Health
Withybush paediatric care gone for good in yet another blow for hospital
OVER seven years after “temporarily” closing Withybush’s 24-hour Paediatric Ambulatory Care Unit (PACU), Hywel Dda UHB decided to close the department permanently on Thursday, November 30.
In January, the Board will meet to receive the plan for its implementation plan to make the change permanent.
A FOREGONE CONCLUSION
Describing the Board’s decision as a foregone conclusion would be grossly unfair. But, as Thursday’s meeting chugged along, it became clear it was.
Bluntly, the Board has neither the money, resources, nor staff to return paediatric care to Withybush. It didn’t have them before the consultation began. In the interim period, the only thing that changed was the catastrophically worse financial performance that led to the Board being subject to enhanced monitoring by the Welsh Government.
The Board’s ability to deliver its preferred option, which included returning some outpatient services for children to Withybush, is doubtful.
However, it now needs a plan to implement its plan. That plan to have a plan for its implementation plan will be discussed in January when the Board will discuss the planned plan for a plan.
If the planned plan for a plan doesn’t work out, the Board will go back to the drawing board to draw up another plan for its plan.
A “TEMPORARY” PROBLEM
In three years, the Board moved from a 24/7 service to a promise to return to a 12/7 service to a bold attempt to preserve an 8/7 service.
As our columnist Badger noted five years ago, the next step was bound to be a 0/7 service.
And then Covid came along.
PACU was closed, and its services “temporarily” transferred to Glangwili during the pandemic.
At the end of the pandemic, PACU didn’t return.
Instead, the Board justified its continued cessation because of the risk of a spike in respiratory viruses.
When that spike didn’t happen, the Board consulted on a “permanent solution”.
And that permanent solution – as glaringly obvious for years – was permanent closure.
A DECADE OF WORTHLESS REASSURANCE
In 2014, the Board stopped providing 24-hour paediatric care at
Withybush. At the time, it said that a 12-hour provision was deliverable, and it planned to return 24-hour paediatric care to Withybush once it recruited clinical staff.
By then, there was only ONE advert for a single paediatric consultant at Withybush and NONE for nurses specialising in paediatric care.
At one point at the end of 2015, the Board suspended its recruitment campaign for posts at WithyWithybush’s after claiming to have recruited staff to fill vacancies there. It announced an intention to launch a more focused campaign later.
In November 2016, the Board restated its commitment to maintaining the Paediatric Ambulatory Care Unit’s opening hours at Withybush from 10am-10pm, even though it faced “renewed and significant workforce challenges at the consultant level”.
In 2017, CEO Steve Moore said the Board was clear: “The changes to paediatric services are temporary and in response to us needing to ensure a safe and reliable service for our families with the consultant paediatricians available.”
After ending the 12-hour PACU cover, the Board did not launch an effort to recruit for three months after its closure.
By the end of the same year, the Board said: “Unfortunately, we have not been able to recruit a sufficient number of consultants to support the re-establishment of the 12-hour PACU service, although our recruitment efforts continue.
“In the meantime, the Health Board is working with staff and partners to explore a number of ideas to support a sustainable PACU service for the longer term.”
In 2018, the Community Health Council issued a report.
It said: “The health board needs to do all it can to resolve the current temporary reduced hours arrangements in PACU”.
CONSULT THE PUBLIC, THEN IGNORE THEM
Thursday’s meeting continued to offer mealy-mouthed platitudes instead of health services.
Board members suggested that parents of children in need of paediatric care would be reassured by the clarity the permanent removal of a key service from Pembrokeshire would provide.
Discussing the lack of transport options, Board members said they would publicise the availability of the Designated Ambulance Vehicle and the use of a taxi service to ferry children and parents from Glangwili.
The disconnection between the Pembrokeshire public and the Board over the issues could not be more complete.
Board members said that the main problem with the attitude of Pembrokeshire’s concerned parents was communication.
Pembrokeshire’s respondents to the Board’s conscientious rubber-stamping process were clear the issue was not communication but concern about timely treatment close to home.
70% said PACU should return to Withybush. The Board’s alternative, closing PACU for good, was overwhelmingly rejected.
If communication were the issue, not the provision of treatment at Withybush, the Board could have resolved it by being straightforward and transparent.
It wasn’t.
All the communication in the world, delivered by the best communicators money can buy, cannot circumvent that epic failure of honesty.
