Category Archives: Edwina Hart

The latest chapter in the unfortunate  recent history of neurosurgery in Wales was reported in yesterday’s Western Mail.   The neurosurgery unit at Morriston Hospital, Swansea, we are told, could close owing to a lack of middle-grade surgeons.  Morriston and Cardiff are now the only two neurosurgery units in Wales. 

It will be recalled that in July, 2007, the Welsh health minister, Edwina Hart, announced a plan whereby all elective neurosurgery generated in Wales wshuld be directed to the two South Wales units, thereby preserving their viability.  This provoked enormous opposition in North Wales, and a well-orchestrated campaign of protest resulted in a U-turn by Mrs Hart after she had commissioned a report on neurosurgery services by Mr James Steers.

It should be remembered, however, that Health Commission Wales (HCW) had, in 2007, produced a report which said, essentially, that there was insufficient capacity in South Wales for two neurosurgery units.  The indication was that Morriston should close.

Mrs Hart had been active in the campaign to preserve the Morriston unit prior to the 2007 Welsh Assembly elections.  It was she who, upon becoming health minister, overruled the HCW recommendations, which clearly did not meet with her approval,  and came up with the ludicrous “All Wales” plan.

Now it looks very much as if, at least in the short term, despite Mrs Hart’s endeavours, there will be a loss of complex neurosurgery at Morriston.

Mrs Hart may yet have to bite the bullet, dust off the HCW report, and accept its conclusion that there is no room for two neurosurgery units in South Wales.

Welsh health minister Edwina Hart’s announcement that north Wales neurosurgery patients will continue to be treated at Walton will be welcomed across the region. Few proposals from WAG had caused as much consternation as her plan to make patients from the north travel to south Wales for brain surgery.

The recommendation by her consultant, Mr James Steers, that a north Wales neurology service should be established is also welcome, although the timescale for its establishment – five years – seems to be firmly in long-grass territory.

However, Mrs Hart’s political reputation has been effectively destroyed by the episode. She has caused enormous anxiety, quite unnecessarily, to hundreds of highly vulnerable people and their families.

She is now digging her hole deeper by seeking to deny that it was ever her intention to make people travel hundreds of miles for delicate surgical treatment. This is what she told the Western Mail:

“I have been disappointed that over the last year there have been many inaccurate stories about the [Steers] review and the potential outcome. Many said that people would be compelled to travel to south Wales for this life-saving treatment. My aim was always to improve services for patients in north Wales. This report does that.”

Well, the “inaccurate stories” were (a) not inaccurate and (b) not about the Steers review. People’s concerns were about the ludicrous “in-country” neurosurgery announcement made by Mrs Hart in the Assembly on 4 July, 2007, long before the review was announced or even contemplated. This is what she said:

“My overriding aim is to secure as many services as can be safely provided within Wales’s boundaries. Of course, there will always be rare conditions and highly specialist services that can only be supported by populations greater than the population of Wales. This means that, in order to get the best possible treatment, there will always be some patients who must travel outside Wales for the services that they require. However, where the Welsh population base is sufficient to support an in-country service, that is the way in which I wish to proceed.

“Therefore, in the case of adult neurosurgery, the approach that I now intend to adopt is one in which we will look as actively as possible at redirecting additional elective work generated inside Wales to the two centres at Swansea and Cardiff. I stress that I am talking here about planned operations; I have no intention of transferring emergency work from outside the area into south Wales. However, where patients know sufficiently in advance to be able to plan for the operations required, I think that planning can allow for that work to be undertaken within Wales, particularly where that may make the difference between having a Welsh-based service or the prospect of having to give up that service.”

Seems pretty clear, wouldn’t you say?

Edwina Hart should seriously consider her position.

For those of you who have not been following the story, this was a meeting called to protest at the plans of Edwina Hart, Welsh Assembly health minister, to require North Wales patients to travel to South Wales for elective neurosurgery. The town hall was packed, with more than 100 people attending. The media were also out in force.

