Tuesday, October 16, 2007

Health across North Wales

Edwina Hart said
Presiding officer, last week I was able to make a statement to Plenary on reconfiguration of health services and structures in South Wales. I indicated, then, that I hoped to return today with a similar statement of progress in relation to issues in North Wales and Powys.

Members will be aware that proposals for service reconfiguration in North Wales have proved controversial across the whole of the area. My approach has been to identify the underlying difficulties which have caused such public disquiet, and to put in place new procedures which, I hope, will allow us to take local populations with us in shaping new , and better services, for North Wales.

Today I want to bring together four strands in that approach, so that Members can be aware of the full picture, as it currently stands.
Firstly, Members will already know, from my oral statement of 25th September , that Michael Williams, then Acting Chair of the Swansea NHS Trust, has been commissioned to undertake a review of consultation processes adopted in relation to service reconfigurations at Prestatyn and Blaenau Ffestiniog. I remain convinced that we have to find new ways of ensuring that consultations are fair, open and thorough and that they are perceived to be so by local patients and clinicians. The Williams report will be with me in December , and I intend to study it carefully, not only for what it will tell us about what took place in Prestatyn and Blaenau Ffestiniog, but for any more general lessons on consultation it may contain. In the same statement I set out new arrangements for consultation on proposals in relation to Llandudno Hospital, making it clear that no services changes should proceed until that new consultation has been completed. That work is now underway, with the CHC in the lead role.

Secondly, I have concluded that in North Wales, as in the South, one of the key reasons why secondary care proposals have run into difficulty, is that plans for developing primary and community health services had been under-developed and under-described. I have therefore asked Dr Christopher Jones, RCT LHB Chair and a General Practitioner himself, to undertake a review of current plans in North Wales for community services and to provide me with a report on their appropriateness for the communities they serve. I want to ensure that primary and community services in North Wales are as strong and as forward-thinking as we can make them. The report which Dr Jones has agreed to produce by December 2007 will help make that happen and, in the process, give confidence to patients that services are being strengthened, rather than diminished.

Thirdly, in reviewing reports of what has taken place so far, and in meeting individuals and groups across North Wales, I have become additionally aware of the importance which clinical governance issues play in some of the decisions which come forward about individual sites and services. The proposed closure of Abergele Hospital, for example, turned, to a large extent, on clinical governance considerations. I have agreed to meet local representatives from Abergele in the near future to hear their views on these proposals, but I have to say today that I cannot ignore the considerable governance concerns about the current services which have been expressed by local clinicians. Presiding Officer, Abergele is only one place in North Wales where these issues have come to the fore. I have decided, as part of my general effort to secure, and bolster, public confidence in bringing about change in the Health Service, to obtain an independent view of those clinical governance issues which are already a matter of public debate from the Academy of Royal Colleges in Wales, and to continue to do so, as and when such matters arise in the future.

Finally, and in order to complete the picture of outstanding work, I turn to a somewhat different issue which has arise in relation to the structural integrity of a major block within Ysbyty Glan Clwyd. While I am pleased to be able to confirm to Members that the building remains safe for its current use, my concerns are that the design of the block is not capable of supporting the improvements in services which will be necessary in the future. I have therefore asked my officials to commission a review into the structural issues in the context of the changes that are proposed for Glan Clwyd hospital and report back to me in December.
Taken together, the four different reports which I have outlined this afternoon will provide vital pieces in the jigsaw of service development which I want to see taking place in North Wales. By January of next year I shall be in a position to take a view on the results of the work I have commissioned and I shall provide members with a further statement at that time.

In the meantime, I repeat the principle which I set out in relation to South Wales services last week. Where there is sound local endorsement of proposals to reform services I do not intend to stand in the way of those reforms proceeding. The completion of the new Porthmadog community hospital and the closure of Bronygarth hospital will go ahead, as will completion of the new hospital at Holywell and the closure of Lluesty and the existing Holywell hospitals, to cite just two examples of developments which are proceeding. Where there is no local agreement, however, as for example at Blaenau Ffestiniog or Flint, then no further change will take place until the work identified earlier has come to fruition.
Presiding Officer, that concludes my up-date of major issues in relation to North Wales. I am as anxious as any Member to make progress towards an agreed and settled set of proposals in every part of the North. But I am even more anxious to do so in a way which demonstrates that local concerns have been listened to carefully and with real respect. I am under no illusions that it will be possible to satisfy every group, or every individual objection to what finally emerges, but I am determined that we do everything we can to find a ways forward which command confidence and credibility amongst patients, staff and the public.

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