Oral - NHS Reconfiguration

I am grateful for the opportunity to make this statement on NHS reconfiguration. Today, I intend to concentrate on matters relating to South and West Wales. Time has been set aside in next week’s Plenary timetable for a statement in relation to reconfiguration issues in Powys and in North Wales.

Reconfiguration refers both to the services we provide, and to the administrative structures of the health service in Wales. In this statement I begin by concentrating on services, drawing on the many meetings I have conducted, and visits made, to all parts of Wales, discussing proposals with staff and patients in order to inform my own views of our plans and proposals for the service change.

Moving from West to East, secondary care proposals for Secondary Care in Ceredigion, Carmarthenshire and Pembrokeshire are being taken forward by a  Planning Forum chaired by Dr Bruce Ferguson, Medical Director of the Bro Morgannwg NHS Trust. This forum is considering how best to network services across the 3 counties in order to provide improved access to the communities. They are currently considering how better to engage the communities more effectively in planning and designing services. They have also set up 7 service groups to look at a number of services, including mental health, and are currently establishing an 8th group, chaired by a local authority to look at the development of community services. This is in line with my wish to place much greater emphasis on developing and optimising primary and community care services, particularly in the more sparcely populated areas in Wales. The groups will be reporting progress back to the forum over the next 12 months.

Let me put on record, again, our determination that a secure and successful future exists for all four major hospitals in the area – a determination which I look forward to repeating to representatives from the Withybush area when I meet them at the Assembly next week.

A key component of the approach I want to pursue to secondary care reconfiguration is to put a new impetus into the way we develop our primary and community health services. In Ceredigion, for example, our capital programme has £20 million  identified for the redevelopment of such services in Aberaeron, Cardigan and Tregaron. These are really important schemes for the local population. The proposals for Aberaeron have already received the support of a local consultation exercise. These and the proposals for Cardigan have been developed through joint working involving health and local government and have involved general practitioners and other stakeholders.  I wish to see work on Tregaron proceeding on this basis also.  I am determined that all three should go ahead in a way which maximises the synergies between new investment we are providing and the future of services at Bronglais. I am pleased to announce that Dr Alan Axford, medical director of the Ceredigion NHS Trust, has agreed to undertake a rapid piece of work, ensuring that we have the best possible alignment between these new community health facilities and services provided from Bronglais General Hospital. I regard this as an opportunity to demonstrate an early step forward in the Rural Health Plan which the Assembly Government is now developing.

Presiding Officer, I need to deal with a particular issue in relation to Prince Phillip Hospital in Llanelli. Members will recall that, earlier in the year, Carmarthenshire Trust took a decision to end emergency surgical services at Prince Phillip. There was a great deal of local disquiet, both at the decision itself and the way in which it had been made. As a result, my predecessor, Dr Brian Gibbons instituted an independent review to look specifically at the process for consultation and the process underpinning the decision to close emergency surgical services at Prince Philip hospital, Llanelli. That review was undertaken by Dr. Neil Goodwin and has now been completed. In his review he looked carefully at the processes used whilst giving consideration to the broader context of how such processes might be better designed and managed for the future. The report contains a number of recommendations which offer us a basis on which to proceed. As part of this statement I can announce that I am today  placing the full text of the Review in the public domain. I have asked my Regional Office to take forward the formal consultation on the recommendations in partnership with the CHC. I look forward to receiving the views of all those in the Llanelli area who have an interest in this matter. It is my intention, to take action in relation to the recommendations of the Review, and to report those actions to Members.

Moving East, the development of primary care and community services in the Rhondda Cynon Taf area are amongst the most advanced in Wales. I commend the work of the Local Health Board in its recruitment of a new generation of young, salaried GPs who, together with other primary care staff, are transforming the quality of services available to the local population. The reform of community services in this area has also proceeded with a large measure of public support and the new Cynon Valley hospital is a symbol of what can be achieved in health service change. A capital sum of £59million has been set aside to improve considerably the services to the communities in this area.

Turning now to service reconfiguration in South East Wales, the consultation on Gwent Clinical Futures has just ended and local health organisations are currently reviewing the views received. As I noted earlier, I do not intend that progress on agreed schemes should be held up in Wales.   The plans for Caerphilly, which will result in the closure of Caerphilly Miners, Ystrad Mynach, Aberbargoed, Oakdale and Blackwood, and a new hospital in Ebbw Vale, with the consequences for the minor injuries services in Abertillery and Dan y Bryn have been supported and I look forward to seeing them go ahead.

It became clear, as the consultation proceeded, that as far as the proposed new critical care centre is concerned, important differences of view exist, in the Gwent area in relation to the vital issue of travel time data. I have therefore asked my officials to review the whole of the available evidence relating to this issue and to report their findings to me.

I look forward to seeing the full results of the Clinical Futures consultation. It represents one of the most comprehensive, and expensive, set of proposals ever contemplated in the Welsh NHS. As Minister, I will need to be satisfied that the project represents a fully coherent whole, and that it represents proper value to the public purse. I commend the work which has gone into the proposals to date, and will report again to Members on it, as the process unfolds.

Presiding Officer, you will be aware that the Assembly Government has a commitment to ending what remains of the internal market in the Welsh health service. In that commitment service change and administrative reform go hand-in-hand because reducing the number of NHS Trusts is key to delivering  our intentions. The Boards of Swansea and Bro Morgannwg NHS Trusts have come forward with proposals for merger and I have agreed that they should proceed to consultation with staff, and through the CHCs, on these proposals. If the merger goes ahead, a single Trust will then serve a population of 600,000, employing 16,000 staff. The consultation timetable suggests that a single Trust could be created by April 2008

To the East of Swansea, proposals for a single organisation from a merger of Pontypridd and Rhondda and North Glamorgan Trusts are well on their way to fruition. Here, consultation with staff and CHCs has been completed, and I have today agreed to the dissolution of both Pontypridd and Rhondda NHS Trust, and North Glamorgan NHS Trust, and the establishment of a single NHS Trust merging the two bodies.  A Shadow Board is due to be in place by December 2007, with full implementation of the Trust merger by the 1st April 2008.

With the new single Trust for the area, I am determined that we will obtain a set of strong, fully aligned services for the population of Merthyr. Members will be aware that I have asked Professor Mansel Aylward to advise me of how this is best to be achieved between the new Town Centre hospital and the future of services at Prince Charles Hospital. I am confident that the progress which has been made in RCT can be repeated in Merthyr – and that the new Trust formed from April 2008 will provide the structure through which these important changes might be made.

Presiding Officer that concludes what I have to say on the current state of reconfiguration work in South Wales. I pay tribute to the enormous amount of work which has gone on already, and to the tremendous sense of commitment to the Health Service which is such a hallmark of local populations in Wales. As I have said before, the question before us is not whether or not to change: change is an inevitable and constant feature of any service which seeks to bring the best to the population it serves. The issue for us, for staff and for patients, is how to make that change in the most effective way possible. I believe that we are well on the way to doing so.