Hywel Dda public meeting 20 September.

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    Having had time to reflect on the case made, which it must be said failed to cover many issues*, I have reached the following conclusions.
    It is quite clear that there is, and will continue to be a shortage of money. (How we influence the top level decisions to allocate more money to our health service is another matter) .  Over and above this consideration however, there is, and will continue to be, a real ( national) shortage of suitable qualified medical staff. ( Quite how this shortage has been allowed to happen over time is also an open question) In the next five years a number of existing local highly qualified staff are due to retire. Qualified, specialist staff, apparently need a throughput of patients to maintain their specialist skills. This has been set nationally at 400 cases a year. ( Fine for urban areas) Such new qualified staff that are available will need to be attracted  by a level and complexity of cases that will maintain and enhance a professional career progression. This points to the need to concentrate specialist areas of treatment into a few centres of excellence. Whilst there is uncertainty about the location of services, medical staff are unlikely to opt to come to our area.

    Plans therefore have to be made to manage these real identified existing and future constraints, rather than as is suggested a new management inspired imposed streamlined health service.

    * At the meeting we were assured that plans would not be implemented until other arrangments necessary to enable The Plan to work were in place. It was clear that these arrangements were in the process of being put in place, or worse, were at a very early stage of consultation with organisations, professions and authorities that would be required to meet new and  increased obligations with attendent and as yet unquantified cost implications. We of course will be required to foot the bill for these.

    I was fortunate to be sitting near to hospital staff at the meeting, and their passion and concern for our future services, was noticably more apparent than that expressed by the Panel.

    In general I thought that the presentation and management of the meeting was quite poor. I am tempted to ask where will be the optimum area to live?

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