The fight for Bronglais - is it personal and emotional? You bet your life it is!

Last night in Penparcau Aberystwyth, 547 people squeezed into both Neuadd Coffa and St. Anne’s Parish Hall across the road to show their support for Bronglais Hospital and to oppose the proposals being put forward by the Hywel Dda Health Board in respect of health services within the area. The meeting was superbly organised by Aberystwyth Town Council and knowing the strength of feeling and the likely high turnout, a video link was set up to relay proceedings from one hall to another.
As the numbers swelled in Neuadd Coffa, the doors were opened up so that those who were standing outside could also hear what was going on. It was biting cold, but no-one seemed to notice. People came from Dolgellau, Tywyn, Corris, Machynlleth, Aberaeron, Tregaron, Llanidloes and Llangurig in a display of solidarity for their nearest District General Hospital – Ysbyty Bronglais and its staff.

Whilst they had been invited to attend, conspicuous by their absence were representatives of the Hywel Dda Health Board.

ABER* Group member, Jack Evershed gave a very clear and precise presentation about what the proposed changes would mean for the hospital and for health services in our communities - a presentation which contrasted markedly with the vacuous engagement document: Your Health Your Future which has been put out by Hywel Dda in an attempt to elicit public opinion about their proposals.

As has been said before, removal of colo-rectal surgery from the hospital means effective removal of skilled abdominal surgery. This in turn leads to a diminishing of A & E because A & E cannot be properly supported without skilled abdominal surgery. In a medical emergency, this impacts on people’s survival chances and also upon the ‘Golden Hour’ - so vital for anyone living in any of the areas mentioned above.

We in Ceredigion, have been asked to comment on Hywel Dda’s proposals. Proposals which have not been properly costed or thought through – plans which are so scanty in their detail that they are an insult to the intelligence of the people of Ceredigion, South Gwynedd and Western Powys. What also needs to be said here is that the people of South Gwynedd and Western Powys, (who actually make up approx. 30% - 40% of the service users of Bronglais), have not even been consulted about these proposals because they do not live within the boundaries of the Hywel Dda area.

Hywel Dda tell us that more care in the community is needed and more health care at home to prevent ‘bed-blocking’, but they give no indication of resources involved in improving social care and medical care in the home, or any real detail of how this will happen.

Last summer my Mum was admitted to Meurig Ward in Bronglais as an advanced cancer patient suffering with edema. Following treatment, we were desperate to get her home. Mum knew the seriousness of her illness and she had made it clear to my Dad and I that she wanted to spend whatever time she might have left with both of us in her own surroundings. But she could not be released from hospital because there were no carers available to look after her. I said that I would care for her myself, but the medical staff were concerned that I would just not be able to manage alone and that without an appropriate timetable of care, she would end up being re-admitted to hospital, which in her condition, was too distressing to contemplate.

The truth is that Ceredigion Social Services, (knowing how strapped they were for resources and how short they were of carers), would have been only too happy to let me take on the role of a single-handed carer, but the medical staff at Bronglais were adamant that it would be unsafe for me to do so, and they were right.

The result was that because adequate care resources were not available, Mum ended up staying on Meurig Ward for six weeks longer than was necessary. She was not alone. It was my experience that 75% of all patients who were in that four-bed unit on that ward were in exactly the same position – with one elderly lady spending a record 12 weeks there.
I have no complaints at all about Meurig Ward and the quality of nursing and medical care was exceptional and if Mum was still here, she would say so too. In the end, thanks to the wonderful Beacon of Hope organisation, we were able to bring Mum home for the last twelve days of her life. But in these straitened circumstances of not having enough carers available, no patient, family, doctor or nurse should have to ‘do battle’ every day to see whether a care package can be put together to release a patient. It is unbelievably cruel and unfair.

