One of the first meetings I had as the MP for Aberconwy was with the Betsi Cadwalader Hospital Trust in order to discuss the issues surrounding the Minor Injuries Unit at Llandudno Hospital. Having highlighted the closure of the unit at night during the campaign and the fact that a permanent closure would save a significant amount of funds for the Trust I was aiming to demand a re-think. Six weeks later I continue to have doubts about aspects of the plans but I do accept that many aspects of the changes proposed are medical led decisions. The consultation process was also clearly transparent and in some ways a model of what a medical led consultation should include.

Before any readers assume that I agree with the proposals being made let us put the issue in context;

1. A steering group to look at the future of LH was set up in 2007. The first meeting was held in July 2007 and the second in October 2007. The papers are available.

2. A review was undertaken by Frank Burns during the period May – Dec 2007. He made 50 recommendations concerning the future of the hospital. The report is also an open document and available to all.

3. A project board was established in June 2008 to consider his report. There were eight working groups established to consider the themes within the report. This included representatives from the League of Friends, CHC and LHAGS.

4. The final report of the Board was published in March 2009. Within this it is recorded that the work group concluded that MIU should close after midnight. It was the project board that decided to investigate nurse led service after midnight with medical support from the GP out of hours services. The board resolved to take advice from Prof. Mike Harmer on the future role of the MIU. The options that he was to be asked to consider were:

• Nurse led with support
• Developed as an out of hours centre – GP’s out of hours contract to be renegotiated in October 2010 and felt that perhaps there was some room to do something creative her.
• Develop as a new build.

5. After the publishing of the report – the Llandudno Hospital project was set up in January 2010. The aim was to consider recommendations of the Burns report and provide detailed plans for;

• Unscheduled Care
• Elective Treatment & Diagnosis
• Rehabilitation
• Women’s Health
• Mental Health

6. To achieve this aim there was to be a project team, a stakeholder group (to include LHAGS), expert support group and a communications group (to include LHAGS).

7. At the meeting of the Stakeholder Group on 24th March 2010 it was AGREED that MIU could not safely be managed without appropriate numbers of qualified staff. It was suggested that doctors were paid more for working at Llandudno but the consultants present said it was a national problem – rather than money. I have investigated this issue since my meeting with the Trust and can confirm that the issue of a shortage of trained doctors / consultants is a current national problem which is worse in Wales at this moment in time.

8. It was AGREED that no emergencies would be admitted after 6pm.

As you can imagine, the paperwork provided by the Trust in support of their decision in relation to the MIU was substantial. I have read and sought advice on many aspects of the recommendations. I continue to be unhappy about issues such as access times and the availability of ambulances in the Llandudno area if the MIU closes as a 24hr facility and as such I have requested a further meeting with the Trust to seek detailed assurances on these issues.

However, it is clear from the paper trail that the proposal to reduce the hours at the MIU has been fairly well documented since 2007 and it is misleading to suggest that this is a bolt from the blue. Even my comments in April alluded to the fact that the cost savings that closure would bring were being investigated in detail prior to the first closure of the MIU overnight at that time.

I have also spoken with or had my staff speak with members of LHAGS and the League of Friends and they have confirmed that the process in their view has been open and transparent. One individual specifically stated that they were “delighted that all the decisions are being made by clinicians and practioners rather than “pen pushers”.

Coupled with confirmation from a Consultant in Cardiff as to the levels of Doctor and Consultant shortage in Wales I have to admit that the case appears to be medically driven rather than financially inspired. And yet....

I remain concerned that the practical impact of the downgrade of the MIU will be a huge blow to the town, the population and the hospital. I will be holding a number of ‘open surgeries’ and ‘public meetings’ during August and September and would ask interested parties to come along and highlight your own concerns. Having read the background papers and copious minutes from numerous meetings I feel that there continue to be questions in need of a response from the Trust and as such will report back following my further meetings with the Trust team dealing with the specific MIU proposal and the wider re-development of Llandudno Hospital.

Guto