Hywel Dda University Health Board

Part of 4. Topical Questions – in the Senedd at 3:41 pm on 8 January 2020.

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Photo of Angela Burns Angela Burns Conservative 3:41, 8 January 2020

Wow, where to start? We talk about the word 'safety', which has been used a couple of times, but let's be clear, the beds in Hywel Dda—the operations have been cancelled because the orthopaedic ward at Prince Philip Hospital has been closed to orthopaedic, to elective surgery, and they're putting medical cases in there. That takes care of an enormous number of the problems with the elective surgery. There is a lack of clarity from Hywel Dda management, who I've spoken to today, as to why the operations were cancelled in Bronglais, in Withybush and in Glangwili hospitals, but there's a real clarity about why they were cancelled in Prince Philip. Prince Philip's elective surgery wards are being used for medical cases, because they say that they've had a greater increase in medical cases.

Now, when I spoke to the chief executive earlier, discussing this with him, one of the things that I felt very strongly was that I accept that there are winter pressure plans in place with all of the health boards, but I do not think that they are imaginative enough or building enough contingency. We know what the trends are doing; we know what the trends are doing throughout the year. You tasked them, Minister, with coming up with winter pressure plans. You gave the extra £30 million. But listening, and carefully, I listened, it seems to be that there was a real 'I don't know what the pressure is' in terms of whether they felt that they didn't have the funding to do it, or whether it was 'let's produce the winter plan we had last year. Dust it off, increase it a bit and redo it'. But it comes down to—an awful lot of it—a lack of contingency planning, that extra fat in the system, where we've had to go away and close down entire elective wards.

I would be very interested in understanding from you what can be done to ensure that there's a real analysis of the data. Because, again, when I spoke to the chief executive, he said that they would be looking into what's happened—they would be looking into why this situation's been caused, but somebody's just made the decision to stop the operations on Monday and on Tuesday and again today. So, somebody already knows that data. So, I'm at a loss to understand why that data isn't currently available as to what is the absolute crux.

I wonder if you could look to encourage the health board and indeed now, Betsi Cadwaladr, to ensure that there is a really strong programme put in place to catch up with elective surgery. And let's be clear, folks: we're not just talking about hips and knees; in Hywel Dda, there's a 19.4-month waiting list already for that. So, imagine if you thought you were going to have your knees done, and puff, you've got to wait again. But it's ventral hernia surgery, bariatric surgery, reflux surgery— all manner of elective surgeries have been cancelled with waiting lists of up to 15 months. So, we're going to make our waiting list problem longer. So, Minister could you look at what might be done in the health boards, where they have had to cancel operations so that they can accelerate a catch-up programme so that our waiting times have an opportunity to improve rather than lengthen?

Finally, I think the elephant in the room is that social services need to be on call seven days a week all year around, like our health services. On call in terms of being able to do delayed transfers of care, because, again talking to the health board, what they're saying is that they can't get people out of hospital, because, although they have great relationships with social services, during periods such as Christmas and new year and bank holidays, people rightly, of course, have time off. No-one's saying, 'Gosh, you've got to work all the time', but we have to have a system in place where there's cover so that the ordinary business of discharging people, which in turn would free up beds to enable people to go into hospital who present at the front door, could carry on apace. Because, again, what I've been told is that part of the problem is they cannot get people out of there. That needs to be part of the winter planning that actually has a few more boots on the ground in terms of social care to get people out. I'd be very interested to know your thoughts on that.

And, finally, I would like to add that I think the staff have done a wonderful job and I'd like to say that the chief executive was absolutely crystal clear, in my conversation with him earlier on, that staff have come in, they've come in on their days off, they've worked overtime, they've cut short holidays in order to try to help this. So, this is not about the front-line effort and commitment and dedication, it's about the planning side of it and the contingency planning side of it being smarter and more agile in order to prevent this happening next year.