There was an impressive degree of political consensus on display. My friend and colleague, Hywel Williams, Plaid Cymru MP for Caernarfon, spoke against the proposals and in favour of continuing the present links with Walton. Two local Labour councillors expressed their disgust at Mrs. Hart’s scheme and said that they were going to take part in a delegation to Cardiff to see her.

Most moving, however, were the patients and relatives of patients who spoke of their appreciation for what the Walton centre had done for them. Nobody wanted to have to travel to South Wales.

Edwina Hart is all over the shop on this issue now. She was invited to attend the meeting, but declined to do so. On Thursday evening, she sent me an e-mailed letter telling me that the meeting had been arranged on a “false premise”. No decision had been made, she said, to require patients to travel to South Wales, and any suggestion to the contrary was “scaremongering”.

The people attending the meeting, however, thought otherwise. Given the clear and unambiguous policy announcement made by Mrs. Hart on 4 July, their scepticism is understandable. What she said was this: 

“My overriding aim is to secure as many services as can be safely provided within Wales’s boundaries. Of course, there will always be rare conditions and highly specialist services that can only be supported by populations greater than the population of Wales. This means that, in order to get the best possible treatment, there will always be some patients who must travel outside Wales for the services that they require. However, where the Welsh population base is sufficient to support an in-country service, that is the way in which I wish to proceed.

“Therefore, in the case of adult neurosurgery, the approach that I now intend to adopt is one in which we will look as actively as possible at redirecting additional elective work generated inside Wales to the two centres at Swansea and Cardiff. I stress that I am talking here about planned operations; I have no intention of transferring emergency work from outside the area into south Wales. However, where patients know sufficiently in advance to be able to plan for the operations required, I think that planning can allow for that work to be undertaken within Wales, particularly where that may make the difference between having a Welsh-based service or the prospect of having to give up that service.”

Mrs. Hart would be well advised to perform as graceful a u-turn as possible on this issue. In her understandable enthusiasm to save the neurosurgery unit at Swansea, she has stirred up the biggest political hornets’ nest North Wales has seen for very many years.

Edwina Hart, the embattled Welsh health minister, had a warm reception when she visited Llandudno yesterday. According to today’s Daily Post, she was doorstepped by well-known Llandudno resident, Delyth Shotter, who complained that her son, Geoff, was required to travel to Cardiff next month for brain surgery. Mrs Shotter said that she was “really concerned about the distance and the accommodation for his family.”

Mrs Hart, seemingly missing the point, replied that “we need better facilities for families.”

Geoff Shotter’s comment summed up succinctly the concerns of North Wales patients over the neurosurgery issue. He said: “It’s a bind to travel to Cardiff. People in North Wales should be going to Walton… I’d rather have the best service up here than in South Wales.”

Mrs Hart’s tetchy response to the Shotters’ concerns betrayed the pressure she must surely be feeling. She accused critics of “running about like maniacs” and promised to “set up a panel of neurologists to review services.”

This is a bit odd. In early August, I received a letter from Mrs Hart, telling me that she “had asked an expert group to look at the best ways of supporting the provision of an all-Wales planned neurosurgery service”. It would appear from the Daily Post’s report, however, that the group has still not been set up.

Speaking as one of the maniacs, I must express some concern at this. We have already had a report from Health Commission Wales which advised that Swansea be closed. That report has effectively been rubbished. Now Mrs Hart is promising to set up yet another panel of experts to examine the same issue. Why does she think that a new panel of experts will come to any different conclusion from the last one?

Mrs Hart must realise by now that her neurosurgery plan, though no doubt playing brilliantly in her Swansea backyard, has gone down like a rat sandwich in North Wales. Surely now is the time for her Assembly cabinet colleagues to tap her gently on the shoulder and tell her to have a rethink.

Perhaps that task could be discharged by Ieuan Wyn Jones. His public utterances so far have been nil; maybe he can find the courage to say something to her in the privacy of the cabinet room.