With the news last week that Hywel Dda University Health Board has declared an internal ‘major incident’ at Withybush Hospital with three wards needing to close and patients relocated to other health board locations following the discovery of unsafe concrete in the building - what now for the future of the troubled Pembrokeshire facility?

Since it was revealed last year that Withybush Hospital is to be downgraded at some point with the loss of it’s A & E unit, anger and concern from thousands of residents resulted in protests taking place outside the facility, with campaigners wanting to see services retained.

Now with Hywel Dda issuing a ‘public notice’ of an ‘extraordinary meeting’ of the University Health Board taking place next month on Thursday, September 14, to discuss the land selection for its new ‘urgent and planned care hospital site’ proposals which will be located outside of Pembrokeshire around St Clears and Whitland, a day before revealing an internal ‘major incident’ at Withybush Hospital as Health Board officials seeks to identify the scale and impact of the Reinforced Autoclaved Aerated Concrete (RAAC) found in the hospital building - is this the beginning of the end for the Haverfordwest facility.

In the lead up to last week’s announcement of an ‘internal major incident’ in relation to concerns over building structure issues, at the end of July, Hywel Dda Health Board released a statement to say that work was continuing on a programme of surveys at Withybush to determine the condition of concrete roof planks in wards at the hospital site, working with a Welsh Government approved external contractor to identify the scale and extent of the issue.

The surveys, which began in May 2023, are aimed at managing the risks around reinforced autoclaved aerated concrete (RAAC) planks and were planned to continue for at least another seven months.

RAAC is a material that was commonly used in construction in buildings between the 1960s and 1990s. Its presence has been confirmed in a range of NHS properties across the UK, as well as at several other properties in Wales.

The scale of the issue at Withybush is not yet known, although it’s understood the same material has been found at Bronglais Hospital in Aberystwyth.

To date, three wards in Withybush have needed to close due to the condition of the RAAC planks found, with the situation being managed and patients relocated to other health board locations in Pembrokeshire.

To make up for the temporary loss of beds at Withybush, 14 additional beds were made available in Cleddau Ward at South Pembrokeshire Hospital in Pembroke Dock.

“Our intention is to manage as much of the relocation of patients within Pembrokeshire as possible,” stated a spokesperson for Hywel Dda.

“While best efforts are being made to conduct survey work as quickly as possible, the resulting findings of the survey work is, in some cases, requiring patients to be moved from wards to alternative locations and adapting services to reflect the availability of the site.

“As time progresses, this is likely to have an impact on other health board services at other sites as we move patients and services to alternate locations.

“Local mitigations are also being put in place, including structural props and temporary closure of impacted areas.”

The news follows a report in January that over a third of buildings owned by Betsi Cadwaladr University Health Board were “operationally unsafe.”

Plaid Cymru’s spokesperson for health and care, Mabon ap Gwynfor MS has blamed Westminster and the Welsh Government for letting such matters occur on ‘their watch’.

“Two decades of underinvestment from Labour, and nearly 14 years of underfunding from Westminster and the NHS in Wales is now literally crumbling in front of our eyes,” he stated.

“We’ve known for a long time that our NHS in Wales is at breaking point and something has to give.

“There have been long-standing problems with patient flow through hospitals, more and more patients being added to waiting lists, and over the last 12 months our hard-working staff have taken to picket lines over pay and conditions. And now a reminder that the buildings themselves are also vulnerable to pressure.

“This is not the first warning that Labour Welsh Government have had that buildings are not up to scratch. Back in January, we learnt that only 62% of buildings owned by Betsi Cadwaladr UHB are operationally safe.

“Yes, Welsh Government’s hands are tied by Westminster, but let’s not forget that this has happened on their watch,” he added.

Preseli Pembrokeshire Senedd Member Paul Davies said that it is of ‘critical importance’ that survey work is done quickly.

“The Welsh Government also has an important role to play in supporting the Health Board and ensuring it has the support and resources it needs to understand the scale of the problem - and to ensure remedial work takes place as quickly and safely as possible, so that patients can continue accessing services at Withybush Hospital,” he remarked.

“Given the seriousness of the situation and the impact it will have on the delivery of services in Pembrokeshire, I will be writing to the Health Minister to ensure the Welsh Government provides the Health Board with the support that it will need.”

“Remedial work needs to take place as soon as possible so that services continue at Withybush Hospital,” he added.

Withybush Hospital is a modern District General Hospital with approximately 218 beds and is the only hospital serving Pembrokeshire residents and holiday makers year round. There are 14 wards, and 6 operating theatres including - a Day Surgery Unit, Emergency and Urgent Care Centre and Adult Clinical Decision Unit (ACDU) and a Renal Unit.

Plans to downgrade the Pembrokeshire hospital and remove its A&E department, saw protests take place outside the facility last year, with campaigners wanting to see services retained.

