SAVE Our Health Services At BRONGLAIS HOSPITAL

The Council held a public meeting in the main hall at Penweddig Comprehensive School. The primary aim of this meeting was to gather public opinion and ideas in order to relay them to the Welsh Government.

Minutes of the public meeting 12/9/14 held in Penweddig School with regards to Bronglais Hospital

Meeting organised by Aberystwyth Town Council led by the Mayor Brenda Haines, Deputy Mayor Endaf Edwards, Elin Jones AM and Mark Williams MP.  Also in attendance Professor Marcus Longley, Simon Thomas AM, Joyce Watson AM, various town and county councillors.

The Chair welcomed all to the meeting.

Apologies were noted from Wendy Morris (previous Mayor), Carwyn Jones, Mark Drakeford, Bronwen Morgan, Bernadette Rees (Hywel Dda Health Trust).

The Mayor Brenda Haines led by stating that this meeting was about their stories so that Prof Longley could take relevant notes. In her own personal experience, the Mayor has had health problems. She has in the past have had to try and contact 3 different number for an taxi ambulance  - and failed to get any and had to pay for a private taxi which cost £96 to go to Morriston.  As an ex-midwife, she was concerned that consultant led maternity is being moved to Glangwili. To Carwyn Jones and Mark Drakeford I say – man-up and deal with Mid Wales.

Lucy Huws – “I was diagnosed with Cushings (cushions) disease and have had treatment in Cardiff. I don’t have a problem with going to Cardiff for neurosurgery treatment – I had excellent service in the Heath, and continue to have good care from excellent GPs and Bronglais locally – but I had bad experiences getting referred from the 4 different hospitals. I was referred from Bronglais to Glangwili – and told I was on a waiting list, despite my consultant Endocrinologist having put me as needing to be seen to urgently. This points to the fact that a consultant from other hospitals, is able to override the decision of a Bronglais Hospital consultant, and it follows then that patients from mid-Wales will not be given the same priority as patients from Carmarthen etc.  Secondly, I sent a letter to Glangwili in Welsh, but I was told because my letter was in Welsh it would take a week to get translated as there was no in-house translators. I was then told that the notes from the previous hospital appointments had not followed to my hospital appointment at another hospitals. When I was called for an operation in the Heath, it was at 5.30 on a Sunday night for the following day. If I did not have the support of the family, I would not have been able to attend due to lack of public transport to get there. What would elderly and sick patients be able to do in a similar situation?

Without proper listening and EQ skills by the Welsh Government – we feel we are not being understood– and we are so dependent on the services of Bronglais Hospital. The cost of security to for NATO summit £50million for security precautions during a 2day NATO summit in Cardiff recently, however here in Mid Wales, we do not get the same level of service to protect our health, which is the biggest threat to life here. Prof. Trevor Purt was one of the highest paid executives in the NHS and has been moved to another high paid NHS trust role of with an increase of salary of £50,000. Who does he work for? Is he doing the government dirty work by cutting costs and being reimbursed for it? Could we please have some accountability and honesty from the Welsh Government .”

Dr Aeron Davies – consultant physician for 30 year in Bronglais Hospital. I’m concerned about the status of the hospital. When you add the students and the holiday makers – there is a population of around 122,000 – a decent population for a General Hospital, expanding from New Quay, Tywyn to Llanidloes. We’ve spoken before about the importance of the golden hour.

When I first started working for Bronglais, it was run by a committee of consultants who discussed how the hospital was run. If they were not happy – they contacted the Welsh Office, a system which worked very well. The start of the failure was when the bureaucrats took over. In 1976, a man had severe heat stroke and was in need of a haematologist. We gave him a unique treatment – the only man in the UK to suffer such heat stroke and recover. We were the first in Wales to use BPM measurement to find artery disease. We were the first in Wales to use insulin for diabetics. We ought to bring back a system of medical consultants in charge of the hospital and not the bureaucrats. The staff are treated very badly – and we need to know how we can improve standards – possibly with the reintroduction of the matron.

John Franzon – “I was admitted to A&E and stayed in Bronglais for 31 days and the staff were excellent. Staff morale was high but external staff were coming in for £55 per hour from as far as Birmingham. They use this form of back staff so that they can say at the end of the year “look at the cost of running Bronglais”. Also – when you look at the people attending this meeting – generally older people – we need to think how we can get younger people involved in the campaign.”

