Minutes:
Members of
the Scrutiny Care Committee were given an opportunity to ask questions to the
representatives of the Ffestiniog Memorial Hospital
Defence Committee.
(i)
In
response to a question regarding evidence that the people of Blaenau needed
community hospital beds on top of what was available at Ysbyty
Alltwen, Dr Walt Evans, Ffestiniog
Memorial Hospital Defence Committee, noted that a great many individuals in Ysbyty Gwynedd were waiting for a bed at Ysbyty Alltwen. He added that
this did not occur when the Ffestiniog Memorial
Hospital was in operation. In addition, there was evidence that many were sent
to other hospitals such as Dolgellau, Eryri, Bryn
Beryl which meant miles of travelling for their families to visit them.
In addition,
reference was made to the numbers of persons from the Blaenau Ffestiniog area who were in hospitals / homes in Llandudno,
Pentrefoelas, Llanrwst, Porthmadog, Pentrefelin and one
had been sent to Tywyn due to the lack of beds, and a
bus journey made it impossible for the family to go and visit.
(ii)
It was asked what evidence was there that other areas in Gwynedd
received a better service than Blaenau.
Dr Walt Evans responded by
noting that every town had a community hospital and there was a real need for a
hospital in Blaenau with an x-ray service and a minor injuries unit. It was noted that the situation was very
complex in Blaenau and there were many complaints as could be seen from the
petitions. Reference was made to the
list of clinics by the Health Board at the proposed Centre, but these clinics
were not special as they should be available in any well-being area. Therefore,
what kind of well-being area would Blaenau Ffestiniog
be.
It was asked how
rheumatology clinics could take place without any x-ray unit.
(iii)
It was asked if there was any evidence of persons who received a service
at Ysbyty Alltwen who were
unhappy with the service?
A member of
the Defence Committee responded by referring to a personal experience where she
had to find a nursing home for her mother, and if she had not done so her
mother would have to go to a home miles away or even in England. She referred further to another personal
experience where a error was made in a patient's records and when Ysbyty Gwynedd Bangor was telephoned to complain it was
said that they had a Concerns Department and not a Complaints Department.
(iv)
In response to an enquiry regarding how many letters received attention
from the Health Board, it was noted that the package presented to the Care
Scrutiny Committee was only a small percentage and that several letters had not
been acknowledged and had not received a reply.
(v)
It was asked what distance was reasonable for people to travel to
hospital. Mr Geraint Vaughan Jones noted that it would be necessary for the
people of Dolwyddelan to travel 20 miles to a
hospital and that the Health Board mentioned a journey of 40 minutes which was
not relevant to any other Health Board - 30 minutes was the national travelling
distance.
(vi)
It was asked if they were aware of any area that offered an ideal level
of service?
In response, it was noted
that the ideal hospital, dependent with no complaints had existed at Blaenau Ffestiniog.
Reference was made to a booklet prepared with 24 cases of complaints
since the closure of the hospital, and a copy had been sent to the Health Board
but was ignored in a meeting with the Health Board Chief Executive and the Area
Director for the West in May.
Further reference was made
to the health profile of Blaenau Ffestiniog by the
Health Board dated 5 June 2013, namely 4 months having resolved to close the
hospital - this stated that 28.5% of the population lived in poverty, the
second highest percentage in Gwynedd; that the hospital admissions rate for
persons over 75 was higher than Gwynedd, North Wales and Wales, yet again the
Health Board decided to close the hospital.
(vii)
Before closing, Dr Walt Evans quoted from a statement from the Health
Board that stated "Blaenau Ffestiniog was not
designated as a hub because analysis of the admissions and use of the hospital
showed that the catchment care was largely confined to Blaenau Ffestiniog itself with a low level of admission from the
west and little activity from the east".
In response to this, a comment was made that Blaenau Ffestiniog
was a town with a population of approximately 5,000. He used to work in a GPs practice that was
responsible for the patients admitted to the memorial hospital as well as
patients from Dolwyddelan. Further attention was
drawn to the fact that the GPs of another surgery in Penrhyndeudraeth
used to visit Bronygarth Hospital, Penrhyndeudraeth.
