(Title Image: © Copyright Richard Hoare and licensed for reuse under Creative Commons Licence BY-SA-2.0)

The Motion

The Senedd: Notes that 8th June 2019 marks four years since the Betsi Cadwaladr health board was placed into special measures and further notes that ministerial oversight of special measures arrangements has consistently been with the current Health Minister.

Regrets that Betsi Cadwaladr Health Board still has significant improvements to make in mental health services, governance, leadership and oversight.

Calls upon the Health Minister to accept his responsibility for failing to deliver the required improvement at the health board and resign.

The Public Accounts Committee recently published a report on this very issue, a summary of which you can read here.

Health Minister painting a rosier picture than staff

Shadow Health Minister, Angela Burns AM (Con, Carms. W. & S. Pembs.), said this debate wasn’t tabled to demoralise staff, but to get answers. The Health Minister has often painted a rosier picture of the situation than staff have. Many of the areas of concern which resulted in the board being placed into special measures haven’t been resolved.

“This is what the Conservatives would do: we would draught in help from experienced managers working in the NHS throughout the UK…. We would implement robust and independent consultation events to engage and empower staff, to help them identify areas of concern free from external pressures. We would underpin the areas that have shown such devastating failures of performance and provide them with management support and funding to improve.”

– Shadow Health Minister, Angela Burns AM

Angela wasn’t the only AM to point out that the health board is named after Betsi Cadwaladr (“the Welsh Florence Nightingale”) and her legacy was being tarnished by association – Darren Millar AM (Con, Clwyd West) even suggested changing the board’s name.

Mark Isherwood AM (Con, North Wales) ran through a number of reports and concerns relating to the board, including the recent Public Accounts Committee report which said Welsh Government intervention has made little impact. He called on the Health Minister to accept responsibility for failing to deliver improvements and resign.

Janet Finch-Saunders AM (Con, Aberconwy) said the board’s finances were “spiralling out of control”, while Caroline Jones AM (BXP, South Wales West) called for an end to political appointments to health boards and a stronger inspection regime.

Reorganisation should be on the table

Jack Sargeant AM (Lab, Alyn & Deeside) painted a more balanced picture; some constituents praise the level and quality of care their receive, while others have clearly been let down. Particular areas of concern were well-known: out-of-hours GPs, ambulance response times and mental health. He didn’t think reorganising the health board should be completely off the table, but any changes had to have a clinical justification.

“This new normal, of course, represents an ongoing financial crisis, it represents recruitment problems, failures in long term planning, particularly in terms of the workforce, GP services collapsing, an over-reliance on locums and agency staff, and a failure to deal with complaints in a timely or appropriate manner.”

– Llyr Gruffydd AM (Plaid, North Wales)

Helen Mary Jones AM (Plaid, Mid & West Wales) repeated a call for performance standards for NHS managers to be introduced so they can be struck off in the same way as medical and nursing staff.

Reflecting on progress to date

The Health Minister, Vaughan Gething (Lab, Cardiff S. & Penarth) said the anniversary was an opportunity to “reflect on reality and the pace of progress to date”. Two areas of concern in 2015 – maternity services and GP out-of-hours services – have now come out of special measures.

He also refused to set a timetable for the board to come out of special measures.

“I noted that any decisions on changing the escalation status of Betsi Cadwaladr will be taken after receiving advice from the Wales Audit Office, Healthcare Inspectorate Wales and the NHS Wales chief executive. That is as standard under the intervention arrangements that we do have in place, so I won’t set….an artificial timetable for the health board to move out of special measures.”

– Health Minister, Vaughan Gething

Replying to Jack Sargeant, he didn’t see any objective reason for the board to be reorganised; the last thing the board needs is upheaval.

Vote

An amended motion noting the anniversary, removing any reference to resignation, but also noting progress made and stating that any decision on special measures will be taken based on expert advice was passed by 32 votes to 20.