Staff Nurse Sarah Webster – “I’m a 26 year old who was raised in this area. I did a degree and now work as a theatre practitioner.  I’m sad to say that I want to move away because of the working conditions in Bronglais – it is not a happy place to work. My mum suffered a heart attacked as if it wasn’t for Bronglais being there to stabilise her position – she would have died.”

Paul Hinge – “I am the Chair of Hywel Dda CHC but I am not talking in that capacity. The issue I wish to raise is disappointment that Bernadette Rees is not here. From my work with CHC – I see that the number of complaints and issues with the Health Board have increased not decreased. The Health Board are run by non-clinical managers who do not know how to deal with people. They are draining the Health Board with their salaries. I am going for an operational on Monday, but based on personal experience – I shall have the Cambrian News on standby as operations are regularly cancelled”.

Mair Benjamin – “I want to speak about the lack of beds in Bronglais. I had orthopaedic problems a few years ago. They had seen the MRI scans- but it was left for a year before it was dealt with by which time the knee gave up. I had to be treated as a trauma patient and due to the knee giving way I had to have a hip operation – then a knee operation. The aftercare after both operations was very very poor.

I know a 23 year old with terrible skin condition who has to go to Cardiff to attend visits and loses 2 days’ work.

I want to mention the loss of Afallon – the mental health ward as well. There was a patient who used to attend Afallon as an outpatient , who could not get the level of service need by her GP is now on the Ystwyth ward for 6 weeks unnecessarily.  If the care in the community is not set up – mental health patients will end up in general wards – tying up even more beds.”

Unnamed – “My wife has recently died as she was a patient in Bronglais. We were referred to Morriston and I was going 110 miles every day to see here. Due to the lack of care – the nurses were trying to put her in a chair and she damaged her other foot. She then died”.

Unnamed – “The Health Board are not going to respond to the issues – nobody could be bothered to turn up. Can we not subpoena them to attend? It defeats the object of the meeting. Can we force them to attend?

Phil Davies – Aberaeron Town Council – “Thank you for calling the meeting. Personally I am grateful for the support of Bronglais during the complication during the birth of my son.  Glangwili is already overstretched with existing services without taking more on. Cardiology is moving – which is a great shame as the service provided by Dr McKeogh. The ambulance service is unable to reach people in time, not their fault – they are being used to move patients to other hospitals from Bronglais rather than be available for emergencies.”

Unknown – “in 1996, I had Hodgkin’s lymphoma. I had really good service in Bronglais, and help including Art Therapy and Aromatherapy on the ward. I was in again last week and would like to emphasise that the still provide a very good service. My brother lives in Llandrindod and was told he had to go to Abergavenny for treatment as the cancer ward in Bronglais was being downgraded.”

Unknown – “I’ve worked as a nurse for 25 years and I know how the trust operates. I’m not surprised that there is nobody here from Hywel Dda trust. Things are getting worse. South Wales has the political clout. Has there been a viability carried out on the risks involved in downgrading?  The other hospitals have a worse record that Bronglais for morality.  The recruitment process is in a complete freefall. HR have made such a balls-up – staff who already have jobs are invited to interview, the wrong people invited for the wrong interview, in one case – 4 of the shortlisted candidates out of the 12 selected were invited but not the other 8. By the time they are ready to interview – people have already had other jobs.  There is a new management system in place and we the staff do not know who we answer to.  For instance, I was trying to put an order in for bins – and had great difficulty in ordering things for the ward.

I was going to start a campaign for a new MRI scanner – funding has been going elsewhere. Patients are asking to be referred to another hospital due to the uncertainty over the MRI scanner.  Appointment times given are also unsuitable for the elderly and people with young families who are being asked to travel long distances with no public transport available.”

 

Ceredig Davies – “To give some background, the County Council did ask Hywel Dda to meet them but they refused. In the end, the agreed to meet behind closed doors. They see these meeting as political meetings and not a listening exercise of being answerable to the public.  Hywel Dda are asking people to attend their meeting in Cardigan, but they never come to other people’s meeting”.

Unnamed - “I’m an 84 year old who has to travel to Swansea to check my pacemaker. Why do I have to travel at unsuitable times for public transport? Billy Smart Circus would not employ the people involved in the running of Hywel Dda”

David – “Why are they moving services to Glangwili when we have a hospital here? They just want to have their own way. All Mark Drakeford thinks about is North and South Wales hospitals. We need consultants here. It should go back to having a Bronglais Health Board”.

