Hywel Dda Health Board tries to finger the CHC .......
The HDHB instigated an investigation into the source of the August 2010 leak of their document.
The report about this in the Western Telegraph on 19th January 2011 was disquieting, to say the least.
It appears that (according to the HDHB) the Community Health Council
(formerly the Pembrokeshire CHC until they were merged with the other Dyfed ones by the Welsh Assembly in 2006)
is 'employed' by - would you ever have guessed this? - the Powys Local Health Board !
If this is to be believed then the NHS employers have a hold over the CHC that they never had before the events of 2006.
This erodes the principle of independent representation for the local community.
It is to be hoped that the incident will stiffen the resolve of our CHC friends
who have a fantastic record of work for Pembrokeshire dating back at least thirty years.
Here are the relevant items: Western Telegraph 19th January 2011
Poor communication is an issue: see Western Telegraph items about this.
Remember the Histopathology story?
Well, one of the pathologists whom the Health Board failed to appoint to Withybush in 2009 has now been given a post in Carmarthen. The 'Carmarthenization' process continues ... but we are trying to keep the issue open with HDHB. See these items from Western Telegraph in March and April 2011 and this factual resume (pdf). Look further into 2011 for questions we have asked the HDHB, and back to 2010 for initial reactions.
** PS ** Update January 2012. Our new pathologist, mentioned above - has now resigned from the post in Carmarthen. A better opportunity came up in England - to work with the other pathologist (a Professor in his own country) who did a locum in Withybush and wanted to come back permanently, but declined to apply when he heard the post had been removed to Carmarthen. Two more pathologists lost to the Hywel Dda Health Board, as well as the two who originally resigned. What a waste of talent! Doesn't it grate when you hear the Health Board bleating about how difficult it is to recruit, when they hugely exacerbated the difficulties themselves?
Remember the Orthodontics story?
grumbles on ...
(what sparked this)
Feb 2011. HDHB Chairman writes to Milford Haven Mayor
in response to a recent public meeting, to which he had sent a mole. Here is the letter, and here is 's response to it, paragraph by paragraph. Later the Milford Town Council had a meeting with the Chairman. Their ensuing statement demanded: a further meeting before finalizing any plans, and funding from wag to account for rurality. Click here to see this sternly worded statement..
Proof of need for Consultant-led obstetrics ...
Which is your nearest A&E?
(1 minute travel clip)
Glangwili or Withybush.
Which to downgrade?
(40 sec travel clip)
The full video
in this item from the Western Telegraph of 9th March 2011 - and an assurance from the HDHB.
And here is evidence ... that the HDHB does not want to talk about maintaining local services.
In preparing the above item proving the need to maintain consultant-led obstetrics locally,
a Western Telegraph reporter approached the HDHB for a statement. Some telling material emerged in the ensuing internal Health Board email correspondence.
They are keen a) to 'keep off the issue of services' and b) to discourage 'unfounded comments to customers/patients thereby raising their anxieties'.
Well, what is the source of these anxieties? The Hywel Dda Health Board themselves of course!
Consistently they are making reassuring-sounding comments without any actual reassurance. So what do they expect?
Click here to see the quotes from these emails sent on 7th March 2011.
The local CHC is not the only one being attacked by employers.
It's happening in Swansea too. See this BBC report of 9th March 2011.
Now HDHB have a ten-year plan. Click here to see it.
You can see that it contains fine words and fine aspirations. Nobody can argue with it. But where are the guarantees to maintain local core services? Nowhere!
March 11th. Fifth public meeting, this time at Tenby courtesy of the Mayor.
Again, the HDHB were invited but did not attend. issued a leaflet summarizing their concerns.These were shared universally by those present, who agreed to have another public meeting.There has been a letter of support for in the Western Telegraph of 23rd March.
You don't think Pembrokeshire has a problem?
Look at this hard-hitting article about Bronglais by Patrick O'Brien of the Cambrian News.Don't expect any different treatment by the HDHB in Pembrokeshire. Interestingly we now have a sequel to this, the WAG have announced funding indicating a U-turn by the HDHB.See the HDHB and WAG announcements, plus Cambrian News article about this though the local people were still expressing a great deal of concern... leading to a definitive announcement by the HDHB Chairman, confirming new theatres. So the CHC and a bad press can be effective. Pembrokeshire and the Western Telegraph take note.
'Engagement' again (or is it just lip-service to the concept?) ...
Look at this letter from a HDHB Director about an 'Engagement' meeting. (more on this) That seems OK doesn't it? But when you look at the accompanying list of 'workstream' leads what's missing?Withybush consultants ! There is only one in this list, and his position is shared. So the crucial recommendations will (conveniently for the HDHB) be made by clinicians outside Pembrokeshire.
