James Evans said the NHS “should not be immune from change” during a debate on rural healthcare in the Senedd this week.
The Brecon and Radnorshire MS led the short debate on the future of healthcare in rural Wales, highlighting significant challenges faced by communities in Powys and beyond.
Video from Senedd.tv
The Brecon and Radnorshire MS led the short debate on the future of healthcare in rural Wales, highlighting significant challenges faced by communities in Powys and beyond.
Video from Senedd.tv
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00:00I now move to the short debate, and I call on James Evans to speak to the topic that
00:06he has chosen.
00:07James.
00:08Thank you, Presiding Officer.
00:09I would like to give a minute of my time to Russell George, Sam Rowlands, Gareth Davies
00:14and the one and only Janet Finch-Saunders.
00:18The future of healthcare in rural Wales is under serious strain.
00:22In Brecon and Radnorshire, we face a unique set of challenges due to our sparsely populated
00:27areas, which has limited access to hospitals and emergency services.
00:33Most residents are forced to travel outside the county to receive essential care.
00:37This issue is especially concerning given our ageing population in Powys, where nearly
00:4228% of the population are aged 65 or older, much higher than the national average.
00:49This figure is projected to skyrocket with over-65s reaching 47,000 by 2036.
00:58Despite these increasing needs, Powys Teaching and Health Board struggles under a £23 million
01:03budget deficit, a clear indication of financial mismanagement.
01:09While some positive steps have been made, such as advancements in stroke rehabilitation
01:14and mobile dental unitsóall these are to be welcomedóthey are consistently undermined
01:19by significant cuts to our essential services, which are always on the front line.
01:26Most concerning are the cuts to MIU opening hours across rural Wales and the downgrading
01:32of Craig Ward in Brecon, which cared for dementia patients.
01:36Knighton Hospital in the north of my constituency has been reduced to a small respite unit,
01:41further diminishing the scope of the care we can provide locally within our cottage
01:45hospitals in rural Wales.
01:48The downgrading of these services aren't limited to Powys alone.
01:52Recently, a Nair and Bevan health board announced the closure and downgrading of wards, meaning
01:57a loss of nearly 15 beds at a minimum.
02:01Our district general hospitals in Merthyr, Hereford, which is across the border, Swansea
02:07and the Grange, are frequently at capacity and on red alerts, and maternity services
02:13in Bronglais can't accept any more patients.
02:18These are not isolated cases, but signs of a systemóour NHS here in Walesówhich is
02:24buckling under pressure.
02:26I do applaud colleagues from all across the political spectrum in this Chamber who have
02:30spoken out cuts to the NHS in their own communities, as we're all facing the same challenges right
02:36the way across Wales.
02:39For non-acute care, the situation is even more fragmented.
02:44It's unacceptable that elderly residents in Abercrave must travel as far as Telford for
02:50eye appointments because of service-level agreements that rural health boards strike
02:55across the country.
02:57Even though a closer hospital in Swansea could handle that treatment, it simply isn't good
03:03enough.
03:04Similarly, patients from rural Wales find themselves driving to Shrewsbury for orthodontic
03:09care for their children, despite these services being available much closer within Wales.
03:16These examples show the breakdown in co-ordination between health boards, leaving patients stranded
03:21in a web of bureaucracy and needless travel, and more often than not, as an MS and other
03:26MSs who represent rural Wales, we are contacted to pick up the pieces.
03:32Our health boards may be under budgetary pressures, but there is no excuse for mismanagement.
03:39That disproportionately impacts our frontline services.
03:44Efficiencies could be found in the NHS by streamlining management, improving organisation
03:51and rethinking our approach to healthcare delivery.
03:56Time and time again, we hear the Health Secretary that they won't intervene in local decisions,
04:02yet this isn't just a local decision, this is a national problem.
04:07We still lack across Wales a unified IT system across health boards, and waiting lists in
04:13Wales are out of control.
04:16We need strong oversight from the Minister, and it's time to shake up the system to root
04:22out waste and prioritise the health of our people.
04:26I know the previous Health Secretary did some work into looking into the organisation and
04:31accountability of health boards across Wales, and I'd be very interested to hear from the
04:35Cabinet Secretary a little bit about that and how he can actually hold health boards
04:40more to account.
04:42What we do see, though, is top-level management positions across health boardsóthey keep
04:47getting advertised, yet I hear countless stories, I'm sure as others do, of roles that one person
04:53used to handle now being expanded into multiple positions with no increases in efficiency.
04:59This must change.
05:00The bureaucracy grows and grows as front-line services are cut.
05:07The critical role of GP practices in rural communities cannot be overstated.
05:11We had a good debate in here earlier on the future of our GP practices.
05:16They are our front line.
05:18They are the stop-the-gap between critical services and community services, but many
05:24of them feel they're consistently fighting against health boards just to provide basic
05:30care because they cannot get contracts arranged with health boards.
05:35Their innovative ideas and solutions to improve service areas are often ignored.
05:39They're presented to health boards across rural Wales, and the health boards don't want
05:44to listen to them.
05:45I'd be interested to hear as well from the Minister how actually our GPs can feed more
05:50into the process and directly correspond with the Minister to make sure that their decisions
05:56and their ideas are being heard by government.
06:00If we are serious about rural healthcare, we do need to empower our GPs and give them
06:05the tools to manage their practices efficiently.
06:10Dementia care is yet another issue that requires immediate attention.
06:16In rural Powys, only 40% of those living with dementia have received a formal diagnosis.
06:23That's shocking, meaning more than half are without essential support and treatment, and
06:29without that diagnosis, they can't get the changes and adaptations they need to stay
06:34in their homes for longer.
06:37With an ageing population, this lack of access to diagnostic resource is alarming.
06:43We must do better for those individuals and ensure that every person, regardless of where
06:48they live, has access to timely, quality healthcare.
06:52The people of rural Wales deserve better.
06:56Our communities are being neglected by a system that has lost sight of what truly matters
07:01and more focuses on urban areas.
07:04We need a healthcare system that serves its people and not one that forces elderly residents
07:10into arduous journeys and ignores the hard work of our GPs and other health professionals.
07:17One thing we do need to look at is the structure of our NHS across Wales.
07:24The NHS is not a sacred cow.
07:28It should not be immune from change, and time and time again we see governments not willing
07:34to grasp it by the nettle and actually deliver the changes needed, because governments worry
07:41about the political backlash of changing the NHS, of driving efficiency and making it serve
07:48the people of rural Wales and the whole of Wales better.
07:52I implore the Welsh Government to forget the ballot box.
07:56Think about the people that the changes could actually make to get them seen in appointments,
08:01get operations done and make sure the system works better.
08:06The future of rural healthcare in Wales depends on action and accountability and a commitment
08:12to making real changes to the people who need it the most.
08:16It's time to prioritise frontline services, invest in our GPs, demand the joined-up approach
08:22that will deliver the healthcare our communities deserve and deliver that NHS that we all need
08:27for the future.