Jacob Ellis – “I’m the Students Union president and in our meeting in the last academic year – we gave a vote of no confidence in the health Board by the students. We are continuing to support the community in its fight to safeguard the hospital. From a student perspective, the choice of University will be predicated on the availability of services. We cannot lose further student numbers due to not having the facilities available. It is a political meeting – yes – but it is a community matter without being party political.

 

Janice Tedaldi – I have a question. I’ve had numerous MRI scans. The other hospitals do not trust the MRI scans from Bronglais. Morriston’s Hospital admits to this. Why does the Welsh Government not provide the funding for it”?

 

Unknown – “I live 13 miles from Aberystwyth on narrow and winding roads. I am very far from Carmarthen. In the winter, we have to grit our own roads; we have to cut our own hedges. When we have accidents – we cannot heal our own wounds.”

 

Lisa Francis – “It is not acceptable for patients in their 80’s to be send to Glangwili for routine items such as a nose bleed. This is empire building. The failure of the MRI scanner is putting health at risk. We are committed to fighting the Health Board. I think is it time for direct action. We are grateful to you for organising, but how many meeting do we have to go to.”

 

Unknown – “My husband had skin cancer and saw Dr Askell in Bronglais but he could not continue with the service. We were passed on to another consultant within Bronglais. He was under a consultant in Bronglais – but again had to have another MRI scan in Morriston. The consultant told us – “wait 2 weeks and if you do not hear anything – contact them”. When we contacted after 6 weeks – we were told that Morriston had not received the referral. Are we second class citizens here? He was treated in the end, and he had a good service in Singleton, but we had to fight to get him there. The consultant knew that we would have to push for the service to be provided and this should not be the case”

 

Martyn Shewring – “It’s a disgrace that the Health Board are not here. Who oversees it? The Assembly. If they are listening – why don’t they do anything? I want to see evidence of accountability from Bernadette Rees. We are raising legitimate concerns here – she should stand by her ward.”

 

Unknown – “How can they expect people who are ill to drive? The Health Board are supposed to be protecting us. Can we have an MRI scan instead of a Health Board?  One of the key drivers of the Welsh Government is that we should have 5 fruit and vegetables a day although there is no scientific basis for this claim.  This is our community and the Health Board should be involved with us.”

 

Ray Quant – “I want to make comments to the First Minister regarding the Williams Report. The report had to look at public services in Wales, but did not want to look at the Health Boards as part of this review. Why not? There is very little in the Williams Report regarding health at all. The health service is bleeding money from the Welsh Assembly – the result of which is that there are heavier cuts on the local authority to fund the Health Boards. Ask the First Minister to look again at the health implications of the Williams Report.”

 

Glynis Somers – “I have a question – if casualties come in – and the A&E ward is full – they will refer to Carmarthen due to lack of beds – are the Health Board guilty of murder is somebody dies due to lack of facilities in Bronglais.”

 

Unknown – “If a staff member gets transferred – staff should refuse to work elsewhere. They also should object if equipment gets moved to other hospitals. We need to launch an appeal to buy a new MRI scanner.”

 

Unknown – “We should not keep having meetings with no Health Board attendance. This is a personal meeting, not a political meeting. Medical people know more than the bureaucrats. The nurses are wonderful. The Welsh Assembly must listen to rural Mid Wales. They do not understand rurality. It is a solemn thing that people should die due to the failure of the Health Board to respond.”

 

Chris Simpson – I am a recently retired pathologist who worked in Bronglais. In the 1960s when the hospital was built – it was here for a purpose. We have to be geographically here. The natural catchment was that we are caught between major hospitals to the South. We have regardless of size provided a good service and run a tight ship until 2006. In 2006 – we were no longer good enough. Everything went downhill and the Health Board overspent. Bronglais did not overspend, but we had to pay for the failure of other hospitals.”

 

Frank Hogg – “What happens next? Official notes are being taken – but we need to make sure that we have access to those notes? I think it is important that the records are available. May we also see the reply from the Health Board and Welsh Government? Many of the stories heard tonight are hearsay – we need to get to the facts. If nurses are paid £55 per hour – we need to find out why? They need to be recorded and need to know what the reply is.

