There was a seminar in Port Talbot Civic Centre yesterday morning at which representatives of the Abertawe Bro Morgannwg University Health Board (ABMU) presented their plans for the immediate future. Deputy leader Cllr Peter Rees, in the absence of leader Ali Thomas, introduced Ed Roberts, vice-chairman of the board and well-known to members, and chief executive David Sissling, who conducted the Powerpoint presentation. Other members of the organisation contributed to the question-and-answer session which followed.

It was clear that the board could not plan very far ahead. They had reasonable predictions of population growth and other factors which affected health provision in the next five years, but cost-cutting had already become necessary (there is a £350m overspend) and much depended on the Welsh settlement after the Government Spending Review. The board had already identified savings of 20% in management costs.

Both board and council members agreed that much more publicity was needed, firstly to promote the positive aspects of  the board’s programme, but also to counteract the rumour mill and press comment which accompanied each change. It was emphasised that Neath Port Talbot hospital is not to be downgraded. Indeed, the hospital will now accept some work from Swansea. There will be changes in facilities but the net result would be an improvement.

The difficulty of recruiting and retaining doctors persists.

The board has set up, or is setting up, community-based care teams linking GPs, pharmacies and the relevant local authority. Teams in the county borough are three, covering respectively the upper Swansea valley, Port Talbot and Neath. Another aim was to involve consultants at a much earlier stage of treatment. The traditional method of handling urgent cases meant that the least-experienced doctors were the first people to treat the sickest people. The off-hand treatment at Bridgend A&E experienced by one councillor, as a stroke victim, showed that there is some way to go – though the member concerned emphasised that, once she was on a ward, her treatment could not be faulted.

There is no prospect of mixed-sex wards being phased out in Wales, never mind in the ABMU area, but Neath Port Talbot hospital provides single-sex bays within wards, and the management is working to ensure that toilet facilities are segregated. There is not such a good story for Bridgend and no indication that they plan to change.

One hopes that the latest reorganisation by the Labour/Plaid coalition, which is barely a year old, is the last for a long time. It seems to me, though, that the most dire effects of over-centralisation are being counteracted by the devolvement of treatment to the community-based teams.  My concerns are the lack of democratic input – one does not want councillors to micro-manage, but surely strategy should not be left entirely to the professionals – and the lack of contact between the teams and the areas in the communities which do not have a pharmacy or GP, as Cadoxton does not.

Certainly members felt that there was unfinished business, and notes have been made for a return visit by the board a year hence.

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