Healthcare Fellowship Award

 Congratulations to Melanie Prince - she works in healthcare as a Point of Care Testing Co-ordinator, and she has been selected as one of six Healthcare Scientists in Wales to receive a Healthcare Science Service Transformation Fellowship.  She will be going to Norway in February, to study how the Norwegians organise urgent care pathways in remote rural areas, and she will be bringing back what she learns there to improve healthcare service locally.  It's a very exciting opportunity!

Health Drop-In at the Swan

 

There will be a drop-in session at the Swan on Thursday 22nd January from 3pm to 6pm, for anyone who's interested in what's going on in local health services.

They'll be talking about Better Together, the local mental health services, and temporary service changes, particularly to the Minor Injury Units, Ready to Go Home Units and Rehabilitation Units.

There'll be tea and coffee available, and staff will be able to chat. 

Health and Wellbeing Forum

 The Bronllys Well Being Park CLT is holding a health and well being forum on Thursday October 3rd at 7pm at Talgarth Town Hall.

There is some concern about the future of Bronllys Community Hospital, after the Powys Teaching Health Board re-designated two wards at the hospital for what they say is a temporary period.  Local people are worried that this temporary period may become permanent downgrading of the services on the site.

Present at the meeting will be our new MP, David Chadwick, Hayley Thomas the CEO of Powys Teaching Health Board, Councillor James Gibson-Watt the Leader of Powys County Council, Matt Perry from the County Council, Claire White from Cwmpas and Sharon Healey from PAVO - so it's a meeting that is being taken seriously by the local authorities involved.

Refreshments will be provided, and the advice is to arrive early, as there is a lot of local interest in the plans for the hospital.

Meanwhile, on the next page of the Brecon and Radnor Express, there is another story about Bronllys Hospital - the installation of new lung-function equipment at the hospital.  This is a Body Plethysmograph, and the Powys Teaching Health Board say that it will reduce patient waiting times and travel, as previously a GP had to refer a patient to a consultant, and the patient would then have to travel to a hospital in England for the tests.  Now they can be referred straight to Bronllys.  The Bodybox can help to treat asthma, bronchiectasis and chronic obstructive pulmonary disease, and is also used in cardiology and rheumatology treatment, to make sure that the medications are not affecting the patient's lungs.

Bronllys Well Being Park

 The longest discussion I had at the Volunteer Fair was with the lady from Bronllys Well Being Park.  This is a Community Land Trust, and has been working for several years now to improve the facilities at Bronllys Hospital, collaborating with the Health Board as much as they can.

Sadly, any plans they had for the future of the Mansion House, at the top of the site, cannot happen, as the Mansion House and Walled Garden were sold off in 2018.  There are plans to turn it into a 'boutique hotel', apparently.

They have produced a large, and very professional looking, booklet detailing what the existing services are on the site, and what they hope to achieve over the next ten years.

The present buildings on the site are pretty old, and not considered to be fit for purpose in the long term.  The group wants the buildings to be replaced, possibly on the same footprint, with new buildings that also incorporate the principles of sustainability.  They want any future buildings on the site to be designed and built to Passivhous standards - meaning that very little heating will be needed, and the buildings would be connected to onsite energy generation and waste management systems, including solar panels, turbines, ground source heat pumps and grey water recycling systems.  None of this is experimental - similar buildings have been built for years, and the technology is tried and tested.

They also want to put in electrical points to charge electric cars and buses, and make the site into a local transport hub.

The whole site is Grade II listed on the list of Historic Gardens of Special Interest with CADW, though only the orchard is being maintained at the moment.  The orchard includes some rare apple varieties, and a local group is already working to improve it, and also grow damsons, pears and other fruits and berries.  They hope to expand to bee keeping and vegetable growing.  When the hospital first opened, it was almost self sufficient in fruit and vegetables, grown on site.  The BWBP wants to put in allotments around the site.

The hospital also once had its own croquet/bowls lawn and tennis court, which they want to repair.  There are also two listed buildings on the site - the chapel, which is closed at the moment because the building is unsafe, and the Basil Webb Hall, presently used by the Health Board as office and meeting space.  There is also the Concert Hall, which has been used over the past three years as a vaccination centre for Covid, and which several local businesses have expressing interest in using for exercise classes.  It would also be suitable for showing films and having theatrical performances.

They want the chapel to be refurbished as a cultural hub for the area, as a venue for arts, creative activities and performance as well as religious services.  They are supported in this by the local Veterans Group.

They want to provide new buildings for the existing services of the Adult Mental Health Unit, the Ambulance Station (which is presently in a fairly inaccessible part of the site), turn the old Nurses' Home into co-care housing (it's currently the Pain Clinic), and provide homes for families which have a disabled member.  The Pain Clinic would have a new, purpose-built building.

They want to provide a community hire, restore and repair shop, for people to borrow and repair tools, and a nursery for local children, as well as a Dementia Home for older people to live with support.

One of the big projects the BWBP wants to do is to move Llewelyn Ward down to a new building near the Concert Hall, where the same medical services would be provided.

As well as maintaining and improving the medical facilities onsite, the group wants to tackle the housing problems of the area by building affordable housing for local young families, housing for older people, and housing for people who need carers.  These would be built in small clusters around the site.