 

Ellen ap Gwynn – “I am the leader of the Council and come here tonight to listen. I will not share my personal experiences, but some of you are aware of the examples I can use. We need to keep Bronglais not just for Ceredigion, but for the other counties who rely upon it. I’m very glad Professor Marcus Longley is here as his report to Mark Drakeford will be crucial. We should be explaining what the vision for Bronglais. We have examples of excellent past practice here.  We should also look again at the Williams report – and ensure health is funded in the same way at the funding which comes to the local authorities to pay for the services the public needs.  I’ve had to travel for treatment personally and can empathise with those of you who are too ill to travel. When we had a local health board, it worked and to budget. Why do we think big is beautiful? Please Professor Longley – can we have a positive future for Bronglais?”

 

Mr Winfield – “The Assembly members here are supportive, but the Welsh Government has made its mind up regarding Mid Wales. The downgrading has an economic effect on the area. Families do not want to move here if their future career is at jeopardy. We need to look at different ways to provide secondary services. Most other countries with rural communities are able to provide the service. In Scotland, they have 3 rural acute hospitals that function is a population similar to Bronglais. In New Zealand, they have similar examples.  The difficulty is the Government are frightened and will not act unless we provide a united front. There are many who are unable or frightened to speak – they are the ones who have the most use of the health service. Of course every decision Hywel Dda health Board takes is a political act. It is not a party political issue.”

 

Jackie Roberts – “there is no orthodontic service in Bronglais, For a 5 minute appointment, children have to miss a whole day of school and parents have to take a full day from work to attend the appointment.”

 

Alan Wyn Jones – “We must think of Mid Wales as an entity in itself. We are all taxpayers and all in this together.  I must add that the use of bank staff happens in other hospitals. My son was recently in Ysbyty Gwynedd and bank staff from as far as Liverpool and Manchester were being used.”

 

Joyce Watson AM – “I know about rurality – I’ve lived in Ceredigion, Carmarthenshire and now live in Pembrokeshire. It is great to see this many people in the same room and I thank the ones who have contributed for their bravery.  I have spent the last few days visiting hospitals and visited Bronglais today to get and understanding of how the £38m invested has been used on the ground. I was told that the scanner used was state of the art. I will question this. I have made notes of the issues raised and will bring them up with the First Minister.  I also asked why the Health Board was not attending – the answer given was that they did not want Professor Longley’s report to be compromised. The report is independent to look at how Bronglais can be improved. I come as a politician to listen to you and seek answers on your behalf.”

 

Unknown – “Which scanner is state of the art? The CT scanner is state of the art, but the MRI scanner is not.”

Alun Williams – “It is important that all of the messages get through to the Welsh Government. There is one danger – that the negative press campaigning from Bronglais has is making it more difficult to recruit consultants. We need to make sure that we get a positive vision out – structures of the Health Board needs to be challenged, but the vision and mentions of Bronglais should be positive ones.”

Glan Davies – I wrote to Mark Drakeford in June and reminded him of the promise made by Jane Hutt in 2002 that every General Hospital in Wales would have a cardiologist. They managed to successfully recruit Dr McKeogh. Has the Welsh Government changed their minds by moving him from Bronglais to Glangwili? 

Mererid Jones (minute taker) – “Just a reminder for those who have spoken but not provided their names that they can give their names at the end. Also – Bronglais has a charity to raise move for new equipment – Friends of Bronglais Hospital. If there is a campaign to raise money for an MRI scanner – this should be used, not the Hywel Dda Charitable Foundation for which the funding could be going to any of the hospitals involved.”

Unknown – “the report by Professor Longley – I’ve been told that we will not be able to see the outcome without the permission of the Minister of Health”

Elin Jones AM – “The report is commissioned by the Minister of Health, but it will be a public document which I can get available on request. It has been a victory to Mid Wales to have this report. Other hospitals under threat of downgrading are not getting such a review and we have fought hard to get this status. There has been a gain to Bronglais that this report will be publicised. It is more important that Professor Longley hears your view tonight than the Health Boards or the Welsh Government.

To respond to some of the issues raised, centralisation plans exists in Health Board throughout England and Wales. We have to make the case that Bronglais is unique due to the geographical position. We’ve won the argument that – and we understand that we have a new challenge ahead of us. We want a new vision- not all specialism can be based in Aberystwyth – but we still need to make sure that lives are protected. We need to be able to give certainly and stability to the staff rather than the uncertainty they have been working under. It is unacceptable that the health Board are not here tonight. We can scrap local Health Boards and find innovative ways of integrating social services with health in Mid Wales. Hopefully all of that will be part of the new vision.”

