I've always taken a close interest in how the NHS is organised in Shropshire - despite it sometimes has been difficult to engage interest in Montgomeryshire. But I've stuck at it. Its also the case since devolution in 1999 (with health being devolved) that the Welsh Gov't has been keen that Welsh patients be treated in Wales wherever possible, rather than across Offa's Dyke in England. But this applies only to patients needing elective surgery of course. Those needing urgent or emergency treatment are still sent to Shrewsbury and Telford because they are nearer. I've always been antagonistic to this approach. Firstly, it has in my opinion inevitably led to less consideration for Montgomeryshire when services are being reconfigured in Shropshire. And it would not be surprising if some resentment might be engendered when the work with potential for 'profit' is retained in Wales, while work with potential for 'loss' is sent over the border.
Anyway last week NHS leaders in Shropshire announced a comprehensive review of services. Not a surprise. Three of the top bosses have announced that over the next six to nine months they will be leading a debate across Shropshire, Telford and Wrekin and Mid Wales focusing on how to provide acute and community services that best meet the needs of urban and rural communities. This is extremely important to Montgomeryshire - which is why I spent this afternoon travelling over to the Princess Royal Hospital in Telford to discuss this with Peter Herring, Chief Exec of the Shrewsbury and Telford NHS Hospitals Trust.
There are several drivers behind this process. Firstly, the fact that we are living longer disproportionately increases the demand on NHS services. Increased demand is putting ever more pressure on a system never designed for such a workload. But secondly (and this has an effect on me personally) there are the horrors of what happened in Mid Staffordshire. Huge numbers of vulnerable people dying as a result of unacceptably poor care. We can no longer take the risk of allowing acute services to operate without the presence of a consultant with the appropriate skills. This makes it very difficult in Shropshire, which is effectively one hospital split on two sites. This is driving the need for debate. The shadow of Mid Staffs is dark and long.
Most concern seems to about A&E. Media are reporting the possibility of one of the two hospitals losing its A&E. While I do not think this at all likely, (and was specifically ruled out in the announcement letter) I do think we could end up with two rather different A&Es. There could be one with a focus on major accidents and wounds associated with violence, while the other could be more focused on heart attacks, strokes etc. Such an arrangement might enable more patients to move straight to the treatment bed, bypassing A&E altogether. It could be an improvement.
Far to early to take a view on all this yet. My interest (and the reason I've always taken a close involvement in Shropshire health matters) is that I want the best access possible for patients from Montgomeryshire. And I want them to be an integral part of the discussions. I have written to the Powys Community Health Council asking that public meetings be held in Llanidloes, Newtown, Welshpool and Llanfyllin when we have more idea of what the discussion is about - probably early in 2014. There will be several aspects of this issue which will appear on this blog site over the next few months.