A history of failure – Labour’s centralisation of health services across the valleys

Cllr Steve Skivens and Cllr Charlotte Bishop

If you’re ill or have an emergency, how do you get help? You may decide to contact the local doctor surgery, try to get to your local district general hospital or, in the case of an emergency, call an ambulance.

Increasingly it seems that where you live may determine your options. We have seen a sea of change in not just the location but also provision of our care and health services over the last two decades.

In years gone by, our communities were served a series of cottage hospitals. Most villages had a GP and NHS Dentist which served communities well.

Within close proximity, there was a good chance of having a district hospital covering more specialised services or severe trauma cases.

To use Caerphilly as an example, we have seen a heavy centralisation of medical care facilities. We have lost a number of GP practices, NHS provision at dentist practices is scarce and day care facilities have closed or become restricted.

Residents in Caerphilly have to get to their default designated hospital at the Grange in Cwmbran.

Remote

The hospital looks great from the outside but this is far from an ideal location given it is not well served by public transport and lacks shops and other facilities in the local area.

It is an out-of-town remote location that does not work for many of the communities it serves.

The reality is, if you don’t have a car your options are dramatically reduced on how you get to this location.

But why has a system that worked for decades, been dismantled in several stages by the Labour Government in Wales over the decades it has held the health brief?

Was there any consideration how people who will be ill, injured or frail get to these locations to get care or help – especially with the deliberate dismantling of the cottage hospital network?

Even our most vulnerable individuals are being restricted on access to day care centres or being transported across the counties to facilities remaining open.

It is worth noting there was a brief respite to the centralisation agenda when Plaid Cymru formed the One Wales Government with Labour in 2007.

One of Plaid Cymru’s conditions for the coalition was that Labour’s advanced plans to centralise hospitals around the country would be shelved – which is exactly what happened until 2011.

As we know, Labour did better at the 2011 elections, were able to form a minority government and therefore resurrect their plans at the earliest opportunity.

Under a centralised hospital system that Labour have brought to bear in Wales, the logistics can be complicated, time consuming, costly and very tiring.

In July 2022, my council colleague Charlotte Bishop and I highlighted the issues that can manifest through Labour’s obsession with health service centralisation.

We travelled using public transport from Abertridwr to Caerphilly and then onto Newport before catching a bus to Ponthir and the Grange Hospital. The one-way journey cost more than £9 each and took two hours and ten minutes.

Promises made to improve access to the Grange from both Blackwood and a well-meaning community charity bus from Trethomas have gone. So, in February 2024 the situation is worse with less frequent buses scheduled.

Yet a dedicated bus service from Caerphilly still runs the short trip over the mountain direct to the Heath Hospital in Cardiff despite it not being the default district general hospital for people in Caerphilly.

Inequality

Has this centralisation policy worked or created inequality across some communities? I do not know anyone living in the Caerffili basin that thinks health provision has improved.

In other policies, the Labour Government may have intended to discourage people from using private cars and getting onto public transport, but their hospital centralisation strategy has had the opposite effect.

So, what are you to do when you fall ill or have an accident? Many people are finding their call to the ambulance service is being met with an unacceptable delay for their loved ones to be attended to.

It has to be said that this is often not the fault of the ambulance service as their vehicles are often left languishing outside hospitals for hours at a time whilst they wait to transfer a patient to the next available bed.

Taking to a private car with a sick or injured patient and onto our poor cross valley roads may be a last resort but it is increasingly the only viable option for many.

The area where we are councillors – Caerphilly – has one of the largest population area outside of our cities yet has no general hospital serving it along with some further reductions on other care and health facilities.

It seems that people’s real concerns about accessing health and care services are not being heard. We say that Labour’s centralisation agenda has failed.

It has failed on change management, it has failed on logistics, and – worst of all – they have failed to listen.