When I came to Llanelli in 1994 to take up an orthopaedic consultant post I was relieved to finally get a permanent job in Wales, to settle in my own country, and raise my children here. I knew Llanelli quite well. I had lived in Gowerton as a child, and my parents had kept in touch with their local Llanelli friends. After retirement they moved to Llanelli to be near their friends, their daughter and grandchildren.
The hospital was a bit small but had plenty of grounds to build new facilities. The staff were confident and friendly but there was a bit of negativity. One consultant even asked me why I wanted the job, with my excellent record and references, which could have got me a job in a “proper” teaching hospital. That wasn’t what I wanted, I wanted to bring excellent care into the small communities like Llanelli, not the big cities who generally had better services.
I remember the hospital haematologist, Dr Majer, who spoke to me when I came for an interview, asking me if I could manage the job. Wales, he said, was very different from Scotland and England where I had trained.
Some doctors had left when they realised what it was really like. I was mystified but later realised that what he meant was that the management decisions could be questionable and I found there was definite prejudice against women doctors in top positions.
The management in my early days was the Llanelli and Dinefwr Hospital Trust. Prince Philip was a new hospital, replacing the old General Hospital. I should have taken note of the vicious criticism of the existence of the Llanelli hospital by clinicians from Carmarthen when I attended local medical meetings.
There was soon a reorganisation of Welsh Hospitals Trusts. Our doctors favoured a union with the Swansea Hospitals but the Welsh Office preferred us to join with Carmarthen to make up the numbers in the West, even though it was a considerable distance away. Initially the arrangement was cordial but the tension developed as the Carmarthen medical staff and management adopted a policy of asset stripping at Prince Philip hospital in favour of Carmarthen, rather than go ahead with improving our hospital.
Over the coming years the UK and then the Assembly Government favoured a policy of saving money by dumping expensive projects like clinical wards, medical and nursing staff and diagnostic equipment. When we raised the money for a new MRI scanner my colleagues in Carmarthen assured me it was wasted in Llanelli.
I put it down to sour grapes and jealousy but in fact it was more than that. They genuinely did feel that we didn’t deserve the equipment we had worked so hard to fund. I felt they looked down their noses at us. They persuaded the management that we needed less and they deserved more.
Later on I was put under pressure to take a day off every week to play golf instead of working hard to reduce the waiting lists. I have never played golf so it was quite bizarre. Probably some other surgeons thought I was reducing their private practice by not having long waiting lists. Why should I take up sport when a lot of people were in pain and needed help?
Prince Philip was never a fully functional District General Hospital. For instance there was no obstetric ward for mothers and babies, just a clinic. Our only Consultant paediatrician was forced out of her job by the medical director (chief doctor) and not replaced. All children had to be sent to Glangwili for medical treatment or paediatric operations.
More recently, under the Hywel Dda University Health board, whole hospitals such as Mynydd Mawr, which could have remained as convalescence and treatment units, were demolished and sold off for housing. In the past local residents had successfully argued the case for retaining Mynydd Mawr hospital only for the managers to overturn the decision later.
The Health Board Management eventually looked only at the money “released” by the closure and sale of our buildings. They were well rewarded by their big salaries, and gave the impression of not caring for this area. They really did seem to act as if they believed we deserved less.
If we had retained the small cottage hospitals they could have been excellent isolation units for Covid patients, but stripping the assets of our hospitals was more important than building capacity.
The investigation into Covid 19 reports, the lack of bed capacity for sick, infected patients, the hospital based outbreaks and the lack of preparedness may be due in large part in Llanelli to the way the local population was disregarded by the local Health management.
The last big battle was the one for saving our Accident and Emergency Department. The hospital had one but the management insisted that we didn’t need one. Despite a long battle, the A&E was closed and replaced with a supposed “State of the Art” minor injury unit. We found out too late it was very basic, and not as promised.
The campaigners — and I was one of them — were deliberately misled. Many did not realise the A&E department was doomed until the announcement was made. The largest town in Carmarthenshire, Llanelli, did not deserve anything like a district general hospital, and certainly not a casualty department!
It’s not all bad, some services of high quality still remain at Prince Philip, but the dream of a district general hospital is gone.
Our nearest accident and emergency department is in Swansea, and perhaps that was always the plan? To force Llanelli people to seek emergency treatment elsewhere so it was paid for out of area, not by Hywel Dda Health Board.
The Swansea Hospitals are much nearer to us than Glangwili Hospital in Carmarthen and you can usually park there, unlike at Glangwili where parking is often a nightmare.
Hywel Dda Health Board’s next move is apparently to build a “State of the Art” new district General hospital somewhere between St Clears and Whitland. I have heard that the site of the hospital is not yet decided and land has not yet been purchased. The construction will take 10 years or so. It is thought that a new “State of the Art” hospital would attract the finest doctors and nurses to the area.
A hospital at this new location in the West is even more likely to persuade Llanelli residents to go to Swansea in an emergency. New hospitals may not attract the best doctors, especially trainees who may prefer the experience and references of established specialist city teaching hospitals. It doesn’t sound like a sensible plan and I doubt Llanelli residents will be consulted.
It’s a scandal that we have been blocked from making many healthcare improvements needed in our own Llanelli Hospital. It’s clear that local needs here are not a priority.
It’s time the voice of the people was heard and not ignored! The Covid Crisis shows us that cutting hospital services to the bone has severe consequences.
