Meltdown. Living with increased risk in Maternity, Paediatrics and Neonatal Health…. and in Ambulances

A Happy New Year to the Welsh Regional Health Service! Sometimes it seems survival is all we can aim at.


Celia Hall for The Telegraph reported 14th January 2005: Doctor suspended after protesting at hospital bed cuts (Chris Overton warned that children could die..)

The Tifi-side Advertiser 6th June reported: New equal status hospital option

Before you read the rest of this post, NHSreality wishes to remind readers of 20th September 2006 when Julie Taylor reported in The Western Telegraph: Applause as health options are rejected – led by the media and an inept chair, this meeting degenerated. I was present and walked out after 5 minutes. No case for change was allowed to be put forward, and I know that most of those present were Hospital and Trust employees. What would they give to be offered this option now? The CHC annual report 2006-7 documents the process and rejection.

Citizens of Pembrokeshire will have to learn to live with increased risk in Maternity, Paediatrics and Neonatal Health until the transport systems and capacity are increased.

Find out how your hospital is performing by entering your post code …


on 6th July BBC News reported: Withybush and Glangwili maternity changes set for August

Complex hospital births are to be switched from Pembrokeshire to Carmarthenshire next month, health managers have confirmed.

Controversial plans to end consultant-led maternity services at Withybush Hospital in Haverfordwest emerged late last year.

£3m is being spent on new and improved facilities at Glangwili, Carmarthen, as well as a new midwife-led unit at Withybush.

The changes will begin on 4 August.

The plans have sparked protests.

The local patients’ watchdog expressed concerns that closing the special care baby unit in Haverfordwest to transfer it all to Carmarthen could put lives at risk.

Hundreds gathered outside the Senedd at a demonstration last month.

Staff were told of progress on the developments at meetings last week.

Consultation ended in May and Hywel Dda health board has insisted the care mothers will receive will be safe.

The changes are:

  • Midwife-led units will be operating at Glangwili and Withybush Hospitals from 4 August
  • All special care baby services will be at Glangwili Hospital from that date
  • Women requiring additional care during pregnancy, labour or birth will be advised to give birth in the consultant-led unit at Glangwili Hospital
  • Those developing any complications will be taken to Glangwili from Withybush with a midwife during the transfer
  • An additional ambulance based at Withybush will operate 24 hours a day
  • A new unit for premature and sick newborn babies at Glangwili Hospital will have four high dependency cots, eight special care cots and one stabilisation cot

…Changes to paediatric services are expected in October…

Hundreds in baby care demonstration 18 JUNE 2014, SOUTH WEST WALES

Baby care changes protest at Senedd 05 MARCH 2014, SOUTH WEST WALES

Threat to maternity care at hospital 19 NOVEMBER 2013, WALES

On 2nd May 2014 the Western Telegraph reported: Health Board to press ahead with controversial Withybush Hospital maternity and paediatric plans, staff told

Hywel Dda health Board is pushing ahead with controversial service changes to maternity and paediatric care at Withybush Hospital, staff have been told this week.

The changes include moving to a 12 hours a day paediatric service at Withybush Hospital and a three-bed midwife-led maternity unit at the hospital.

The changes continue to cause concern.

One nurse who did not wish to be named contacted the Western Telegraph to say staff were told the changes would come in on August 1 and that they were fearful that Glangwili would not be ready to cope….

….A stand alone Midwife Led Unit for low risk deliveries will contain three beds staffed by a midwife and a health care support worker. During a birth, the mother’s community midwife will also attend to support the delivery. All GP and 999 obstetric referrals will go to Glangwili Hospital. …

West Wales is imploding and demand cannot keep up. Cathy Owen reports in Walesonline 18th September 2014: Family demand apology after woman dies in ambulance queue at Swansea hospital . Sonia Powell, 73, had been waiting in a queue of around 15 emergency vehicles for nearly 40 minutes when she passed away…

…Mrs Powell’s death came on the very same day the British Medical Association (BMA) warned the NHS in Wales was facing “imminent meltdown”.

Ross Lydall on 18th December in the London Evening Standard reports: London ambulance crisis: number of emergency crews queuing for 30 minutes outside A&E quadruples in two years 

Find out how your hospital is performing by entering your post code …

With little transport infrastructure parking is an issue everywhere: The Pembrokeshire Herald reports 11th December 2014: Plan to resolve hospital parking chaos and on December 26th “Centralisating care causes Carmarthen chaos”. (issue 78 – not on line as yet) and for the Western Telegraph December 31st 2014, Becky Hotchin reports “Mum stranded at hospital had to pay £100 taxi fare”.

Surely the answer must be to ration by sub-optimisation of care, with “barefoot doctors” in each locality. (Heuristic (sub optimal) decision making – ignore part of the available information, basing decisions on only a few relevant predictors.) The age of sufficient volunteers is past, and there will almost certainly need to be a co-payment… Head wounds do bleed profusely and can be worrying,  but they appear often far more dramatic than they really are. Some incentive to individual behaviour change, and demand, and self care seems ethical….

New Year Cartoon




This entry was posted in A Personal View, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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