Health
Hywel Dda board to consider refreshed health strategy to 2040
New plan promises more care closer to home, ‘Digital First’ services, and stronger focus on prevention
HYWEL DDA UNIVERSITY HEALTH BOARD will consider a refreshed version of its long-term health and care strategy at a public board meeting on Thursday (Jan 29).
The proposed strategy, titled A Healthier Mid and West Wales – Healthier lives, well lived, sets out the Health Board’s priorities up to 2040 and updates ambitions first published in 2018.
Health chiefs say the refreshed plan does not change Hywel Dda’s core aim of helping people live healthier lives for longer, with a stronger emphasis on preventing ill-health and supporting people to stay well. Instead, it updates the strategy to reflect changing needs across the region, alongside wider pressures on health and care services including rising demand and the lasting impact of the COVID-19 pandemic.
The strategy sets out how clinical developments, new digital tools and community facilities could provide more opportunities to offer help earlier and closer to home, while outlining how services may need to adapt in the years ahead.
Hywel Dda said the draft refresh has been shaped by engagement with communities, staff and partners across Carmarthenshire, Ceredigion and Pembrokeshire. The engagement took place in two phases between July and November 2025 and involved almost 3,000 people.
Residents were asked what matters most to them in living a healthier life, as well as being invited to share views on priorities for health and care. The Health Board said feedback was used to develop four key themes which underpin the refreshed strategy: thriving teams, healthier communities, great care and positive futures.
During the engagement, people consistently raised concerns about the distance they have to travel to access healthcare. The Health Board said the refreshed strategy aims to deliver more care closer to where people live, with greater support in communities and at home.
The plan also outlines an expanded role for digital services, including easier access to advice, appointment booking and test results. The Health Board said it intends to create a ‘Digital First’ service designed to connect homes, communities and hospitals.
The refreshed strategy also builds on work started in 2018 on a Social Model for Health and Wellbeing, which aims to shift services away from mainly reacting to illness and towards preventing ill-health earlier, with prevention described as a central priority for improving health and reducing long-term demand.
Hywel Dda Chief Executive Professor Phil Kloer said: “Our communities have been clear about what matters most to them. People want fair access to care, strong local services, and support to stay well in their daily lives.
“This proposed strategy refresh is about listening to that feedback and setting a clear direction for how we work together over the next 15 years. Our strategy focuses on health and keeping people well, not just treating illness.
“It is also guided by our values of belonging, growth and working together. These values continue to emphasise the importance of putting people first, improving our services, and supporting each other to deliver the best care possible.
“We will continue to work with our communities and the individuals who play a vital role in shaping our social model for health and wellbeing.”
Lee Davies, Hywel Dda’s Executive Director of Strategy and Planning, said delivering the refreshed plan would require “a more radical approach” to how care is provided.
He said: “The principles of our 2018 strategy remain the same, but the world around us has changed. This refresh ensures our vision, goals and priorities reflect today’s challenges and opportunities.
“We will continue to move towards prevention, wellbeing and primary and community care, supported by digital solutions where appropriate. Most importantly, it shows how what people told us is being reflected in our plans.”
The Health Board said that if the refreshed strategy is approved, it will be finalised and published in multiple accessible formats. Work with communities, staff and partners would continue as delivery plans are developed, and the strategy would be regularly reviewed to reflect changes and developments in health needs across the region.
Health
Future of Withybush Hospital petition sparks urgent call for Senedd debate
CALLS have been made for an urgent debate in the Senedd over the future of services at Withybush Hospital as political pressure mounts ahead of the Welsh Parliament election.
Paul Davies MS and Samuel Kurtz MS have written jointly to Carolyn Thomas MS, Chair of the Senedd’s Petitions Committee, urging that a public petition concerning healthcare provision in Pembrokeshire be considered as a matter of urgency.

The petition, which has already gathered more than 10,000 signatures, raises concerns about changes to services at Withybush Hospital and calls for intervention to protect healthcare provision in the county.
Reaching the 10,000-signature threshold means the petition qualifies for consideration by the Senedd and could be recommended for debate in the chamber.
The two MSs say the issue should be discussed before the Senedd dissolves ahead of the Welsh Parliament election on May 7.
