Hywel Dda Health Board reshuffle plans to be referred to Welsh government

Campaigners say the move has given them hope

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Controversial plans for big changes to the NHS in mid and west Wales have been referred to the Welsh government.

Hywel Dda Health Board wants to change accident and emergency care at Prince Philip Hospital in Llanelli.

The Special Care Baby Unit at Withybush Hospital in Haverfordwest would also close under some of its plans.

But Hywel Dda Community Health Council's (CHC) move will mean the decision is taken by ministers in Cardiff.

A health board spokesperson said: "We are disappointed by this referral as we have had a series of constructive meetings with the CHC over the last three weeks and did not believe that we had got to the end of that process".

It is understood the health board's proposals to close two minor injuries units at Tenby and South Pembrokeshire hospitals have also been referred by Hywel Dda Community Health Council (CHC) to Health Minister Lesley Griffiths for a decision, along with a plan to close Mynydd Mawr Community Hospital in the Tumble.

Several local campaigns have been fighting to protect services.

'Redesigning care'

Hywel Dda Health Board met on the 15 January to make final recommendations on wide-ranging proposals to reorganise health services in its area.

The plans include:

  • Redesigning emergency care at Prince Philip Hospital to be a nurse-led service but supported by doctors. The hospital would retain a 24/7 emergency medical assessment and admissions unit.
  • Centralising complex baby care at Glangwili hospital in Carmarthen, which would lead to the closure of the specialist baby care Unit at Withybush hospital in Haverfordwest.
  • Closing two minor injuries units (MIU) at Tenby and Pembroke Dock with staff redeployed to Withybush. The health board would commission a pilot project which would mean the MIU at Tenby would remain open for eight weeks during the peak tourist season in the summer.
  • Shutting Mynydd Mawr Community Hospital which treats elderly patients with services delivered in the community and at Prince Philip.
'First class healthcare'

Managers insisted they had to move forward with overhauling services, to meet the challenges of an aging population, retaining and recruiting medical expertise, and to meet financial pressures on the NHS.

The board argues the changes will help it deliver "first class healthcare services to the local population, now and into the future" and will support delivery of more care closer to people's own homes and ensure hospitals are better equipped to deal with the most seriously ill patients.

Analysis

So what happens next?

Well, if the Welsh government decides that everything is in order then a panel of assessors will be put together chaired by Chief Medical Officer for Wales Dr Ruth Hussey.

She will go through the community health council's representation line by line and give the minister Lesley Griffiths her assessment.

Then the buck stops with the health minister.

She can either tell the health board to modify its plans, to press ahead with them or re-jig them and start again.

She could instruct them to start a whole different plan and another round of consultation.

It will be very interesting to see what happens.

The health board insisted that none of the changes will take place until it is safe and appropriate to do so.

It has also pledged a £40m investment for new community health centres to provide a range of services including diagnostic tests, outpatient appointments and physiotherapy.

These will be located in Aberaeron, Cardigan, Carmarthen, Cross Hands, Crymych and Whitland.

Since those decisions were made - Hywel Dda CHC has had six weeks to assess the plans and hold talks with the health board before deciding whether or not to make any referrals to the Welsh government.

The CHC had previously told BBC Wales that negotiations with the health board were set to go "down to the wire". The deadline for referral of Hywel Dda Health Boards plans is Tuesday 26 February.

It is understood the CHC has written to the Health Minister and health board to explain its decisions. If any proposal is referred then the CHC has to indicate alternative options which it believes will better serve patients.

The health board said it looked forward to working with the CHC and Welsh government as part of the formal referral process.

Meanwhile, opposition politicians in the assembly called on First Minister Carwyn Jones to intervene and stop the reforms.

Mr Jones said ministers could not comment publicly on specific proposals while they were on the health minister's desk.

"All relevant factors will be taken into account bearing in mind that what we all want to see is a safe and sustainable health service," he added.

Professor Marcus Longley, director of the Welsh Institute for Health and Social Care at the University of Glamorgan, said it was a "really difficult decision" for the health minister.

"This dispute, this controversy has been going on for many years now," he said.

"Successive health boards and leaders locally haven't really come up with a solution that satisfies local people so now the judgement of Solomon is going to be required by the minister."

He said the situation in the area was unique because there are "four major hospitals distributed across a population of less than 400,000".

Last week the north Wales patients watchdog Betsi Cadwaladr Community Health Council decided to give its backing to plans to make big changes to the way health services are delivered across north Wales.

The decision provoked widespread criticism from campaigners and some local politicians from the four main political parties.

It came because Betsi Cadwaladr Health board plans to transfer of high-level intensive care for babies currently provided at Wrexham Maelor and Glan Clwyd hospitals across the border to Arrowe Park Hospital on the Wirral, England.

It also proposes to close four community hospitals.

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