Oral - Emergency Surgical Services At Prince Phillip Hospital In Llanelli

The provision of emergency surgical services at Prince Philip Hospital in Llanelli has been the subject of debate and discussion among the local health community for two years. The need for such consideration has been very real. The wider patterns of change in patient care mean, for example, that there has been a general reduction in the need for emergency surgery—for example, evidenced by appendicitis being less common and better treatment for peptic ulcers reducing the need for surgery for perforated ulcers.

These reasons, linked to the reduced working times in the new consultant contract, the wider European working time directive, training requirements and sub-specialisation, mean that patterns of acute surgery delivery need to change. My reason for agreeing to an independent inquiry therefore focuses on the question of whether due process was adhered to in addressing these challenges. It has been said frequently in the Assembly that patients and the public need to be clear about the range and quality of services that they can receive locally, and see tangible signs of new investment in their future service, if service change is to be brought about successfully.

There are important plans, in an advanced stage of preparation, for new investments in planned surgery services at Prince Philip Hospital. In my view, these investments need to be firmly agreed in the public domain before other services are altered. Against that background, and in broad terms, I want my inquiry to consider how the proposals for change in Llanelli were formulated, how the process of consultation upon these proposals was conducted, how the outcome of that consultation was determined, including the role of the community health council, and how plans for implementation of that outcome were formulated.

No matter how compelling matters may appear to professionals, change in the health service depends upon demonstrating to the public that the process followed was fair, open and responsive, as far as the outcomes are concerned. The views of patients and the public have to be listened to, carefully considered, and taken into account. The level of concern in Llanelli is such that, in my judgment, an independent report into these matters is required. There are lessons to be learned and I am determined that we should do so.

I am not able, at this stage, to announce the name of the individual who will be appointed to carry out this work. My intention is to appoint someone who is wholly independent of the local area, of the Welsh national health service and of the Welsh Assembly Government, but who has an authoritative understanding of the issues involved and of they way in which changes in the health service are best brought about. I hope to be able to announce a name in the next few weeks.

I have to inform the Assembly that I have received a letter this morning from the chairs of the Carmarthenshire NHS Trust and the Carmarthenshire Local Health Board setting out their failure to secure a safe service as from 2 February, when new medical rotas have to be instituted at Prince Philip Hospital.

I very much regret this failure and I would have much preferred to see the service continue while the inquiry was conducted, but the advice from the chairs is unambiguous: the service cannot be provided safely and will therefore have to be suspended. However, my officials continue to be in discussions with Carmarthenshire trust to see what can be done to reinstate the emergency surgical service at Llanelli while the inquiry goes on. In doing so, we need to ensure that nothing that we say or do puts patient safety at risk.