Friday, June 20, 2008

A Tale of Two Countries.

Ventured over Offa's Dyke today to meet Tom Taylor, Chief Exec of the Shrewsbury and Telford Healthcare Trust. He's a blunt speaking man. Doesn't mince his words. Recently, he told a Westminster Select Committee that his Trust is £2 million down annually, because its paid less to treat Welsh patients than its paid to treat English patients. He still wants to treat them though, which is more than you can say for the Healthcare Trust in Bristol. Chatham House rules apply.

But some things are on the record. When I first met Tom, around three years ago, the Trust was a basket case. Debts around £35 million, and a 'must be repaid' loan from the Department of Health. Looked impossible, but Tom Taylor, with the help of others, has turned it around. £4.0 million repayment last year and on schedule for debt wipe out in two years time. It even looks as if the 'basket case' could be a Foundation Trust in the very near future. The Royal Shrewsbury is 'our' local DGH, as it is for all the people of Montgomeryshire.

Different picture in Powys, where I live. Debts are running away, and all of the local Community Hospitals have been deemed to be clinically unsafe (or some similar description). Its a financial disaster. It seems a pity to me that there is not some way of transporting the management expertise and financial discipline that's done the business in Shropshire, over the border into Powys. Should add that I have no criticism of the newly installed executive bosses at Powys LHB, whom I hear good things about.

And our discussions today really highlight the utterly appalling performance of the Assembly Government regarding renal dialysis. When I first discussed the issue with Tom Taylor three years ago, there was a base unit at Shrewsbury, and because of increasing demand, the intention was to create 6 bed satellite units at Welshpool and Telford. Well Telford was built, and because nothing happened in Wales, it was decided to increase Telford to a 20 bed satellite unit - and now that's been built as well, and opened. And Welshpool? You've guessed it. Still nothing. If there is one failure that has undermined confidence in the National Assembly in my part of Wales, it is this. The cost would be about £2 million, less than 10% of the annual cost of free prescriptions. Frankly, it brings shame on the Assembly Government.


Sarah Millington said...

Your absolutely right. The health service provided in Telford & Shrewsbury is fantastic, even so much that having lived Telford previously and then moved to Powys I continued to travel back to Telford for my son to be given his necessary hospital treatment, the level of service was simply not available in Powys.

Here in Powys we live in a rural community and we all accept the challenges that may bring us from time to time but that does not mean we should have to miss out on the same level of service that is provided in other perhaps more urban areas such as Telford & Shrewsbury.

I agree no criticism of the new bosses of the Powys LHB, I like you hope they can bring the financial discilpline and expertise needed.

Glyn Davies said...

Sarah - all the more striking because of the desperate financiasl state that the Trust was in just three years ago.

I really do worry about this issue of 'repatriation' of services back to Wales. If it had been known that we would have an Assembly Governmnet that intended to follow this route, there would never have been a Yes vote. Its another case of ideology befor ethe interests of patients.

Unixman said...

Stupid question? Where would you go for specialist orphopaedic servces?

Glyn Davies said...

unixman - Can't see total repatriation, because it would have a devastating impact on services in Montgomeryshire - but I can see substantial repatriation. It may even be that this is what has caused the delays with the renal unit. I suspect the Assembly Government want it to be linked to Wrexham rather than Shrewsbury.

Patriot said...


English Trusts charge Tariff which is average cost. This is resulting in easily acquired surpluses where there are monopolies like Telford/Shrewsbury. For every new patient thay get paid the marginal cost plus the fixed costs of buildings etc. which have already been paid for. It is therefore far more expensive to send Welsh patients over the border. Thats what happens when you bring phoney markets into inappropriate settings. Your fire should be directed at Westminister not WAG. Incidently your lot want to free the market further leaving the likes of Telford to further exploit patients in your area where there is little option in where they can practically travel to for treatment.