Another project they are interested in is providing space for the Men in Sheds group - and a Women in Sheds group, too!

Another proposal is for Shepherds Hut accommodation around the site for vulnerable people who need some peace and quiet for a while, such as military veterans.

And they want to provide a wildlife pond for wild swimming, and plant more trees.

Some of these projects are already running, and if they get only a fraction of what they are proposing it will enhance the site greatly.  I hope they get it all!

So, THERE WILL BE A MEETING at Talgarth Town Hall on Thursday 23rd March from 7pm to 8.30pm, with refreshments afterwards.  This is advertised as a Health and Well-Being Forum, and they will be discussing health and well-being issues relevant to South Powys.  There will also be a video of support from the actor Michael Sheen, who has already taken an interest in the project.

Second Jab

 When I got back from my travels, I was very pleased to find that I now have an appointment for my second Covid jab.  They've arranged it so I can easily get to Bronllys and back by bus (surely nothing will go wrong this time?).

So I'll be fully vaccinated when I go back to work.

Bus Pass and NHS Tests

 When I was sitting on the bus to Hereford, it occurred to me that I have just passed a Significant Birthday, so I am eligible for a bus pass!

I looked it up online when I got home.  Transport for Wales issues the bus passes, and there is a simple form to fill in.  You need your NI number - and a digital passport style photo.

That was the fun bit.  I already had a head and shoulders shot, but I was smiling, so that wouldn't do.

I transformed my bedroom into a photographic studio!  I had a blank wall behind me, and set up a big mirror to sit in front of.  I've taken photos of myself in various costumes before, and the first three or four are always rubbish, so I was expecting to do a bit of experimentation.  Eventually, I had the curtains closed, the main light on, and a lamp at each side to prevent shadowing.  I was also trying to take the photos without wearing my glasses.  I don't have terribly bad eyesight, but bad enough that details can be hard to make out.

However, I got what I considered to be a reasonable photo, and it was accepted when I submitted it on the form!  Now it should take 10 working days for the card to reach me.

Something else happened when I passed my Significant Birthday - I got a test kit from the NHS, to take a sample of my poo to see if I have bowel cancer.  I was quite impressed with the efficiency of it all - I sent off my little sample to a lab in Wales, and I've already had the letter back to say that I'm healthy.

Changes at Nevill Hall Hospital

 I've been waiting for the booklet to appear, about the changes to the regional health service, and today I picked one up outside the Chemist's.  It's very clearly laid out, but the news is disappointing as Nevill Hall is being downgraded and people will have to travel further for the services they will no longer be providing.

The changes come in on November 17th, earlier than expected because Grange University Hospital near Cwmbran has opened four months early to help cope with the expected increase in Covid-19 cases over the winter.

The services which will still be available at Nevill Hall are:

The Minor Injuries Unit

Day surgery, where the patient is discharged on the same day as the operation.

Outpatient clinics

Diagnostic services - X-rays, CT scans, MRI and so on.

The Medical Assessment Unit, Enhanced Frailty Unit, and 213 inpatient beds.

Midwife-led maternity services.

Services which will no longer be available from Nevill Hall are:

Consultant-led Accident and Emergency Services (the nearest A&E for most people in the area will be Prince Charles Hospital in Merthyr Tydfil, or County Hospital Hereford).

Children's inpatient services (again, probably Prince Charles Hospital)

Consultant-led births and Special Care Baby Unit (now at The Grange near Cwmbran)

Inpatient surgery requiring overnight stay.

For people in Hay, this probably means a greater reliance on County Hospital Hereford.

There is also a Minor Injuries Unit in Brecon and Llandrindod Wells.  At the moment, the Minor Injuries Units are Appointment only - you can't just turn up.  This is because of Covid-19 precautions.

There's also information available now for getting to and from hospitals on public transport, which would have been a great help to me several years ago when I was rushed to Nevill Hall with food poisoning and the staff there were somewhat at a loss to advise me how to get home (one of them suggested I go home via Monmouth - which would not have helped.)  The website is www.myhealthjourney.traveline.cymru

Local Responses to the Pandemic

It all seems quite normal out there (apart from the lack of toilet rolls in the Co-op!), but local people and businesses are starting to take the pandemic of Covid-19 seriously.
When I went into the chemist's over the weekend, the women at the till were wearing helmets with clear face guards, white coats and blue gloves.
Lucinda's hairdressers now has a sign up asking people to re-book their appointments if they have any symptoms (high temperature, cough) and not to come to have their hair done if they have just come back from a foreign holiday.
There's a hand sanitiser dispenser taped to the outside door of the Granary.
Meanwhile, on Facebook, there's a new page called Hay/Talgarth Community Covid 19 Support. They've been getting a list together of people who are willing to help vulnerable people locally - things like delivering groceries to people who are self-isolating, or phoning up isolated people to chat.
Cat Wylie-Fox will be live streaming her regular 2pm dog walking as a bit of entertainment for isolated people, on the Facebook page The Quarantine Break.
In Talgarth, they are thinking of using the old Coronation Café on the central square as a central point for supplies - the library was considered, but now it's part of the school building it might be best for older people and people with suppressed immune systems to avoid areas where children might be carrying the virus without symptoms themselves (or without serious symptoms).
In Hay the library was suggested as a central point too - it does have a separate entrance from the school building.
As a delaying tactic, to stop the virus from spreading so fast, Powys County Council have put out guidance. They are saying that anyone with a high temperature and/or a continuous cough should self-isolate for seven days. The County Council is also making it possible for as many of its staff as possible to work from home. Public Health Wales has advice on self-isolation. People are being asked to call 111 only if they feel they cannot cope with their symptoms at home, or their symptoms get worse.
The organisers of the Facebook page (including Gareth Ratcliffe) are now waiting for national and regional advice so they can plan for the best help to give and see where it will be needed.

