Sir,

At the fourth meeting of the Pembrokeshire Health Board, 27 people sat around the table. One end of the room was packed with a crowd of public-spirited citizens from the Tenby area, all waiting for item No.8 on the agenda.

We could take no part in face to face discussion, but five speakers were allowed to make the case for the reprovision of NHS services with beds, to replace existing services at Tenby Cottage Hospital. It was no coincidence that during the earlier agenda items, we had been strongly reminded of the current Board's financial shortfall of £3.4 million, which included the inherited debt from the previous Trust Committee of £2.4 million. Health Board members were well aware of these figures, but we, the campaigning group from the Tenby area, were being softened up or forewarned.

Let it be in no doubt that despite the fact that no doctors from local practices were present, the population was well represented. Christine Gwyther AM and Pat Wright, chairman of the Friends of the Cottage Hospital, made inspiring cases. Their passion, historical detail and downright facts brought surprise to the faces of some Board members.

Clr. Caroline Thomas, Mayor of Tenby, the Rev. Nanette Lewis Head, of St. Johns Church, Tenby, and Mollie Neate, chairman of the Tenby and Saundersfoot branch of the Labour Party, made equally strong cases for the full reprovision of NHS Cottage Hospital services at the Gas Lane site.

Those of us present were given copies of 'The Executive Summary of the Full Business Plan for the reprovision of services currently provided at Tenby Cottage Hospital'. It provided less detail than we had hoped for.

All the 'non-financial benefit criteria' (I quote from the document jargon) indicated that Tenby's preferred option scored the highest points. Already 2,500 local households had voted for this in our Assembly Member's April 2003 survey. The only point lost was on 'fairness', which reflected the opinion of the north of the county, whose 99 per cent representation on the Health Board was concerned that they were not getting a fair deal compared with the Tenby area.

'The Financial Appraisal' followed. A cost benefit analysis estimated that the capital cost of the option preferred by local people was £1.5 million more than the proposed private sector bed provision at Park House Court site. Also, the running or revenue cost of an NHS joint provision at the Gas Lane site was estimated to be up to £200,000 per annum more than the private sector bed option. In health provision terms, neither of these sums is vast, and could well be found. We all know that NHS funds are not limitless, but to defeat a capital project, planned over a period of 10 years by four different committees, by this relatively small difference, is hard to accept.

The Welsh Assembly have given £8 million, £4.6 million for the Pembroke Dock scheme and £3.3 million for the Tenby reprovision scheme. Due to the debts of the Health Board, our one-site NHS facility has lost out. We don't know the details. Maybe the South Pembs. Hospital has lost out as well. The Board's figures need close examination. It happened before under a previous Trust that similar figures were wide of the mark.

In the 'Final Summary' of the Health Board's document, the preferred option, listed on a 1-5 scale, was in favour of private sector beds provision.

The local preferred option, i.e. a one-site NHS provision with beds, came second. So what we want came very close. When the committee were asked to vote, there was not even a clear show of hands - just 27 nods. No one voted against, no one abstained. The lack of any previous enthusiastic discussion had forewarned us of their intention.

At the end of Christine Gwyther's plea, she said clearly that the Health Board could ask the Assembly for more money so that Tenby and district could get the health facility with beds, i.e. the option they wanted.

The Board is unlikely to do this, but we could! The option on offer, a contracted private arrangement with little security for the future, is a sad second best for future generations. Why waste this golden opportunity and the capital the Welsh Assembly has granted us on the building and equipping of such a private scheme?

Some re-engineering of the Health Board's figures, a little more money, or a temporary increase in the Board's debt plus some imagination is needed. The Friends of Cottage Hospital have over recent years donated over £93,000 worth of equipment to the old building and they may have more to spend. They will certainly not carry on their fund raising to benefit the private sector.

Further representations and an even larger number of local people will demonstrate on Wednesday, August 6, at the Derwen Health Trust at Withybush Hospital. We do not realistically expect any different decision. In September, Health Minister Jane Hutt will give her final decision. Every reader of this newspaper should write to try and convince her to stop this 'second best' decision in its tracks. It is still not too late, so pick up your pens now.

Marjorie Bevan,

Joint Secretary,

Tenby and Saundersfoot Labour Party,

(A witness to the

Health Board meeting).