Reproduction unit poses hurdle for Samarès rehab return

Tuesday 08 February 2022

The Health Minister has hinted that it’s unlikely rehabilitation services will move back to Samarès Ward, with the impact of the move on the assisted reproduction unit a key consideration.

Last month, States Members unanimously approved a bid to restore a bespoke rehabilitation unit at Samarès Ward or another location by the beginning of March.

Samarès Ward – which is located within the Westmount Centre at Overdale – had been the main base for stroke and head injury rehabilitation since the building opened in 2004 until May 2020, when it was closed to create more space for potential covid patients, with existing services moved to Plémont Ward at the General Hospital.

The Government initially fought against the proposal, brought forward by Senator Steve Pallett, lodging an amendment which gave no commitment to replicate services at Samarès, but withdrew if after a late-night meeting of ministers on the eve of the debate.

Appearing before the Health and Social Services Scrutiny Panel on Friday, Deputy Renouf was asked to provide an update on the work that had been done since the proposition was adopted. 

Pictured: Senator Steve Pallet brought forward the proposition to restore a bespoke rehabilitation unit at Samarès Ward or another location by the beginning of March. 

He said a team of officers had been “rapidly drawn together” after the debate and that they were now “looking at options for the provision of the rehab unit and that includes a return to Samarès Ward”. 

Dr Anuschka Muller, the Health Department's Director of Improvement, added they were going through “an option appraisal for various options including Samarès”.

“For Samarès in particular, a working group has been formed to identify the detailed requirements necessary to consider to move to that facility again particularly around costs and timescales,” she added.

Deputy Renouf said that the rehabilitation services move back to Samarès Ward would affect the Assisted Reproduction Unit.

“[The Assisted Reproduction Unit] are in the planning because if we were to move rehabilitation services back to Samares they would need to move to another location so that is being planned and all options considered,” he said.

Pictured: Deputy Richard Renouf described the debate over the location as a “co-issue”.

He also described the debate over the location as a “co-issue”.

“It has become important to so many people and we are listening and we are resolving and we are now talking about and working towards establishing the right location which will be, I hope, acceptable to all as a result of the States decision,” he added.

Deputy Renouf, who said he aimed to bring some “sort of report” by the deadline set by the proposition, 1 March, said that individual service users were not able to join the group due to time constraints, which meant the group had to “look at things pretty quickly”.

Asked how he had came to change his position “very late in the day” by Senator Sam Mézec, the Health Minister responded that it was as a result a Council of Ministers’ meeting.

“I think that is known that we met late that day and the amendment we had considered putting in arose out of a wish to move the debate from one that was just going to be about premises, because I believe it should be about more than that,” he said.

“It was about concentrating on the service that needs to be given and that’s what our amendment was trying to do, because I had confidence, we would be able to deliver the good service that is needed in Plemont Ward. With the comments that were coming in from members of the public and individual States Members, clearly that confidence wasn’t shared so therefore we did move our position to one in which we could accept the original proposition which required us to look at all possibilities and particularly the possibility of Samarès Ward which is exactly what we are doing.”

Pictured: Medical Director Patrick Armstrong said he had recommended broadening  the  debate about rehabilitation services across health services.

Medical Director Patrick Armstrong said he had provided advice on the Ministers’ decision but acknowledged the clinicians’ point of view - which was outlined in an open letter to States Members describing a return to Samarès as a potential "mistake" - was not the only thing under consideration.  

“I was asked for advice and that is our role in this role - we provide advice. But, as always, there are always more considerations than just clinical input, as we know through the covid process,” he said.

He said his advice and that of other clinical colleagues had been to broaden the debate about rehabilitation services across health services, rather than focus on “particular parts of that pathway or specific conditions”.

He added that there are advantages to having rehabilitation services based within the hospital, such as the access to acute medical teams or the hydrotherapy pool. 

Stressing the need for an answer to the challenge thrown up by Senator Pallett's successful proposition, he said: “If that is back to Samarès Ward, so be it."

“Hopefully that will be temporary because we are hoping that we will have a new hospital built there at some point but that I am sure will be taken into consideration in the work that is going on," he added.

Mr Armstrong continued: “The evidence is very clear it is best for people’s physical and mental wellbeing to get home earlier for early support and discharge we haven’t got that bit right and that’s the bit we need to fix.

"...We need to move beyond this debate. We need to work together."