The Bakers Table in Talgarth are ready to deliver bread in the Talgarth area, and the Rhydspence Inn does takeaways. Nonna Caterina Italian Food are preparing for being unable to operate their pop-up evenings by offering a Friday and Saturday delivery service of handmade pasta and dessert. All the pop-up evenings they have already arranged are happening, unless the advice changes.

Updated to add: The Science Café has cancelled future meetings for the foreseeable future, and the next Hay Music concert is also cancelled.

Council Meeting - Library, Health Care, Miles Without Stiles, an Accessible Town and Woodland Group

There was some discussion about the Library building, and what would happen to it after the Library moves to the school in April. Bearing in mind that Hay Council are already in complicated negotiations with the County Council about the transfer of assets, would it be sensible of them to add to that by declaring an interest in acquiring the Library building?
The County Council have recently changed the way they decide their corporate asset policy to a case by case basis, where no precedents are set by their decisions in other cases. And they will only consider transferring the asset freehold if it is in their interests.
The councillors have discussed this before, trying to decide between the Council Chambers which need so much work doing on them and the Library building - because the County Council would not allow them to keep both.
So they came back to the problem of the tenants in the Council Chambers, which generate income for the Council, against the costs of repairing and making the Council Chambers accessible.
And they decided that they should at least declare an interest in the Library building, and sort out a business case for taking it over.

Health care for the area is another concern, as health care provision is getting centralised further south, in the areas of greater population, leaving rural areas like this part of Powys behind. Apparently, everywhere should be within a 60 minute journey to a Major Trauma Unit. This is complicated for Hay by Hereford Hospital being over the border, and they also talked about the desirability of improving the Air Ambulance service.
There is also a Well-Being Plan coming down from central government - which is all very nice, but the councillors were unsure how, exactly, it would be implemented.

And then they talked about something that concerned me, as a lapsed archaeologist.
The Miles Without Stiles project has been going ahead, with new surfacing for the Bailey Walk being put down. That's all fine - but the workmen have also been putting a new path in at the Warren, over the old tramway. There were comments that the councillors thought that the new path would be put in to one side of the tramway, but it seems that damage has been done as the path is being put in on top of it. If this is the case, there should have been an archaeologist at least doing a watching brief to see what was uncovered.
I'll be going up there tomorrow to see for myself.

And on a related note, there are plans to improve the town's accessibility, and maybe even make a thing of Hay being an "accessible town". There is, apparently, grant money available. They want two charging points for electric cars (there's one already at Drover Cycles), and there's money for the path improvements for Miles Without Stiles, and Hay in Bloom. This could link in with the well-being ideas, promoting walking and getting out into the countryside for healthy living, and gardening, especially as Hay has an aging population. The council intends to talk to Hay Walkers and the Tourist Information Office, and get them involved.

And, finally, permission has been granted for the Woodland Group to have a container to keep their tools in! It will be sited somewhere near the motte, as the auctioneers who own the cattle market have no objections. It was mentioned that there is a container on site at Hay School, and now that the building work is nearly done, it might become available so the Woodland Group don't have to buy one. The old school buildings are being knocked down now, and the swimming pool is closed while this work goes on - they were told they would have to close for seven weeks.

ShropDoc

I have a chest infection - I started coughing on Thursday, but I thought if I just took it easy over Friday and Saturday I'd be fine for work on Sunday.
I wasn't getting any better - in fact, I was getting worse, and by Sunday I also had pain in every joint in my body.
I knew I needed medical assistance, but I wasn't sure what to do - it's several years since I've been into Hay Surgery, and I couldn't find their phone number (and they'd be closed on Sunday anyway). I tried NHS 111, and found it was only for England - and then my neighbour brought me the number for ShropDoc.
The first young lady I spoke to took my details, and said someone else would phone back within the hour - and please to keep the line clear. "I'm not going to be chatting to all my friends," I said, somewhat tartly. I tend to get querulous when I feel ill, and it had taken me all my time to crawl downstairs to the phone.
Within the hour, I spoke to a Sister, who took more details, and said I really ought to be seen. Could I get to Brecon? Since I could hardly totter around the house, the answer was no - and I couldn't face the thought of ringing round people I knew with a car to take me. It just seemed like a monumental task which was completely beyond me. By this time I was nearly crying and saying I just wanted the pain to go away. So she said she would send someone to see me.
I crawled back to bed.
A little while later, a lovely lady came and examined me, and to my alarm said that she'd really prefer it if I went into hospital. She wanted to put me on a drip. At least I knew I hadn't called them out for something trivial, but I said I'd really rather not, so she left me with a stack of painkillers and some antibiotics for the chest. And, bless her, she even made me a pot of tea. "I couldn't find a teapot," she said, as she came upstairs with teabags floating in my cafetiere. So she said I should go into Hay Surgery on Monday, and left me to it.

