Call for fewer trusts in Wales

BMJ 1996; 313 doi: (Published 24 August 1996) Cite this as: BMJ 1996;313:443

The Welsh Office was this week coming under increasing pressure to review the size of trusts in Wales in the wake of the crisis at Swansea's Morriston Hospital. Last week the trust chairman resigned after a vote of no confidence in him and his chief executive by consultants.

Sixteen of the consultants have also resigned as clinical directors, and Dr Keith Vaughton this week handed in his notice as medical director of the trust, although he remains as a consultant. The resignation by the consultants was in protest at redundancy notices issued to two consultants and a senior hospital doctor after a £1.8m elderly care contract was lost to the neighbouring trust Singleton (17 August, p 385).

The Welsh Office announced this week the appointment of Professor Sir William Asscher, who retires at the end of September as principal of St George's Hospital Medical School, London, as the new chairman of Morriston NHS Trust. As the appointment was being made there were calls for some trusts, including Morriston and Singleton, to be merged. The problem of a number of competing trusts in small areas is replicated in some other urban areas in Wales. There are 30 trusts in the principality, including five ambulance trusts, for a population of just 2.8 million.

In a letter to the Welsh secretary, William Hague, Labour's health spokesman in Wales, Rhodri Morgan, said: “It is clear that competition across a range of medical and surgical services between Morriston and Singleton is not doing the NHS any good. Cooperation would be far better than competition, and merger of the trusts would bring administrative savings that could be directed into patient care. Merger in Swansea would be welcomed across the board, and I believe that there is a strong case for doing the same, for example, between the University Hospital of Wales and Llandough trusts in Cardiff.”

Dr Bob Broughton, the BMA's Welsh secretary, said: “This concept of reviewing the appropriate size of trusts and looking for possible mergers has been informally discussed by officers and may well be the subject of further debate.”

The chief executive of Morriston, Tony Beddow, was still in post, 10 days after the vote of no confidence in him and the chairman. His position is expected to be top of the agenda for the incoming chairman and new board. After the resignation of chairman Peter Allen, four of the remaining five non-executive directors of the trust also resigned in support. In a statement they said they had resigned collectively “in recognition of our full support for Mr Allen's chairmanship and in the belief that recent events have made our continued membership of the board untenable.”

The redundancies that sparked the row have been withdrawn. One of the main worries of doctors was that, had they gone ahead, Morriston would have been forever associated with redundancies, thus damaging future recruitment.—ROGER DOBSON, medical journalist, South Wales

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