Mark Williams MP – “Thank you for the opportunity again. There is so much case work with regards to health – it implies that there is a very big problem in Hywel Dda Health Board with the management structures in place.  Professor Longley is listening. We need to note all the stories. I want to share 2 stories with you. I’ve never had to stay in a hospital in my life, but my father who is in this 80s lives in rural Powys. He had a serious health problem with 15 minutes to spare and do what was necessary. We reached a conclusion that it would be better for my parents to move closer to Aberystwyth and the family as well as being close to the local hospital. The services he requires are no longer there – but we should be entitled to the same services.

Regarding the comments made about midwife led service – prospective parents have been sent letters regarding this, warning that they should be looking to have their children in Pembrokeshire and Carmarthen. When I spoke to Bernadette Rees from Hywel Dda – she denied any such letter had been sent – but I showed her a copy of that very letter.  Core services have to remain.

I would also like to mention the experience of volunteers and workers in the Afallon ward turning up to find a locked ward. For shame. I have faith that that Assembly Members here will make the case, but the key person we need to talk to at the moment is Professor Longley.”

Janet – “I work in the hospital and want to share to you some of the positive aspect of the staff. They have faith in the hospital and from their own goodwill – come in to work on their days off to ensure that the work is being done. I’ve provided care where no service was available – to make sure that the patient does not suffer. We will gain success stories. We are working with the nurse lead services to get integration for years to come. Let’s take the power back to us. This is want we have to do.”

Dr William Roberts – “Thank you on behalf of the ABER group. The Minister of Health did listen and promised to deliver a Mid Wales report about how the services should be developed. Since that time, there has been considerable comment and things have moved forward.  Bernadette Rees is not here for a very good reason. If she came, she would have to explain the actions of Hywel Dda in the part – but we want to know what she is going to do about and the future.”

“Ms Rees is clear that the Professor Longley report is crucial and will determine how services are to be delivered in Mid Wales. Mid Wales is of strategic importance to Hywel Dda – they must work in partnership with Betsy Cadwalader and Powys health Board. The report will be pulling evidence from several strains of rural health care models. Links with tertiary care is very important to keep doctors trained in an attractive and exciting place to work. I am confident that it will align a form of good employment.

We need to support the current position and await the outcome. It feels to me that this is the final chance to meet the challenge head on.  There are issues to be resolved – Professor Longley needs to be convinced and the Welsh Government needs to be convinced that it can be delivered. With the personal commitment of the new chairman, something very positive is happening with goodwill and confidence. Those involved now feel this way.”

END OF MEETING

 

Other messages received (written)

Beryl Young – “Referred for treatment (OA) Knee osteoarthritis 2 years ago. I’ve been put on a waiting list on the 4^th of June 2014 and told that no surgery will be possible until at least June 2015.”

Alison Sayes – “As a midwife with 37 years’ experience (the last 7 of which in on the Gwenllian ward in Bronglais – 20 years as a community midwife and on a midwifery lead care unit in Halifax). I am concerned about possible plans for Gwenllian to become midwife led. I fully endorse the ethos of MLC, but I have grave concerns about the suitability of Gwenllian as such a centre in light of the geographical area – i.e. transfer ties in obstetric emergency events.”

T Williams – “Hywel Dda are deliberately using bank/agency staff to give the false impression that Bronglais is expensive and centralisation is the cheapest option. At the same time, they are failing to recruit staff for vacant posts. A minister “worth his salt” should be asking the Health Board to provide figures for Bank/Agency staff. They will discover that taxpayers’ money is being deliberately wasted by Hywel Dda and should be exposed.”

M Budd – “If we in Bronglais lose further consultant led services, we will not attract the young G.P. trainees for their widest possible further medical experience and future employability. Bronglais needs such doctors on its staff or who else will want to work there?

Malcolm Tulip – “Would like to say how helpful Bronglais has been for me. The palliative care has been absolutely very good. We need local hospital services for local people, travelling a far distance can harm some people. Thanks Bronglais”.

Alan Hewson – “Only a major change in political decisions will halve the destructive effect of the NHS not only in Mid Wales, but throughout the UK. The Health Services is about people and not about profit.”

