TWINS James and Lynnea Hardy were about to set out on the education trail on Friday last week, entering into a whole new world of experience and opportunity in primary school.
To look at them you would never guess that they spent the first week of their lives in South West Acute Hospital’s (SWAH) neo-natal unit, having their weight gain, ability to feed, heartrate and temperatures monitored.
Born in May 2013 at 35 weeks plus five days gestation they and their Dromore family owe so much to the neo-natal unit and the staff who provided the care and support necessary to ensure they were well enough to go home.
But the future of the service for premature and sick babies is now under threat thanks to the Western Trust’s controversial £12.5 million Savings Plan which was launched at a heated ‘Extraordinary Trust Board Meeting’ in Altnagelvin last Thursday.
All five of Northern Ireland’s Health and Social Care Trusts have been tasked by the Department of Health to develop draft savings plans to deliver their share of a total of £70 million of savings in 2017/18.
It is the Western Trust’s responsibility to make up £12.5 million of this over all province wide savings plan.
In all, 12 proposals have been put forward in order to reach the Western Trust’s set target of £12.5 million savings this financial year.
Only four of these have been assessed as having a ‘low impact’ on our services, amounting to £3.1 million. 
The Savings Plan contains specific proposals related to a change or withdrawal of service, which are considered to be ‘major and/or controversial’ and will require the Department’s approval to implement, following the outcome of the public consultation.
Among these, are proposals for:
n  a ‘rationalisation and consolidation’ of day-care services affecting Dromore and Rosslea
n the loss of eight to 10 nursing homes with an estimated 275 domiciliary care packages not being put in place,
n a reduction in routine elective surgery and a ‘reformation of the neonatal service at South West Acute Hospital’ to a ‘transitional care based service’, provided within the Paediatric Ward  with a Specialist Nurse.
“But how would that actually work?” asked Julie Hardy, James and Lynnea’s mother.
“When the twins were born there was so much focus and thought put into infection control in the neo-natal ward.
“My eldest son, Theo, was not allowed into the unit to see his brother and sister, neither were our immediate family, in order to prevent potential infection to the babies on the ward. They had to stand outside by the window of the neo-natal unit and we held James and Lynnea up so they could meet them for the first time. 
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So how will they be able to have that same level of infection control on a children’s ward?”
Unfortunately none of the detail as to how this or any of the other proposals would actually be implemented has been made available to the public yet. That is despite the fact the first seven days of a six week public consultation period on the Trust’s proposals has already passed.
The Savings Plan does however realise that, if implemented, the proposal to remove SWAH’s neo-natal ward “may impact on capacity in the Paediatric ward in SWAH”.
This is a reality that is not lost on Julie either.
“When we were in the neo-natal unit there were six to eight bays for babies. By moving to the Paediatric Ward you are immediately reducing the number of bays either available to paediatric patients or to premature babies -- how will the care be prioritised?”
Had SWAH’s neo-natal unit not been available to Julie when her twins were due, she and her husband Dave would have faced the prospect of travelling to Craigavon Hospital.
“To me, if your baby really needed the care that can only be provided in a neo-natal ward, Craigavon is a very long way away, especially if you want to breastfeed,” says Julie, “I wasn’t able to stay in the neo-natal unit with my two. I stayed in the maternity unit and when James and Lynnea needed fed, I would have to walk the length of the corridor to get to them. That walk, several times a day was exhausting enough for me, having just given birth to twins. I can’t imagine having to travel to Craigavon or Belfast.
“The reason our two were in there is because James was slightly small and they wanted to monitor Lynnea’s heart. They wanted to check they were both putting on enough weight and that they were feeding themselves because with premature babies, they don’t always have that natural latching instinct, whether that be for breastfeeding or bottle feeding.”
Julie is full of praise for the care she and her children received on the neo-natal unit.
“I was able to use the Milk Bank from Irvinestown on the first day the twins were born before my own milk came in and everything that you could imagine was at hand: nappies, blankets, clothes and hats which had been specially made for he premature babies at SWAH.
“We were very well looked after.
“When I went into labour, two scheduled caesarian sections and an emergency section were put on hold for me because a twin pregnancy carries more complications.Thankfully I was able to deliver both James and Lynnea myself, but I was taken to theatre just in case.”
An online petition campaigning for the retention SWAH’S neo natal service was set up last week and has already attracted over 1,900 signatures of support.
The Western Trust has assured that should any of the proposals be implemented they would be made on a “temporary basis” for the Financial Year 2017/18.
However Fermanagh and Omagh District Councillor and mental health practitioner, Raymond Farrell has likened the Savings Plan to: ‘kicking a can down a road and putting off so much that it is going to come back to bite us’.
“I have talked with many people who are waiting on operations, in crippling pain, and these proposals would be incredibly demoralising if implemented,” he said.
“The solution to all of this could be quite easy: get the Northern Ireland Assembly up and functioning,
“We have an agreed sum of money between conservative giovernemtn and the DUP available that could help mitigate against all of this if we had a functioning Executive.
“There is so much talk of the importance of ‘language’, be that Irish, Ulsterscots or whatever. The only language I want to talk about is the language of suffering, which we can do something about to stop.
“I don’t like to see cuts and austerity, but Northern Ireland is, per head of population, receiving more money than people of England, Scotland and Wales. That needs to be put into context.
“We need to get up and going, whether that be here or by Direct Rule in order to help improve the lives of our people here.
“We cannot hang about on this.
“There are people sitting waiting on drugs that require a government to legislate -- drugs for cancer and other serious health conditions. That cannot happen without a Minister. All we need is for our government to sit down and fund and legislate so that these drugs can be utilised.”
Another of the Western Trust’s key proposals is to reduce its reliance on high cost and non-NHS locums, nursing agency and agency Social work staff, upon which SWAH in particular has been relying heavily on to maintain safe service delivery.
“That will only place stress and pressure on existing Western Trust staff which ultimately will affect their health and well being,” said Mr. Farrell.
The Savings Plan anticipates that this particular action will result in the closure of around 30 beds across medical and care of the elderly wards.
“There will be an increase in waiting times for routine care within our hospitals,” states the document, “This will impact on throughput across our acute hospitals and requires a remodelling of inpatient beds and care spaces across both sectors.”
In looking at potential areas of spend reduction in-year the Trust has sought to take account of: “Safety, Deliverability, Impact and Strategic Direction,” says the Savings Plan document.
The consultation period began last Thursday and will run until October 5, 2017.
The Trust plans to hold public meetings in Londonderry, Enniskillen, Limavady and Omagh during this time. The dates and times of these will be publicised at a later date.
You can respond to the consultation document by e-mail, letter or fax as follows: Equality & Involvement Team, Tyrone & Fermanagh Hospital, 1 Donaghanie Road, Omagh, BT79 0NS; Telephone: 028 8283 5278 or E-mail: equality.admin@westerntrust.hscni.net