For what happened to be the last few weeks of her life, my Mum felt anxious and guilty because of the pressures and stress involved in trying to secure a care package. Despite our best efforts to convince her otherwise, at this most precious time, added to all of her burden, I know that she felt guilty and fearful about how we were going to cope. And for us, it was simply awful; every day my Dad I would visit her and every day we would manage to hold it together until we got to the car park, when we would both break down because powerless to help her, we thought we were letting her down at the very the time when she needed us most. Speaking to other relatives of patients on the ward, it was clear that they and their loved ones were all experiencing exactly the same traumatic emotions and no-one should ever have to go through this.

So when Hywel Dda talk about introducing Virtual Wards as part of their care at home concept without offering any costs or detailed plan forming up part of the equation, it makes me very angry indeed. Never mind ‘virtual’………. Hywel Dda need to get a handle on what happens in the real world.

How inept. How incompetent. Why is this Board still employed when they are clearly not fit for purpose?

Just like me, I know that everyone who came to Penparcau last night had their own personal story to tell about why Bronglais is so important to them and the people they love – such experiences show us very clearly that the changes which are planned by Hywel Dda will only ever result in an unsafe and a dangerous health service for most of the people of Mid Wales.
Whilst Hywel Dda’s plans are apparently clinician-led, last week’s letter to the Health Board, which was signed by 50 out 60 senior medical staff at Bronglais and proclaimed ‘no confidence’ in the Health Board, speaks volumes about what most of our caring, hard-working clinicians really think.

There can be no doubt that the Hywel Dda HB and the Welsh Government Health Minister must surely know by now that it isn’t only a group of so-called ‘rebel’ consultants who have no confidence in them or their plans, but that these thoughts and actions are echoed by the majority of us who live in this part of Mid Wales.

Fight for Bronglais? You bet your life we will.


*ABER – Achub Bronglais Emergency Rescue

Geography is the very reason why services at Bronglais (Mid Wales General Hospital) must be protected.

I was struck by the words of Sir Gus O’Donnell, Cabinet Secretary, who, speaking at a meeting of Cardiff Business Club last evening said:

‘The best policy is evidence based policy’. 

Makes complete sense I thought…..

I wish the Hywel Dda Health Board and the Welsh Labour Government Health Minister would take note. 

Here are some ‘evidence-based’ facts for them to consider which I hope will explain why Bronglais Hospital, Aberystwyth   -  (the only District General Hospital serving Mid Wales)   -  must not have surgical and obstetric services cut back anymore.

·        Taking away colo-rectal surgery will mean that it will be nigh on impossible to attract skilled abdominal surgeons to Bronglais.

·        If you cannot attract skilled abdominal surgeons to Bronglais, then it is unlikely that you will be able to carry out emergency surgery there.

·        If you cannot offer emergency surgery, then you might as well close down A & E.

·        Whilst new day surgery theatres are proposed, it isn’t possible to do ‘big’ surgery in day theatres.

·        The number of surgical, gynaecological and orthopaedic beds at Bronglais has dropped by 50 per cent over the past eight years.

·        There has been research carried out into similar hospitals in Scotland (Dumfries and Galloway) where they have 69 surgical beds, whereas Bronglais has around 35 and that number is diminishing.

·        It is very difficult to attract good general surgeons without the right number of surgical beds.

·        Last year alone, 739 operations were cancelled at the hospital and obviously, behind everyone one of these cancellations is a human story.

·        Bronglais covers a catchment area of 150,000, swelling to around 200,000 in the summer when tourists visit the area.

·        There is only one cardiologist at Bronglais.

·        Glangwili Carmarthen Hospital covers a catchment of 170,000 people but has five cardiologists.

·        People I have spoken to from Southern Meirionnydd, western Montgomeryshire and Radnorshire  -   (the catchment area which Bronglais serves), as well as Aberystwyth and Ceredigion, are horrified that expectant mums with anticipated need of a Caesarean might have to travel to Carmarthen for that surgery – a journey of approx. one hour and fifteen minutes by road from Aberystwyth – and two and a half hours from either Tywyn or Llanidloes!