Unnamed (name available but not to be publicly released) -  “My husband died 46 years old due to cancer in Bronglais in July 2014. The service he received from the nursing services and the Intensive Care and Meurig ward was excellent, and the hospital is absolutely crucial for all Ceredigion residents. I am very concerned about the changes in the Intensive Care unit. Simply, the very ill patients (such as car accidents) would not survive the trip to Carmarthen. It is not acceptable that the service is being gradually eroded and a reduction in the numbers of bed. I had to wait for 10 months for treatment during my husband’s illness (I was having a cyst and ovary removed). I received a patronizing letter from Hywel Dda Health Board telling me it would be acceptable to wait 10 months as the blood test (CA125) is normal, but I asked the oncologist why the cancer markers of my husband is normal regardless of the fact that the cancer had spread to other parts of his body. His answer was that blood tests are not very reliable. I had to suffer the situation knowing full well that my husband was not going to survive and we have a 9 year old child.  I want to ask: -

·         Why the number of beds has been reduced and the waiting lists so long?

·         Why is there only 1 PET scanner in Wales with so many people suffering from cancer?

·         Why are the excellent and dedicated staff of Bronglais under so much stress?

·         Why does Hywel Dda Health Board not take the concerns of the population seriously?

·         Why are they threatening the lives of the area population by taking the services away from us?

 

Catherine Hughes – “My daughter has had Juvenile Arthritis since the aged of 4 ½. She received excellent care from Bronglais and referred to Gobowen due to the fact that there are no Rheumatologists in Bronglais anymore. Is she allowed to be referred to Gobowen, as we are in limbo with regards to future care”

Alex Thomas – “My aunty (who lives in Llanidloes) went into early labour in March 2012 birth by C-section. The baby’s condition deteriorated and he was placed in an incubation unit in Bronglais.  As his condition worsened, he was moved to Glangwili SCBU in an ambulance. He almost did not make the journey alive. His mum has to stay in Bronglais all night without her son and his father travelled to and from Carmarthen from Llanidloes every day for 2 weeks; with a 2 year old at home to take care of. Taking neonatal care from Bronglais is a dangerous and ridiculous move. It is vital.”

 

Graham Owen – “As a regular patient at Bronglais, I am treated by excellent consultants who were involved in wider research in conjunction with other teaching institutions. My experience with Carmarthen Glangwili has been appalling and I feel I have been treated as an outsider and of no consequences, no communication and ignored.”

 

Janet Owen – “As a fairly healthy individual, I have great sympathy for those who must travel to receive treatment for severe conditions. However, I believe we are all entitled to treatment of all kinds, whether we are life-threatening or not. We are not getting the service we have paid for. We need a good small hospital here in Bronglais.”

 

Sian Jones – “My mother lives in Meirionnydd and had an accident in Aberystwyth. She broke 3 fingers, and was told by Bronglais that she must travel to Swansea for treatment. When we explained that geographically she wanted to be referred to Wrexham instead (as it is on the bus route to her home), she was told that she would have to go at her own risk and own arrangement (i.e. she couldn’t get an ambulance to Wrexham even though one was offered to Swansea). When we got to Wrexham – no notes were provided and the investigation (X-rays etc.) had to be done again. Huge duplication.”

 

A M Leney – “We have had an expert bowel cancer team in Mr Jackson and Mr Salami – who have successfully operated on three of my elderly relations. Please keep this service”.

 

Eve Ropek – “In a wider context, the NHS is being starved of investment prior to privatision (like the railways) – a form of public theft. The disparity between the obscenely high salaries at the top and those at the coalface is a disgrace.”

 

Davies – “One occurrence recently – 11/9/14 with effect of the closure of the Acute Mental health Service in-patient in Bronglais. On this date, a known user of this service needed immediate treatment – due to the fact there is no beds in the area. The patient and staff required transport to an acute admission unit – leaving Aberystwyth for Llanelli and halfway were detoured to Cardiff, and then detoured to Bangor due to where beds being occupied and availability. This entire unnecessary journey taking hours and hours including the transport costs. We need mental health beds locally – before this situation happens again – this is just a recent occurrence that needs looking into with answers.”

 

Alex Thomas – “I am a qualified Speech & Language Therapist who grew up in Aberystwyth and trained for 4 year in Cardiff. I intended to come home and work for the local NHS. Having qualified in July 2013; no full time permanent posts have arisen (or temporary for that matter) therefore I have moved away and work for East Cheshire NHS Trust now. I want to work in Ceredigion and contribute to my local healthcare service.”

 

Sandra Oliver – “I’m very disappointed that Afallon Ward (mental health) has been permanently closed. Is there sufficient care in the community to make up for this loss?”

 

Brendan Somers – “Maybe we need to go and meet Hywel Dda instead of asking them to come to us.”

