Sunday, 15 August 2010

An introduction to Withybush Hospital

Four years ago, the Labour government wished to close several hospitals, including Withybush Hospital, Haverfordwest.

Withybush Hospital is the only hospital in Pembrokeshire with an Accident and Emergency Department. It was long needed, and finally built, in 1978 as a result of a public outcry when a man died on the way to Carmarthen.

You won't find it in Withybush's "About Us" section, because its staunchest supporters are the medical staff and members of the public who do not get such an official voice, but Withybush Hospital is a burning political and emotional centre of the otherwise quiet Pembrokeshire. Calculations about 4 years ago revealed that, on average, each citizen of Pembrokeshire gave £5 to Withybush - especially Ward 10, the cancer care unit. (In a great many obituaries, you see "Donations to Ward 10". Ward 10 is never defined, because everybody knows.) It's the largest employer in the county, to the best of my knowledge it has the lowest rates of infection in Wales, and it's been listed as one of the UK's "Top 40" hospitals.

Pembrokeshire's winter population of 100,000 often swells to 300,000 in the summer because of the influx of tourists. It's not exactly a risk-free county: we have cliffs, we have the sea, we have several oil refineries and no overnight fire service.

We also have a great deal of space between ourselves and Carmarthen. So nothing was more symbolic when a government official was dispatched to come and tell us why Withybush should close, and had to start by explaining why he arrived late. "I didn't look at a map first, so I didn't realise how far away you are."

It's a long hilly road to Carmarthen, 30 miles along an almost entirely single-lane road heavily populated by oil tankers and tractors. It takes the best part of an hour to get there from Haverfordwest. From various corners of Pembrokeshire, it can take about an hour to get to Haverfordwest itself. Trains leave Haverfordwest every 2 hours, and take about 40 minutes to get to Carmarthen.

"The golden hour" is a phrase used by doctors to describe the amount of time a patient has to live without treatment should they have a severe heart attack. To close Withybush would therefore be a death sentence for all such patients.

So keeping Withybush Hospital open seems like a pretty good idea to me, for reasons moral, economic, and health-wise. I believe it costs in the region of £8 billion a year, admittedly a lot more than the £4 million currently spent on homeopathy for "patient choice", but an extremely small fraction of what is currently spent on illegal wars.

I make no apology for including this blogpost in the category of "Health/Science/Medicine Versus Nonsense". There's a lot more nonsense out there than quack remedies marketing themselves as miracles, and I'm afraid uninformed (or indeed misinformed) government policy can qualify as just such nonsense.

In 2006, upon plans to close or massively downgrade the hospital, Pembrokeshire suddenly churned with activity. A group called "SWAT" - Save Withybush Action Team - sprang to life: many of its members were doctors. (Sadly their website seems to have vanished within only the last few months.) 1000 people attended a public debate in the vast agricultural hall outside Haverfordwest, and many more attended smaller meetings in their villages. Thousands of people wrote letters and signed postcards and petitions.

We remained entirely unimpressed with pontifications such as "quality of patient care has to be at the heart of a progressive health service", and arguments that more care could take place "in the community" therefore led onto a necessity to close the hospital. The Local Health Board was staffed with government officials who knew nothing about Pembrokeshire, and were basically there to tell us a lot of things we knew perfectly well were untrue. Fortunately, our arguments were actually so well-researched, so noisy, and so strong, that in the end the lady in charge actually announced that the Local Health Board wished to pursue the agenda chosen by the activists, rather than one of the two dictated by the government. We had some suspicion that this would be pushed under the carpet until the next election, but for now, Withybush was safe.

Until a brave soul leaked a certain document to the Western Telegraph . . .

The health board are, of course, furious, and denied everything. They also assured the BBC that Withybush is here to stay. But can we trust them? There are, I understand, still plans to move many essential services away through the back door. Not only will this mean it takes a great deal longer to treat people, and that ill people will have to undergo the discomfort and danger of a great deal more travelling, but also it will discourage doctors and nurses and other medical people from coming to work here. There has been quite enough deliberate discouragement of that already - including, it is alleged, tearing up and hiding of job applications in order to skew appearances of a department's viability.