We need you the public to be more aware of the issues
So have issued a statement to the Western Telegraph. Part of the HDHB response is: "Only when we are clear that clinicians have identified the best solutions can proposals be put forward". What clinicians? The twenty of twenty-one workstream leads who are outside Pembrokeshire?
April 2011. Computer failure !The HDHB forced a mediocre computer system on the staff at Withybush.
This displaced an excellent one that had been in use for years. Six months after it was supposed to be switched off, the old one has had to be restored. Clinicians are unable to get vital information off the new system, wasting theirs and patients' time, causing delays in treatment.
Revolution is brewing !There has been a rash of complaints all over Dyfed.
These cover rundown of Aberystwyth and Llanelli, orthodontics and eye surgery. Pembrokeshire take heed!
One-stop Breast Clinic ? This exellent clinic has run for years.
now it is a Two-stop Breast Clinic. Patients have to wait till next week. Why? Immediate sample examination is gone, due to loss of on-site Histopathology.
The Patient Experience.We are getting stories of frustrations for patients due to:
loss of on-site histopathology .. and ..
replacement of excellent computer system by a mediocre one.
This is a clinician's comment about the new "Myrddin" computer system:
"review of investigations and scans etc. is an order of magnitude more difficult since the ghastly Myrddin system (wizardly it ain't) has been foisted upon us. This system has added at least an hour to my day's work with no benefit."
Here are recent examples of patient experiences.
1. Patient attends a cancer clinic for biopsy result but the consultant has to apologize.
No report has arrived, and it is unobtainable on the computer.
2. Hospital calls patient to clinic for result of Ultrasound scan but (again) consultant has to apologize. No report has arrived and it is unobtainable on the computer.
Result in both cases: trip wasted, continuing anxiety, annoyance, need for a further attendance, and delay in treatment.
3. Patient has been seen, operated on, followed up and discharged - satisfied. A few days later, irate phone call from a waiting list co-ordinator berating him for wasting NHS time and money, so he is being taken off the list. "Stop!", he says, "I've been treated and discharged!". Response from the caller? "Well, the computer doesn't say so".
4. Patient has biopsy procedure in Carmarthen and is told to attend Withybush for result and that: "all your notes and results will be there". On arrival at the Withybush appointment there are no details from Carmarthen.
A combination of failing computer system, misplaced staff faith in it, and occasionally sheer arrogance.
Many adverse waiting list experiences are associated with the mediocre new computer system and over-reliance on it.
Here is an experience due to the loss of Orthodontics:
5. Patient has painful tooth problem, dentist refers to Orthodontics. Nothing heard for six months, eventually an appointment arrives for Morriston.
6. No letter arrives for a routine six month outpatient review. Several phone calls and two months later patient decides to go to GP and ask for a referral letter. Two weeks later a letter arrives from hospital stating that patient's name has been removed because of: no response to a (fictitious) letter. One irate phone call later - appointment made, six months late..
7. This gentleman's case reached the Llanelli press. He suffered an agonizing extra half hour due to having to be taken as an emergency to Carmarthen (17 miles from Llanelli) when he was only five minutes away from Prince Philip Hospital. Think how much worse it would be in Pembrokeshire if Emergency Surgery were no longer available at Withybush (31 miles from Carmarthen - 46 miles if you have to travel from St David's).
We would like all such experiences to be reported.
Here is a report of increased complaints, though disputed by the Health Board. We encourage you to complain to the Health Board about this sort of thing, they need the feedback in order to improve.
Maternity Services. Decisions without Withybush representation.
It's really happening. Loss of Consultant Obstetrics is threatened due to a recommendation from the Women's and Children's Health Clinical Programme Group of the Hywel Dda Health Board. Who is the Director of this group? A Bronglais paediatrician. Who is the Chair of the Neonatal Working Group which contributed to the decision? Another Bronglais paediatrician. Of course the Hywel Dda management can say these decisions were made by clinicians.
Here are extracts from an email exchange between Obstetrician and Chairman. And here again are examples of the consequences, should the Consultant unit be lost. Here also is the Response to WAG Maternity document (as a pdf) from our Community Health Council that makes the same crucial points about Rural Obstetrics more dispassionately than our examples. This issue won't go away. See this Western Mail report of the crisis in neonatal facilities in Wales.
20th April. We have had 3 further public meetings
- at Pembroke, Fishguard and Solva. There is increasing public concern about the intentions of the Hywel Dda Health Board. See this meeting summary.© Peter Milewski 2012