Paul Davies MS said the strength of public support highlighted deep concern among residents about the future of healthcare services in Pembrokeshire.
“Reaching 10,000 signatures demonstrates the strength of feeling across Pembrokeshire about future services at Withybush Hospital,” he said.
“Residents, clinicians and campaigners have raised serious concerns about patient safety, travel times and the cumulative impact of service changes.”
Samuel Kurtz MS said it was essential that the Welsh Government was required to respond to the concerns in a formal Senedd debate.
“Given the potential impact that the centralisation of hospital services could have on rural communities, it’s vital that this issue is debated in the Senedd before dissolution,” he said.
“People deserve the opportunity for their elected representatives to scrutinise these decisions and for the Welsh Government to respond formally on the record.”
Concerns over rural healthcare access
The future of Withybush Hospital has been a long-running issue in Pembrokeshire, with repeated campaigns over the years to protect services at the Haverfordwest site.
Previous controversies have included the loss of consultant-led maternity services and changes to paediatric provision, while more recent concerns have focused on the withdrawal of emergency general surgery.
Critics argue that moving services to larger hospitals, particularly Glangwili Hospital in Carmarthen, risks increasing travel times for patients in a largely rural county.
Campaigners say this could place additional pressure on ambulance services and potentially delay life-saving treatment.
Ajay Owen, founder of the campaign group SARS Cymru, said the petition reflected widespread anxiety across the county.
“The fact that the petition has surpassed 10,000 signatures in such a short window shows there is real concern across Pembrokeshire,” he said.
He warned that removing emergency surgery from Withybush could make it harder for patients suffering serious trauma or medical emergencies to receive treatment within the “golden hour” — the period during which rapid intervention can be critical for survival.
Campaigners argue that the combination of ambulance response times and travel distances to Carmarthen could result in some patients waiting more than an hour before reaching hospital.
Health board position
Hywel Dda University Health Board has previously said that service reconfiguration across west Wales is designed to improve patient outcomes by concentrating specialist staff and resources at fewer sites.
However, critics argue that centralising services risks leaving rural communities with reduced access to urgent care.
The Herald understands the Senedd’s Petitions Committee will now decide whether to fast-track consideration of the petition and recommend a debate before the Senedd breaks up ahead of the election campaign.
If approved, the issue could be discussed by Members of the Senedd in the final weeks of the current parliamentary term.
Community
Emergency call to restore vital Withybush hospital services
AN EMERGENCY call for councillors to fight a “total failure of the people of Pembrokeshire” downgrading of services at Withybush hospital has been backed.
At the March meeting of Pembrokeshire County Council, an emergency notice of motion by the council’s 11-strong Conservative Party group demanded that the Welsh Government immediately reverses the decision to cease emergency general surgery at Withybush Hospital.
Last year, Hywel Dda University Health Board consulted with its communities on options for change in critical care, dermatology, emergency general surgery, endoscopy, ophthalmology, orthopaedics, stroke, radiology and urology.
At a recent two-day meeting, the board, amongst its many other decisions, backed changes into emergency general surgery which will see no emergency general surgery operations taking place at Withybush, but a strengthening of the same-day emergency care (SDEC).
At the March council meeting, the Conservative council group, led by Cllr Di Clements, proposed a motion which read: “This council requests that the Labour Welsh Government intervenes in Hywel Dda University Health Board’s recent decision to cease emergency general surgery at Withybush hospital and immediately reverses their decision.
“We believe removing this service critically undermines the sustainability of Withybush hospital’s A&E department.
“Also, the decision by the Health Board does not take into account the impact and potential serious risks it will have on Pembrokeshire residents.”
Cllr Clements’ supporting statement, which included a call for Leader Cllr Jon Harvery to write to the First Minister and Welsh Government, said Pembrokeshire residents “have seen continual downgrading of services over the years, and this has been detrimental to all residents,” adding: “We believe this recent decision is life threatening to those who need emergency surgery and a matter of resident’s safety.”
At the meeting, Cllr Michael John said “there had been an erosion of services for many years,” supporting Cllr Clements’ call, but proposing the addition of calling on the health board to meet with councillors.
Newly-elected Fishguard county councillor Billy Shaw, himself a former biomedical scientist who had worked at Withybush, said the service under Hywel Dda University Health Board had become “Carmarthenshire-centred”.
