18 October 2005


Death by a thousand cuts

The campaign over the perceived threat to Withybush hospital is gathering momentum. An email from "concerned members of nursing and medical staff" claims that the Welsh Assembly is intent on "salami slicing" services at the hospital with a view to inflicting death by a thousand cuts.
There are two entirely separate issues involved here: the recent cuts designed to fill the black hole in the Trust's budget, and the Welsh Assembly's long-term plans for healthcare provision across the Principality.
It seems that the received wisdom is that there is a certain inevitability about the cuts designed to save £2 million a year for the next four years, though there are those who believe that insufficient attention has been given to the possibility of subjecting the Trust's bloated bureaucracy to an intensive course of liposuction rather than taking the knife to front line services.
However, it is WAG's long term plans that are causing most concern.
Recently, I attended a seminar at which we were told by a senior civil servant that the masterplan was to divide Wales into four health regions, each served by a super-hospital.
What was not made clear was whether this would be an addition, or an alternative, to the present provision.
Medical staff at Withybush fear it will be the latter and just as the introduction of a superstore into a town sucks business away from the existing shops, so will these new facilities draw patients away from district hospitals.
There is one key difference between the grocery business and the NHS, which is that people move to Tesco out of choice.
The fear is that, with control over both the superstore and the corner shops, as it were, the NHS will be able to engineer circumstances whereby patients are somehow encouraged and directed towards the larger hospital.
Then, say the medical staff at Withybush, the politicians will be able to chip away at existing services on the grounds that demand has fallen to a point where they are no longer economically sustainable.

Wake up call

Those readers of last week's Western Telegraph who stayed awake long enough to reach page 32 might have noticed a story headlined 'Bosses should go as council fails children'.
Underneath was a press release from Cllr Michael Williams calling for heads to roll over a critical report on the county council's children's services by the Wales Social Services Inspectorate (WSSI).
What may have baffled readers was that the Telegraph's article contained not a word about what was actually in the WSSI report, which may have left the impression that Cllr Williams was just letting off steam.
However, that impression would be false because the WSSI report raises some extremely serious issues - some of which I dealt with last week (see October 11) - concerning the way we are governed here in Pembrokeshire.
Still, I suppose, regurgitating Cllr Williams press release was easier than reading through the 64-page report and telling their readers what it was about.
It seems to me that the chief moral justification for government is to protect weak from the strong.
Nowhere is this justification more evident that in the protection of children from abuse, or neglect, by adults.
So it is a sorry state of affairs when it turns out that Pembrokeshire County Council fails to carry out what is one of its most basic duties for the sake of a couple of hundred thousand pounds.
Regular readers will know that Old Grumpy is not of the tax and spend persuasion, but having the lowest council tax in Wales, as the Independent Political (sic) Group constantly boasts, is poor consolation if the result is that vulnerable children are exposed to the risk of abuse.
In any case, better funding of children's services could easily be achieved without raising council tax if some of the wasteful expenditure was cut.
It is surely disgraceful that this service goes short of cash while thousands of pounds are spent on fancy civic lunches; chauffeured jaunts to Royal garden parties; freebies by the sea, attending conferences that serve no useful purpose; and dozens of the ruling elite's other frivolities.
To give you a flavour of what goes on in children's services I offer the following quotes from the WSSI report: "There were examples of unacceptable delays in carrying out initial assessments. For example, in one case the initial visit was made five months after the referral was received; in another there was a delay of six months between the start and conclusion of the assessment; in another there was a delay of four months. In none of these cases was the reason for the delay noted in the file."
Referrals are usually made by teachers, doctors or the police and these lead to an "initial assessment" of the case.
If serious issues are raised at that stage, the process moves on to a more thorough "core assessment".
The report says: "Core assessments were present on some files; on others the intention to do one was noted, but the assessment had not started; on others there was a reference to a core assessment but it could not be found. There were several examples in which three or four months had passed since a recommendation for a core assessment, with no progress or explanation on the file."
That sounds like a shambles to me and Cllr Michael Williams is quite right to call for those in charge to be held to account.


Designer label

The WSSI report contains a table in which seven performance indicators are placed under four headings.
The headings, themselves: "Poor, Inconsistent, Mainly good and Excellent" give an insight into the bureaucratic mind.
To me the heading "inconsistent" stands out like a sore thumb.
When I played golf, I was one of Pembrokeshire's most consistent players off the tee - my drives invariably ended up in the long grass.
I assume inconsistent was chosen because it serves to indicate a degree of disapproval without putting in the boot.
Surely, "Less than satisfactory", or some similar term, would be more appropriate.
Whatever, the fact is that, out of the seven indicators, six are branded "Inconsistent" and only one "Mainly good".
A less than satisfactory performance in anybody's language.

Toff at the top

Little did I know when I wrote a lighthearted piece about the Tory leadership battle two weeks ago (see Tory boys), that my words would have such a dramatic effect on the outcome.
Poor old David Davis, his confidence completely undermined after seeing himself described as "a dreary, uninspiring fellow", got up on the conference platform the following morning and bombed completely.
The big beast, Kenneth Clarke, "too old and Eurosceptic" has fallen into an elephant trap and, unless there are mass defections from the Davis camp, Liam Fox is not expected to survive the second round.
That will leave David Cameron and David Davis to fight it out among the membership.
It seems the party faithful have taken to the Old Etonian, and the poor council house boy is headed for a bitter disappointment.
Ah well, the Tories always did love a toff.

In denial

Word reaches Old Grumpy that Cllr Brian Hall is sticking to his claim never to have visited the proposed LNG caravan site in Waterston ( see The invisible man).
Below are extracts from Cllr Hall's expense claims for 11 and 31 January this year.
The figures on the right represent the number of miles claimed.


If Cllr Hall didn't visit the site in question, it means either there is a second LNG accommodation site in Waterston that we have not been told about, or that he claimed mileage for visits to Waterston that he didn't make.
I have emailed Cllr Hall's party leader, Cllr John Davies (copies of expense claims attached) asking him if he can tell me which it is.
I have also asked Cllr Davies how he can reconcile Cllr Hall's continuing presence in his Cabinet with the promise that, under his leadership, the council's business would be conducted in line with "the highest ethical standards".
I await his reply with interest.

Is your journey really necessary?

A row is brewing over a seminar organised by the Welsh Local Government Association at the Gwbert Hotel Cardigan to discuss issues concerning Local Development Plans.
Apparently, Pembrokeshire County Council nominated 11 delegates, all of whom were members of the Independent Political (sic) Group.
So much for the spirit of inclusiveness that the Leader is always banging on about.
The story doesn't end there because, of the magnificent eleven, only eight turned up.
And members who were there as representatives of the National Park tell me that, of those eight, only one remained when the seminar closed at 4.30 pm.
Of the seven who decided to take an early bath, the palm must be handed to Cllr Brian Hall who helped himself to a cup of coffee, signed the attendance register and then, as my mole put it, "buggered off".
I am reliably informed that Cllr Hall's "attendance" at this "approved duty", for which he is entitled to claim some £25 in travelling expenses, lasted little more than 15 minutes.
Could this, not the Tardis, be the reason he manages to pack so much into a single day?

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