THE Royal Gwent Hospital's accident and emergency department - among Wales' busiest - is not fit for purpose, say health watchdogs.

Patients' privacy and dignity are being compromised, and basic facilities such as toilets are not good enough, says Aneurin Bevan Community Health Council.

A CHC report pinpoints the layout of the department, which deals with around 84,000 patients a year, as a fundamental problem, with observation of patients in waiting areas also difficult.

Its comments are backed by an independent member of Aneurin Bevan Health Board, who said the situation during a visit to the department earlier this year "horrified me."

Chief officer Cathy O'Sullivan's report of a CHC monitoring visit to A&E last month, states: "We believe the layout of the minor and major areas of the A&E department at the Royal Gwent Hospital are not fit for purpose.

"Comments from patients and relatives confirmed that it gives a very poor impression of the hospital generally.

"The CHC has concerns about the privacy and dignity of patients in what are often quite public areas."

Independent health board member Professor Helen Houston "totally concurs".

She told a board meeting that during a visit to A&E "about six months ago" through the 1,000 Plus programme, she noted "free access to huge numbers of people, who wander back and forth."

"Patients were just on display and it horrified me," she said, adding that staff had told her about a business case for improvements.

She is "slightly surprised" it has not yet appeared, and added: "Even if changes are approved tomorrow, it will be several months away, and something should be done sooner."

Health board chief operating officer Judith Paget also "totally concurred" with the CHC's comments, especially concerning minor injuries.

That unit was developed several years ago in a temporary building, during an A&E reorganisation carried out she said, "on the basis that the SCCC (Specialist and Critical Care Centre) would be operating by now."

A comprehensive department revamp will cost £1.5m-2m, which Mrs Paget acknowledged must be a priority, and which may require Welsh Government backing.

The CHC report concludes: "While appreciating current financial constraints and the difficulties of upgrading a busy department, we are concerned that urgent action is needed, particularly in view of the current timescale for the development of the Specialist and Critical Care Centre." The latter will not be completed for at least five years.