LAST WEEK, there were ambulances stacked up outside Newport's Royal Gwent Hospital and no beds for non-emergency patients across Gwent.

Although yesterday was a quiet day in the accident and emergency departments of the Royal Gwent and Abergavenny's Nevill Hall Hospitals, Welsh health minister Dr Brian Gibbons came face to face with staff who had to deal with the misery of large numbers of emergency admissions, bed-blocking, long waiting lists and a lack of staff.

And the front-line NHS employees gave him their prescription for solving many of the ills of our two largest hospitals.

Last week saw chaos outside the Royal Gwent as ambulances stacked up outside with emergency patients, with staff unable to find them a bed.

Gwent NHS Trust chairman Brian Willott admitted that the problems experienced last week were the result of a collision of a number of factors - more than the average number of admissions needing a bed and an unusually high number of bed-blockers - those well enough to be discharged but with nowhere to go.

Mr Willott said: "Because this hospital regularly operates at around 98 per cent capacity rather than the recommended 85 per cent, we don't have the flexibility to respond quickly to a situation like we had a week last Monday."

The total number of outpatients in the Gwent NHS Trust who are waiting for their first appointment has barely dropped from 47,291 in December 2002 to 45,783 in December 2004.

After talking with staff Dr Gibbons told the Argus that reducing waiting times to those of the English NHS would be "a real challenge".

He said: "The level of people attending casualty in Wales is 20 per cent higher than that in England and the number of admissions is 30 per cent higher."

Dr Gibbons admitted the Welsh NHS is unsustainable because of the demand on the acute departments and said: "We need to assess patients more quickly and make sure only those patients who really need to be there are there.

"They then need to be discharged more quickly. The sister on the ward here told me if nurses had more specialist skills then maybe 30 per cent of patients could be treated and discharged by nurses.

"That's a challenge they have set themselves here at the Royal Gwent. We've been criticised at the Assembly for over-managing the NHS so we are now prepared to give more responsibility to each Trust.

"More finance is required in A&E and the particular pressures and demands here mean the turnover of staff is perhaps worse than in other hospitals and I think there's a need to rotate staff from casualty to other departments to avoid burn-out.

"But some progress has been made - four years ago the number of patients in Gwent waiting more than 18 months for treatment after seeing a doctor was 1,100, now it's zero."

But Dr Gibbons rejected the idea of using the English style walk-in-clinics to reduce waiting lists.

"I'm not convinced by them but there is a definite need to concentrate on relieving casualty departments.