Describing the Board’s decision as a foregone conclusion would be grossly unfair. But, as the meeting ground on, it became clear it was.
Bluntly, the Board has neither the money, resources, nor staff to return paediatric care to Withybush. It didn’t have them before the consultation began. In the interim period, the only thing that changed was the catastrophically worse financial performance that led to the Board being subject to enhanced monitoring by the Welsh Government.
TOTAL DISCONNECTION
Board members suggested that parents of children in need of paediatric care would be reassured by the clarity the permanent removal of a key service from Pembrokeshire would provide.
Discussing the lack of transport options, Board members said they would publicise the availability of the Designated Ambulance Vehicle and the use of a taxi service to ferry children and parents from Glangwili.
The disconnection between the Pembrokeshire public and the Board over the issues could not be more complete.
Board members said that the main problem with the attitude of Pembrokeshire’s concerned parents was communication.
Pembrokeshire’s respondents to the Board’s conscientious rubber-stamping process were clear the issue was not communication but concern about timely treatment close to home.
If communication was the issue, not the provision of treatment at Withybush, the Board could have resolved issues by being honest and transparent from the outset. It wasn’t. All the communication in the world, delivered by the best communicators money can buy, cannot circumvent that epic failure.
PERMANENT CLOSURE “BETTER”
Six years ago, “temporary” became the status quo.
Then “temporary” became a further “temporary reduction”. During Covid, the whole service was “temporarily” withdrawn.
So intense was Board members’ collective delusion at Thursday’s meeting that the permanent removal of the PACU service and its replacement with a vague promise of some outpatient clinics for children returning to Withybush sometime over the rainbow was represented as an improvement on the current position.
Even this Thursday morning, the current position was “temporary”, not permanent.
The Health Board’s thesaurus must look very peculiar.
Its word games demonstrate the extent to which the Board had long dispensed with the pretence of PACU’s closure temporary nature.
In the meantime, the Board plans to tell more people about its Dedicated Ambulance Vehicle and plans to fund taxis for distressed parents and sick and injured children.
You can bet that’ll make everything better.
Health
Phone calls to reduce GP visits for 42% of patients this winter
NEW research from the Royal Voluntary Service has shown that a simple phone call could significantly impact well-being, reducing GP visits by 42% among patients who receive regular telephone support.
The charity urges those feeling isolated this winter, particularly the elderly, to use telephone support services as a way to improve health and free up GP appointments, potentially reducing waiting times. It is estimated that if people experiencing loneliness in later life reduced their GP visits by just one appointment a year, this could free up 588,000 appointments annually.
As winter approaches, the Royal Voluntary Service reports that isolation can sharply increase, especially for adults over 75, with nearly half (47%) of people in this age group feeling lonelier in the colder months. Among those who live alone, one in six say they feel forgotten during winter, and 20% report having no one to turn to for emotional support.
In addition to loneliness, older generations face several winter worries, including increased heating costs, cited by 55% of respondents, and reduced ability to go out, which 29% said they dreaded as winter sets in.
To address these challenges, Royal Voluntary Service has launched the Stay Safe, Warm and Well campaign in partnership with Yakult. The campaign provides a guide for practical and emotional winter preparation, encouraging sign-ups for telephone support services and offering access to the Virtual Village Hall online community for events and activities. Practical advice on money-saving and energy-saving tips is also available through the guide.
Royal Voluntary Service Ambassador Elaine Paige, who has herself made support calls for the charity, described the positive impact these calls can have. “A warm, friendly phone call can transform someone’s day. Some conversations leave you smiling long after the call ends—something we could all use, especially in winter. For those facing the season alone, there are amazing people ready to remind you that you’re not alone,” she said.
The charity’s support services match volunteers with individuals across the UK for friendly chats, reducing isolation and boosting mental health. Catherine Johnstone CBE, Chief Executive of Royal Voluntary Service, said: “The feedback that conversations with volunteers are helping people to visit their GP less is testament to the value of connection.”
Yakult Marketing Manager Reshma Patel added: “Our research with Royal Voluntary Service shows that one in four adults over 75 feel they’d benefit from practical and emotional support over winter. We are committed to helping people access the Stay Safe, Warm and Well guide to support their overall well-being.”
Health
Over 1500 patients in Wales blocked from leaving hospital
THE First Minister Eluned Morgan has been pressured on her government’s failure to clear hospital beds in Wales, leading to delays for people seeking urgent medical care.
