Royal College of Surgeons raise concerns over erosion of health services in Wales

A Royal College of Surgeons (RCS) report on the Cardiff and Vale University Health Board (CVUHB) sheds light on the gutting of the National Health Service due to budget cuts by the Labour Party-run Welsh Assembly government.

The Royal College of Surgeons’ Professional Affairs Board (PAB) for Wales published their findings last May after a panel of professionals visited the University Hospital of Wales (UHW) in Cardiff, the biggest in Wales. The RCS passed the report to the Labour-run Welsh government who are presiding over this unprecedented attack on public health provision. Health Minister Mark Drakeford was “very concerned to read the RCS report,” but intends to go ahead with the decimation of health services.

CVUHB is one of the largest NHS organisations in Wales, providing health services to around 472,400 people living in the Welsh capital Cardiff and the Vale of Glamorgan.

The report exposes the disastrous consequences of cost-cutting drives by the Health Board in order to meet end of year financial targets, with callous indifference to the plight of patients.

Among the key findings are:

* There had been more than 2,000 elective procedures not scheduled because of lack of beds or cancelled in the first three months of 2013. The most prevalent complaint from the clinicians was the inability to admit patients for elective surgery.

* Patients are regularly dying on the waiting list from their cardiac pathology, mostly valvular disease (defects in heart valves). In addition other patients’ hearts are deteriorating while waiting for surgery, such that it is more difficult to treat them when they are submitted to surgery. Adam Cairns, chief executive of CVUHB, has admitted that 12 patients died over a 15-month period while on the heart operation waiting list.

* Some services are almost completely failed and some effectively suspended, such as paediatric tonsillectomy.

* Children are now regularly being fitted with hearing aids because there is no ability to treat their otitis media (ear problem) with surgical grommet insertion.

* Patients are suffering complications because of delays in treating ureteric stones by stent insertion.

* The Accident and Emergency (A&E) department was failing to cope with the constant influx of patients. This is an infrastructure failure. For instance there are only three resuscitation bays and patients are often stacked up in corridors and ambulances. There are staffing issues in terms of a timely attending to patients.

* A patient recently died in the A&E corridor from a ruptured aortic aneurysm. Failures also occur because of the inability to transfer patients who are to be admitted due to the unavailability of inpatient beds.

* The report points out that there are further attempts to save money by closing beds.

The full RCS PAB report can be found here .

In the aftermath of the RCS findings, comparisons have been made with the Mid Staffordshire NHS Foundation Trust, which was found to have had detrimental failures in care and patient safety by the Francis Inquiry this year.

Over the last three years, the Labour-led governments in Wales have presided over £660 million pounds in cuts for NHS Wales, in line with their Conservative and Liberal Democrat counterparts in Westminster. This is aimed at dismantling NHS services and privatising them. Further huge inroads into the public health provision are under way.

All NHS health boards and NHS trusts in Wales are struggling to cope with financial targets imposed by the government and face a similar erosion of services. The critical situation in the CVUHB and at other Health Boards and NHS Trusts in Wales is the product of years of underfunding, restructuring and streamlining of services.

Recent reports highlight the fact that 13,000 operations have been cancelled in Health Boards in Wales over the last three years. CVUHBs cancellations amount to 4,442 during that period.

Earlier this year a letter from the Royal College of Emergency Medicine, signed by 24 consultants at hospitals across Wales, warned that “emergency departments are at the point of meltdown” and that most days “they are seriously overcrowded,” jeopardising patient care and safety.

The percentage of patients who spend less than the target of four hours in Accident & Emergency before they are treated, admitted or discharged in all emergency care facilities in Wales is 89, while CVUHB’s percentage is at 85. Current UK health legislation stipulates that 98 percent of patients attending A&E should be seen, treated, admitted or discharged in under four hours.

Commenting on the situation of the CVUHB, its chief executive Adam Cairns said, “It is fair to say that this organisation was struggling like many others, to cope with the pressures,” and admitted that he was “on record already having apologised to patients.”

In March, CVUHB approved a plan to slash its spending by £90 million, including a £35 million cut to the wage bill. Last June they announced 385 job redundancies to meet this financial target.