Diolch yn fawr, Llywydd. This debate is about protecting and developing regional centres of medical excellence, and I’ve allowed Mike Hedges some time at the end of my speech as well.

We mustn’t forget that short debates in this place are important and can be effective in shaping Government policy. It’s almost 10 years to the day since I had a short debate on organ donation and opt-out and now we see it as the law of the land and several other lands.

Also, a previous short debate about 18 years ago started moves for a Swansea medical school. I’m hoping that today’s short debate will foster a similar change in mindset because the future of major trauma in Wales is the subject of a current review that is going out for consultation.

There’s a perception in south-west Wales that all key services are being centralised in Cardiff. The major trauma centre for south Wales is the latest example—the suggestion is one major trauma centre for south Wales and it should be in Cardiff.

Seasoned Senedd watchers will remember a previous debate on paediatric neurosurgery. Was it going to be—? We needed one unit—was it to be Swansea or Cardiff? Swansea had the only paediatric neurosurgeon at the time, 15 years ago, yet the unit went to Cardiff, which didn’t have a paediatric neurosurgeon. A couple of years later, about 10 years ago now, we had the same debate about adult neurosurgery units. There was one in Swansea, there was one in Cardiff. Review says: ‘You can only have one’. Hey presto, it goes to Cardiff. So, we’ve been here before.

The leader of this independent review, Professor Chris Moran, in leading the review that suggested the one major trauma centre should be in Cardiff, further suggested that the award-winning burns and plastics unit at Morriston would also, ideally, be located in Cardiff then. So where does all this stop? There’s a review down the line about thoracic surgery. We’ve got thoracic surgery in Swansea, we’ve got thoracic surgery in Cardiff. I’ll hold another short debate nearer the time, shall I? I’ve had representations this week that neurosurgery in Cardiff—which, as you know, we’ve lost from Swansea—is under pressure. You need neurosurgery for a functioning major trauma centre, yet I’ve had patients this week telling me that they’re on the waiting list for neurosurgery in Cardiff and have been offered neurosurgery in Liverpool, Oxford and elsewhere, because neurosurgery in Cardiff is under pressure.

Rhaid i Lywodraeth Cymru gydnabod nad yw Cymru’n dod i ben yng Nghaerdydd. Ni ddylent esgeuluso Abertawe, de-orllewin Cymru, canolbarth Cymru a rhanbarthau eraill o Gymru. Mae pobl yn ne Gwynedd a sir Drefaldwyn yn defnyddio gwasanaethau arbenigol Abertawe. Mae angen i Lywodraeth Lafur Cymru ddatblygu gweledigaeth ar gyfer Ysbyty Treforys yn Abertawe i ddod yn ganolfan rhagoriaeth rhanbarthol gwirioneddol, ac yn saff o’i dyfodol. Nid yw’r canoli yma yn broblem sy’n wynebu de-orllewin Cymru yn unig, wrth gwrs. Mae angen i ni weld Llywodraeth Cymru yn datblygu gweledigaeth ar gyfer y gogledd hefyd, a buddsoddi mewn ysgol feddygol ym Mangor a chynlluniau eraill o’r fath. O ystyried y ddaearyddiaeth, y dalgylch a’r arbenigedd allweddol sydd yma, mae gan Ysbyty Treforys y potensial i fod yn ganolfan rhagoriaeth rhanbarthol allweddol yn ne orllewin Cymru, nid yn unig o ran dadl bresennol y ganolfan trawma, ond mewn llu o feysydd eraill, ac i fod yn gadarnle i ddiogelu presenoldeb pob arbenigedd yma yng Nghymru.

Morriston is a specialised tertiary centre now. Any dilution of specialised tertiary services at Morriston could potentially undermine attempts by the Swansea bay city deal and ARCH—a regional collaboration for health—to further develop health research and innovation in south Wales. Swansea’s excellent medical school is already a focus for high-quality research and development, as is the institute of life sciences, attracting the very highest calibre researchers, not to forget, obviously, the £450 million bay campus as well. Only by having high-quality and challenging tertiary services will Swansea and south-west Wales ever be able to attract the very best medical staff and researchers. The Swansea bay city deal and ARCH programme are founded on the principle of developing south-west Wales as a leader in terms of health innovation and research. Welsh Government must not undermine that.