According to a report from BBC Wales, there are currently 1,600 patients across Wales waiting to be discharged from hospital compared to England where there are currently 12,000.
However, when comparing population sizes, it’s revealed that Wales is performing worse than its closest neighbour, with 0.05% of the population of Wales stuck in hospital beds compared to 0.02% in England.
The Welsh Labour government have been criticised for their failure to clear out backlogs in the system,
The Liberal Democrats have now called on the Welsh Government to provide urgent social care funding to local authorities to help alleviate pressures on the NHS in Wales.
Speaking in the Siambr on Tuesday, The Leader of the Welsh Liberal Democrats Jane Dodds MS described how over twenty years of Welsh Labour government in Wales had let to a “desperate situation in our NHS, with services nearing breaking point.
Welsh Labours refusal to change their approach and fix a system clogged up by mismanagement is directly responsible for the current situation faced by thousands of patients.
Delays in discharging patients from hospitals are placing huge pressures on both staff and those awaiting care, but there is a way out of this mess and the answer lies in social care.
I have been told by numerous professionals working in healthcare that the first step towards fixing our NHS is made by providing local authorities with the funding to fix social care services within their respected areas.
By dedicating adequate investment into our social care services, we can make life easier for patients discharged from hospital while also lifting the strain on health services throughout Wales.”
Education
Concern over ‘highest-ever’ school bullying rates
RATES of bullying in Welsh schools have reached record levels, with more than one in three children and young people reporting being bullied, the Senedd heard.
Gareth Davies raised concerns about a 6% increase in bullying between 2021 and 2023, according to a survey of more than 130,000 pupils in 200 secondary schools.
The Conservatives’ shadow mental health minister told the Senedd: “These results are higher than ever previously reported in the survey, which is deeply troubling.”
He said the latest survey showed regression on “just about every metric of pupil wellbeing”, including growing social isolation and a rise in behavioural issues.
Mr Davies, who worked in the NHS in north Wales for more than a decade, pointed to a 2021 legal duty to have regard to the mental health of children and young people.
He said: “The mental health of pupils has declined and reports of bullying in schools have only increased, so the Welsh Government have failed in that duty, unfortunately.”
Plaid Cymru’s Cefin Campbell called for an update to 2019 anti-bullying guidance for school governing bodies following a commitment from the Welsh Government eight months ago.
The shadow education secretary focused on the impact of poverty, warning the high cost of school uniforms can cause stress and lead to bullying.
Mr Campbell, a former lecturer, expressed concerns about penalties, such as detention, for pupils over non-compliance with uniform policies.
Raising a report on “horrific” experiences of racism in Welsh schools, he said one pupil was told a classmate did not want to sit next to them due to the colour of their skin.
“That’s entirely unacceptable in our schools,” said Mr Campbell.
Labour’s Carolyn Thomas warned children’s mental health is at an all-time low, pointing to smartphones and social media as major contributing factors.
She said: “They can be used to bully, manipulate and control, sending young people into an isolated world of despair, not thinking they can get out of it or go to somebody for help.”
The North Wales politician highlighted a petition calling for a ban on phones in schools.
Rhys ab Owen, an independent who represents South Wales Central, stressed that bullying can impact people for decades to come after school.
“But it’s an issue that doesn’t affect learners equally,” he said. “In Cardiff, around a third of learners come from ethnically diverse backgrounds.
“And I was staggered to read a survey from 2020, which said that 61.5% of learners had expressed stereotypes over skin colour, religion and nationality.”
In a statement on November 12 to mark anti-bullying week, Lynne Neagle accepted that bullying continues to be an issue in Welsh schools.
Pledging to prioritise the problem, Wales’ education secretary said new statutory anti-bullying guidance will be published for consultation after Christmas.
Ms Neagle pointed to concerning trends, including 42% of girls scoring high or very high in a questionnaire on psychological problems compared with 27% of boys.
She told the Senedd: “I wouldn’t want to be a teenager growing up today.”
Ms Neagle stated the Welsh Government provided more than £800,000 this year for one of the biggest surveys of children and young people in the UK.
She said: “The link between bullying and mental health is well known. At its most extreme, young people have taken their own lives as a result of being bullied. This is a tragedy for the young life lost, for their family and friends and for whole communities.”
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