 

Unnamed (info can be provided on request) – “I’m suffering from cancer at the moment and receiving excellent chemotherapy at Bronglais.  The aftercare however is patchy. I have to wait at home I day a week to wait for the nurse to come and change the dressing on my arm. No time is given for the appointment and as a result, I lose more time from work which I cannot afford.”

 

Mercedes Mills – “It has been a very frustrating meeting. Various people commented on the fact that this is the 3^rd meeting held with no representatives from Hywel Dda Authority. We needed a more tight direction or chairmanship to ask personal stories and to say what is going to happen next. What are our representatives doing about all this? Two of the 3 of them were present. Fortunately, they got to speak at the end, but very little was promised. At least the report will be published. Let us hope something is done this time. However, I am still grateful that the meeting was organised.”

 

Non Jenkins – “I want our health service to be patient centred, with thought given to how individual conditions can be treated in very part of Wales, but especially Mid Wales. My experience of Bronglais includes: -

·         My husband surviving a brain haemorrhage. Because he was stabilised at Bronglais prior to surgery in Morriston. He would not have survived the journey to Glangwili.

·         My disabled son received excellent care as a child, overseen by top quality paediatrician at Bronglais who co-ordinated his care and development. A distant specialist could not have offered a comparable service.”

 

Rachel Hughes – my sister lives in Llandrindod and suffers from cancer and I live in Aberystwyth. She has taken her children to live in a tent for the 6 weeks she was receiving cancer treatment in Cheltenham – 85 miles one way as she was too sick to travel and did not have the means to pay for a hotel for such a long period of time. Had she received an option to attend Aberystwyth – she would have selected this as I would have been able to support her.

 

Unknown – we live 70 miles from Gobowen Hospital, an excellent orthopaedic facility, and 73 miles from Swansea. Although I have specifically asked to be referred to Gobowen, but as this is in England – the Health Board seems very reluctant to refer me – regardless of the fact that getting to Welshpool, Shrewsbury and Gobowen is much easier as there are rail links from Aberystwyth to all hospitals.

 

Bill Parker (written submission received) – “I have taken an interest in the administration of the Health Services by the Welsh Government and the Health Board by attending Community Health Council meetings, through correspondence with the Health Board and the Minister and studying the Integrated Planning Framework which is available on the internet.

 

It has become clear to me that the Health Board has so many constraints placed upon it by Government as detailed in the Framework that it’s really influence in the planning of provision and delivery of services is miniscule. Yes, they are responsible for day to day organisation and service, and indeed the acquisition of all resources required, however they can only act in compliance with the plan agreed by government, and for which their financial allocation has been agreed.

 

The Chair of the Health Board mentions a number of constraints (which are Government requirements) in her recent letter to me: -

“Welsh Government has made it clear that the NHS will focus on prevention, care closer to home and improving quality and safety of services.”

“We cannot plant in isolation of other health Boards in Wales largely because the population is too small to give critical mass of patients that would allow Doctors to gain and maintain their skills and this is particularly so in our region.”

“Already, many specialist services are only provided from two major tertiary centres in the south of the country or even in England (for examples serious burns, major trauma, neuro-surgery, many cancer surgical procedures, neo-natal services) and if we are to meet the relevant Royal College standards to improve outcomes and make working in Wales attractive to Doctors, we potentially have to look at other area.”

“We must incorporate an element aimed at reducing health inequalities, where all the evidence shows that more deprived communities will have shorter lives and more illness.”

“To ensure we can meet need, we must also plan in partnership with social services colleagues and the third sector to tackle deprivation and the impacts of deprivation on two fronts – health and well-being”.

“Our planning must ensure those patients who do not need to be in hospital are provided with a comprehensive (multi agency) package of care in either a residential care or home environment. This is part of the care closer to home ethos we are working towards, alongside making sure more services are available outside the hospital environment.”

“Since we are a public body, accountable through legislation to the Welsh Government and wholly reliant on public money, it is right and proper that the Government sets the parameters that we work within, reviews our plans to assure itself we are addressing the issues, assesses whether we are meeting our statutory responsibilities and the hold us account in terms of delivering our plans”.

 

Now given all those constraints is it any wonder that when the public challenge the plans (which by the time they are published or leaked are very well developed) that they are politely listened to with deaf ears.

 

I think that we are totally misled to the belief that the Health Board are responsible for service changes and I believe that this myth results in a great deal of waste of the public money they tell us they are trying to save.