Finally, looking at the map above of the location of District General Hospitals in Wales, it isn’t rocket science to see why Bronglais is so essential to the people of Mid Wales.  Services here should be ramped up, not scaled down.

·        Geography is the very reason why services at Bronglais (Mid Wales General Hospital) must be protected.

WHEN THE DEEP PURPLE FALLS..................

Dilys Francis (1929 - 2011)

Just over two weeks ago, my Mum, Dilys, passed away at the age of 82.  She had been battling cancer for the last three years and had enjoyed some long periods of remission but very sadly, since last May, she had become desperately ill and we knew that it was only going to be possible to treat the symptoms of the disease.

Dilys was a remarkable woman who led a full and happy life.  She was extremely fortunate to find the right life partner and I was blessed and immensely priveleged to have her as my Mum.  I count my lucky stars that I had her in my life for just over fifty years and my Dad and I have some wonderful memories of some amazing times, particularly as for over twenty of those years, we all worked and run a business together.

The last twenty or so weeks have been pretty intense for my Dad and I as we trotted backwards and forwards to Bronglais Hospital to see her and to try and secure a care package to bring her home   -  which is all she wanted.  Eventually, we got her home on the 21st September and with the help of the wonderful Beacon of Hope, Aberystwyth, we were able to look after her for the remaining twelve days of her life. She passed away peacefully on the 3rd October with both my Dad and I at her side. 

 It's so surreal now to realise that I won't see her or be able to talk to her anymore, but her influence on me is so very great.  I miss her beyond comprehension, yet I know  she will be with me always.

My Dad Tom and I wish to acknowledge with thanks all of the meassages of sympathy and kindness extended to us at this difficult time.  We also want to thank all of the health professionals at Meurig Ward, Bronglais Hospital, the Beacon of Hope, Aberystwyth, the community nurses of Church Surgery (led by Kryshia), Mari Curie and Cere-Care (led by Ceri) for all their help over the last few weeks  -  you have become like our family.

What follows below is a tribute to my Mum which was read out at her funeral last week, by our old family friend, John Bailey:

Dilys was born in Willesden, London, in 1929;  the middle daughter of Julia and CharlesLloyd Davies who kept a dairy in Roundwood Road. 

Certainly, Charlie Lloyd Davies decided to remain true to his Welsh roots in giving his three girls, Megan, Dilys and Gwyneth, three very Welsh names.  However, he could not have known how appropriately he named his middle daughter   -    for ‘Dilys’, when translated into English, means: ‘honest, sincere and something which is genuine’.  And Dil, (as she was popularly known), was absolutely all of these things.

When war broke out in 1939, Dilys and elder sister Meg were evacuated to Charles’ cousin, Dyfi in Machynlleth.  This wonderful woman filled her home, Bryntyrnol, with eight children (including her own), belonging to friends and family.  Dilys thrived on Welsh country life.  She attended school in Mach and learned Welsh.  Bryntyrnol offered her the security and routine which she cherished all her life. 

At Bryntyrnol, every child had chores to complete.  There was a day for baking, a day for laundry and on Sundays after supper, the children might have an impromptu concert, with every one doing a turn. Dilys, who had a wonderful singing voice, would entertain her housemates with her party piece, ‘When the Deep Purple Falls’   -   top of the hit parade at the time, and which she would often refer to in later years as: ‘My Song’.  

On returning to London after the war, Dilys attended Tottenham County School where she excelled at English, French, Domestic Science, Singing and Commercial Subjects.  Sadly, at the age of thirteen, she lost her father and her mother, whom she adored, courageously continued to raise her three girls and run a business.  Ever methodical and efficient, in 1948, Dilys started work as a secretary  - first at the Library Association and then as PA to the Managing Director of Challen Pianos.

Like most London Welsh girls, Dilys and her sister would attend dances at the London Welsh Club in Gray’s Inn Road.  At about the age of sixteen, she met a sociable type called Tommy Francis.  Dilys, (who had by now grown up to be a bit of a stunner), had no shortage of young men wanting to take her out  -  and Tom would tease her  mercilessly about some of these hapless admirers, often turning up and embarrassing her when she was out on dates with them!   

