Stealth methods SIR, I wonder if there is any way in which present Medical Administrive Bureaucrats can be stopped from using stealth methods by which they are further reducing the medical based services in the ancient town of Monmouth? When I was appointed as Medical Officer of Health to the Ancient Borough of Monmouth along with three other district councils in 1968, Monmouth and its surrounding area at that time were considered to be a "socially adequate area" by the old Monmouthshire County Council. Of the ten "Socially Deprived Areas" in Wales, eight were centred in Blaenau Gwent, which part of the Monmouthshire County Council's area. The Borough of Monmouth was indeed blessed with one of the most robust hospitals in the county, served by the most caring General Practitioners, dedicated nursing and ancillary staff. It had a very active casualty department with on site x-ray facilities. The in-patients were monitored and given, I believe, the best of care by our dedicated doctors and nurses. There was a very dynamic physiotherapy unit at Parade House. There the patients were seen by appointment, waiting times were negligible and working people were usually back at work within the hour. Latterly, there was also a very active Speech and Language Therapy Unit, especially geared for the Cerebro-Vascular Accident patients. All this was complemented by very dedicated Pharmacists in the town. In addition to all of this, the Monmouth Borough Council was totally supportive in maintaining these facilities. I well remember when, early in the 1970's, there was a threat by the Welsh Office to close the Monmouth Hospital. They assisted me, as their Medical Officer of Health, to lead the thrust to save the hospital from closure by meeting the Welsh Office representatives at the Monmouth Council Chambers. Within two weeks of this meeting, the closure of the Hospital was rescinded. Not only that, but I was able to obtain one of the two Lilian Board Cancer Units for Monmouth Hospital. Only two units were allocated to Wales as a whole by the Lilian Board Trust. In 2008, I see that a number of the above services are either no longer available or are in short supply. One is aware that, due to bureaucratic mismanagement, we have lost the robust Casualty Unit. On the weekend our medical needs are no longer covered by the General Practitioners of our two local surgeries. There is one contracted out medical practitioner, who covers our vast county area. Often the people of Monmouth, in urgent need have to wait long hours, or in desperation seek the Casualty Department at Nevill Hall Hospital in Abergavenny. This creates undue pressure on a major hospital unit. Recently, the Government has produced a thrust to involve local pharmacists in the provision of medically orientated advice to the public. It now appears that this extended role of the pharmacist is to be cut and they will not be available either for honouring prescriptions or giving advice on Sundays and Bank Holidays. Such an ill-conceived move in an ancient historical town like Monmouth, depending upon tourism and having a number of caravan sites in and around the town, would be counter productive as there will be no pharmaceutical based avenue for them to seek help in a medical emergency. Care in the Community 1993 Act specifically identifies the County Councils as the bodies responsible for its enactment. Our locally elected county councillors should keep this in mind when the local medical services and needs of their communities are under threat. As elected councillors they have a duty to serve the electorate. The same must be understood by those who serve in Parliament and the Welsh Assembly that 1974 Act Re-organisation of the National Health Service was produced to bring the Health Service nearer to the patients. Therefore, local councillors, Members of Parliament and the Assembly Members have a positive role to play in ensuring that the local community needs are met in order to avoid a serious and detrimental medical outcome. It would appear that in 2008 Monmouth is now a "Medically Adequate Area", although we pay the highest rates in the county and maybe the whole of Wales. I therefore wonder if the people of Monmouth can set aside their political affiliations on this life threatening issue and demand as a body that, with the loss of services over the years, they would now like to see the hours of pharmacists extended to two hours on a Sunday and Bank Holidays to compensate for the services already lost, and certainly not to carry out the cuts as envisaged. Dr M.S.Matharu (Consultant in Public Health, retd, the last Medical Officer of Health for the Borough of Monmouth)
