Passing the buck

Dear Ms Aspin, 

Thank you for your further email of 26 September addressed to Vaughan Gething AM, Cabinet Secretary for Health, Well-being and Sport regarding your concerns about the services provided at Pen y Maes health centre in Wrexham.  I have been asked to reply.  

I am sorry that you were disappointed to receive a response from an official rather than direct from the Cabinet Secretary.  Welsh Government Ministers receive a large volume of correspondence and cannot always respond personally.  For this reason correspondents may from time to time receive a reply on the Cabinet Secretary’s behalf from his officials.  However, the Cabinet Secretary takes a close interest in all his correspondence. 

I note your further concerns.  It was explained in our previous response that the Betsi Cadwaladr University Health Board took over management of the practice in October 2016 and is continuing to explore potential options for the future provision of services.   

In Wales, the Cabinet Secretary has a role to set the strategic direction for health services and hold the NHS to account.  Health boards plan how services are delivered ‘on the ground’ and regularly review these services to ensure they meet the needs of their resident population.  Therefore, the health board will be the most appropriate organisation to contact to provide the specific answers to your enquiry. 

Yours sincerely 

Paul Haynes Government Business Team Health and Social Services Group  

In reply to the second and third emails I sent to Vaughan Gething, this dropped into my inbox yesterday. No more informative and equally 'helpful' as the last reply from him. Obviously, Mr Gething, who is, remember, the Cabinet Secretary for Health, Well-being and Sport in the Welsh Assembly, is an extremely busy fellow and hasn't got time to reply in person to the likes of me. The fact that, being Secretary for Health, means that it is his job to be interested in what's going on in the Health scene throughout Wales, seems to have passed him by, and of course, as his constituency is in south Wales, he doesn't rely on us to vote him back in when the next election rolls around.

So, once again, in spite of the fact that I did inform him previously that I have already contacted BCUHB and a great many more bodies and people besides, the official line continues to be, 'Not interested, go and ask them.'

We have now gathered a fair amount of coverage of what is happening in our Health Board and it's all grist to our mill. For example:

• In BUCHB and doubtless in other Welsh health boards too, directly managed GP practices  get £29 per patient more than GP managed practices.
• Although the East Area team have assured us several times that they are 'committed to GP managed practices', they also told the recent Scrutiny meeting with the Council that they 'have no intention of putting Pen y Maes out to tender again in the near future'. 
• They are NOT 'meeting the needs of the resident population', unless you count days with no GPs and a shortage of nurses as meeting our needs.

So the bottom line is that although one of our MPs has become involved and is asking questions, even though Welsh NHS is devolved so he does not have any obligation to do so, Mr Gething, who does have a responsibility (the clue is in your title, you know!), has decided not to bother.

Sadly, we're not the only practice suffering. http://www.dailypost.co.uk/news/north-wales-news/gp-surgery-blasts-bullying-health-13754767

But we're not going away. We're going to keep on keeping on!

Still doing battle

After two missives to Vaughn Gething, our Health Secretary, I received an off the peg reply from one of his minions who, like all the others, had perfected the art of saying nothing very comprehensively, so this afternoon, I sat down with Classic FM for inspiration and composed this:

Dear Mr Gething,

Thank you for the response to my letter, sent by a member of your team. It seems as if the organisation of your response network is geared to siphoning people off to other organisations who may or may not be able to help them. I'm afraid that in this case, this response is not helpful.

We have already contacted the CHC, BCUHB itself and the CEO, Mr Gary Doherty, to no avail. We are not being given anything helpful in regard to how the parlous situation at Pen y Maes health centre can be resolved and seem to be continually shooed away and told that 'it's OK folks, your concerns are unfounded/ we have it all in hand / we know what we are doing (delete as required).

Unfortunately, no-one seems able to tell us 

a) why salaried GPs do not seem to want to work for the East Area team of BCUHB

b) why this is not being invstigated

c) why Dr Sankey, erstwhile clinical lead, who was willing and eager to take on the practice as a GMS        with a full team of medical staff, was turned down

d) why BCUHB seem hell bent on directly managing our and other similarly placed practices           themselves, irrespective of whether it's the right solution or not

e) why the Board thinks it acceptable to pay considerable sums of money employing locums when item c) was available.

I’m sure you are aware that directly managed practices cost around a third more to run than GMS practices. Between April and August BCUHB overspent by three million pounds on just six directly managed practices, five of which are under the East Area team and of those, four  in Wrexham, Pen y Maes, Beechley and Hillcrest, as well as Ruabon. The first three have all lost their clinical leads due to resignation.

I was hoping that you, as Secretary for Health in Wales would also have an interest in this problem and given your position, could endeavour to obtain the answers to the above. I remain ever hopeful and would greatly appreciate an answer that deals specifically with the points I have raised here.

Sincerely, etc

Dreaming - and shouting

Often at night, I dream and the dreaming is, on occasion, accompanied by some shouting. Sometimes the sound of my shouting wakes me up but generally, it falls to Keith to wake me up and inform me that I was shouting. After that, I usually manage to get out of the dream cycle and go back to normal sleep, or what passes for normal for me anyway.

