Taking a closer look at health service cuts in Wales

Marc Jones
Ambulance getty creative 300x225 Taking a closer look at health service cuts in Wales


Flint is angry. The small town in North Wales has united in a wave of growing protests against plans to close its community hospital. More than 1,500 people marched through the town, with a population of 12,000, last week to confront the local health board management at a consultation in the town hall. Initially, the managers would only permit 40 to attend but reluctantly upped that to 100, with the rest remaining outside chanting.

The proposal to close and relocate services five miles up the road in Holywell is the last straw for many in this solidly working-class town. More than a third of households are without cars and the public transport system is patchy at best. There’s a sense of a key public service being taken away without their blessing.

Flint is one of 19 community hospitals across North Wales facing closure or reduced services, as the health board struggles to find £65 million in savings from its £1.1bn budget, although they reject claims that the proposed changes are driven by cost-cutting alone. Other services, such as neonatal intensive care is being moved out of Wales altogether to Arrowe Park hospital on the Wirral. That’s a three-hour journey from some parts of Gwynedd. On a good day.

Local politicians decry the changes, as you’d expect, but the Labour representatives are curiously muted. The Assembly Member for Delyn, Sandy Mewies, doesn’t show up and Flintshire’s new council leader Aaron Shotton has to be dragged up to speak. The reason for this isn’t readily apparent to most of the people on the march. Their anger is directed at the local health board managers inside the town hall.

But this isn’t a simple tale of Tory NHS cuts causing the local hospital to close as is the case in England. In Wales health is still the responsibility of Labour – who are in government. The agenda here is being driven by Cardiff not London, and Labour health minister Lesley Griffiths has made the point forcefully that change is “inevitable” and “compelling”. This is due to parts of the Welsh NHS being near to collapse – despite 13 years of Labour health ministers at the helm in Wales.

Griffiths’ department commissioned a highly controversial report by Professor Marcus Longley of Cardiff University which was released in May. But when correspondence between the Welsh government and Prof Longley was released in July, it created a political storm when the opposition accused Longley’s report of being “sexed up” at the request of Welsh government officials, a claim strongly denied by Griffiths and Longley.

Yet there is no doubt in my mind that Labour believes the Welsh NHS needs radical change based on delivering major secondary care services from fewer and more centralised sites. Labour’s pursuit of this idea can be traced back for at least a decade, including Welsh government strategies such as Designed for Life and the more recent Together for Health. All argued for fewer sites providing the full range of hospital services. Emerging plans for health services across Wales are now confirming this.

The reality of imposing a metropolitan-style NHS service on largely rural parts of Wales is patients dying on lengthy journeys across poor roads. A study carried out at the University of Sheffield Medical Research Unit shows that increasing the distance from A&E decreases health outcomes. The study looked at the outcomes of 10,315 patients with life-threatening conditions and found that: “Increased journey distance to hospital appears to be associated with increased risk of mortality. Our data suggest that a 10‐km increase in straight‐line distance is associated with around a one per cent absolute increase in mortality.”

The Wales Ambulance Trust is still regularly failing to hit arrival time targets and protests against the withdrawal of key services are growing. In Llanelli, the district hospital is due to lose its A&E department, a move that has prompted the local Labour MP Nia Griffith to break ranks and campaign against her own health minister’s proposals. Similarly, the mental health ward closed in Aberystwyth’s Bronglais Hospital without notice or warning, all health boards in Wales are now preparing for long battles over the future of health services in their areas.

It seems the feeling amongst opposition politicians such as Plaid Cymru Mid & West Wales AM Simon Thomas is that the Labour government is hiding behind local health boards and letting them take the flack for proposals that are incredibly unpopular: “Instead of making the case that their changes will lead to better outcomes, the Welsh government has left it to local health boards to outline their reasons for service changes  that now seem to boil down to an inability to get the staff needed for an all-Wales health service.”

This perceived failure to manage is emerging as a key aspect of the growing wave of protests across Wales. Health boards have failed to plan their workforce needs over the medium term, in some cases have disbanded and deskilled nursing staff and failed to apply any imaginative solutions to local health needs – preferring instead the sticking-plaster solution of paying costly locums instead of long-term workforce planning.

But unlike the parallel storm brewing in England, it’s one Labour is hoping will blow over without too much political fallout. If the angry voters of Flint were to find out who was behind the closure plan, I think things could get very awkward.

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  • Twm Owen

    I can’t see this gathering storm blowing over, or responsibility going unnoticed anywhere in Wales.
    It’s right to say plans to centralise services can be traced back a decade or so, but the Welsh Government has also dithered, in part due to Plaid Cymru.As Labour’s 07-11 coalition partners the party put the brakes on health reorganisation (as in how actual services are delivered, rather than how health boards are configured) with Labour only to happy to oblige them – having got electorally unstuck in part due to proposed health reforms.Since the One Wales Government (Lab/Plaid) suspended health reorganisation, the financial collapse had made the outlook for health services much bleaker and cost saving has become an even greater driver. It has also become harder for health boards to offer shiny new replacement health centres etc.The neglect of meaningful reform of the health services is a great shame on Welsh governments and the National Assembly. Politicians from all parties have shied away from the difficult debates and played to the gallery – while ignoring the patient that has been left outside on a trolley, yet to be rolled into theatre, never mind the operating table.

  • Seven

    While passenger rail networks across Europe are dense, they aren’t well integrated. As was and often still is the case in the Germany, transcontinental journeys often require separate reservations and tickets on different airlines, and sometimes awkward transfers between multiple stations in transit cities. And through schedules, much less through reservations or tickets, are often difficult to obtain. All of this is especially true for travel in whole or in part in the eastern portion of the enlarged EU, or beyond.

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