Following the request by Cllr Clements, Leader Cllr Jon Harvey agreed to any letter writing, saying he had “fought long and hard to return services to Withybush”.
He gave the personal example of an operation he had over a decade ago at Withybush, saying if he had had to travel to Glangwili he had been told he “wouldn’t be here today, as simple as that”.
“There’s been an erosion of services year-on-year, it’s just not acceptable.
He finished: “It’s important we show the health board and Welsh Government we care for our residents.”
Cllr Rhys Jordan said: “It’s a total failure of the people of Pembrokeshire, Hywel Dda has taken emergency services away Pembrokeshire and once again it will be the people of Pembrokeshire that pay the price; it’s our families, our neighbours, our elderly and children.”
He added: “What does that say about how we are managed? Pembrokeshire can be managed with less, that we should be grateful for less; Pembrokeshire is not a second-class Wales.
“This decision must be reversed. Pembrokeshire deserves better than being failed again and again.”
Members backed Cllr Clements’ call, with Cllr John’s amendment added.
Welsh Labour has said that, if it wins the May Senedd lections, it will commit to a new multi-billion-pound west Wales hospital, a proposal described as a “pre-election distraction” by Conservatives.
The long-mooted hospital plan, previously proposed in St Clears and Whitland locations, was put on hold by the health board for financial reasons.
Health
Coal mine closures linked to 53% higher ‘deaths of despair’, study finds
Research suggests legacy of pit closures still shaping health and mortality across former mining communities
A NEW academic study has found that communities with a history of coal mining experience dramatically higher rates of deaths linked to suicide, alcohol misuse and drug poisoning.
Researchers from Bangor University analysed mortality data from across England and Wales and found that so-called “deaths of despair” are 53% higher in areas with a coal mining past compared with places without a mining history.
The study, published in the journal Social Science & Medicine, examined patterns of mortality between 2015 and 2023 and is believed to be the first research of its kind to investigate the long-term health impact of coal mining’s decline.
Long shadow of industrial decline
The term “deaths of despair” refers to deaths caused by suicide, alcohol-related disease and drug poisoning. It was originally coined by researchers in the United States to describe rising mortality among working-class communities experiencing economic decline.
The Bangor study suggests similar patterns are visible in Britain, particularly in areas where coal mining once dominated local economies.
Researchers say the data points to the lasting impact of industrial collapse, economic instability and deep-rooted health inequalities that continue decades after pits closed.
Lead author Eurwen Williams, who conducted the research while training as a clinical psychologist at Bangor University, said the findings reflect the lived reality of many communities.
“As a clinical psychologist, reflecting on our research into deaths of despair in former coal mining communities, I am struck by how clearly the data echoes the lived realities of growing up and practising in North Wales,” she said.
“Behind every data point is a life lost and the story of a community living with the consequences of industrial decline, economic instability, and longstanding health inequalities.
“Distress does not arise in a vacuum; it is profoundly shaped by social and structural change.”
Warning for the future
Co-author Dr Christopher Saville said the findings highlight how persistent health inequalities can become once industrial communities lose their economic base.
“It is sad to see just how persistent these health inequalities are,” he said.
“At a time when we are talking about AI causing a new wave of deindustrialisation, it is vital that we learn the lessons from the last time around and avoid some of the mistakes that were made.”
Lessons from the coalfields
Coal mining shaped large parts of Wales for generations, particularly the South Wales Valleys where entire towns grew around pits.
However, the industry’s rapid decline during the late twentieth century, culminating in widespread pit closures in the 1980s and 1990s, left many communities facing unemployment, economic hardship and social upheaval.
Researchers say the study demonstrates how those changes may still be affecting public health decades later.
While the coal industry itself has largely disappeared, its social legacy remains deeply embedded in many former mining areas.
The researchers say their findings underline the importance of tackling structural inequality alongside individual health support.
Communities still paying the price
The study concludes that the health consequences of industrial decline can persist across generations if communities are not supported through economic transition.
Researchers say the findings should inform future policy decisions, particularly as new technological changes threaten to reshape labour markets once again.
The authors warn that without careful planning and investment, new waves of economic disruption could produce similar long-term consequences for communities across the UK.
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