the autumn. Throughout the consultation, the consultation process is guided by independent experts the Consultation Institute. The Board will then formally start their conscientious consideration process.

This rigorous review will ensure that Board members, which includes Executive Directors and Independent Members, can thoroughly evaluate all views gained through the consultation and follow a model that seeks to be unbiased and acknowledge relevant public concerns.

The consultation findings and stakeholders’ views will be presented to the Board at the end of November 2023 for a decision on the future options for the urgent and emergency services for children and young people at Withybush and Glangwili Hospitals.

For more information on the consultation, please visit the Health Board’s website: https://hduhb.nhs.wales/future-children-services/