South Wales Evening Post - 23 January 2009
Assembly Health Minister Edwina Hart has warned medics they need "to remember who they work for" in the war of words over neurosurgery.
Mrs Hart has hit back over criticism that her decision to keep one neurosurgery service based over two sites — in Swansea and Cardiff — went against the advice of senior officials.
The attack came from Cardiff-based consultant neurosurgeon Richard Hatfield, of the University Hospital of Wales, who said all the neurosurgeons in Wales agreed there should be a single site.
Mr Hatfield said: "People want services as locally as possible and one can understand that, but what you have to look at is the sustainability of those services.
"We cannot have a neurosurgery service in every DGH (district general hospital)."
But Mrs Hart has pledged her "absolute commitment" to keeping the current system in place and said the row was pure "mischief making".
The minister, who is also Gower AM, was warned by officials the service should be centralised or it would be unsustainable, leaving people in South Wales dependent on Bristol for neurosurgery.
But despite the advice, she decided on the one service over two centres option "in the best interest" of Welsh patients.
Mrs Hart told the Post, she was committed to keeping the Morriston Hospital-based service in place and the current option was being closely looked at by Dr Alan Axford, interim medical director of Hywel Dda NHS Trust, who is part of a group tasked with considering the issue.
She said: "Clinicians need to remember who they work for.
"I have shown my absolute commitment to what I have said on neurosurgery — it's just mischief making.
"As Dai Lloyd (Plaid AM for South Wales West) indicated we want to have Swansea and Cardiff and the whole network working together.
"At the end of the day I have given all this to Dr Axford, who will look at all of the issues.
"I think what we have done is the right thing to have things looked at properly."
Alan Axford has been asked to head the group which will look at how the one service-two centre option will work in practice.
He has also been asked to look at how to develop and improve both our neurosurgery and neurological services across South Wales.
Dr Axford will then advise Mrs Hart on how much it will cost to deliver the recommendations, over what timescale, and how the services will be provided.
Before Mrs Hart was made Assembly Health Minister, following the 2007 elections, she took part in protests against the switch of neurosurgery away from Morriston Hospital to Cardiff, as Gower AM.
The recommendation to site all neurosurgery services on a single site in the Welsh capital, was originally put forward by the controversial health body Health Commission Wales during July 2006.
It led 105,537 people to sign up to the Evening Post's petition against the plan.
Mrs Hart had earlier called on neurosurgeon James Steers to head up an independent review into neurosurgery across South Wales.
In the first draft of the review, put forward to the Assembly in July of last year, the group said there should be an urgent development of a single site neurosurgery service in South and West Wales.
Although the Health Minister was not shown the draft report, she was clearly told in a letter from her senior medical officers, based on the report, which warned if there was no decision to move to a single site in Cardiff, the region's neurosurgery service would fall into rapid decline.
But in the second draft of the Steers report, changes were made to refer to a "single neurosurgical service" for South Wales.
The advice allowed Mrs Hart to take up the one service over two site option instead.
Mrs Hart said: "I understand that Jonathan Morgan (Welsh Shadow Health Minister) has reinforced the Tory position and that there will be one centre and that will be Cardiff," she added.
"My view has always been that we also need to look at the needs of Swansea and West Wales."
She said the findings of Dr Axford's report would have a role to play but she wanted the Swansea Cardiff site option to remain in place.
"The point is that it will depend on what the outcome of Alan Axford's report is.
"I want the two centre solution."
Jonathan Morgan, Welsh Conservative Shadow Health Minister, said a full comment was needed from Mrs Hart in the Senedd to show she had acted impartially at all times over the issue.
He added: "This report raises serious concerns about the competence of Mrs Hart and her ability to discharge her ministerial responsibilities objectively.
"We know that when the Health Minister takes decisions they can have far-reaching consequences with implications for the well-being of patients.
"Her apparent intervention in this case could put the welfare of patients at risk.
"The issue of neurosurgery demands the highest degree of ministerial competence and care.
"This report suggests the minister overruled the advice of experts and may have based her decision simply on the fact that her own constituency is near Swansea.
"Mrs Hart must make a full statement to the Assembly in order to satisfy members and the public that her involvement in this issue has been appropriate and impartial at all times."
