How can we get people to respect regulations?

We have a responsibility to tell them that they are letting us down and they are putting lives in danger

GJ Jones Cyncoed, Cardiff

IN OUR city, our country and worldwide we are facing a crisis unlike anything any of us have seen in our lifetimes.

Here in Wales we are under a lockdown, a firebreak lockdown designed to do nothing less than save the lives of our fellow Welsh men and women and to protect our cherished NHS.

Most of our fellow citizens seem to be following the restrictions that the Welsh Government was forced to impose because of the growing pandemic. We should all be grateful to our neighbours who are helping to look after us.

However, and sad to say, there do seem to be a small minority of people who refuse to join in this life or death struggle and whose actions are putting all of us in danger.

Whether their anti-social actions are deliberate or come from ignorance of the regulations is unclear but, whatever the reason, they are undermining the firebreak lockdown and therefore putting us all in danger.

So what should be done about this situation and how can these people be corrected?

■ The Welsh Government must ensure its messages are clear.

■ The police have a part to play in enforcing the law, of course.

■ And finally, all the rest of us have a responsibility to tell those not following the regulations that they are letting us down and they are putting lives in danger.

GJ Jones

Cyncoed, Cardiff

We cannot afford to get this wrong

I am writing on behalf of clinical colleagues in response to the letter by John Evans published in the South

Wales Echo on October 27. His letter exemplifies the wonderful care provided by the hard-working and dedicated staff at Velindre hospital. The same staff are working under increasingly difficult circumstances in an ageing, overcrowded set of buildings. Everyone agrees Velindre Cancer Centre desperately needs to be redeveloped so it can provide 21st century cancer care.

Sadly, Mr Evans’ letter also exemplifies the misinformation being perpetuated by both Velindre NHS Trust and the Velindre Cancer Centre supporters Facebook page.

Two from many examples of misinformation:

■ It has been suggested radio-frequency ablation (RFA) for oesophageal cancer will be delivered at the new Velindre Cancer Centre. It will not. Endoscopy is not planned. RFA is now delivered in Cardiff and Vale so patients no longer need to go to Gloucester.

■ “Fewer than 30 patients a year need an unplanned emergency transfer”. These words are directly quoted from Velindre NHS Trust. A Freedom of Information request to the Welsh Ambulance Service PROVES it has been around 100 a year, every year, for the last 5 years.

Even this very newspaper on September 28 suggested breast cancer surgery is performed at Velindre. It is not and it will not be, as the current plans are for a non-surgical oncology cancer centre. Breast surgery is undertaken at Cardiff and Vale.

Regarding his comments about Clatterbridge, I would like to clarify for Mr Evans some of the fantastic work done by the “Transforming Cancer Care” team on Merseyside. I discussed this very matter only this week with a senior oncologist at Clatterbridge who has been at the helm of the development.

Clatterbridge re-located the acute care (in-patient beds) next to the central Liverpool University Hospital in June 2020, now called the Clatterbridge Cancer Centre- Liverpool. There are two other sites separate to this for elective outpatient care at the original Clatterbridge site on the Wirral and in Aintree.

The central Liverpool site has 110 beds, will treat blood cancers as well as solid cancers, and was delivered for £180m. The cancer centre is physically and managerially separate from the acute hospital BUT all of the facilities required for modern 21st century cancer care are on site, whether required in an emergency or elective setting. Complex treatments such as gene and immunotherapy are delivered in central Liverpool so if a patient gets into trouble, which they can do, they are supported by ITU doctors within minutes.

“Cold” services at the Wirral and Aintree sites will deliver Radiotherapy and some of the more straightforward chemotherapies, supported by satellite chemotherapy clinics.

As the direction of cancer treatment continues to change, Merseyside is now well placed to deliver the newer, more effective therapies.

These treatments provide a greater chance of cure, but may have greater initial toxic side effects requiring support from colleagues in different specialties to keep patients alive. Merseyside are truly transforming cancer care, and I suggest interested readers look at their website www.clatterbridgecc.nhs.uk/ about-centre/mission-aims-andvalues

Clatterbridge is one of many examples of modern, co-located and integrated cancer care. This perhaps explains the growing concern from specialist cancer nurses and doctors in SE Wales, both outside and inside Velindre, regarding the route chosen by Transforming Cancer Services at Velindre NHS Trust. Concerns have also been expressed by cancer experts in Swansea, Glasgow, Oxford and London, as well as Liverpool.

In fact, no one contacted around the UK has supported the proposed model of care.

I would be surprised and disturbed if the Nuffield Trust reached a different conclusion.

There is little doubt the project, as it stands, will not transform cancer care at all. It will provide more of the same for the next 30 years or more, albeit in a new environment.

These are the same cancer services that leave Wales with one of the poorest cancer survival rates in Europe. Despite good intentions, the disinformation that is being perpetuated, may ensure that cancer survival rates in Wales remain near the bottom of the pile.

Let’s get on and develop the satellite radiotherapy and chemotherapy unit in North Gwent which has unanimous clinical support. This will improve access, allow more patients to be treated and reduce delays. In the meantime, we need to ensure we build a new main Velindre Cancer Centre, which will provide the most effective cancer treatments possible, in an environment which is safe for patients.

Rather than blind loyalty, I strongly suggest the supporters of the current proposals ask their clinicians whether the plans for the main

Cancer Centre to have no surgery, no interventional radiology, no endoscopy, no cardiology, no chest physicians etc, and in particular no intensive care unit, will be safe and effective.

We will have this for 30 years or more, and cannot afford to get it wrong.

The people of South East Wales deserve better.

Dr Ashley Roberts MB BCh MD MRCP(UK) FRCR

Former President of the Welsh Association for Gastroenterology and Endoscopy (2012-14) and British Society of Gastrointestinal and Abdominal Radiology (201618)