5th March 2012

What will “super hospitals” mean for Wales?

What will “super hospitals” mean for Wales?
By Carys Hepworth, Wales Online Mar 4 2012

 

As the campaign to keep services at Aberystwyth’s Bronglais gathers pace, Wales on Sunday reporter Carys Hepworth – who was born at the hospital – looks at the broader ideas behind “super hospitals” proposed for Wales.

While health boards and the Welsh Government insist they are yet to make any decisions on the future of Welsh hospitals, public fears for the much-needed services in rural areas are growing.

Health boards are being told to save £1m or more every week for the next three years due to funding cuts, and Wales can no longer afford the all-singing, all-dancing district general hospitals we currently enjoy.

But is the focus on the M4 corridor, with accessible “centres of excellence” offering wide ranges of specialisms, leaving elderly and vulnerable patients in more remote areas dangerously forgotten?

More than 700 angry campaigners took part in a protest at Cardiff Bay’s Senedd last week and a petition signed by 8,000 was handed to ministers.

As a result a motion was passed promising to ensure Welsh citizens are within a safe distance of their lifesaving services.

Yet health boards argue that centralising specialist services will improve patient care.

Reports by influential experts have repeated this over the past decade by saying the status quo is not sustainable.

Experts have questioned the safety of surgical procedures when offered in hospitals which rarely perform them.

If a surgeon works at the busy University of Wales Hospital in Cardiff, they may conduct several specialist procedures daily – whereas a surgeon at a more remote hospital may only perform them once or twice a month, resulting in less experience or opportunity to specialise.

There are also arguments that this leads to good quality doctors being put off working in smaller hospitals as a result, and that multi-purpose “centres of excellence” will entice the cream of the crop to Wales – particularly as EU policies make it harder for the UK to recruit doctors from outside Europe.

These arguments for centralisation have prompted greatest anxiety among populations living the greatest distances from specialist centres.

The most vigorous current campaign is that by residents of the large rural area served by Bronglais Hospital in Aberystwyth – about 90 minutes by road from the nearest larger hospital at Carmarthen.

Dr William Roberts of the Achub Bronglais Emergency Rescue (aBer) campaign group says people in rural areas were being offered the opposite of “safe services”.

He said: “We are not being offered safe services, our consultants have told us and the minister that.

“If the board really had the people of Mid Wales in mind, they would be developing services in Mid Wales.

“What we are being offered is poor in its content and so lacking in vision.”

The health boards under pressure to make savings point to arguments that improving access to home care is cheaper, and for many patients, preferable.

Chilling case studies put forward by current and former patients, however, dispute these arguments.

If emergency maternity services were moved from rural Wales, resulting in a long drive to the nearest hospital with required expertise, what about births which become difficult with no prior warning?

Hannelore Cossins, from Lampeter, was shocked into labour in 2008 after hearing her brother was dying of pancreatic cancer.

Her placenta parted, immediately killing baby Astrid, and the family and doctors and are certain had Hannelore travelled further afield than Bronglais for emergency attention, she would have died before even reaching the hospital.

Health boards argue hospitals are the most expensive part of the healthcare system and the current plans to relocate services will see more moved into the community so they are more accessible to patients and avoid a trip to hospital.

Health boards have not published any concrete proposals for change yet, and are still discussing ideas with staff and local people.

And, of course, examples exist of people whose lives have been improved through better care in the community.

Geraint Jones, from Llanilar, was in Morriston Hospital for a week after contracting pancreatitis and, after discharge, found that having nurses care for him in his own home eased the pressure on his family, meaning he could spend more quality time with them.

Instead of a painful operation, he was given an eight-week course of antibiotics – considered less of a risk than surgery, with less time spent in hospital, thanks to the Acute Response Team.

Currently, all neurosurgery in South Wales is provided in Cardiff, while Swansea serves Wales and the South West England for burns and plastic surgery, and North Wales patients travel to Liverpool for certain services.

Read More http://www.walesonline.co.uk/news/wales-news/2012/03/03/what-will-super-hospitals-mean-for-wales-91466-30453272/#ixzz1oFBJpKkp