It was evident that a high level of the population of Blaenau used the
hospital and therefore it was quite obvious that a hospital was needed
there.
Further
reference was made to letters from other professional bodies opposing the
changes as follows:
·
a letter from the Local Medical Committee (January 2013) stating
"we reject any of the current proposals to the closure of beds in North
Wales, without prior thought regarding the impact of such change. There has been no convincing argument put
forward that such closure will improve patient care. It seems to be proposed as
clearly a cost cutting exercise”.
·
a letter from the Petitions Committee (March 2017) stating “We
appreciate the rural nature of the area, and transport difficulty experienced
especially by the elderly in reaching NHS sites, We also note that there is no registered
nursing homes in the area and the care home that has been used as a stepped
down facility does not have the capability for such a role. Inpatients facilities would provide this
service. North Wales Local Medical Committee would fully endorse
and support the campaign to alter the current developments to include the
facilities currently being withdrawn.
Also support the re-introduction of those withdrawn services as soon as
possible to maintain service provision close to home as the stated policy of
the Welsh Government”.
A request
was made to send the above letters to the Chief Executive of the Health Board.
(viii)
In response to a query regarding what services
they wished to see back, the importance of having inpatient beds back in
Blaenau was noted and the minor injuries service would come as a result of
these.
(D) The Chief Executive of the
Health Board responded to the above questions and observations as follows:
(i)
In terms of the process regarding where the hubs should be, the size of
the population was not considered at the time but a combination of population
size and the catchment-area that used it.
Because if an area was used in a wider catchment-area, you would have
fewer units as people already travelled there.
The rationale in the context of Blaenau was appreciated that more people
from the local area used the hospital, but if you looked at reducing the hub,
the rationale did not necessarily work.
(ii)
In terms of the rationale for change, the Chief Executive stated that
skills and effectiveness could not be maintained and it would be difficult to
attract staff if they only treated a few patients with half day sessions.
(iii)
The Chief Executive personally had no evidence to suggest that the
motive had arisen due to unfavourable treatment. There was a rationale, and he
had not seen any evidence that the residents of Blaenau Ffestiniog
had been treated unfavourably, but rather he had seen evidence why the change
was made and to him is appeared that individuals within the Health Board had
undertaken a logical process as well as they could, bearing in mind that
reducing the hubs would be difficult and certainly it would be difficult to
explain to the population that the provision would not be available in the
future. It was not believed that the
process had been done due to financial difficulties as the majority of Health
Boards were in deficit across the whole NHS in England and Wales.
(iv)
In terms of people, the Health Board agree that there was a challenge in
terms of nursing and residential beds but there was a problem everywhere. The fact that there were no beds does not
mean that people should stay in a NHS bed and they would have to work together
to get all the different beds to respond to needs.
(v)
The Chief Executive could not respond regarding the situation with extra
care housing.
(vi)
In terms of complaints, the Health Board were of the opinion that more
people were likely to phone the concerns department rather than the complaints
department. However, the Health Board
has a complaints department and they deal with a wide range of examples
regarding complaints and serious cases.
(vii)
Regarding the lack of correspondence, it was recognised that this was
something that the Health Board needed to apologise for. In the same manner, there was a great deal
of correspondence and the Health Board had re-iterated many matters and had
tried to explain the process and the motive but it was difficult to prove a
motive or justify what people believe to be a motive.
(viii)
Regarding being in special measures, the Chief Executive was of the view
that the Health Board did not have a link / relationship and the trust of the
population in they way that they should.
It was something that they had tried to improve and if the Health Board
went back in time in terms of engagement, it was deemed that things would have
been different.
(ix)
In response to the additional letter received from the Local Medical
Committee, the Chief Executive had held several meetings and this matter had
not been on the agenda. However,
although it would be excellent to have 20 hubs, the challenge was to attract GPs
to posts.