SWEEPING health care reforms will go ahead despite fierce opposition.
Betsi Cadwaladr health board members confirmed inpatient and minor injuries services will be scrapped at Flint Hospital while long-term intensive neonatal care will be removed from Wrexham Maelor Hospital.
The decision to forge ahead met with shouted protests and walk-outs from members of the public who attended the special meeting on Friday.
Speaking to the packed hall at OpTIC in St Asaph, Dr Martin Duerden, assistant medical director, said: “This is a very important meeting. We had a meeting back in July when we agreed the recommendations would go to consultation and now we have to make a decision.
“I’m genuinely pleased so many people have taken part in the consultation.
“These types of decisions are taking place all over the UK. Some of the change is difficult and can be uncomfortable in terms of how we can put them in place.
“The process is clinically led. It is based around very sound ideas around what should happen (in terms of) safety, sustainability of services and resources within the system.”
Over a period of several hours, the board, led by Chairman Professor Merfyn Jones, chief executive Mary Burrows and vice chair Dr Lyndon Miles, green lit plans to make changes to vascular care and mental health care for the elderly.
They also gave the go-ahead to controversial plans to close minor injuries units at Flint, Ruthin, Llangollen and Chirk hospitals, and close inpatient beds at Flint Community Hospital.
The enhanced care at home service, where patients are treated in their own homes where possible, will be rolled out across Flintshire and Wrexham within the next two years.
Some outpatient services will be retained at Flint, and the board will apply to the Welsh Government for funding to open a new primary care facility catering for the town.
Geoff Lang, executive director of primary care, community and mental health services, said: “There has been very strong opposition to some of our proposals, particularly those changing local hospital services and minor injuries units and X-ray services from members of the community who enjoy access to these services at the moment.
“They have raised issues such as transport to services, the impact on carers and our capacity to provide care.”
According to the board, the findings of the consultation suggested residents broadly supported proposals to provide more care in the home, but investment is needed if the new service, which has been piloted in Denbighshire and on Anglesey, is to roll out across the board.
Mr Lang continued: “We must recognise that the resources to deliver the new model must be unlocked from existing services.”
It was also confirmed intensive neonatal care would be contracted to Arrowe Park, Wirral, meaning babies born under 27 weeks will be cared for outside of the Betsi Cadwaladr health board area.
Members acknowledged the neonatal care issue was “emotive”, but argued the move, which will affect an estimated 36 babies a year and will have associated costs of more than £1 million, was necessary to bring remaining services up to the UK standard introduced by the National Institute for Health and Clinical Excellence in 2010.
Consultant paediatrician Dr Brendan Harrington said at the meeting: “Some of these standards in terms of timescale should be in place and we do not have them in place. All parents want the best critical care.”
Dr Harrington said all other services at the special care baby units, where about 700 babies a year are treated, would remain.
He said: “The vast majority of babies will still be cared for in North Wales.”
Ten hospital “hubs” will be developed, among them Wrexham Maelor, Holywell Community Hospital, Denbigh Infirmary and Ysbyty Glan Clwyd.
These decisions follow a 10-week consultation launched in August last year, where members of the public and various bodies, including the Community Health Council, were asked to put forward their opinions on the proposed changes.
The only major alteration to the proposals outlined last year was the decision to make Mold Community Hospital into a hub rather than Deeside, although the board made a “commitment towards developing the role of Deeside Hospital alongside this in the future.”
X-ray services will be retained at Mold, but will be removed from Llangollen.
Although members of the board insisted the changes were not an exercise in money-saving, Dr Duerden admitted: “Money is a critical issue. We are all working within austere times. Everybody has to recognise there’s not as much money available as there was. We have not had growth within our budget for several years and we are not expecting to have growth for several years.”
He added that, as a result of an ageing population, with estimates for the next 25 years pointing to a 60 per cent rise in the number of people over the age of 60, as well as a general rise in the number of people in the board’s catchment area, the service had to adapt.
He added: “We are not in a position to do nothing. Not changing is just not sensible. We have to look at how we can provide services in a different way.”