Health Minister blames lack of progress in hospital plans on delayed business case

Martin Shipton

Health Minister Eluned Morgan has deflected questions about a reconfiguration of cancer services at the University Hospital of Wales in Cardiff, saying the Welsh Government can’t comment until the local health board has delivered a business case.

Concern is mounting about the physical state of the existing hospital. We reported recently how the Shaping Our Future Hospitals (SOFH) Committee at Cardiff and Vale University Health Board remains suspended, thus consigning progress to limbo.

Two years ago the board received a high level overview of the infrastructure challenges faced daily by its estates team and all staff at UHW. The report has now been published.

The problems it faced included:

* Increased risk of an infection outbreak due to limited space in wards and theatres;

* Space inadequacy in the Intensive Therapy Unit (ITU) to house a ventilation system, with air change rates not meeting current Health Technical Memoranda (HTM), and temperature control lacking;

* The majority of the current electrical infrastructure is now 50 years old, so beyond its life expectancy and non-compliant with HTMs. A critical failure would result in closure of wards and essential departments;

* The main tower and link blocks are in cast concrete, and burdened with a façade starting to break away and fall off, with potential life-threatening danger to patients, staff and visitors;

* Asbestos is present in many areas of the hospital which have low or no access during normal working procedures;

* The original waste pipe infrastructure is unable to accommodate current requirements. Blockages occur regularly which together with the necessary repairs “significantly and severely impact on patient services including availability of showers, wash hand basins and toilets.” Major leaks are an environmental risk;

* There is 50-years-old pipework in the underground tunnels, over and beyond life expectancy, leading to interruptions in water supplies and heat to critical areas;

* The leak risk was highlighted by a photograph of a sharps bin suspended from a leaking pipe to prevent the leak from damaging the energy centre plant beneath it. The tunnels frequently flood, impeding the smooth running of the hospital.

* There are 76 lifts, mainly original, well beyond life expectancy and unable to cope with current demand, despite a lift upgrade programme in place.

Critical failure

The report concludes that UHW and UHL (University Hospital Llandough) will suffer a critical failure in the near future, and advises that only a new hospital would provide the safest route forward.

The business case for the new developments is currently being assessed.

At the same time, a decision not to co-locate the new Velindre cancer centre with UHW nevertheless means that a new acute oncology service will have to be built there.

South Wales Central MS Rhys ab Owen asked Baroness Morgan two questions relating to the new centre.

The first was: “How much additional cost has been incurred by the decision not to co-locate the new Velindre Cancer Centre and the resultant need to provide an acute oncology service at UHW?”

The Minister responded: “UHW already provides acute oncology services. Cardiff and Vale University Health Board is developing a business case for the development of a new facility that we expect to include a number of cancer related services and would operate as part of the networked clinical model that includes the new Velindre Cancer Centre. We have not yet received this business case for consideration.”

The second question was: “Will the Minister state where on the current University Hospital Wales site will the acute oncology service, with dedicated in-patient beds, an assessment service, a cancer research and trials hub be built, due to the decision not to co-locate the new Velindre Cancer Centre?”

Baroness Morgan responded: “We have not yet received a business case from Cardiff and Vale University Health Board and are therefore unable to confirm the clinical services included or the proposed siting arrangements.”

Deflected

A spokesperson for the campaign group Colocate Velindre, which argues that it makes no sense to build New Velindre on a standalone site, said: “These answers in the Senedd throw new light on events in our recent briefing on UHW’s difficulties.

“In both answers the Minister for Health and Social Care deflected blame for lack of progress straight on to Cardiff and Vale. This was on the alleged grounds that the government has not yet received the hospital’s business case for UHW2.

“This really is a literal case of being disingenuous when the Welsh Government knows well that it itself suspended the very committee advancing UHW2.

“Eluned Morgan’s answers in the Senedd fit in with the suspicion reported by Colocate Velindre that the Welsh Government is indeed intending to go on spending on the inefficient New Velindre project while at the same time stymying UHW2’s attempts at reprovision even as the hospital’s’ fabric falls apart. It seems the winner, a wrong facility in the wrong place in the wrong hands, inexplicably takes all.”

A spokesman for the health board said: “Cardiff and Vale University Health Board is currently in the process of developing a business case for a new facility at the University Hospital of Wales which will support a more streamlined, networked clinical model for cancer patients requiring complex acute care, a bone marrow transplant unit and will provide a research facility for patients with cancer. The Business case is anticipated to be submitted to the Welsh Government in due course.”

Vital

A spokesman for Velindre University NHS Trust said: “The development of the new Velindre cancer centre is vital in safeguarding the provision of crucial cancer treatment and care for the 1.5 million people of south Wales over the coming decades.

“It will support the region in improving the quality of care, patient experience and outcomes. The development of the new Velindre Cancer Centre allows us to keep pace with increasing demand as the number of people referred to us with cancer grows every year.

“The current cancer centre is more than 66 years old and does not have the facilities or space necessary to meet the future needs of patients. The opportunity to co-locate the new Velindre Cancer Centre on an acute hospital site was considered at the outset of the project and it was not feasible.

“The Trust asked the independent health think tank , The Nuffield Trust, to review its plans, including the location of the new Velindre Cancer Centre, in 2020. They concluded that co-location on a nearby acute site would not be possible for some considerable time, and that immediate action, including the development of the new Velindre Cancer Centre, is logical, reasonable and will deliver a wide range of patient benefits as part of the regional model for cancer care.”