Hospitals 'only place for 24/7 care', NHS Wales deputy chief says
Austerity means that hospitals are now the only places able to offer the 24/7 care that some elderly people need, a senior NHS Wales boss has told AMs.
Deputy chief executive Kevin Flynn said public spending cuts had made the social care system as a whole unfit for purpose and unsustainable long term.
Last winter the NHS had more ill and elderly patients who needed urgent hospital care than expected.
Mr Flynn said it resulted in delayed treatment for thousands of others.
AMs on the Public Accounts Committee asked senior health officials for reassurances that another severe winter would not push the health service to the point of breakdown, including thousands of cancelled operations, as happened last year.
NHS Wales chief executive David Sissling told them that plans had been developed since May and had been "road tested" to ensure they were robust.
But his deputy Mr Flynn said there were deep-seated problems in the system which were exacerbated by public spending cuts which made comprehensive care for the elderly - in their own homes or residential homes - hard to deliver.
He said: "The difficulty is, that with austerity across everywhere at the moment... inevitably, the only system that will take them, that is 24/7, is the ambulance and hospital system.
"So it's a systematic problem of where these people end up. At any point prior to that, within various systems, we could have probably intervened to the stage where they didn't get to hospital.
"The challenge of unscheduled care is how do we ensure that those things are happening, and it's not just a health issue, it's a social issue - how do we look after neighbours and so on."
Mr Flynn warned that longer stays in hospital for elderly people had serious knock-on effects for scheduled operations.
He said an elderly person with a broken hip would normally be in hospital for 14 days, during which time that bed would have been used to accommodate patients who had undergone five separate scheduled operations.
AMs also expressed concern about controversial plans for up to 400 job losses at the Cardiff and Vale University Health Board between now and March 2014.
However, board chief executive Adam Cairns said given the scale of the financial savings he had to make, and the impact of the pay bill on his overall budget, it would be "intellectually dishonest" to pretend that staff numbers would not be affected.
He said there would only be 20 to 40 compulsory redundancies and insisted that a constructive dialogue was ongoing with unions.
Mr Cairns also called for a debate on terms and conditions of NHS contracts in Wales, saying they could make some staff more expensive to redeploy than staff in England.
He said that if a worker in the NHS in Wales is redeployed to a role where fewer skills were required, their contracts gave them pay protection from their original job for up to 15 years in some cases, compared to around two years in England.
"So you can make the change, you can go through all the difficult tasks that are associated with that [redeployment], but from a cost perspective, nothing happens for 15 years," he said.
"That's not what happens in England, those arrangements are different...so you could see those cost savings coming through in a shorter timeframe from those in Wales."