 

There are many questions concerning the direction the NHS is taking, the way it is governed and managed which remain unanswered. I believe that each of us should express our concerns and ask for answers as often as possible.

 

Written submission unnamed: -

Reasons to keep Bronglais: -

Speaking up for “hidden disabilities” – not everyone can just “jump in a car” and drive or be driven for 2+ hours over horrendous and accident-ridden roads:

·         People with agoraphobia, travel phobia (e.g. trauma after car accident), social phobia, autism, learning difficulties, Alzheimer’s – just because it isn’t as obviously restrictive as a broken leg doesn’t mean that these disabling conditions should be dismissed or disparaged, sniggered at or treated with impatience and contempt. They deserve dignity and care.

·         These people rely on familiar known services (and medical staff) within their own known area – suffering and death will result from inability to cope with being catapulted into unknown situations and having to deal with a succession of strangers. Some will not seek medical care as a result, if services are dispersed.

·         As we know from elderly support services such as Age Concern, if a family member is taken ill and whisked away to a far hospital, their relatives will suffer distress and financial difficulty. They are “hidden” sufferers too, especially if they themselves are ill or disabled. What if the patient is their sole carer?

“Obvious” points: -

·         Aberystwyth is the main central town of West Wales with a huge catchment area that relies on medical and other social services being located here.

·         Central University town – student numbers will decline if parents are worried that no or limited hospital services here.

·         If the University declines, the town will decline.

·         Running down services or putting question marks over them mean that key medical personnel (nurses, technicians, doctors, consultants) will not dare apply for jobs here due to job insecurity.

·         The “golden hour” for treatment will be lost – death and suffering will result.

·         What is the point of promoting “equal opportunities” and “accessibility” services in the University and other employers for people with disabilities if the infrastructure can’t support it?

·         People who are already ill, both with the original condition and after treatment such as chemotherapy, should not be forced to endure hours on sick-making roads, especially in bumpy ambulances or over-fast taxi drivers (who may not want the responsibility of sick passengers).

·         It’s not just one visit – what about repeat consultation and treatment? Not everyone can afford expensive hotel fees, or overpriced train journeys to avoid road travel.

·         Main resort for ageing population- people retire here to “lie healthily by the sea” especially with our marvellous prom and other facilities. Medical services must remain here to back that up.

·         Residents paying council tax and NI insurance for decades deserve key services in return for investment.

 

Health officials should not seek to “slide out” of services from under our noses. It’s dishonest and a betrayal of the people they are supposed to serve. Perhaps collectively, we as residents, could come up with solutions, but not if we are excluded from discussions. And certainly not if officials from health boards and government continue to cry off hearing our concerns by not attending these meeting – it’s cowardly and simply confirms that we don’t matter.

 

People say “how many deaths will it take before they listen” – however, death is not the worst thing that can happen and should not be used as a benchmark for action. What about “how much suffering it will take before they act to relieve it”/ - suffering is acute, long term and happing right now. That should be the priority – when did health care stop being humane?

 

We have had the courage to stand up and say “do something about it” – what about those who actually have the power to act? When will we hear them stand up for us?

 

Clarification received on e-mail by Chris Simpson

I just wanted to say that there is an error on the documentation handed out to people at the meeting tonight.  It is quite true that the Histopathology Department has closed at Bronglais. This was, however, nothing at all to do with Hywel Dda HB. Histopathology departments have been merging across the UK for the last 25 years, for perfectly sound operational reasons.

 

Regarding the MRI scanner. The conventional MRI scanner is a closed cylinder around 1m in diameter. Patients are moved into the scanner on a horizontal sliding “stretcher” and they have to be still while the scan takes place. Many patients experience severe claustrophobia while they are in this closed cylinder. When the existing MRI scanner at Bronglais was being considered, I think the radiologists were approached by some very convincing salesmen from the MRI companies. They suggested buying an “open” scanner. This is, in effect, half a cylinder. They said it had the same resolution as the conventional scanners. The advantage of the open scanner is that obese patients and those with severe claustrophobia problems could easily be accommodated at Bronglais. It was suggested that Bronglais would be taking many patients from elsewhere in Dyfed and Powys because the open scanner was so much more patient-friendly than the conventional scanner – in effect it would generate considerable income for the radiology department by sucking in many patients from the surrounding areas. So the order for the open scanner was placed and it was installed. As we all now know, the resolution of the scanner was not as good as a conventional scanner – so patients from Bronglais have to go elsewhere, rather than patients from elsewhere coming to Bronglais.