QUESTIONS over how ambitious plans to transform healthcare across Pembrokeshire and beyond will be paid for have been put to health board bosses.

On Monday, members of Pembrokeshire County Council had the chance to scrutinise Hywel Dda Health Board’s current consultation plans.

The meeting, which was live-streamed on the council’s website, saw local members raise their concerns – and those of their constituents – over the viability of the health board’s proposals.

Councillor Bob Kilmister, cabinet member for finance, said he was worried by the lack of financial data available to those being asked to have their say.

“Surely you have to have some understanding of how much things will cost and whether there’s a cost benefit before you ask people to make a consultation about what they want?” he said.

Speaking about plans to build a new site between Narberth and St Clears, he said: “We don’t even know if it’s affordable.”

“I can imagine that Welsh Government may well decide that they will possibly supply you with the money but they may well ask you to pay it back.

“Can you actually afford any of these options, based on the current performance which is already the worst in Wales for an NHS section?”

Speaking on behalf of the board, Dr Phil Kloer said new hospitals generally cost around £1million a bed.

"It's the scale of order of hundreds of millions," he said.

But, said Dr Kloer, the cost could potentially be minimised by maintaining more services at community hospitals, which Withybush and Glangwili are both earmarked to become.

Dr Kloer agreed the data was not as detailed as would be ideal, but the health board was confident that the proposed new models would bring savings.

"In the end, the more we invest in hospitals the less we have to spend in community and primary care," he said.

No guarantee of funding

Cllr David Howlett said he was sceptical of the health board’s ability to deliver a new hospital, saying there was no indication from Welsh Government that there was money available for it.

“You’re talking about delivery by 2025, I will be quite frankly amazed if that actually happens,” he said.

Cllr Howlett said he was shocked to discover there was a £61million backlog of maintenance at the health board’s four hospitals, including £11million at Withybush and £22million at Glangwili.

But, he said, facilities costs at Withybush were lower than at other hospitals in the region, adding: “Surely it’s better to invest in a hospital with less cost per square metre and that has got - in your report - the actual room to expand?”

Withybush Hospital serves a large population, some on the coastal fringe as you have mentioned with massively increased population in summer, ferry ports and industry, your own reports acknowledges both the development potential at Withybush and that it is by far the current hospital with the lowest costs.

“While I acknowledge change is needed, please don’t disproportionately affect the people of Pembrokeshire.”

“Is it not time to go back to the drawing board with your consultation?”

Recruitment problems

Cllr Kilmister said he also failed to grasp why the health board could attract agency and locum staff but not permanent workers.

“Have you actually asked yourselves ‘are we actually doing our job correctly in keeping, retaining and paying staff in the proper way’ or are you simply blaming all your troubles on your non-recruitment?”

Speaking on behalf of the board, Dr Phil Kloer said there were a number of reasons why people might not have been attracted to work in the area, from ageing facilities to unpopular rotas.

Coastal communities across the country also struggled with this, he said, but progress had been made in recent years in attracting new staff, including from overseas.

"When I started as medical director we had no permanent A&E consultants at Withybush, which we're celebrating.

"We're being quite innovative, and we're having to spend some money to do that."