4. Will the Minister outline the Welsh Government’s policies for the future of health services in Pembrokeshire? OAQ(5)0004(HWS)

Thank you for the question. Our aim is to ensure that people in Pembrokeshire are provided with high-quality, compassionate health services. Our focus will be on improving patient outcomes and in doing so, we will be led by the most up-to-date clinical advice and evidence.

Of course, it’s absolutely essential that appropriate emergency health services are actually based in Pembrokeshire in the future. You will be aware, Cabinet Secretary, that I’ve been re-elected with a strong mandate in Preseli Pembrokeshire by standing on a platform to reintroduce full-time paediatric services and the special care baby unit at Withybush hospital. Given the clear public support in my constituency for re-establishing these services, are you now prepared to listen to the people of Pembrokeshire by considering re-establishing these particular services?

Thank you for the question. We rehearsed this argument before the election and I’m sure we will do more than once afterwards. I don’t see the Member’s re-election to his constituency as a referendum on this particular issue. There are real challenges in this area between a very clear demand for locality versus the quality of the service that is provided as well, and you’ll be aware that the Royal College of Paediatrics and Child Health reviewed the changes to the services that had been made, in maternity and neonatal services, and they came back and confirmed that no person’s care had been compromised, no-one had suffered any clinical harm from the changes and, in fact, it had improved the service being provided to your constituents. Now, that’s the most up-to-date clinical advice and evidence. I just do not believe that any Minister of any party in this position would, on the basis of that evidence, decide to change the service, because to do so we be to fly in the face of that evidence and, I believe, would be agreeing to provide a worse service for the people of Pembrokeshire because of the public noise made about wanting services to be provided locally. We need to have a balance in understanding those services that need to be provided in specialist centres. We need a smaller number of those across the country to provide actually better outcomes for our people and, at the same time, to understand what services we really do need to provide locally and more of those services in a primary and community setting where possible. I appreciate I’m unlikely to persuade the Member to change his position in today’s exchange, but, as I said in my first response, I will be guided by the very best most up-to-date clinical evidence and advice, and where that tells me that changing a service back to the way it was is not the right thing to do for people in Pembrokeshire, I will not do it because I do not think that that is a responsible thing for me to do.

I want to congratulate the Cabinet Secretary on his appointment but I also want to pay some tribute to the previous Minister, who had a very tough job and has exercised some change. They are not veiled congratulations, I can assure you. However, moving swiftly on, I did last Friday visit Withybush hospital and I did speak with staff and patients about the new services and how they are bedding in. I’m pleased to report, having done that, that the picture is overwhelmingly positive. I did speak with a woman who had just had delivery of her sixth baby in that new unit and who had nothing but praise for the midwives, the staff and the facilities that she availed herself of. But there was an issue that did come up and that was the future of the 24/7 dedicated ambulance vehicle, or the DAV, that was introduced for emergency transfers between Withybush and Glangwili hospitals as part of the phased introduction of safety measures supported by the previous Minister. Hywel Dda Local Health Board has extended that contract with the Welsh ambulance service but it is due to end at the end of the financial year. Cabinet Secretary, while the service is being used less, maybe, than it was anticipated—but it is shared with other services—the staff did say that it is valued and needed. My question therefore is: would you commit to discussing with Hywel Dda health board the option for putting those vital services on a permanent footing? Also, Minister, I have spoken to you about visiting both Glangwili and Withybush hospitals, which you’ve agreed to, but I would like to have your agreement on record. Thank you.

Thank you for the two questions. Yes, I’ll be happy to arrange a convenient time to visit both hospitals and to meet staff in the midwifery units. On your specific point about the dedicated ambulance vehicle, this was an important part of providing confidence about the service to make sure that there was emergency transfer, if needed, to take women and their babies to Glangwili. In many ways, I am pleased that it has been used less than anticipated because that underlines and underscores the fact that safe care is being provided in that midwife-led unit. Over 200 babies were born in that midwife-led unit in Withybush in the last calendar year: women and their babies safely delivered with high-quality care. That’s real praise for the midwives themselves. I also wanted to praise the paramedics, who are not sitting with their feet up and having a cup of tea when they are not being used to transfer people to Glangwili. They are actually undertaking work within the hospital in different teams, using their skills in a way that benefits the whole service. So, it is a really good example of the way integration can work in the planning of the service. I will definitely take up the issue and have a conversation with Hywel Dda health board and the Welsh ambulance trust to look at the future of that service on a more sustained footing.

We haven’t forgotten the election that we’ve just fought, and I do very clearly recall the Labour Party candidate in Carmarthen West and South Pembrokeshire speaking very clearly and pledging that, if he had been elected, he would come to this place and argue for the return of maternity services to Withybush hospital and argue in favour of the repatriation of paediatric services to Withybush hospital. So, was he seeking to mislead people in the constituency? What will the Minister do now to ensure that paediatric services particularly are safe and secure in Withybush in order to ensure that the emergency services are also safe and secure?

I thank the Member for the question. In understanding what we do, I go back to saying that we have to be led by the evidence and the advice. To make this work, it’s perhaps instructive to look at what happened at Prince Philip—not at the distinct model there, but that Prince Philip Hospital stopped being an issue because clinicians within Prince Philip Hospital had a conversation about what was possible. They stopped talking down what they were doing. They stopped having a row in the pub and they said, ‘What can we do? What can we do safely? What do we want to do, and how do we get there?’ They had a conversation between themselves about leading care and about leading change within that hospital for a model, now, that there is not very much noise about. Broadly, people support what’s taken place there.

I’m really pleased that that engagement with the clinical community in Withybush is still taking place. For example, at the start of May, there was a workshop day involving a range of clinicians—both primary care as well as secondary care and the community health council—to look at where they are and where they want to be as well on a range of these services. They have got to have that constructive conversation because if they can’t agree amongst themselves what is appropriate and what is necessary for that particular part of the world and how they can go about providing it, we are unlikely to be able to support them or make choices that the people of Pembrokeshire would want to see. So, understanding what they want, having a constructive conversation and being prepared to lead that change—or to support difficult choices if those have to be made—is part of what I think we should expect, and I’m really pleased to see that is now happening on a more consistent basis within Withybush. It’s a good thing for clinicians and the public they serve.