In the morning, I have a vague recollection of having been talking or shouting and if I don’t, Keith is more than happy to remind me, but he never remembers what I have said and in the bright light of morning, I have forgotten what was bothering me so much, but I do seem to spend a lot of my dream time arguing and fighting with people.

Last night, it appears that I shouted again, just one word, ‘Bastard!’ I’m quite sure this was not directed at Keith and actually, you’ll be relieved to hear, it’s not part of my regular vocabulary, but this morning I did have a vague recollection of being extremely angry and frustrated with someone.

Of course, it could be the effect of all this protesting.

Which is a shame as there is still plenty of that to do yet!

Protesting in the rain

Well, we gathered in the pouring rain and had a brief question and answer session before the BCUHB executive meeting, with the same answers to the same questions, but at least they have been made more aware of the depth of feeling and some of the media have covered our protest. 

What happens now? Who knows!

More protesting?

This week seems to be one for protesting about what is or is not being done that should or should not be being done - if you follow my drift.

After a brief seguė into ringing the council to point out that, once again, the playing field has not been mown once since late spring and when are they going to do something about it, I went back to my Welsh class.

Remember this, about the reduction of choices available?
Well, now that the local FE college has responsibility for delivering Welsh courses locally, the cost has doubled and there are no concessions as there were with Prifysgol Bangor and there are fewer course venues available.

We have more or less finished our course started under Bangor but there was a problem on the horizon. It seemed that Coleg Cambria had won the contract knowing full well that they did not currently have a Uwch course, which should be where my group goes next. Fast forward to the present. As the courses are now developed nationally, it was decided that the new Uwch course would be trialled in south Wales this year, so yes, you've guessed it, no course for us!

Not that that deterred Coleg Cambria from taking our money under the guise of enrolling us on the Uwch course (Yes, that's right, the one that's not yet available).

Fortunately, our current tutor is a star and is 'getting round the problem', so he will be providing us with .... something, but I'm not allowed to say more!

Protesting

This is part of our protest against the Health Board here in North Wales, who are failing us day after day. On Thursday, I and I hope, many other patients, will be at Glyndwr University to register our protest at the Board's Executive meeting. Wish us luck!

The surgery with no doctors

BCUHB

You may remember a post I did a while ago about delays in allowing GPs to work in Wales, which was of particular interest to us as our surgery had come under the control of Betsi Cadwalader University Health Board, and things were not going well.

I did get an answer to my query, basically saying that they have speeded up the process and anyway, that lot in NHS England are even slower when the movement is from Wales to England.

However, things have now moved on. A wonderful doctor took the place under her wing and developed a plan for keeping the health centre in business and even offering extra services. Unfortunately, this weekend we learned that because she was tired of hitting 'brick wall after brick wall' in her dealings with BCUHB and her efforts to get them to back her, she has now resigned and we are back in limbo, with a scary lack of, well anything really. 

So, time to hit the keyboard again and I have fired off an email to our local Welsh Assembly Member, with an additional one to Vaughan Gething, who is our Secretary for Health.

'Once more unto the breach, dear friends, once more ...' to quote Henry fifth!

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Dear Mr Skates,

You may remember Mark Drakeford in 2016 maintaining that we in North Wales were 'crying wolf' over the recruitment crisis of GPs. Unfortunately, the chickens have now come home to roost and for over a year now, we 9000 patients at Pen y Maes health centre, Gwersyllt, Wrexham, have been suffering day to day with a crisis situation. The staff who are there have been doing an amazing job under extremely difficult conditions, but there have been times when no doctors have been available and people have ended up in A&E at Wrexham Maelor in a far worse state than they would have been had they had timely access to a doctor. It isn't difficult to see that this puts even more pressure on an already overstretched service at the hospital and one wonders how soon before the first preventable death occurs.

To add insult to injury, it seems that an amazingly driven and committed doctor who has been working there, produced a viable and much needed plan for the future of the practice, but has now resigned as she has, to quote 'hit brick wall after brick wall' when dealing with BCUHB. Given that BCUHB is still in special measures, I am at a complete loss to understand how the Board can be allowed to be obstructive in a situation like this. We don't even have the option of transferring to other practices, even if we wanted to, as there are already two in the area about to be taken under BCUHB control and others have closed their lists as they are unable to take on any more patients, much less 9000 of us. I am particularly concerned about hints that staff do not want to work for BCUHB east area, which would seem to suggest that, rather than an out and out shortage of GPs, there is a shortage of GPs willing to work here. To quote 'Hamlet' 'Something is rotten in the state of Denmark' (for Denmark, substitute BCUHB).

As AM for our area, I and the rest of Pen y Maes's patients, would urge you to look into this matter as soon as possible. The uncertainty and lack of regular medical provision is extremely concerning and is a worry that those who are already suffering from health problems can well do without.

I look forward to hearing from you as soon as possible and I shall also be contacting Vaughan Gething in his capacity of Cabinet Secretary for Health.

Sincerely,

Jenny Aspin

 In the meantime, I think we might be going to have to chain ourselves to railings somewhere ...