THANK you to Joanna Sayers and the Western Telegraph for highlighting the Hywel Dda consultation ‘Transforming Mental Health Services.’ A group of us attended the launch of this in Lampeter and the recent ‘Drop In’ in Letterston.

The presentation launching the consultation could have been a transcript of that used to justify the centralisation of maternity and paediatrics – and we are still waiting for some of the changes we were assured would be in place before this would take place, which does not inspire confidence in further centralisation.

To be assured that ‘no change is not an option’ and buzz phrases like ‘safe and sustainable’ and ‘open and transparent’ immediately raises warning flags to anyone who has followed the health board’s asset stripping of Pembrokeshire, and this does seem to be more of the same.

I appreciate that there are serious issues with the current service model and that it is laudable to seek to avert crises by earlier intervention, but the proposals would see our acute adult ward (St Caradoc) reduced to four community beds, a 12 bed assessment unit in Carmarthen for admissions of up to five days, and a longer term 15 bed acute unit in Llanelli. That is a five hour round trip from Aberystwyth, assuming you have access to a car!

We in Pembrokeshire are not much better off.

Should there not be some consideration to the involvement of the whole family in acute mental health crises?

How can that be when such huge distances are involved?

They are very keen to emphasise ending the ‘stigma of mental illness,’ yet our very sickest are to be removed to a different county – how can this be right?

Also questions need to be asked about the transport of acutely ill mental health patients – the literature suggests ‘Third Sector’ such as St John Ambulance, but I have also been told ‘the back of a police van.’ Seriously?

Yet again we are told that it is ‘recruitment issues’ that are spearheading the changes, but again questions need to be asked about Hywel Dda’s policy towards recruitment since its inception.

Admittedly adverts no longer specify ‘Hywel Dda Health Board (Carmarthen)’ unless that is the location of the advertised post, but centralising maternity and paediatrics was supposed to reduce the bill for agency/ locum staff – instead of which it has increased exponentially.

They are keen to claim that ‘all our staff are behind this change’, yet that is not what we are hearing.

Having spent the last six weekends tackling the appalling jungle of neglect on the Withybush estate and realising the huge amount of care that has gone in to the original design and planting of the Bro Cerwyn site, it is hard not to see the neglect of the grounds as a metaphor for the way that Pembrokeshire has been treated by Hywel Dda (probably at the behest of the Welsh Government given the budget situation.) Perhaps policy questions need to be addressed to those who advise the politicians? Why are such similar policies being applied both sides of Offa’s Dyke? Centralisation may well be a good approach in urban areas, but why is greater consideration not being given to the needs of rural areas? The current mantra of Telemedicine wears a little thin given our current broadband and mobile coverage.

I would urge everyone to look closely at this consultation and also the ‘Transforming Clinical Services’ launched at the same time and which could have significant repercussions on our A&E and primary care.

Attend as many events as you can and demand more – and more accessible – meetings because it does feel as though this is all being slipped ‘under the radar.’ We are trying hard to separate the good from the bad, so that we are not unduly critical but the more we look at these proposals, the greater the sense of unease in spite (or because?) of the enthusiastic rhetoric of the proponents from the health board.