I asked my neighbour to run me down to the surgery, and then I was very surprised to get a phone call from one of the doctors on Monday morning, to find out how I was (better than I had been) and to say that I was already on the list of appointments, as the paperwork from ShropDoc had just come through. I was very impressed.
So I spent a while in the waiting room of the surgery. They have a screen on the wall now where patients who knew what they were doing could check in and see the time of their appointment, and they have a box on the wall which people were using to post forms for repeat prescriptions - and there was a steady stream of people coming in to collect prescriptions from the receptionists (who were all lovely and helpful).
Also, Radio Two is very soothing.
So I was seen, and examined again, and told to keep taking the tablets I'd got.
And now I intend to spend the rest of the week in bed!

I was very impressed with how smoothly it all came together - and I'm very grateful for the NHS!

Council Meeting - a Bench, the Gliss, Defibrillators and Festival Buses

This was the final Town Council meeting before the elections on 4th May. So everyone is anticipating change.
Fiona Howard will no longer be mayor.
A new chap (Derek?) had been co-opted onto the council this time, and he seemed quite on the ball, asking pertinent questions from time to time.
Here's hoping that enough people stand for election to make it a contest (though town councillor is a pretty hard job these days). Rob Golesworthy has already been out campaigning (I got a flyer through my door). He's standing as a Conservative.
And at the end of the meeting, Steve Like announced that he will be stepping down, because he can no longer work with Powys County Council - who have consistently failed the community of Hay for years, he added.
Gareth Ratcliffe is standing for re-election to the County Council, and thanked everyone for their support. Several County Councillors will not be standing for re-election this time, so after the 4th May the PCC may look quite different, and maybe different decisions will be made.

But the first item to be addressed yesterday evening was the on-going saga of the bench by the BT boxes opposite the Cinema Bookshop. BT have still failed to replace the bench they moved properly (it's way too low now), so the councillors were considering issuing an ultimatum. They want to site a memorial bench to Arnold Wesker there - and were half-seriously considering siting it across the front of the BT box so that BT couldn't open it! And they're thinking of issuing a bill to BT for the re-siting of the bench, and all the time the Town Council have spent on dealing with the matter when they could have been doing something more important.

Meanwhile down at the Gliss there are four abandoned vehicles, and no authority seems to want to do anything about moving them. It seems to be down to the Town Council to take action.
"We sit here and look at problems," Fiona Howard said. "We've got to find answers."
"We're not backed up by the relevant authorities," Alan Powell added.
They were also concerned about people camping overnight down there, and discussed installing a lockable gate. Another consideration is charging for parking over the Festival - it might be possible to get someone down there to collect money for the Festival, possibly someone from one of the sports clubs, which would assist them in fund raising.

And the transfer of assets from Powys County Council to Hay Town Council is also on-going. The PCC seems to want town councils to take on more responsibilities, but seem reluctant to take the final step of signing the assets over to the town councils. And of course there is no extra money available to the town councils to take on these extra responsibilities. At a recent meeting between representatives of town councils and the PCC, all the other town councillors and clerks reported similar problems. Although they had all come individually, without talking to each other before hand, they presented a united front against the PCC representatives. In fact, the people from Llandrindod Wells said that they always had a solicitor present when discussing anything with the PCC!

Nobody is sure what will happen after this year's elections....

Some good news, though, is that the town council are applying to have more defibrillators sited around town. The Gliss was suggested, but turned down as there is no electricity supply available there, but the Co-op was agreed to be a good site, in association with Cusop Council, and possibly the Craft Centre and St Mary's Church, to serve the estates at that end of town. "They can't always rely on prayer!" Steve Like said.
The Sports Ground was also suggested as a suitable site.

Although the Chamber of Commerce sent an email round recently saying that the Festival shuttle buses through town will be returning this year, it seems that things are not that simple. Herdmans Coaches have been given the contract, but apparently the bus drivers don't want to stop outside Tinto House/Clocktower - they claim it is dangerous. However, this is the site of the regular bus stop for the Browns bus into Hereford - they don't seem to have a problem with it for the rest of the year. Clarification will be sought from Hay Festival.

Bronllys Well Being Park AGM

The Concert Hall at Bronllys Hospital will be the venue for the first AGM of the Bronllys Well Being Park group, at 7pm on Thursday 24th November, and it'll be more than just a committee meeting.
There's a keynote speaker, Chris Jones, who is the Deputy Chief Medical Officer for Wales. He'll be talking about the opportunities for "citizens and the NHS to achieve better health and well-being outcomes by working together as equal partners" - as it says on the poster.
There will also be a fund raising quiz night to finish the meeting, run by "a popular local Quiz Master"!
All this and refreshments too!