Previous UK-wide reviews—this is the latest one—have seen services based in Cardiff lost to Bristol because the two cities are so close together geographically. Paediatric cardiac surgery was lost from Cardiff to Bristol some years ago. There was a review of cardiac surgery following the Bristol cardiac unit’s deaths scandal. It was decided: ‘Too many units, let’s have fewer units’. Cardiff was pitted against Bristol and despite the problems being in Bristol originally, Cardiff lost out to Bristol in cardiac surgery at that time. We currently send a number of neonatal cases from south Wales to Bristol. We need to be strengthening the high-level specialisms here in Wales, and that means not just in Cardiff, but in other parts of Wales. As regards major trauma centres, there are 27 now in England, and one in Wales will be. What is to say that a subsequent UK review of 28 major trauma centres will not recommend centralising in Bristol as has happened previously, if we’re going to have Cardiff and Bristol sat next door to one another?

In terms of trauma services, there are many questions that need to be asked and many points that need to be clarified, and hopefully the consultation coming up will do some of that. It is therefore vitally important that the public in south-west Wales and mid Wales are given an opportunity to scrutinise these plans in detail. We know that over a third of all major trauma patients in Wales originate in south-west Wales; this is as a result of the particularly high rate of road accidents on rural and semi-rural roads, agriculture and activity-based accidents often linked to tourism in rural west Wales.

Other Members in this place are also concerned. We’ll hear from Mike; I’ve obviously raised my concerns already with the First Minister, ABM and the community health councils. This matter is hugely important and needs in-depth scrutiny. The concerns of people in south-west Wales and other parts of Wales need to be heard. We need an open debate around these issues and the long-term future of hospitals such as Morriston and other regions of Wales, and that means the Welsh Government setting out a long-term vision for these regional centres of excellence.

With the proposal for the one trauma centre in Wales to be sited in Cardiff, with the implication that burns and plastics may well follow and be lost from Swansea to Cardiff, triggering yet another domino effect, what happens, as I’ve already implied, to thoracic surgery reviews subsequently? Siting everything super-specialised in Cardiff makes the NHS in Wales vulnerable to losing those specialisms completely, if a subsequent UK review pits Cardiff against Bristol—so close together geographically.

Burns and plastics in Morriston is an excellent unit, a leader in its field. It held off competition from Bristol to be the burns and plastics unit for the whole of south Wales and the south-west of England. We need regional centres of medical excellence dotted around Wales—Cardiff, yes, Swansea, Aberystwyth, Bangor, Wrexham—to attract our most talented doctors, nurses and consultants to all parts of Wales in the face of a recruitment crisis in all parts. So let us have a mature debate about Swansea and Cardiff working together in the same ‘team Wales’—now that would be radical in a medical sense—instead of being driven apart by that same old tedious Swansea-Cardiff competition, and Swansea always coming second.

Now, the NHS is not awash with money. We’ve heard the budget; we’re not awash with money. We cannot move an excellent burns and plastics unit to consolidate a decision on trauma on a whim, just to consolidate a Cardiff decision because you need burns and plastics in a major trauma centre as well. Why not have the major trauma centre in Swansea? That wouldn’t be a radical solution, because burns and plastics are already there. We could keep the unit there, not have to move it, expensively, elsewhere. And in closing, why not have a truly collaborative, Swansea and Cardiff together, approach? Considering the NHS in Wales as a whole and the people in Wales—yes the people in south Gwynedd, Powys, Pembroke, Ceredigion, Carmarthenshire, they depend on Morriston now for their tertiary care. Let’s put a stop to the domino effect of haemorrhaging tertiary services to Cardiff and beyond. Diolch yn fawr.