The seaside town where people feel scared and abandoned | UK | News

It’s one of the largest towns in Wales, where people once took healthcare on their doorstep for granted. 

However, several years ago, the accident and emergency department at the town’s once-prestigious and new Prince Philip Hospital was shut down. And in a few weeks, the hospital will also lose its 24-hour minor injuries unit (MIU), which was promised to the town when the A&E closed.

The locals feel neglected and powerless. Not only is Llanelli the largest town in Carmarthenshire, it’s the biggest anywhere west of Swansea in the entire country. It’s a big place to be without this level of healthcare. The promised 24-hour MIU will now only operate from 8am to 8pm.

As is often the case, the reasons for this are financial constraints and recruitment issues. Hywel Dda University Health Board, responsible for healthcare across Carmarthenshire, seems unable or unwilling to hire enough doctors to keep the MIU fully operational at Prince Philip Hospital.

The health board maintains that this change is temporary, lasting only six months. A report discussed by health chiefs last month revealed increasing sickness levels among the hospital’s MIU staff, with stress-related conditions being a factor, and some medical staff have left permanently, reports Wales Online.

Andrew Carruthers, the health board’s chief operating officer, remarked: “It’s unacceptable to continue to expose our nursing staff to the critical risk presented without a doctor present. Failure to take action will lead to more staff leaving and could leave the daytime service fragile.”

Despite attempts to quell the discontent in Llanelli, residents are left feeling vulnerable. The journey to Carmarthen’s Glangwili Hospital is 24 miles and Swansea’s Morriston Hospital is 11 miles away.

Yet, when confronted with a grave health emergency, the distance to these hospitals can seem insurmountable. In the year leading up to September’s end, about 31,000 individuals relied on Llanelli’s MIU services, with some 6,000 using it during the night hours of 8pm to 8am.

For three weeks straight, since September 28, local protestors have been camped outside Prince Philip Hospital, voicing their outrage at the health board’s contentious decision. Day in, day out, the protest persists around the clock.

Tents dot the lawn by the main entrance, with demonstrators braving the elements overnight, standing firm and acknowledging the supportive honks from passing drivers. Despite the knowledge that their actions won’t overturn the impending change set for November 1, the protest remains significant.

A letter obtained by WalesOnline from a health board official starkly states that the decision “will not revisit this decision”.

The government’s steadfast refusal to consider a policy reversal is starkly at odds with the public outcry, underscored by petitions demanding change that have swiftly amassed over 10,000 signatures — a figure that rivals the population of Carmarthen, the county’s second-largest town. To illustrate the scale, Llanelli boasts over 40,000 residents, and its parliamentary constituency saw an electorate exceeding 70,000 in this year’s general election.

Earlier in the year, Llanelli resident Rachel Beckett and her fiance Dwain Jones experienced the critical importance of the MIU at Prince Philip Hospital first-hand after a harrowing accident. Dwain sustained severe injuries from a fall through a glass greenhouse, with a large glass fragment impaling him and causing significant blood loss.

Recounting the traumatic event, Rachel said: “When he fell through the greenhouse there was only a bit of the glass protruding out,” adding, “I thought it was only a little bit so I pulled it out to dress the wound and discovered this eight-inch piece of glass that was as sharp as a knife. I tried unsuccessfully to stem the flow but it quickly became obvious that I would have to get Dwain to hospital by car or he was going to die.”

Rachel rushed her partner to the MIU in Llanelli, a move that saved his life. Several months after this harrowing experience, Rachel is resolute in her belief that health authorities are once again neglecting her hometown.

“If the unit had not been open Dwain would have lost too much blood and he would not be alive today,” she said.

“The A&E department shouldn’t have been taken away. If anything, that should be brought back due to the bottlenecks at Glangwili and Morriston. People are having to wait hours for ambulances and a journey of that distance isn’t always possible. What about people who haven’t got cars? The decision that they’re now going to cut the MIU’s hours for six months is just crazy.”

Dwain was fortunate to survive. His accident happened during hours that the MIU would still be operational under the new proposals.

However, in summer, when people spend more time outdoors into the later evening, the next person to suffer such an incident may not be as lucky. As Rachel highlights: “Accidents don’t stop at 8pm.”

The protesters camping out in the rain and wind outside the hospital understand that their passionate demonstrations and commitment may ultimately prove futile. They may not be able to halt the health board’s contentious plan.

Yet, they persist, showing up day and night, mirroring the MIU’s operating hours… until November, at least.

Suzy Curry, Llanelli resident, local councillor and vice chair of the ‘Save Our Services Prince Philip Action Network’, said: “The main purpose of the protest is to not let them get away with it.

“With changes like this, we are supposed to have a consultation. We all know that if the unit shuts for six months, the chances of it reopening are slim. They are saying there are no doctors on site but there is an Acute Medical Assessment Unit at the hospital which is staffed by doctors who are called upon in an emergency, so to simply say there are no doctors is not ‘true’.”

