Sir, The downward spiral of services at Withybush Hospital took another dive when the Wig Service was the latest thing to disappear. In the great scheme of things, it may not seem like much, but to a cancer patient it is a 'huge' issue. As Cancer Research UK says, 'Hair loss and hair thinning can be very stressful. Some people find it the hardest part of having cancer and its treatment. This is understandable because our appearance is closely linked to our feelings of self-esteem'. It was brought to my attention by two very concerned members of staff on Ward 10 and the Chemotherapy Day Unit at Withybush Hospital, Haverfordwest, that the wig service which was available to chemotherapy patients within the hospital had been stopped. I am sure you can imagine that the trauma of a lady losing her hair when going through cancer is terrible. The 'wig ladies' were able to speak to people even while undergoing treatment and help them through this difficult time. The cost of wigs was very reasonable and patients could get wigs for only £20 or £30 extra on top of the £90 wig voucher (the Health Board contributes the sum of £90 towards the cost of the wig in the form of a voucher). I am simply asking why a perfectly good system, employed at Withybush Hospital for many years, well received and appreciated by patients, and for which the staff had received a 'Chairman's Award for Excellence' was changed. What was the rationale for so doing and who made the decision and who was consulted in the process? Were the views of patients taken into account? The wig service is now provided by a private company, Todaro's (on whom I place no blame as they are a private company and have a business to run), and people have to travel to Milford Haven. I appreciate they have a dedicated room for wig fitting, but ladies still have to go to a 'trendy' hairdresser and upstairs (which is difficult for some during treatment) to a consultation about wigs. I work for Pembrokeshire Cancer Support, so I rang Todaro's and spoke to the lady who is responsible for this service. I asked her what the minimum price for a wig was over and above the £90 voucher. She explained that they have very few on offer at £165 (they had these sometime ago and have very few left). She said wigs range from £250 to £1,000. The £250 is £160 in excess of the voucher and by the lady's own admission this is generally their base cost. There is also a £35 consultation fee payable. I know from my own experience that cancer causes financial issues. For many ladies, the wig is essential and this could cause financial problems. I wrote to the vice-chair of the Hywel Dda Health Board, Mrs. Sian-Marie James, on April 2, and asked her: Why was the service taken away from Withybush Hospital? Why is the cost of wigs now much more expensive with an outside private organisation? If the cost needs to be so much higher, why does the wig voucher value not reflect this? When Hywel Dda agreed to Todaro's having this contract, why was it not agreed for hospital or home visits like the original service? Can you explain the methodology used to decide this change in service and were the cancer patients and staff involved in the decision? It has taken four weeks to get a reply as Mrs. James had to get 'comments' from Mrs. Lewis (County Director for Pembrokeshire). I waited four weeks to be told.... 'In Wales, there is currently a system where all wigs are provided via a 'voucher' style service. Following referral from the chemotherapy or dermatology teams, patients are able to source their wig from any hairdresser or wig outlet they wish. The Health Board contributes the sum of £90 towards the cost of the wig. There is currently work being undertaken on an all-Wales basis and I understand that a revised policy is likely to be issued shortly. I trust this information is of assistance'. So, I waited four weeks to be told nothing! If there is an all-Wales policy review, then why change the system before the results of that review are complete? If the old system was working perfectly fine, why change it? The extra financial burden alone is reason enough to leave it as it was. Surely, 'if it ain't broke, don't fix it' applies here. I really think that Hywel Dda Health Board have no idea what a huge issue this is for people going through cancer treatment. If you think the removal of the wig service for cancer patients is wrong, or the removal of other services is wrong, why not let the Health Board know. It is in all our best interests to fight for the services at Withybush Hospital because one day you may need them yourself!

Lyn Neville, Pembrokeshire Cancer Support.