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00:00I don't know if you've ever heard of a term naffy sandwich, I'm happy you can laugh over it, but it's serious.
00:08It's naffy sandwich, bread at the top which is North Wales, bread at the bottom which is South Wales and sweet nothing in between.
00:19So there's Mereolosia, Powys and Ceredigion, we get it in your heads now, we do not exist as far as the Welsh Assembly is concerned.
00:34Actually as you said Doctor, the long term consequences of a stroke can be really significant.
00:43Some people make a very quick recovery but others have long term disability.
00:50And so it's really important that we get that stroke care right and that we have access to the best, highest quality evidence based care.
01:00We don't want to see a need for families, for individuals, for patients to have to travel so far.
01:07The fact of the matter is, as somebody who's just travelled up from the Berkeley area this evening, the road network isn't good if you've got a car and unable to drive.
01:17If you're independent on public transport, good luck.
01:21And so I think these are all very important points that need to be borne in mind, accepting that there will be clinical considerations of course,
01:30but in terms of that added factor, that wider factor for the patient and their families, that really needs to be borne in mind.
01:37And it, I believe, makes even stronger the case.
01:41The seventh part of Mereolia depends to a large degree on bronchitis.
01:46Now if you think of the part of the area that I represent in Brodersalli, Brodersalli has seen a significant downgrade of its health services already.
01:57You could essentially say that the hospital there has been downgraded.
02:00The MIA unit has been downgraded. We've lost one of the inpatient wards there.
02:05Maternity units have effectively gone.
02:08We've lost a number of doctors.
02:11And now we're seeing that the processed hospital is also losing parts of its service, which we are so dependent on.
02:21Amazingly, it's an hour and 47 minutes from Brombyce to Prince Philip and it's an hour and 47 minutes from Brombyce to Morriston.
02:30It makes no difference to this community whether it's within the health board or in the next door health board.
02:37The geographic distance is the same.
02:39So what that means to me is that the planning of these services very often shouldn't be done within the health board.
02:48They should be done at a national level so that you have geographically spread throughout Wales the services that Wales needs.
02:59If there needs to be specialist centres, then let's develop those specialist centres fairly across Wales rather than each health board designing within its own area.
03:13Rehab, as Phil said, is essential and it should be seven days a week, not five days a week, seven days a week and intensive rehab.
03:20That's a huge challenge for all stroke units, I think.
03:24Not just the ones in Hywel Bar, not just Brombyce or Carmarthen, Whittybush or Llanellin.
03:29All stroke units will struggle to meet that standard.
03:32But that's the standard to meet. That's the struggle.
03:35And just shifting patients from one hospital to another away from family, possibly for weeks at a time, is going to cause problems even though they may get access to high levels of rehab.