A Full Body Up-Grade

Earlier this week was my 6 monthly trip to the dentist, who whizzed a little tool round my mouth to get rid of stuff that had built up on the teeth and was polite enough not to mention all the dentistry he could be doing to make my mouth perfect (he did that last time, and I know there are teeth broken and teeth missing, but as long as nothing hurts and I can still smile, it's good enough!).
Then I noticed just how many scratches there are on my glasses. My mum had been reminding me of one of my step-cousins while she was here. As a small child, she'd needed glasses, but hated them, so rubbed them up and down in the sand pit to scratch them and make them impossible to see through. Before my glasses got to that state, I thought I'd better get back to the Opticians on Backfold.
Turns out, I was last there in 2008.
However, they were able to see me the same day, and the good news was that my eyes hadn't changed all that much. It was fascinating to have my eyes tested with all the impressive machinery they have now - including the one where you look at a red dot in the centre of the screen and tell the optician how many little green lights are appearing round the edge of the screen. Having passed that one with flying colours, I asked if I was now qualified to be a space fighter pilot! And she showed me photos of the backs of my eyeballs!
While I was there, the ladies at the front desks were talking about Eugene Fisk's new book O Happy Hay! One lady said she'd seen him sketching outside the chemists - and apparently half the retail price is now going to a fund for the refugee crisis.
So, having sorted out the teeth for another six months, and now awaiting the new lenses for my glasses, I thought I'd go round to Jenesis the hairdressers to have a new, shorter hairstyle.
This time next week, nobody will recognise me!

Globe Hustings - Health and Education

I must say I was most impressed by Andrew from 18 Rabbit, who chaired the meeting magnificently last night.
There were 6 candidates on the stage. From left to right they were Chris Davies (Conservative), Chris Carmichael (Green), Matthew Dorrance (Labour), Roger Williams (Lib Dem), Freddy Greaves (Plaid Cymru) and Darran Thomas (UKIP). Roger Williams was the only one who didn't need to use the mic.
The opening statement was from Maggie Sims of the Bronllys League of Friends, laying out the problems with the NHS in this area, problems with linking up social care and hospital treatment for the elderly particularly, travelling long distances for specialised care, and long waits to see consultants. She also said that the League of Friends have campaigned for ten years to keep Bronllys open, and they're not about to give up now!
So, she asked, what are the candidates plans for the NHS? What about funding? And will there be a fair deal for Wales, which is at present underfunded in comparison to Scotland?

Chris Davies (Con) said that a lot of services for Powys are provided by Shropshire and Herefordshire. He's in favour of a cancer centre at Bronllys.
Chris Carmichael (Green) said that travel costs for treatment are a problem. The Greens want to reverse the NHS cuts and will fund this by dealing with tax evasion and by raising taxation. About 7 billion pounds needs to go into the NHS, and tax evasion stands at around 25 billion at the moment, which would fund it easily. He also wants to see health and social care funded together and working together more (at present, social care is funded by County Councils, who are having their budgets squeezed).
Matthew Dorrance (Labour) said they want to provide 1,000 more health professionals. Funding is determined by something called the Barnet formula, which is the cause of underfunding in Wales, and this needs to be changed. He doesn't see a problem with people going across the border for services - after all, it is a National Health Service.
Roger Williams (Lib Dem) supports the new vision for Bronllys (I've talked about this in previous posts). Cutting the deficit is an issue. He supports increasing tax on the wealthy. The boss of the NHS (I missed his name) recently said that about 8 billion pounds a year is needed and Roger Williams also wants to see more investment in Llandrindod Wells Cottage Hospital.
Freddy Greaves (Plaid) also wants to see 1,000 more doctors across Wales. He wants to see incentives given to GPs to encourage them to settle in rural areas, such as paying off their student loans. He wants to see health and social care integrated, too. He also wants to end austerity, scrap Trident, and tax sugary drinks - and reverse the privatisation of the NHS.
Darran Thomas (UKIP) lives in Rhayader, and his nearest big hospital is Aberystwyth. He thinks it's terrible that the Air Ambulance service is funded by charity shops. The NHS should remain free at the point of delivery and funding should be increased for the elderly and mental health. He wants to scrap tuition fees for health professionals and bring back matron in hospitals - the old way of running hospitals. He also wants to see training for NHS managers. He would also tax corporates, and scrap the HS2 rail line.

Questions from the floor started with John Stark's observations. Cancer units, for instance, need a lot of specialised technology and staff, and a low density rural population can't support that, so travel to larger centres of excellence is necessary.
A chap from Clyro started to make a point about foreign aid, but was stopped by Andrew in the chair, to keep things on topic.

The next question started with the comment that the Conservatives are negative about the health service in Wales.
Chris Davies (Con) said that, no - the staff are great, but the management is rubbish, and it's the Welsh Assembly's fault.
Matthew Dorrance (Lab) said cutbacks by Westminster are to blame, but the Welsh have gone for a preventative approach to health care. Billions have been wasted on top down re-organisation (cheers from the audience).
Roger Williams (Lib Dem) said the NHS has low morale, and the English and Welsh services should work together.
Freddy Greaves (Plaid) said that the Powys satisfaction rates with the NHS are the lowest in Wales. He wanted less re-organisation, no more PFI schemes and hospital car parks to stop charging so much. We should look to Scotland, which has the most efficent health service now.