A primary concern among the demonstrators is the difficulty and sometimes impossibility of reaching Glangwili Hospital at a moment’s notice. Patients requiring urgent medical care are directed to Carmarthen instead of Swansea’s Morriston Hospital (which is under a different health board), despite it being over double the distance.

Ms Curry stated that an agreement was supposed to be reached between Hywel Dda and Morriston Hospital, allowing A&E patients to go there in emergencies – a development yet to occur. Regardless of the guidance provided, patients in need will seek the closest available medical help, and fears are already mounting that the overnight shutdown of the MIU at Prince Philip could lead to deteriorating A&E performances in both Carmarthen and Swansea.

Anyone who has visited Glangwili Hospital’s A&E department during the night knows all too well that it can ill afford more patients.

Ms Curry, speaking during her shift at the protest site, voiced her concerns: “The health board say they are concerned about patient safety but what about the safety of the general public at large who won’t have an MIU to attend overnight?

“When they shut the A&E here they said we would have an MIU open 24 hours a day. This is a broken promise from the health board. They’ll tell you they can’t get the doctors but when was the last time they advertised vacancies for doctors? Two doctors have left because they heard the unit was shutting overnight. The whole management (of the health board) is not fit for purpose. They have managed us into this crisis.”

Hywel Dda chiefs have scheduled a drop-in event at the Antioch Centre on Copperworks Road for Wednesday (October 23), from 2pm to 7pm, where people “will be able to learn more about why the temporary change is needed, how to access care in different circumstances, and what the next steps will be for further engagement with the community”.

Yet, despite the outcry, there has been no agreement to a public meeting, leading Ms Curry to speculate: “I’m guessing they just don’t want one. I feel they don’t really want to be answerable to the people of Llanelli.”

Amidst acute worries about access to medical care at night, there’s prevailing anxiety that Llanelli’s health service reputation might repel prospective residents and investors for years.

Ms Curry expressed her alarm: “Llanelli is the biggest town in the health board region and we should have an A&E department, not just an MIU. And the fear of course is that the six-month night-time closure will be a permanent one. They are not recruiting doctors. Have they thrown the towel in? “

Nia Griffith, Labour MP for Llanelli, has been prominently supporting the protests outside the hospital, slamming both Hywel Dda and their manner of communication as “unacceptable”.

Echoing concerns, she said: “The MIU needs to remain a 24-hour service permanently, not just a daytime one. The call to reduce the opening hours temporarily was made by the health board at short notice and without public consultation. The decision was one created by the health board’s inability to recruit appropriate personnel and inadequate management of staff absence. Serious questions need to be asked as to why they have left this situation to fester for so long and why this much valued local service is now under threat.”

Hywel Dda University Health Board responded by confirming that normal 24-hour service at the unit will resume from next May. They also want to clarify that patients with severe conditions will continue to receive care at Prince Philip Hospital after being transported by emergency ambulance or referred by a GP.

Jon Morris, the clinical lead for the hospital’s MIU, said: “We want to assure people that the MIU is not closing and if you have a minor injury, you can continue to walk into the unit between 8am and 8pm from 1 November 2024. Outside of these hours, and if the minor injury is urgent and cannot wait for attention until the unit re-opens at 8am, then the advice to patients is to visit NHS Direct Wales symptom checker online or call NHS Direct Wales on 111 for advice (choose option 2 for mental health). This service can also connect you to the Out-of-Hours service when GP surgeries are closed. In a life-threatening emergency, always call 999.

“The temporary change to MIU opening hours is being put in place to protect patient and staff safety due to not having the appropriate MIU GPs in place during evenings and overnight. We have had a number of GPs working in the MIU in recent years but have had an issue finding GPs who are willing to cover night shifts. While this temporary change is in place, it is important to stress that Prince Philip Hospital continues to provide acute medical care for the local population from the adult Acute Medical Assessment Unit, for example, stroke or heart attack. These cases come into the unit via ambulance or via GP referral.

“We will work closely with GPs and the Welsh Ambulance Services University NHS Trust to ensure these patients continue to be seen in Prince Philip Hospital, as their closest hospital, during this temporary change to the Minor Injury Unit. This means we continue to care for medical emergencies at Prince Philip Hospital and in typical circumstances, these will not be diverted to either Glangwili or Morriston Hospitals.”

Since 2018, there have been plans to revolutionise healthcare across the Hywel Dda region, encompassing the counties of Pembrokeshire, Ceredigion, and Carmarthenshire, a huge geographic area. The centrepiece of this ambitious plan is the construction of a major new hospital, potentially located in St Clears or Whitland in western Carmarthenshire, which would be even further from Llanelli.

This proposed facility, costing upwards of a billion pounds, is set to feature a gleaming, cutting-edge A&E department, while the existing A&E at Glangwili Hospital, already a 24-mile journey from Prince Philip Hospital, would cease to exist.

Ms Curry expressed her concerns about the health board’s strategy: “From the health board’s point of view, they have such a vast area to cover that they are trying to put a pin in the middle and hope that will work,” she said. “But the vast majority of people are in Llanelli and to make them travel so far for care is outrageous.”