Political storm as AMs fight to save A&E unit
IT’S approaching seven years since Education Minister Leighton Andrews was sacked for campaigning against the closure of a school in his own constituency because it fell foul of a surplus places policy he was responsible for implementing.
While he sought to justify his stance by saying he was doing no more than representing the views of his constituents, many – including the then First Minister Carwyn Jones – saw it as an inconsistency too far.
A similar paradox has now arisen with the decision of a number of Valleys Labour AMs to oppose a proposal from Cwm Taf Morgannwg University Health Board that could see the closure of the accident and emergency unit at the Royal Glamorgan Hospital, near Llantrisant.
But the AMs concerned have gone significantly further than Mr Andrews by backing a strategy that would see guaranteed funding for specialist consultants to be based in the unit for 10 years.
In doing so, they have committed themselves to a joint strategy with some local Labour MPs, some council leaders – as well as some Plaid Cymru AMs.
The issue relating to the Royal Glamorgan Hospital’s A&E unit has its roots in 2014, when five south Wales health boards devised a plan to address concerns that maternity care, neonatal care, children’s hospital care and emergency medicine were spread too thinly across too many hospitals.
After a public consultation, health boards and community health councils finally agreed on a series of recommendations.
These included closing A&E at the Royal Glamorgan, but as yet no changes have been made.
Dr Nick Lyons, medical director of Cwm Taf Morgannwg, told the BBC that most doctors in the Royal Glamorgan’s A&E department were temporary staff, which brought “very real safety issues” because the health board could not ensure training and development or “effective team working”. He added: “What we need is a safe service that you can rely on, you can trust, and when you most need it can respond to your needs and treat you effectively. At the moment I can’t deliver that [at the Royal Glamorgan].”
He said it was “easy with hindsight to say perhaps decisions should have been made earlier... but now we need to do that catch-up and do things properly”.
The opponents of the A&E closure proposal have issued a list of demands which include:
Rule out the closure of A&E at the Royal Glamorgan or changing it to a 24hour Minor Injuries Unit;
Reinstate the option of maintaining a full consultant-led A&E at all three hospitals [in the area]. This would require a serious new attempt at recruiting emergency consultants who would have secure full-time emergency posts working across all three hospitals. It would also require at least a 10year commitment to the Royal Glamorgan so that potential staff can apply with confidence;
Bring forward proposals to extend the opening hours of the Minor Injuries Unit at Ysbyty Cwm Rhondda and Ysbyty Cwm Cynon and make these more readily accessible for walk-in patients;
Bring forward other proposals for community health services, including improvements in the out-of-hours GP service, that might alleviate the pressure on all three A&E departments and bring services closer to local communities.
In addition, the campaigners have called on the health board to carry out a detailed audit of how people would be affected by the closure of the A&E department, broken down on a local government ward basis across the area, as well as an analysis by health condition.
The campaign, and its demands, have not gone down well with First Minister Mark Drakeford, himself a former Health Minister.
He has stated that it is for doctors, not politicians, to decide the future of the Royal Glamorgan Hospital’s A&E department.
He said: “It needs to be a clinically led, not a politically led decision.”
Rhondda MP Chris Bryant responded to Mr Drakeford, saying: “I’m not going to make any apologies for fighting for the A&E at the Royal Glamorgan. The decision lies with the local health board but my job is to stand up for my constituents and ensure any decision meets ‘ the Rhondda test’.”
Jeff Jones, a former Labour leader of Bridgend council, said he had considerable sympathy for the First Minister.
“In 50 years involvement in politics, I have never seen such indiscipline among a group of politicians towards their own party,” he said.
“Supporting a campaign that would guarantee funding of the A&E department for 10 years is ridiculous. We don’t know what the financial position is going to be like in a year’s time, let alone 10 years’ time.”
Mr Jones said politicians had a duty to fund the NHS, but they ought not to be making clinical decisions.
“These are decisions which can decide whether people live or die.
“If you ask people, they will always say they want cottage hospitals, but cottage hospitals can’t provide the expertise you can get in a centralised location.
“I suspect there’s a degree of panic about, and politicians are jumping on a populist bandwagon because politics is volatile and they’re frightened of losing their seats.”
One of the signatories to the Royal Glamorgan campaign is Plaid Cymru AM Delyth Jewell, who represents the South Wales East region.
She said: “I signed it because I am concerned about the possible impact on the Prince of Wales Hospital in Merthyr, in my region, if the A&E closes at the Royal Glamorgan.
“I agree that it looks strange for Labour politicians to be campaigning for it to be retained when ultimately it’s their government that runs the NHS.
“I accept this is a difficult issue, but I can understand why people want to have A&E units in their local hospital.”