Sean O'Donahue said that the Tories are demonising the NHS, but looked at from around the world, it's really quite a good service. He also mentioned the problems in Powys because of the low density population.
Darran Thomas (UKIP) said we should be proud of our NHS. He also read out some of the promises that David Cameron made in 2010, all of which have been broken, such as no re-organisation, and no front line job losses.
Chris Carmichael (Green) said that the NHS is admired around the world. But we need to increase funding to the same level as other European countries. He also wants no more PFI, which is ridiculously expensive, no more re-organisations and no privatisation. He'd also like to see more general surgeons, rather than narrow specialisations.

The next questioner said that there is a need to co-operate. Lots of money is wasted in ways that do not help patients. Can we expect a general hospital in Powys soon?
Roger Williams (Lib Dem) said that the problem was location. When he spoke to people in Llandrindod Wells, they wanted a general hospital there, and when he spoke to people in other areas, they wanted it in Newport, or at Bronllys. Hereford Hospital survives because of patients from Powys - otherwise Herefordians would have to go to Worcester. He also wants to see better provision for mental health, which is very poorly served in Powys. He also wants carers to be better supported, the unsung heroes in the health system.
Chris Davies (Con) agreed that cross-border co-operation was crucial. He was also against moving Nevill Hall hospital further south.

To round up, Maggie Sims said that it was good that several candidates have said they want to see a better link between health and social care - and that, in their campaigning to save the hospital, "We wouldn't have slogged our guts out if Bronllys staff weren't fantastic."

So that was the first half of the evening. Next time - Education.

"A New Way of Delivering Services"

One suspects that this is code for "cuts".
There will be meetings all over Powys shortly run by the County Council and the Teaching Health Board, and the nearest one to Hay will be in Brecon on 8th October at Elim Church. There will be workshops from 10am - 1pm and 2pm - 5pm, which need to be booked in advance, at consultation@powys.gov.uk or by ringing Melanie Hardwick on 01597 826160. Then from 6pm - 8pm there will be a drop in session.
Powys County Council has to find £70 million in savings by 2020, so they want to discuss new ways of delivering services - which presumably means getting residents to provide the services for themselves as "volunteers", or passing services over to local councils who can't manage to provide them either (like the toilets, which are still under threat).
The Health Board has been experimenting with Leg Clubs and Virtual Wards, apparently.

Council Meeting - Festival Traffic, Painting the Bridge and De-fibrillators

Gareth Ratcliffe reported back on a meeting he'd been to with the police, the organisers of Hay Festival and the people from the Globe. He implied that everyone was helpful except one party there....
To assist with parking problems, the Hay Festival people said that next year they would be selling tickets for events along with parking tickets, so there would be a space for the visitors when they arrived.
The Globe claimed that they had provided 80 parking places in a field just over the border in Cusop, and that they had had no parking issues over the Festival. Gareth, who works for the Co-op now, pointed out that Festival goers had been using the Co-op car park.
The problem seems to be a loophole in the licensing system - as the Globe didn't have a traffic management plan in place, it couldn't be judged as part of the license to hold the event, whereas the Festival does have a traffic management plan, so it is part of their license. The Festival are understandably reluctant to take on the parking problems caused by the Globe - the main problem apart from lack of parking provision was the blockages caused on Heol-y-dwr corner by delivery trucks and so on, with a lack of supervision by members of staff from the Globe. The police were called several times to sort out the traffic snarl-ups. This had caused problems for the shuttle bus - the route goes along Broad Street, up Heol-y-dwr and round to the top of the car park before going back to the Festival site. The Festival said that they would rather re-route the shuttle buses away from Heol-y-dwr next year, if nothing could be worked out. The Globe said that next year they would use the layby in front of the bungalow just behind the Globe for deliveries, but it's not very big.
The councillors are going to invite the management of the Globe to a Council meeting so they can talk to them in person.

The bridge desperately needs re-painting - it gives quite a bad first impression of Hay if a car is approaching from that direction. The best bit of it is the section which was demolished in an accident a while ago, and re-painted. Contractors for the County Council have quoted £40 - £50,000 for the painting job, which apparently would involve taking the metal work apart, painting it and re-attaching it to the bridge. Which seems rather a lot. Powys has an approved list of contractors it can use, who work across Wales, so they don't use local traders for jobs like this. It was almost tempting the councillors to get out there with their paint brushes themselves! In fact, I'd be tempted to get out there with a paintbrush, too - I've got some odd half tins of paint, and between the local residents we could have a rainbow bridge! A chap on Black Lion Green has painted the little bridge down there, and it looks quite nice.

Meanwhile there is a movement nationally to provide de-fibrillators in public places so that people who have heart attacks can be treated more quickly, while they are waiting for the ambulance or first responders to arrive. Apparently the equipment is practically fool proof, and if it is used incorrectly it won't work. Talgarth and Brecon are both getting one, and Gareth was keen to use the traditional walk to Clyro near Christmas time as a fund raising fancy dress sponsored walk. £1500 is needed to get one, and the Lions Club are interested in doing something towards it. It could be kept at the Clock Tower or the Market Square - somewhere central - and I think they said that BT would give a grant if it was placed in one of the phone boxes.

