THE unconvincing response by the medical director to the tragic death of Malcolm Green should leave no doubt that the health service in west Wales is not fit for purpose.

Ready prepared trite statements “that we have identified failures and will ensure there is no repeat” are disingenuous and show that lessons have not been learned.

Smoke and mirrors tactics have created the very conditions which have led to unnecessary deaths. The causes are multiple and complex but show you cannot run the health service like a business because mistakes have far more serious consequences than breaking eggs on a production line.

With regard to this particular incident, why was it necessary to hold meetings on a Saturday and how long did it last?

When I worked at the hospital clinicians would always put needs of patients first and ignore the proliferation of “talking shops”.

It is already difficult to recruit and retrain high quality staff so the determined intent to make further cuts is irresponsible and extremely dangerous. Eventually all departments will be affected because of interdependence and training criteria. It will also lead to a deterioration in General Practice since many trainees settle near their training base and all family doctors require good postgraduate education to retain accreditation.

These problems started with the “Reform of the Health Service” by Kenneth Clarke and were aggravated by successive Labour and Tory Governments, so we no longer have a proud national service but a national disaster.

There are far too many causative factors to mention here but the main ones include a detached dysfunctional management system. The bloated bureaucracy with rewards for failure, revolving doors redeployment, overgenerous redundancy payments, salaries, and pensions have been at the expense of clinical services and are the best ever examples of Parkinson’s Laws.

The changes started before I retired 10 years ago and it became increasingly difficult to provide personal continuity of service.

There are still a few examples of good practice but the disjointed, inefficient multi doctor systems make it difficult to achieve ideal results.

Every initiative thus far has lead to a decline in services which is the reason for public lack of confidence with the health board and Welsh Government.

Let us hope that SWAT ‘s excellent campaign to secure a Judicial Review will result in breathing space otherwise more lives are going to be lost.

DR DAVID JONES, FRCP

Retired consultant physician