Welsh NHS and social care ‘a shambles’ – top doctor
THE health and social care system in Wales is a “shambles” and is no longer sustainable or fit for purpose, a former hospital director has warned.
Dr Iain Robertson-Steel, who retired as director at Withybush Hospital in Haverfordwest, Pembrokeshire, in April, claims the Welsh Government needs to be held to account for 10 years of poor planning and failed management.
He said the Welsh NHS reached the point of “near catastrophic failure” last winter due to long delays for beds and unacceptable A&E waiting times.
In January and February this year, more than 5,000 patients spent 12 hours or more in emergency units before being transferred, admitted or discharged – the highest since records began.
And he fears if the trend from last summer continues, our health and social care system could be hit even harder this winter.
“Patients were put at risk, hardworking staff were driven to the point of near exhaustion and goodwill was exploited,” said Dr Robertson-Steel, recalling last year’s winter demands.
“The NHS was under extreme
pressure in winter 2017-18, with long delays in A&E, mass cancellations of elective operations resulting in waiting lists growing and quality of treatment declining.
“Massive budget overspends occurred due to a shortage of staff and the employment of locum doctors and agency nurses.
“Discharges of frail elderly patients became virtually impossible and readmissions rates increased.
“Patients became ‘stranded’ in hospital, blocking beds at high cost and resulting in increased delays to discharge and front-door chaos.”
Dr Robertson-Steel, who was formerly director of A&E services at the Royal Wolverhampton NHS Trust, said Welsh politicians “buried their heads in the sand” when the going got tough. He claimed Health Secretary Vaughan Gething and the – soon-to-be former – First Minister Carwyn Jones were not held to account.
“The bottom line is that the current Welsh Government has been responsible for NHS and social care in Wales for over a decade and a series of ministers have failed to address the core issues and develop fit for purpose services for the future,” he added.
“[The Welsh] Government blame health boards for failing to deliver, when the problems faced by hardpressed and much-criticised boards are beyond their ability to solve.”
One way of solving the unrelenting strain, he claims, would be to create a single National Health and Care Service (NHCS) to ensure health and social services were more closely integrated.
He also suggested reducing the number of health boards and trusts to cut down on unnecessary bureaucracy and management.
“Drastic reductions and real cost savings in management staffing and structures could be made if the social care functions and the budgets of the existing multiple local authorities were made part of a single unified health and social care service,” he added.
“Wales has the opportunity to build a National Health and Social Care service fit for the next 70 years, embodying the principles of the Founding fathers, Beveridge and Bevan, based on fair care for all, free at point of need.”
And Dr Robertson-Steel said Mark Drakeford, as the incoming First Minister, has a “brief window of opportunity” which the former frontline medic said: “He must take... or resign within the year. The public need real leadership with fresh ideas delivered with honesty and transparency.”
A Welsh Government spokesperson said: “These comments are illinformed and an insult to the hard work and dedication of NHS staff.
“We know that coping with the different demands on our NHS that the future will bring means services will have to change and adapt. We have responded to a recent independent Parliamentary review undertaken by experts and set out our long-term vision for the NHS and Social Care in A Healthier Wales which aims to transform the way services are delivered and ensure they are fit for the future.
“Our draft budget now provides an additional half a billion pounds next year for the health and social care system, to provide services for Welsh citizens and support this long-term plan.
“Last winter was one of the most difficult the NHS has faced in many years. It’s testament to our excellent staff across the NHS, social services and third sector at every level, that the vast majority of patients received timely and high quality care. Local winter plans are in place, including additional funding, to respond professionally to expected pressures.
“Rather than running down the NHS in Wales in its 70th year, acknowledgment of the many successes in our system and progress being made would be more positive.”