West Wales Health has to have a future – somewhere in the “middle” ground… Back to 2006 and reversing the wrong decision taken then not to build a new Hospital.

Pembrokeshire and the Welsh health services are degenerating rapidly. In the Pembrokeshire Herald on September 1st 2017 Jon Coles writes  “Minister’s answer raises more Withybush questions. But it is the staffing crisis across the nation (see Times letters; page down) which is the issue, due to political denial and short termism. This is a template for the debates going on all around the country.

The article rightly points out the problems of recruitment and retention, but gives the impression that this problem could be solved locally. It is of course a National problem, of rationing of medical student capacity over decades, and of a gender bias towards female doctors, who work fewer life hours.  The gender bias is a result of undergraduate recruitment, and could be addresses by graduate recruitment. The problem of few applicants from rural schools and deprived areas needs to be addressed by adverse selection. State supported places at Medical School are a majority in the UK, but this is not the case abroad. So more and more determined applicants who are rejected may choose to train in Prague or in Malta. This is a National Problem and the “rules of the game” mean Hywel Dda is going to fail. To attract medical staff for the next decade areas such as Pembrokeshire need to combine resources with surrounding areas, and have high tech cold surgical units in their centre. 

The “middle” ground is around Whitland or St Clears. Funny than was mentioned some time ago…

Katy Woodhouse in the Western Telegraph writes: Last chance to have a say on health services changes 

As if the Trust are going to take any notice. Utilitarian decisions taken for the people of West Wales mean that each District General Hospital will lose a little, but the overall result could be better eventually, provided there is adequate funding and the longer term rationing of medical student and nursing places is corrected. Do attend the last meeting in Pembroke Dock on Friday 15th September, and then reflect in a decades’ time… Kate implies that the Trust are reconsidering the plans of 10 years ago!

IT may feel like deja vu but the idea of a new hospital between Haverfordwest and Carmarthen has been raised again, over ten years since it was suggested by the then health board.

As Hywel Dda Health Board prepares to make more changes to services in the area – stating that changes need to be made – residents are being urged to have their say.

The current consultation on ‘transforming services’ and mental health provision are drawing to a close and Hywel Dda state there have been a number of surprising suggestions made by those who have already taken part.

“I’d like to thank everyone so far who has taken the time to attend an event, write us a letter or fill in our survey. We understand that this may not be a new message to most, that you may have heard us say many times in the past that the NHS needs to change. But what is different this time is that we have our doctors and services telling us that if things don’t change, our money and the time and expertise of our staff will be spent on simply maintaining the same services and plugging gaps.
“In the field of medicine we should be investing in new ways of working, modern buildings and giving our staff the time to change the way they work for the benefit of their patients. It is time to move forward and no longer stand still.
“So I’d like to formally invite any Pembrokeshire residents who haven’t yet shared their thoughts to come to Pater Hall and make their voices heard. Now is the time for people to speak up and share their ideas and experiences to help make the NHS in mid and west Wales the best it can be.”


NHS ‘FACES STAFFING CRISIS POST-BREXIT’

Sir, Most people realise that there is a looming crisis in the NHS because of the growing shortage of capable and qualified people available to work in it at all levels. It is perhaps less well understood that this manpower shortage will be greatly exacerbated by the impact of Brexit. If solid reassurances are not forthcoming in the near future, there is a real risk that the quality of the service people expect from the NHS will deteriorate. We are already seeing staff who are EU citizens leaving the NHS or seriously considering their options for the future. This should concern us all.

While I acknowledge the complexities of negotiating with EU officials representing the interests of 27 other member states, and the need to seek guarantees for UK citizens in living and working in Europe, surely the prime minister and her ministerial team could do more now to assuage the fears of our EU colleagues.

If nothing is done now, then we face the very real threat of highly qualified and valued members of staff leaving in ever greater numbers in a relatively short period of time. Nobody should underestimate the dire consequences if and when this scenario becomes a reality over the coming months.
Tim Melville-Ross

Chairman, Homerton University Hospital NHS Trust, and former director-general, Institute of Directors

Breaks Ranks 24052006
This entry was posted in A Personal View, General Practitioners, NHS managers, Post Code Lottery, 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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