Friday, 11 September 2015

Health board ducks key questions over maternity services

This evening's health board consultation meeting into keeping maternity services in Wrexham's Memorial Hall attracted fewer than 20 people. Those who did attend heard from two health board managers who admitted to having no obstetric experience and managed to leave those present with even less faith in the board's intention to close a consultant-led maternity service in either Wrexham, Bodelwyddan or Bangor.

Under questioning Prof Matt Makin, who is driving this process for the health board, admitted that - although they had quantified the risk from continuing as they are - there was no risk assessment made of the other options. These include removing consultant-led maternity services from Wrexham Maelor Hospital, which would mean about 1,000 births moving to Chester and 1,100 moving to Ysbyty Glan Clwyd.

His claim that only about five babies each year would need an emergency transfer from Wrexham drew a sharp response from nurses and midwives working on the maternity unit who were present. They were able to describe numerous cases in the past few days that had seen perfectly normal births - just the kind that would be on a Midwife Led Unit - become an emergency. Under the health board's plans, that would mean an emergency transfer to the nearest obstetric unit in Chester or Glan Clwyd.

 Prof Makin ducked a question of whether parents could opt not to have their babies born in England. It's a valid question, especially as the 1,000 births would cost an estimated £4 million extra to cash-strapped Betsi Cadwaladr.

He also failed to explain whether staff would follow the babies, i.e. be redeployed in Chester or Glan Clwyd. His claim that Chester has the capacity begs an obvious question - if Chester can recruit enough doctors to maintain a consultant-led service, why can't Betsi Cadwaladr?

It was perhaps revealing that the Countess of Chester was described by this senior board member as "our fourth district general hospital".

Prof Makin said they had advertised 14 times in 12 months for obstetricians without adequate success, but neglected to add that this problem had been identified as far ago as 10 years and critical shortages of middle-grade doctors were known to be a problem in the past three years and yet senior management did nothing.

This is a crisis of the management's own making - they have failed to recruit and plan their workforce adequately and they seem unable to address the current shortage of doctors with any imagination.

Plaid Cymru has proposed both long-term and short-term solutions: In the long-term we need to expand the Medical School provision in the North to enable doctors to train and settle here. In the shorter term we must push for Advanced Nurse Practitioners and Advanced Neonatal Practioners to help cover middle-grade doctor shifts as well as pushing for greater cooperation between the Mersey Deanery, Wales Deanery and Welsh Government in terms of providing enough training and recruitment opportunities here.

Bizarrely, Prof Makin was able to point to an intensive GP recruitment drive that he hailed as a success. It begged the obvious question of why they hadn't thought to do similar with obstetrics.

Other questions that remained hanging were attempts to get the health board to define the term "temporary" and what strategy they had in place to end the temporary phase. 

They also failed to explain what would happen to Special Care Baby Units in the affected hospitals. Wrexham's SCBU is regularly closed to new admissions due to current pressures and a rising birthrate - if it had to take an extra 1,100 babies from Glan Clwyd, where would any of those sick babies go?

There were plenty of probing questions from those present. The only jarring note was the local MP's focus purely on Wrexham rather than ensuring that all three were maintained for the good of mothers and babies across the North.

Thanks to the staff who attended and were brave enough to challenge their senior management. No amount of platitudes convinced any of those present that the Health Board has any idea what it is doing.

PICTURED: Leanne Wood, Plaid Cymru's leader, signs the petition started by Carrie Harper calling for all three maternity services to be retained. Plaid Cymru locally will continue to collect names to submit to the consultation process every Saturday under the arch by the Horse & Jockey. Please join us!

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