I'm sorry that this entry contained so few references. Especially in the last paragraph, such things can only be spread by word of mouth - you're hardly going to find written proof anywhere. Sadly, much of the material that was online and available at the time now seems to have been taken down. But when you get as involved with something as I was, you don't forget the facts and figures. They will come, I hope, because SWAT will doubtless reform, and I am also going to ask them to help me retrieve them!

I'm going to follow this up with - I hope - at least two blogposts: one about the history of Withybush Hospital and the plans for closure, and the other about my recollections of the campaigning. I'll also address exactly why I am so strongly in favour of what the politicians think of as the "the old way" and "inefficiency", and why the grand words about community care and access to specialised services basically do not make sense for the majority.

Now, should this flare up and it turns out that "the first document" is the accurate one, you'll see several more blogposts on Withybush Hospital - I hope a few of you will join the fight!

In the meantime, a few little news items from 2006:
A BBC report on the activities of SWAT, and how the poor little health board feels these people are really Luddite and getting in the way of inevitability;
A transcript of a conversation with someone who has witnessed the consequences of this "progress";
Another BBC news item about the "disappointment that people have decided to demonstrate";
Wales Online about the "two options" (i.e. both closure) between which the public was originally "invited" to choose, closure or massive downgrade amounting to closure being this wonderful "patient choice";
The Western Telegraph on how SWAT planned to create an "Option 3" despite not having the time and resources the Local Health Board did (recall that not only did SWAT do that, but Option 3 got chosen!);
The Western Telegraph records a debate between Bernadine Rees of the Local Health Board and Dr Chris Overton of Withybush Hospital (NB Dr Overton was suspended for 6 weeks for his original whistle-blowing over the dangers facing Withybush Hospital, while Bernadine Rees was given an MBE);
Our local MP Stephen Crabb, the Tories in Carmarthenshire, and Paul Davies AM, give their support to Withybush.

1 comment:

Steph Ashley said...

I was a member of SWAT, and in fact it was on a visit to the Senedd with them that I ended up joining the Welsh Lib Dems.

What I'm at a loss to understand is why we've had a vast one-off expenditure to build a shiny new A&E unit, and it's only resulted in a huge part of the premises looking ghostly and unused. Anyone seeking emergency treatment is now herded into a tiny waiting area with only about nine chairs - er, what? If your plan is to run something down and then close it quietly, why would you invest in it? I can't find the necessary levels of cynicism to assume that WAG really wanted people to believe the hospital was safe while money was being spent on 'improving' it, and so the pressure group would go away and let them get on with downgrading and closing the place, but I have to admit it makes no sense to me any other way up.

The hospital is the most serious casualty of it, but it serves to illustrate the lack of capacity of our local politicians. Apologies for length and anecdotal nature of the following further illustration, it's true but like you I've had to rely on memory as the subject matter is even drier than the hospital campaign and I'm without the links to the relevant documents - annoying!

When WAG were setting out their spatial economics agenda for Wales a couple of years back, defining need by geography, they correctly identified the towns around the Haven as collectively the most populous area of the country after Cardiff and Swansea, with complex needs (due to the refinery contractors, military bases and tourists who keep the population in a constant state of flux) best met by services within Pembrokeshire. Somehow though, between the first and second drafts of the document, all of this had been removed and instead Carmarthen was made the priority 'hub town' for service requirements of all of south-west Wales. Irritating in the extreme, I thought, but more irritating still was the fact that of all the interested parties who could have put forward a response, only John Gossage of the Carms West and South Pembs Lib Dems wrote anything. Not one of the councillors bothered.. I doubt they even knew it was going on, seems to me they have their eyes to oil and tourism to solve all of Pembrokeshire's problems and meet all our needs. Idiots.