Postone hospital downgrading, MS urges

Liberal Democrat Senedd Member Jane Dodds has written to Powys Teaching Health Board demanding they postpone their imminent decision on permanently downgrading Llanidloes Hospital, citing serious concerns about the lack of meaningful community consultation.

In a strongly-worded letter dated 9 June 2025, Ms Dodds, who represents Mid and West Wales and is leader of the Welsh Liberal Democracts, accused the health board of failing to adequately engage with local residents about the future of the hospital, which was temporarily downgraded to a 'ready-to-go-home unit' in December 2024.

"There is considerable apprehension within the community about the potential permanent downgrading of the hospital," Ms Dodds wrote. "Such a decision would have a profoundly detrimental impact on local residents who rely heavily on the essential services it provides."

The MS highlighted what she described as "serious concerns about the lack of transparency and democratic engagement demonstrated by the Health Board throughout this process", stating that "many residents feel that there has been a consistent failure to adequately consult or involve the community in decisions that directly affect their healthcare provision."

The controversy stems from Powys Teaching Health Board's decision in October 2024 to approve plans that would see Llanidloes and Bronllys hospitals provide care packages for patients requiring no additional treatment and are "ready to go home", whilst Newtown and Brecon hospitals would provide rehabilitation care for patients.

The changes were implemented on 1 December 2024 as part of measures to tackle a £23 million budget deficit forecast for the financial year. The health board said the temporary changes were needed due to financial and staffing pressures.

Despite opposition from local doctors and a 2,300-signature petition against the move, the plans were approved unanimously by the health board. Following the implementation, GPs were instructed to stop sending patients to Llanidloes War Memorial Hospital, despite available beds, causing what Llanidloes Town Council described as the start of a "downgrade disaster".

The temporary downgrade has faced significant political opposition. Montgomeryshire MP Steve Witherden attended a public consultation meeting in August 2024 and subsequently called for the proposal to be withdrawn, warning that "there is nothing so permanent as a temporary solution".

Senedd Member Russell George also raised concerns with the First Minister, seeking transparency about what the changes mean for the long-term future of Llanidloes Hospital and reassurances that budgetary constraints would not compromise patient care.

However, the First Minister responded that "service changes are not a decision for the Welsh Government" and that "it is up to the local health boards to respond to the local needs".

In her letter, Ms Dodds went beyond requesting a delay to the decision, calling for a complete reversal of the current arrangement. "I am calling for a reversal of the downgrade, and in particular a restoration of the ability of local GPs to admit local patients to the Hospital," she wrote.

The MS requested that Powys Teaching Health Board "delay your imminent decision on the potential permanent downgrade of the Hospital, until you can demonstrate meaningful community engagement with the residents of the Llanidloes area."

Powys Teaching Health Board has been grappling with significant financial challenges, predicting a budget deficit of just under £23 million this year due to financial and staffing issues. Executive medical director Dr Kate Wright previously explained that the current system of looking after patients with mixed needs across all sites "isn't particularly efficient" and is expensive because "the same level of staffing is needed no matter what the patient need is on the ward".

Local doctors from Machynlleth and Llanidloes have warned that the plans could see staff recruitment affected and innovative work at hospitals cease, with some units potentially having to close due to reduced nursing satisfaction.

The health board is expected to make a decision on the permanent future of Llanidloes Hospital's services at their next board meeting. Ms Dodds' intervention adds to mounting pressure on the board to reconsider both the timeline and the extent of community consultation before finalising any permanent changes to the hospital's role.

Powys Teaching Health Board has been contacted for comment on Ms Dodds' letter and the concerns raised about community engagement.