An English teacher who suffered a devastating stroke has lost the ability to speak following major delays in his NHS care, his family claims. Gareth Thomas Hale, who had been celebrating his all-clear from prostate cancer, collapsed in the front garden of his home in Bassaleg, Newport, on April 25, 2021.
Despite a neighbour spotting Gareth and immediately dialling 999 at around 5.30pm, his family say an ambulance failed to arrive, forcing a paramedic - who was at the scene roughly an hour after the initial call - to "pull" the patient into the back of his rapid response car and take him to A&E by 7.30pm.
Due to the two-hour delay in getting the 66-year-old to hospital, it is alleged he missed the window of opportunity to be thrombolised - a treatment which can reduce the impact of stroke - or given a thrombectomy to remove the blood clots as it is not available in Wales. Gareth, who was running his own online English teaching business, has now lost all his written and verbal communication, cannot use his right arm or walk unaided. In response, the health board has said thrombolosis treatment would not have been suitable for Mr Hale, and said an investigation into circumstances surrounding Mr Hale's care has been carried out.
Bosses at the Welsh Ambulance Service admit current pressures are impacting on the safety of patients and say staff are "dead on their feet" due to the huge volumes of calls they are taking each day. They say that they are helpless because of the volume of ambulances tied up outside A&E departments for up to a day unable to hand over patients because of the capacity problems in the NHS. You can read their full interview here.
Read more: Wales ambulance staff 'dead on their feet' as waits hit unprecedented levels
"For someone who loved communication, languages and singing, we can't even describe the trauma he is currently experiencing. His business, hobbies and life as he knew it is now over," said his heartbroken daughter Lisa Hale. "That night we nearly lost Dad. He did pull through though, however what he's left with is devastating. It's like he's trapped in his own body."
Gareth, described as a "languages fanatic", was also an avid hiker, loved the outdoors, cycling, playing guitar and singing and was training for the London Marathon when he had the stroke. He had previously served in the police in both Wales and London for more than 30 years and volunteered as a junior rugby coach in Bassaleg.
Lisa said her dad was initially taken to A&E at The Grange University Hospital in Cwmbran before being moved to University Hospital Llandough for specialist care and then to the Royal Gwent Hospital. But she claims his aftercare and rehabilitation has been "dire" since he arrived home just before Christmas, particularly when it came to addressing his mental health.
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Gareth is now living with a condition called Broca's aphasia which results from injury to the speech and language part of the brain. His family are now working hard to try and rebuild his future and give him some quality of life. Lisa added: "He lives alone and now needs long-term care, but he is the most determined person I have ever met and works hard on his progress daily. While some outpatient rehab is available, it's patchy and nowhere near enough to get him back to a place where he can find peace of mind."
Lisa has now set up a GoFundMe page to raise funds to support Gareth's rehabilitation and development. To donate please go here. She added that any leftover funds will be donated to the Newport Stroke Support Group.
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The Stroke Association claims a "postcode lottery" of stroke treatment exists between Wales and England. The charity said a stroke plan for the NHS was being implemented in England where providers are held to account, whereas in Wales the stroke delivery plan ended in 2020 and they are still waiting for a successor.
Katie Chappelle, associate director for Wales at the Stroke Association, said: "Treatment for stroke is time sensitive, so getting the best treatment in the quickest time is key to survival. A stroke is a clot or a bleed in the brain and every minute this isn't treated 1.9 million brain cells die. It's vital that stroke patients call 999 as soon as they see the signs of stroke, are sent ambulances rapidly and are quickly admitted so they can receive time-sensitive lifesaving treatments.
"If you spot the signs of a stroke in you or someone else, it's vital to call 999 straight away. This lines up getting scanned and seen by a stroke specialist as soon as possible when you arrive at hospital giving you or a loved one the best chance of survival and recovery."
Despite time being of the essence when a stroke strikes, as things stand the Welsh Ambulance Service does not categorise stroke as a life-threatening 'Red' call. The aim is for ambulance crews to reach Red calls - which are reserved for those who are in cardiac arrest, choking, not breathing, unconscious or about to give birth - within eight minutes. However, stroke patients are either categorised as 'Amber one' or 'Amber two', neither of which are subjected to strict timed targets.
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Commenting on the incident Lee Brooks, executive director of operations at the Welsh Ambulance Service, said: "We are genuinely sorry about Mr Hale's experience, and know how upsetting this must have been for him and those around him. A paramedic in a rapid response car arrived within the hour of the 999 call for Mr Hale, and in lieu of an ambulance – all of which were already committed to patients at the hospital or in the community – a decision was made to take Mr Hale to hospital in the response car.
"Mr Hale's family wrote to us last year to raise a concern, and we asked for their consent to begin an investigation and share our findings. We invite Mr Hale's family to contact us again directly to afford us the opportunity to do this." In response to this point, Lisa claims the only reason they have not been able to progress the investigation until now is because it would have meant breaking the news to her dad that had he got to hospital on time, he might have had a better chance at recovery - and up until this point he hasn't been mentally well enough to hear this information.
Lee Brooks added: "There is extreme pressure across the entire urgent and emergency care system in Wales – lengthy hospital handover delays coupled with demand on our service and staff absence, exacerbated by Covid-19, has led to very long response times for some patients. The public can help us by using services appropriately. The NHS 111 Wales website should be the first port of call for health advice and information, and please also consider your nearest minor injury unit, pharmacist, optician or GP. Only call 999 in a serious life-threatening emergency so we can protect our precious resources who need us most."
A spokesman for Aneurin Bevan University Health Board, which is responsible for The Grange and Royal Gwent hospitals, said: "We're sorry that Mr Hale's family were unhappy with the care he received. The health board has conducted a thorough investigation into the circumstances surrounding Mr Hale's care and have provided a comprehensive report of its findings to him and his family.
"In our response, we have also provided an explanation as to why thrombolisis treatment would not have been suitable for Mr Hale. We would be happy to answer any further questions Mr Hale's family may have regarding his care." To get more stories like this, subscribe to our Wales Matters newsletter here.