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| A&E downgrade threat in north Wales, minister confirms | A&E downgrade threat in north Wales, minister confirms |
| (35 minutes later) | |
| Plans to downgrade the A&E department in one of the three general hospitals in north Wales are being considered, BBC Wales has learned. | Plans to downgrade the A&E department in one of the three general hospitals in north Wales are being considered, BBC Wales has learned. |
| Health Minister Mark Drakeford has confirmed A&E services at Ysbyty Gwynedd in Bangor, Glan Clwyd Hospital at Bodelwyddan and Wrexham Maelor were being examined. | |
| The health service was constantly changing, he said. | The health service was constantly changing, he said. |
| Betsi Cadwaladr University Health Board said no decision had been made. | Betsi Cadwaladr University Health Board said no decision had been made. |
| "We are looking to see where we can improve things now, or in the future, but I can't say exactly what that will mean but downgrading is one of the options," Mr Drakeford told BBC Radio Cymru's Manylu programme. | "We are looking to see where we can improve things now, or in the future, but I can't say exactly what that will mean but downgrading is one of the options," Mr Drakeford told BBC Radio Cymru's Manylu programme. |
| "The important thing is that the system works together so that the people of Wales receive the treatment they need, where they need it," he added. | "The important thing is that the system works together so that the people of Wales receive the treatment they need, where they need it," he added. |
| Critical report | Critical report |
| It is not known exactly what downgrading could mean in north Wales but in Llanelli, Hywel Dda Health Board decided to make the A&E department in Prince Phillip Hospital a nurse-led unit supported by GPs. | It is not known exactly what downgrading could mean in north Wales but in Llanelli, Hywel Dda Health Board decided to make the A&E department in Prince Phillip Hospital a nurse-led unit supported by GPs. |
| Changes are also being considered at A&E departments in south Wales where the number of accident units could be reduced from eight to five. | Changes are also being considered at A&E departments in south Wales where the number of accident units could be reduced from eight to five. |
| The proposed changes come as health boards across the country were told by assembly members on Tuesday that they must learn lessons from failings at the Betsi Cadwaladr Health Board. | The proposed changes come as health boards across the country were told by assembly members on Tuesday that they must learn lessons from failings at the Betsi Cadwaladr Health Board. |
| Some senior managers at Betsi Cadwaladr have already stepped down after an earlier critical report. | Some senior managers at Betsi Cadwaladr have already stepped down after an earlier critical report. |
| The assembly's public accounts committee said the new leadership now faced a "huge task". | The assembly's public accounts committee said the new leadership now faced a "huge task". |
| It found the management of a C. diff outbreak and infection control "extremely concerning". | It found the management of a C. diff outbreak and infection control "extremely concerning". |
| North Wales AM Aled Roberts wants the health board to present any A&E restructuring plans as soon as possible. | North Wales AM Aled Roberts wants the health board to present any A&E restructuring plans as soon as possible. |
| 'Network of services' | 'Network of services' |
| "As with any plan of that sort, that will prove to be very controversial," the Lib Dem AM said. | "As with any plan of that sort, that will prove to be very controversial," the Lib Dem AM said. |
| "I think that one lesson that has been learnt, hopefully, is that the health board makes some sort of suggestion soon and there is enough opportunity for people to understand exactly why they're bringing these plans forward." | "I think that one lesson that has been learnt, hopefully, is that the health board makes some sort of suggestion soon and there is enough opportunity for people to understand exactly why they're bringing these plans forward." |
| BBC Radio Cymru has been told previous changes to the health care system in north Wales had been criticised for a lack of public consultation. | BBC Radio Cymru has been told previous changes to the health care system in north Wales had been criticised for a lack of public consultation. |
| The Betsi Cadwaladr health board said no decision had been made about changes to the three emergency departments in north Wales. | The Betsi Cadwaladr health board said no decision had been made about changes to the three emergency departments in north Wales. |
| "There is evidence that consolidating certain services into centres of excellence can provide better outcomes for patients," the board said in a statement. | "There is evidence that consolidating certain services into centres of excellence can provide better outcomes for patients," the board said in a statement. |
| "Increasingly, the three hospitals are working together as a network of services. | "Increasingly, the three hospitals are working together as a network of services. |
| "People will still be able to go to their nearest general hospital in an emergency, even if they are subsequently transferred elsewhere for specialist care." | "People will still be able to go to their nearest general hospital in an emergency, even if they are subsequently transferred elsewhere for specialist care." |
| Geoff Ryall-Harvey, chief officer of the patient watchdog North Wales Community Health Council, said its members had not been told of any plans to downgrade any of the three A&E departments. | Geoff Ryall-Harvey, chief officer of the patient watchdog North Wales Community Health Council, said its members had not been told of any plans to downgrade any of the three A&E departments. |
| "I think the 70 members of the community health council would be very, very concerned if this was to happen," he said. | "I think the 70 members of the community health council would be very, very concerned if this was to happen," he said. |
| "There would also have to be a public consultation before any change of this sort, and we would be involved in that," he added. | "There would also have to be a public consultation before any change of this sort, and we would be involved in that," he added. |
| 'Major reorganisation' | 'Major reorganisation' |
| Meanwhile, the vice-president of the Royal College of Physicians in Wales, Dr Alan Rees, said health boards across the country were being forced to look again at their services. | Meanwhile, the vice-president of the Royal College of Physicians in Wales, Dr Alan Rees, said health boards across the country were being forced to look again at their services. |
| Dr Rees added that the status quo was no longer possible. | Dr Rees added that the status quo was no longer possible. |
| "That would then beg the question what happens to the hospitals which lose their A&E, and there would have to be major reorganisation in those hospitals," he said. | "That would then beg the question what happens to the hospitals which lose their A&E, and there would have to be major reorganisation in those hospitals," he said. |
| Changes to GP contracts in 2004 are seen by some as the root cause of the problems currently facing A&E departments. | Changes to GP contracts in 2004 are seen by some as the root cause of the problems currently facing A&E departments. |
| At the time many GPs decided not to sign up to new out-of-hours and weekend working patterns so many patients turn up at A&E with minor complaints. | At the time many GPs decided not to sign up to new out-of-hours and weekend working patterns so many patients turn up at A&E with minor complaints. |
| Manylu will be broadcast on BBC Radio Cymru at 14:04 GMT on Wednesday, 11 December, and will then be available on BBC iPlayer | Manylu will be broadcast on BBC Radio Cymru at 14:04 GMT on Wednesday, 11 December, and will then be available on BBC iPlayer |