WHEN I came to work in Withybush Hospital in 1984 there were over 300 beds available to Pembrokeshire patients, serving a population of 112,000. Today we have just over 180 beds serving a population of 118,000.

Welsh Government figures released last week showed that nearly 20% of beds have been cut in the Welsh NHS in the past decade. This has occurred while our population continues to increase. I fear that too many hospital beds and nurses have been lost in the name of efficiency.

During the last 10 years there has been pressure exerted on management from successive governments to make the NHS more efficient and reduce nursing staff and beds. I even remember a time when there was a call for managers from the private sector e.g. Marks and Spencers, to come in to show how it should be run, and at one period Time and Motion Consultants were brought in to Withybush and this was soon followed by a reduction in the number of “staffed”

beds on the wards.

Over recent years, the whole situation has been complicated by numerous statements from government and management such as; “Withybush hospital has too many beds”, “we depend too much on hospital buildings, and that “more patients should be treated at home”. It was also stated that facilities would be put in place so that these patients could be treated at home or discharged safely to community care after a period in hospital.

Now beds have been removed from Withybush, and beds at Tenby no longer exist. We find ourselves in a situation where hospital beds have to be found over the winter for extra medical emergencies, partially because the system of community care as suggested seven years ago and reinforced earlier this year has still not been put in place. As the system of home treatment cannot cope, how are they suggesting that they deal with the problem?

Their solution is to have a planned closure of Orthopaedic beds to make them available as “surge” beds for unexpected additional medical emergencies.

This is unsafe practice because orthopaedic nurses may have had generic nurse training in the past but now they are trained specifically to nurse orthopaedic patients not acutely ill medical patients. A plan should have been made to appoint more medical nurses to cope with the winter pressure and this should have been done two months ago in order for these nurses on short term contracts to get up to speed before having to deal with very sick medical emergencies.

We have always had some cancellations over the winter period but the majority are not cancelled and if the number of staffed beds had not been so drastically reduced over the last five years no patient would need to be cancelled. There is no doubt that that life saving procedures should demand priority, and everyone agrees that beds must be found for seriously ill people. However, in the past beds have always been found , and some major cold orthopaedic surgery was done at the same time and probably this could be done again.

If Hywel Dda Health Board implements these changes then it will cause increased pain and suffering to a great many people not only in Pembrokeshire but throughout Dyfed Powys. This will be exacerbated if the plan to have Withybush open for emergencies for only 16 hours per day is also taken forward.

I firmly believe that although we are all living in a time of financial restraint where managers in the health service have difficult decisions to make, the decision [to cancel elective orthopaedic operations] was a bad one.

G E PHILLIPS

Retired Consultant Oropaedic Surgeon at Withybush Hospital