Monday, August 10, 2015

NHS future in Montgomeryshire.

Traditionally, most secondary care accessed by Montgomeryshire patients has been from hospitals located in Shropshire. It follows that Montgomeryshire's MP still retains a significant role in NHS provision for constituents, even though healthcare in Wales has been devolved to the Welsh Government. In fact, I have taken a close interest in the Shropshire NHS for decades. I recall a regular squash partner, who also happened to be a brilliant 'guts' specialist in Shropshire berating me about the crazy decision to build the Princess Royal Hospital in Telford over 30 yrs ago. Dr Paul Brown, who died very young, used to tell me "If you build a new DGH at Telford, in the long term you will be closing The Royal Shrewsbury". There is a plaque on the wall at the Princess Royal remembering Paul. He was a lovely man and I felt sad as gazing upon the plaque commemorating his work a few months ago.

Be done with this nostalgia. Let us consider the position today. As Dr Paul Brown predicted 30 yrs ago, Shropshire cannot support two major hospitals. The current structure is completely unsustainable, will go bankrupt in the near future, and must be reformed as soon as possible. I had long hoped for a brand new replacement hospital, somewhere between Telford and Shrewsbury, on a green field site. The first stage of this would have been a new 'Emergency Centre' taking all the 'blue light' emergencies in Shropshire and Mid Wales, leaving the two existing hospital sites to deal with all 'non time critical' patients. It's an option which has been carefully studies over last year. But sadly, and disappointingly, I fear this optimum option will be kicked into oblivion later this week. I anticipate us being told it is unaffordable. I do despair.

So what can we expect to hear on Thurs. In my view there cannot much doubt about where we are going - one Shropshire hospital dealing with 'emergency care', and one Shropshire hospital dealing with diagnostic and elective care. No matter how this is cut, it means a significantly lesser range of services available at both hospitals - in the interests of a better sustainable service as a whole across Shropshire and Mid Wales. The big question for Montgomeryshire is which arrangement best suits us. I've agonised over this. Believe me, it's not an easy question to answer.

There are other (in my view secondary) questions as well. What is going to happen to the spanking new Women's and Children's Hospital in Telford, and where are those currently going to A&Es who are not deemed emergencies going to be treated in future. We do know there will be a network of what are called Urgent Care Centres, strategically located around Shropshire to deal with this. But we have not a clue what will happen to my constituents in Montgomeryshire. I do find this policy vacuum hard to comprehend.

I anticipate we will all know a bit more detail later in the week. The one thing that is not going to happen is nothing. Structural reform of the NHS in Shropshire is going to happen. And soon. And if Wales does not engage with this reform, it's going to happen anyway. Not surprisingly I've been worried about this for months. I fear we are already in the position of commenting on decisions made by others, rather than contributing to the making of the decisions that impact on us.

And while I'm commenting on cross-border health issues, let me tell you about a constituent who wrote to me today. She is due two replacement knees. She is in great pain, and has been told that if she lived in England she would wait 2 months for her operations. But since she lives in Wales she will have to wait 9 months. It's enough to make you cry.

1 comment:

IanJ said...

Has anybody in Shropshire, or indeed Montgomeryshire, reviewed the old cottage hospital structure for the modern world.

Private hospitals seem to survive well on 40 beds parachuting consultants in on a regular schedule for their specialties. And limited pressure on beds from A&E or "bed blocking".

Of course that doesn't answer the issue of emergency care centres. At least here this seems to be being portrayed more as a cost issue than the medical efficiency claimed for some A&E mergers.