The A&E units at both Withybush and Carmarthen's Glangwili Hospital could shut if plans go-ahead by Hywel Dda University Health Board's to build an ‘urgent and planned care’ hospital between Whitland and St Clears, which would leave Pembrokeshire without a general hospital.

Both Withybush and Glangwili facilities would become community hospitals, with a focus on "patients who do not need to be in an acute setting but need support".

Campaigners opposed to the downgrading at Withybush fear the extra travel time from parts of Pembrokeshire could cost lives.

Posting in the ‘Save Withybush Campaign’ group on Facebook over the weekend, referring to the serious collision at Newgale on August 12, which saw a car crash off the A487 and into a campsite, colliding with a number of people and a tent, injuring nine, including passengers in the car, and with one patient flown to University Hospital of Wales, four taken by road to Glangwilli Hospital, and another to Morriston Hospital, local resident Audrey Thomas voiced her concerns.

“This terrible occurrence really is when you need a LOCAL Hospital, when something serious has happened!’ she remarked.

“Just when will someone listen and understand that you cannot just rip out services and expect everything to carry on regardless. Just pray no one is at risk of death tonight.”

Another posted: “Terrible as this accident is, maybe it would be a good time to highlight the fact that our local hospital Withybush was not considered suitable to treat those poor people!”

One member of the group said that they had just spent the weekend in A&E at Withybush with waits up to 12 hours. “There is a huge demand for our hospital - busy with hoildaymakers and locals from all over the county - all urgently needing medical help,” they remarked.

Non Gallagher pointed out the poor state of the building and how it has been left to deteriorate over the past dozen years.

“The building is falling apart. It wasn't built to last, it was built to be high maintenance. But 13 years of no adequate maintenance and botching has left it crumbling. Pillars and floors are cracking.

“Thirteen years of no building maintenance and cutbacks - this is exactly what you get. Hywel Dda have been allowed to waste money by not having a rebuild program in place. This is the reason it's going to cost so much to maintain the Withybush site.

“This is absolutely down to budget cuts from hywel Dda and Westminster.

“15 years ago, we had a fully functional hospital. They let it fall down. Proactive non-intervention and then asset stripping.

“Instead of selling off the land they should have built a brand new hospital next door in 1995/6 and then there wouldn't have been the problems,” she added.

Consultations were launched back in March by the Health Board on proposals to build the new hospital between Whitland and St Clears, which would leave Pembrokeshire without a general hospital.

Health board chief executive Steve Moore has stated that a new hospital is ‘vital’ for the locality, but admits it would take several years to achieve.

“We are stretched very thin at the moment, and that means we struggle with staffing," he said. “Quite often, people struggle with waiting times.

“While they may be able to get to the hospital front door, it can be a real challenge for our staff to see them in a reasonable timescale, and that creates a poor service for the public.

“Building a new hospital will allow us to do much better at that.”

Local politicians and county councillors have voiced their concerns over the proposals, including MP for Preseli Pembrokeshire Stephen Crabb, who stated: “The Health Board submitted ambitious plans to the Welsh Government in the hope of securing in the region of £1.3billion investment into health and care in mid and west Wales.

“Whilst the narrative from the Health Board is compelling about how this money will be used to bring as much care as possible closer to people’s homes, with plans for a network of integrated health and care centres, designed with local communities, across Carmarthenshire, Ceredigion, and Pembrokeshire, I remain concerned that at the end of the day, it leaves Pembrokeshire without a general hospital and without an emergency and urgent care department.”

The three potential sites are within a small geographical area in the south of the Hywel Dda area, within the county of Carmarthenshire and near to the Pembrokeshire border.

Two are near the town of Whitland and one near St Clears, as follows:

• Whitland Spring Gardens (formerly site 12) is a short distance north-east of the centre of Whitland. It is between the A40 to the north, Whitland rugby pitch to the east, and Spring Garden homes to the south.

• Whitland Tŷ Newydd (formerly site C) is part of Tŷ Newydd Farm. The site is to the east of the old Whitland creamery. The town centre and the A40 road is less than one mile to the north of the site.

• St Clears (formerly site 17) is land at old Bryncaerau fields, next to the junction of the A40 and A477 in St Clears. The A4066 Tenby Road is to the south, the village of Pwll Trap to the north, and the A40 to the west.

Hywel Dda has stated that the overall geographical zone for the new hospital - between Narberth and St Clears – was agreed because it is the area that would mean most of our population is within an hour of an emergency department (either at this hospital, Bronglais Hospital, in Aberystwyth, or Morriston Hospital, in Swansea).

With an ‘Extraordinary meeting’ of the Health Board now planned for Thursday, September 14, at 9.30 am to be held at Canolfan S4C, Yr Egin, College Road, Carmarthen, to discuss the land selection for the new hospital site, Hywel Dda University Health Board stated that it is committed to ‘openness and transparency’ and conducts as much of its business as possible in a session that members of the public are welcome to attend and observe.

The meeting will also be accessible to view via the Hywel Dda University Health Board website on the day of discussions.