The strategic aim of the Wales Deanery is to commission, quality assure and support the education and training of trainees, hospital doctors, GPs, dentists and DCPs in Wales.
This includes the development of innovative models of education and training delivery, building training capacity and leading on postgraduate medical and educational research.Nothing wrong in that strategic aim you would say...except that the Welsh Deanery exerts considerable influence on Health Boards from behind the scenes, an influence which is not open and transparent and neither is it scrutinised or challenged by any patient representative body.
In fact if the Welsh Deanery tells the Betsi Cadwaladr University Health Board to locate its Level 2 and what is left of Level 3 Neonatal Intensive Care on one site in North Wales rather than two then move it must.
The following are minutes of a meeting held last week between the executive of the Community Health Council and the Health Board to discuss the centralisation of neonatal intensive care:
Since early 2012, the health board has been in discussions with the Wales Postgraduate Medical Training Deanery and the All Wales Neonatal Network regarding proposed changes to arrangements for medical staff training, specifically around neonatal training. The discussions with the Deanery are part of all-Wales changes to put all doctors undergoing neonatal training into Neonatal Intensive Care Units. The health board had understood that the changes affected intensive care registrar grade only.
In March 2013 the Deanery advised the health board that it intended withdrawing the five trainees normally placed at Ysbyty Glan Clwyd from September 2013. At this stage the health board learned that the training places also included senior house officer grades. This inclusion would have an adverse effect on the rotas.
Since that time the Health Board has worked intensively with the all-Wales Neonatal Network and the Deanery to try to resolve the issue. At the beginning of April consensus was reached that the five trainees could continue to receive all their training within North Wales. However, the Deanery and Neonatal Network would only support retention of trainees if the health board demonstrated the intention to move neonatal intensive care(for babies who are over 27 weeks gestation and who need shorter term intensive care) to one local neonatal unit (LNU) in the region and did not try to maintain this particular service in two LNUs.
Dr Harrington explained that in order for the health board to retain these doctors, it must deliver all planned neonatal intensive care in North Wales from one LNU. Although no definitive decision has been reached, it is likely -but at this stage not certain - that the recommendation will be for the single LNU to be located centrally within the region at Glan Clwyd Hospital, the rationale being that to centralise the LNU at Wrexham Maelor would have a greater impact across North Wales.The notes of this meeting demonstrate quite clearly that when the Deanery says jump the Health Board will just roll over and say "How high".
Since receipt of these notes a member of the campaign group, the North Wales Health Alliance has written to Professor Gallen, Dean and Head of the Welsh Deanery at Cardiff University asking some fundamental questions regarding the role of the Deanery in configuring and delivery of Health Services in North Wales.
The following is an extract from the letter:
"... Perhaps you would be so kind as to elaborate upon the arrangements reached with the health board so that members of the public who are rightly, very concerned with the lack of transparency and openness in coming to far reaching decisions, which will affect prospective parents and to bring clarity and an end to the confusion...
The role of the Deanery in the board's decision making process and planning its neonatal services is not well understood and, consequently, positions have been taken in strong opposition to the board's plans...The fact that an un-elected and unaccountable University Department wields such secretive influence over the delivery of health services throughout Wales is frankly unacceptable and needs to be addressed at Welsh Government level as a matter of urgency.
It is very disappointing that this planning 'on the hoof' has now created a spiral of decline in neonatal services afforded to north Wales residents, and people will be asking why has this been allowed to happen and the role played by the Deanery.
It would be most helpful if you could provide an authoritative explanation as to your role and that of the Deanery in contributing to the board's planning process for neonatal care, which observers conclude to be inept"