Edwina Hart says a two site unit is what patients want
A decision by Wales' health minister to keep two neurosurgery services open despite official advice for one to close has been described as "reckless".
Labour's Edwina Hart was advised to establish a single unit but decided to keep both units at Swansea and Cardiff running.
The Conservatives and a senior neurosurgeon have criticised the move.
But Edwina Hart defended her decision by saying that patients wanted both units.
She recommended that neurosurgery operated as a single unit on two sites.
But that decision differed from advice from senior medical advisers, seen by the BBC's Dragon's Eye programme.
A written warning to the minister in July 2008 says that without a decision to centralise neurosurgery on a single site, the service would be unsustainable and leave south Wales dependent on Bristol for neurosurgery.
There have been concerns for several years that without centralising neurosurgery on a single site in south Wales, the service faced major problems.
The issue played a key part in the 2007 assembly elections.
The row over neurosurgery services led Ms Hart to order an independent review which recommended a "single neurosurgical service" for south Wales.
A minister acting in this way is acting reckless
Jonathan Morgan AM, Conservative
But defending her decision, Ms Hart said: "I've gone through very complex reviews of all these issues... but I think we have to recognise that it's very important that we have two sites if we can have two sites.
"My view is that what people want is two sites, and you've got to look at what the patients want as well as to what's required, and as long as I can have services on that basis I will do it.
"At the end of the day, decisions lie with me as a politician and I was elected to take them."
But the Conservative health spokesperson, Jonathan Morgan, said that "a minister acting in this way is acting reckless".
"I think Edwina Hart is absolutely right that we have had a series of complex reviews, one of which she actually commissioned herself," he added.
"The problem for her is that all of theses reviews pointed to one particular outcome, and that outcome she has now ignored.
Accusing the minister of "playing politics with the lives of people in south Wales", Mr Morgan said Ms Hart no longer had his confidence.
The future of services at Morriston, Swansea has sparked protests
"In making the wrong decision - which she what she has done in the eyes of the officials and experts - it could lead to a depletion in the level of patient care.
"It could put patients at risk, and moreover, we could see the service being lost altogether from south Wales."
Richard Hatfield, consultant neurosurgeon at the University Hospital of Wales in Cardiff, said all the neurosurgeons in Wales agreed there should be a single site.
"There are multiple problems but one of the main ones is trying to maintain a 24/7 service when doctors are being reduced by the working time directive to work only 48 hours," he said.
"People want services as locally as possible and one can understand that, but what you have to look at is the sustainability of those services. We cannot have a neurosurgery service in every DGH (district general hospital)."
However, Ms Hart won support for decision from the Swansea Liberal Democrat AM, Peter Black, and also from the Plaid Cymru AM, Dai Lloyd.
"The process of government is one of negotiation and compromise between the minister and her officials," insisted Mr Black.
"Let's be clear about this, although there is very clear advice and consensus that there is a single site, there is no clear consensus on where that site should be.
"I think the minister has taken the right decision in saying that we should have a two-site solution with one unit at this stage, and we should see how this works."
Plaid's Dai Lloyd backed that view: "I agree with her. We are talking of a single service working on two sites, working together.
"It's not just a narrow neurological view. It works with cancer networks, it works elsewhere, it's not a novel concept.
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