It is pertinent I think, that she and Tom became best friends, long before romance ever entered the equation.  From Best Mates they became Soul Mates,  eventually marrying in 1958.

Their’s was a partnership in every sense: in business, in friendship and in love.  This was sealed with the birth of their daughter, Lisa, in 1960.

Together,   -  (and throughout their lives, they worked as a team, doing absolutely everything together)  - Tom and Dil  ran various businesses. 

First in London: at Amwell Cottage Dairy, (when I first got to know Tom and Dilys as a milk boy); the snack bar at Newbury Street, (where I became a partner); then when they moved to Wales in 1969, taking over the Buckley Arms, Dinas Mawddwy, (where I was also involved). Finally, they started the Queensbridge Hotel on Aber’s Promenade,  where they remained for thirty years, with the three of them running the business until Lisa was elected to the National Assembly in 2003 when they eventually retired  -  first to Queen’s Square and then to Bryneglur.  They had a wonderful social life with many friends and during their time at the Queensbridge were remembered for being very charismatic hosts.

There are many words which encapsulate the spirit of Dilys. 

True to her name, she was honest and she didn’t suffer fools. 

She was both fun and very funny  -  a natural comedienne with a talent for mimicry.  Many of you in your messages of condolence have fondly remembered her wonderful sense of fun and her great wit and humour which would have us doubled up with laughter.  But she also possessed an incisive intelligence and compassion  -  she totally ‘got’ people and understood them.  She was very giving and was always generous to others; often before being generous to herself.

She cherished ‘her Tom and her Lisa’ and looked after them with great care and love.

Even Tom's boxers were ironed with creases down the front!  More than anything, she liked to be at home within her own square mile and adored cooking and entertaining for her friends and family.

She was also determined and very brave.  Typically, when she was first diagnosed with cancer, she arrived home from the hospital with Tom and Lisa and said:

 ‘Right, let’s have a gin and tonic and a fag and then we’ll get on with this…’

Throughout her illness and even towards the end, she was upbeat, fun to be with and funny.  So much so, that the carers, (who were caring for her at a sad and difficult time), used to look forward to seeing her.

Dil always soldiered on.  Loyal and tenacious, she never faltered in her support for those she loved and cared about.

In her last days, all Dilys wanted was for Tom and Lisa to carry on and look after each other – that was her message to them and one they will carry forward.  She would urge us all to remember the good times and we are blessed to have so very many.

Dilys loved and she was loved. 

She was the love of Tom’s life;

She was Lisa’s constant guiding star;

 She was my very good friend.

Dilys Francis   -    the very ‘genuine’ article.

Message to the reader: Top-Concert / Assembly point / Top seat!

Not sure why I chose this name for my blog except that it seems strangely appropriate and has personal family significance.

Back in 1870 something, my great gandmother, Susannah Lloyd lived on a small farm called Peneisteddfod situated right at the top of a mountain overlooking the village of Foel in Montgomeryshire.  She married a local stonemason, Ezekiel Francis from nearby Llangadfan and went on to raise six sons at Peneisteddfod and for several more generations afterwards, scattered Francis family members would always find their way back there.

The local boys from Foel used to jokingly refer to Peneisteddfod as 'Top-Concert'  -  a comic play on the translation of the name from Welsh to English  -  'Eisteddfod' being more often used to describe a cultural festival or occasion of sorts and 'Pen' meaning 'top of..' or referring to something high up on a hill.  Another meaning of the word is also that of a place where people would assemble and sit down together.  I like this idea of communion and that this blog should be an 'assembly point of thoughts and debate'   -  (not just my own you understand!) And so in some self-indulgent way, the name fits.  I look forward to posting regularly and to hearing from others.  In many ways, I feel that perhaps I've been silent for too long!

Hwyl am y tro,

Lisa Francis