THE despairing, and perhaps - mutinous, remark quoted above came as a response to the news that Hywel Dda intends to downgrade Withybush Hospital still further by removing general emergency surgery from its available services.

The purpose of the health board’s Extraordinary Meeting last Thursday and Friday (February 18-19) was to address service fragilities, improve standards and reduce waiting times. The board had in front of them an independent consultation report summarising more than 4,000 questionnaire responses in addition to the feedback shared at public events, staff meetings and stakeholder sessions.

At the Tenby Observer and our sister paper the Cambrian News, we spoke up for the 400,000 family members, friends and neighbours who make up the population of Mid and West Wales. We made it clear to the 22 members of the board that they had a life and death decision in their hands.

“The people of this region have clearly spoken,” we said. “They have signed petitions, attended meetings, put together consultations, lobbied, pleaded, begged and simply asked you 22 not to destroy the life and care services of this vast region.

“We want things to stay as they are. (We would really like them to improve). The status quo will do for now, until at least the people of this land have spoken in our national election.”

But the board proves determined to press on with its centralisation agenda, downgrading facilities in Pembrokeshire and Ceredigion in favour of Carmarthenshire. One Save Withybush campaigner said: “the CEO of Hywel Dda showed alarming complacency, saying ‘people won’t like it’.”

Another said: “Pembrokeshire has always been referred to as The Jewel in the Crown of Welsh Tourism, but this action now taken shows that the People of Pembrokeshire have been totally ignored over and over again, and that Jewel in the Crown is about to be smashed to pieces.”

So what was the rationale behind the downgrade? The future service model for emergency general surgery chosen by the board is one which, when implemented, will bring together surgeons from Glangwili and Withybush hospitals into a single team.

“This will mean that emergency operations will be provided from Bronglais and Glangwili hospitals,” explained Hywel Dda. “This aims to help address long‑standing staffing pressures and improve the safety and quality of care for the most seriously ill patients.

“Under this decision, patients at Glangwili and Withybush hospitals will be able to access care through Surgical Same Day Emergency Care units, which can support most people without the need for an operation. Patients from Withybush Hospital who need an emergency operation will be transferred to Glangwili Hospital and return to Withybush Hospital, their home, or the community, when well enough to do so.”

The Board went on to say that it “recognises that this will result in more patient transfers between hospitals.” But it’s said so lightly, as if there’s no understanding that such long and arduous journeys will inevitably affect outcomes.

Dr Neil Wooding, Chair of Hywel Dda University Health Board, said: “As a Health Board, our ambition is for people to live healthier lives for longer by supporting people to keep well and preventing ill health. The decisions made today help us to address some of the services that are the most fragile and need to change to be able to deliver healthcare that is safe, sustainable, accessible, and kind.”

It sounds caring, doesn’t it? But what does it actually mean in a county where there is next to no NHS dental provision and residents spend day after day ’phoning the surgery only to find that there are again no appointments available? In this context, how are locals going to maintain a level of health that removes the need for emergency or surgical intervention? And how are the 6.3 million visitors to Pembrokeshire each year going to be kept safe and well?

Local MP Henry Tufnell was dismayed: “It’s the latest of decisions around access to healthcare that I’ve been incredibly concerned about,” while Kerry Ferguson, Plaid Cymru Senedd election candidate for Pembrokeshire, called on the Health Board to urgently reconsider their decision, and to take into account the risks and impact. She said:

“We are so disappointed with the Health Board’s decision to remove the current emergency general services from Withybush. Whilst the Board has committed to maintaining and strengthening Same Day Emergency Care, residents of west Pembrokeshire will still face at least an hour's journey to receive emergency operations or significant treatment.

“Residents in Pembrokeshire are rightly worried and anxious about the services Withybush might lose, and losing their emergency general services is a huge blow.

In addition, on Thursday, Hywel Dda pushed ahead with plans to downgrade stroke services at Bronglais Hospital. The board plans to merge stroke units and turning the service into a ‘treat and transfer’ at the Aberystwyth hospital.

Reacting to the decision, Protect Bronglais Services, who were set up in direct response to the threat posed by the changes and handed in a 17,000 name petition against them, said the decision meant stroke provision at Bronglais is still unclear.

Chair, Lisa Francis, said: “Just how these patients will be transferred is still something of a mystery… No-one around the table mentioned ambulances; nor did anyone mention the Senedd elections.”

“‘Engagement’ covers a multitude of ‘do-it-yourself, mark-your-own homework’ possibilities and that’s just not good enough for the people served by Bronglais,” she added.

The changes to both hospitals would force patients in West Wales to travel to Carmarthen for emergency treatment in a range of specialisms.

Mark Williams, Chair of the North Ceredigion Forum for Older People’s Care said: “Not for the first time, the health board have ignored the overwhelmingly expressed concern of local people over transportation now to Glangwili General Hospital… Indeed transport to services miles away was barely mentioned at today’s board meeting.”

Pembroke County Councillor Jonathan Grimes also underlined the transport issue when he said: “Removing general emergency surgery critically undermines the sustainability of Withybush hospital. In addition, this undermines the effectiveness of the A&E department that will result in patients having to be transported further afield for urgent treatment - in a county severely lacking transport infrastructure.”

Dwyfor Meirionnydd MS Mabon ap Gwynfor said: “We all agree on one thing - that we want to see the highest level of care for patients – our loved ones. But that care must take into account travelling distances for patients and their families.”

Welsh Conservative Senedd Members have reacted angrily to the decision by Hywel Dda University Health Board to remove emergency general surgery services from Withybush hospital and downgrade stroke services at Bronglais Hospital.

Samuel Kurtz MS said: “Residents in Pembrokeshire and Ceredigion are being treated like second class citizens, as it is always us in the West that have to see our services cut.

“The salami slicing of services is exactly what the Labour government have wanted, and the health board are delivering. This is a sad day, and residents will rightly be angry and concerned.”

He later added: “I have taken time to review Hywel Dda’s latest decisions and once again Withybush loses out. Emergency General Surgery is being cut. Yet again our western communities are told to travel further and accept less. That is not fair. Serious questions also remain about what this means for the long term future of A&E at Withybush. For me, that is a red line.”