Council Meeting - Bronllys Hospital

There's always a space in the Council meeting for questions from the public - and these can be anything at all.
On Monday night, it was something else that added to the general atmosphere of doom.
A lady stood up and asked if the council had heard the latest news about Bronllys Hospital. She had brought along a glossy document, and explained that there had been a meeting on 16th December launching an initiative to turn the hospital site into "Bronllys Health Park". The document talked about forest walks, and outdoor classrooms, and it all sounded lovely, until the lady noticed that there was no mention of the hospital itself in all these plans.

So, there are going to be "drop-in sessions", at very short notice, and on weekdays so anyone with a full time job can't get to them.
They are: 14th Jan, Parish Hall, Hay, 3pm to 5pm
17th Jan, Bronllys Mansion House (on the hosptital site) 9.30am to 11.30am
20th Jan, Llyswen Village Hall, 10am to noon
20th Jan, Town Hall, Talgarth, 2.30pm to 4.30pm
followed by a public meeting at Talgarth Town Hall on 29th Jan from 6pm to 8pm.

The council hadn't been informed about any of this, and Bronllys Council had no idea about it either. Thanks to this lady, posters are going to be distributed so residents are at least aware of the meetings.

There is also going to be a meeting of the Powys Health and Well Being Group at Tomatitos on 7.30pm at Tomatitos. This is a group for local people who are concerned about health issues.

An Overwhelming Response

Front page news in the B&R this week is that the decision on future hospital provision known as the South Wales Programme will be delayed. When the plan went out to public consultation, they had over 53,000 responses, many of them very detailed, and they obviously weren't expecting that level of interest. So now Opinion Research Services are providing an independent analysis of the responses received, and there should be some sort of decision by the end of the year, instead of October, as they had originally planned.

More Thoughts on the Health Service Proposals

I was sent a copy of this letter a few days ago, by a lady who was sending it to the B&R, to voice her concerns about the proposals for hospital changes in South Powys and across South Wales. The B&R haven't printed it in this week's edition, so I thought I'd put it here:

Are we living in a Soap?
Dear Editor,
We are all sitting comfortably watching our favourite soap. "Casualty" is mine, lives are at risk in the City and the services will save them if they can. What we don't realise is that we have a different reality to face in Country areas like Powys.
Kirsty Williams AM and our ambulance crews have highlighted the lack of cover we already suffer from in Powys.(BandR 20/6/13).
Now we hear that Neville Hall A & E Casualty is to go. Hereford is already overstretched, possibly going bankrupt, and ambulances can get sent away.
Our ambulance paramedics are going to be put under even more pressure and we will be left waiting and waiting for that emergency medical help, which could save us or a loved one. The longer we wait, the further we have to go, the greater the risk to our lives and continuing health.
Again it seems, by the backdoor, life changing and frightening decisions are being made about our health services. The Authorities are to drastically cut our access to A &E services in Powys. The notice of the consultation meetings was very short, a week to ten days, and the title South Wales Programme is not very striking. I could not get to any of the meetings but a neighbour did and returned with an expensive looking, questionaire containing a brochure. They were told at the last meeting that only 150 people had attended meetings in total. So only 150 people are aware of the gamble our Health Board is proposing to take with our lives.
Looking at what the South Wales Programme is not offering us, a brochure should have been sent to every household in Powys. The brochure has "have your say on it" but it is confusing and tricky in the way it is written. It probably makes sense for us to travel further afield for certain specialities but for A and E (which is at the heart of this proposal), I think not! It even asks you to opt for a hospital that is not built yet, (the SCCC in Cwmbran), that needs a quarter of a billion pounds to complete. Where is that kind of money to come from in these times?
Can this be a valid consultation with a non existent option in it? Some say our best bet would be the Prince Charles in Merthyr but that is still too far for us in South East Powys and the A470 gets closed regularly for accidents and the inclement weather.

I am wondering where all the people we voted for to protect us in Powys are in this? Why are they not looking out for our families and communities over this issue? Life is hard and busy, for many of us in these days, and our communities are older, vulnerable and far too trusting. We look to our representatives to fight for us. They should be up in arms, knocking on doors, organising petitions and public meetings.
What are they doing about this and those who want to replace them at the next elections?
Well, I have had a wake-up call and I will be phoning the number on that glossy brochure 0300 0830020, and getting my own copy. I will be ticking the "strongly disagree" box on page 1 and the "another option" on page 2. I will be filling up the "further comments" box on page 3, with that other option (the upgrade of Neville Hall). On page 4, fair play to them they ask about positive and negative effects of the South Wales Programme with regards to equalities. In this section I will explain that all of us, living in this rural area of Wales are being disadvantaged, and our health and well-being threatened, whatever our equality needs maybe. Could this also be a human rights issue?
They asked what can be done about this and I will tell them that the only remedy is for Neville Hall Casualty to remain and for it to be improved with the newest technology.
So I have decided that it will not be good enough for me to just watch my soaps and hope for the best.
If you agree, please phone for your own brochure and do anything else you can think of to keep us all as well and safe as we can be, in this part of the world.
Yours Sincerely
Mrs P Outwaite,
The Old Chapel,
Velindre
Powys

The South Wales Programme - Health Consultation

Ellie Spencer was going door to door with the booklets for the health consultation last night. It's huge - 47 pages - and even then it provides links to websites where there is even more information to look at. The consultation finishes on the 19th July, and it covers consultant-led maternity services and neonatal services (loosely pregnancies with problems and premature babies), inpatient children's services and emergency medicine, which covers A&E services. Five local health boards are coming together for this, across South Wales and South Powys.
I think that's possibly one of the problems. South Powys doesn't really fit with South Wales, and it doesn't really fit with anywhere else either - and it's a huge area with a small population. A lot of people who need hospital treatment around here go to Hereford rather than Nevill Hall in Abergavenny, and the English health boards have plans of their own that may not mesh well with the plans for South Wales.
Anyway, on the plus side the brochure is written in plain English, and there are addresses and websites and emails to contact for people who have views about the proposed changes.
Early on in the brochure, they say this about their plans: "We acknowledge that in the future some of our patients may have to travel a bit further to access a small percentage of our services."
Hmm - "may have to travel a bit further" is a bit of a problem in an area where ambulances can't always get to patients in their target times now - and even without the changes ambulances that are supposed to be providing cover for South Powys have been called as far afield as Cardiff or Montgomeryshire. If there are changes that affect lengths of journeys for treatment, then the size of the ambulance fleet needs to be increased to provide adequate cover for everyone.
But they have thought of this: "The Welsh Ambulance Service will play a key role in taking patients to the right place for the right services." Here they give an example of what they mean. Terry has fallen off a ladder, and his partner Clare calls 999 for an emergency ambulance - but it doesn't say anything in this example about how long Terry will have to lie at the bottom of the ladder waiting for that ambulance, nor how far the ambulance will then have to travel to get him to the right hospital. Poor Terry.
So that's a concern.
While we're on the subject of travelling to and from hospitals, the brochure also mentions families visiting their loved ones in hospital, and the availability of public transport.
A few years ago, I got what I think was food poisoning - I was up all night throwing up, anyway - and eventually, in desperation, I called an ambulance. It arrived - that wasn't a problem at all. The problem was getting home from Abergavenny after I'd been treated. It's difficult to get to Abergavenny from Hay by public transport, so I hadn't visited for years. I didn't have a clue where the bus station was, and the people in the office didn't have a clue about buses either. Their suggestions included "Can't you get a taxi?" (which would have cost far more than I could afford) and "Can't one of your friends pick you up?" (my friends were all at work, and I didn't have their phone numbers with me anyway). Eventually, one of them dug out a bus timetable from the back of a file somewhere and suggested that I should go to Monmouth. I'm not sure what I would have done in Monmouth - I have no idea about how to get from there to Hay either. I just wanted to get to Brecon, and then I knew I could get home (bearing in mind that I was tanked up to the gills with morphine and clutching a little bag of pills to take later). They did, bless them, call a taxi to take me to the bus station, or I'd have been wandering round Abergavenny all day, but it took me around three hours to get home.
So if some patients may have to travel a bit further in future, it's going to be even more difficult to get home after treatment.

Another major problem mentioned in the brochure is the difficulty of attracting new doctors to the area, especially consultants in a speciality. They point out that, with the seven hospitals across South Wales presently providing specialist care of one sort or another, some consultants don't see enough patients to keep up their expertise in that speciality, so the idea is to centralise the patients in fewer hospitals, with the hope that the health boards will then be able to attract the staff they need to the area. (I'm now wondering why we can't have roving teams of specialists, honing their skills by covering several hospitals.... Maybe it's a silly idea - I don't know.)
This points up a problem further along the system than the health boards, because they say this: "If we were to continue providing these services in all existing hospitals in South Wales, to meet these standards we would need to recruit very many more doctors, considerably more than we would need to recruit if we concentrate these services in fewer hospitals. We know these doctors simply aren't there." So there seems to be a problem with the training of doctors, especially in emergency medicine, which has existed for some time, so there aren't enough of them.
The quotation above also touches on another problem - that of cost. Fewer doctors in fewer centres means a lower cost overall - the option for change that seems to be preferred by the writers of the brochure would cost 14 million pounds - not the cheapest, but balancing the advantages against the disadvantages such as travel times.
"Finance is an important consideration in the South Wales Programme but it is not the main reason for change," they say.

Another financial consideration is the proposal to build an entirely new hospital at Cwmbran as one of the new specialist centres for the area. Work hasn't started on building it yet, and it won't be ready until 2018 or 2019. It seems worrying to pin one's hopes for the success of a plan on a major element that hasn't actually been built yet.

Finally, they say that most health care in the region will not change - it will still be provided locally - and therefore the primary health care and GP services are important to the success of the health service overall.
"The contribution of primary care, especially GPs and their teams, will be critical in providing the integrated care patients need. We fully accept that in some areas we will need to strengthen our GP services, particularly in the out-of-hours period."
There are concerns locally about the Haygarth practice, and how long it takes to get an appointment with a doctor there.

So that's what I've got out of reading the South Wales Programme, and now I'm going to send my thoughts to the email address they give - swpresponse@wales.nhs.uk
They also give more information at www.wales.nhs.uk/swp