4. Statement by the Cabinet Secretary for Health and Social Services: Services Fit for the Future White Paper

Part of the debate – in the Senedd at 4:18 pm on 27 February 2018.

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Photo of Vaughan Gething Vaughan Gething Labour 4:18, 27 February 2018

I don't broadly accept much of what Rhun ap Iorwerth said in his contribution to be frank. When it comes to the consultation, I think this was a full public consultation over a reasonable period of time. We deliberately chose to have additional events for those people who don't regularly take part in consultations. We engaged Communities Connected to do so. I realise that the Consultation Institute wanted to run their own event. We said we would not engage with that because I don't believe that the Welsh Government should send Ministers or officials along to events where our stakeholders pay for that access. I do not believe we should help the Consultation Institute to run their business. This is about how the public engage and how we have gone out proactively for the public to engage in those events more generally and then specifically for those people who regularly do not get engaged in consultation. 

On the point about the future of community health councils, again we've been around this track many times before and I continue to say I want to have a citizen-voice body across health and care with a strengthened role in representing the citizen across the health and care sector. That means reforming CHCs. It means you have to remove CHCs as they currently are, given they're in primary legislation, and replace them. This isn't about having a period of time where no citizen-voice body exists for a period of months or years before I then genuinely need to replace it with something different. It is about, if we were to move forward with legislation, we would have to then set out what that new body would look like and how it would replace at the same time when CHCs are then superseded by that new body.

This goes back to, whether innocently or not, not reflecting on what has been said on several occasions in this place and outside it. I understand the concerns that are raised, but the national Board of Community Health Councils themselves have recognised that they want to see an expansion in their role across health and social care. As we have more integrated care, it must be sensible that a citizen-voice body doesn't just stop at an artificial line between health and social care. It's also that they recognise that they want to see a reform of their place within the service reform conversation. They also want to see a reform of their role as regards inspection. When CHCs were created, of course, we didn't have Healthcare Inspectorate Wales. We now have a professional inspectorate undertaking one part of inspection, but CHCs themselves are very clear that they would like to have a successor body still having the right to have unannounced visits to areas where care is being administered, and that's something that we are talking constructively about, about what could happen in the future. So, this isn't a case of abolishing and doing away with CHCs and not replacing them at all. That simply isn't the perspective that the Government takes. It isn't the proposal we've set out. It isn't what I've said time and time again in this place and in others as well.

And, on the points about intervention, I thought your comments were somewhat flippant about where we are and looking to intervene in organisations that are struggling in some aspects of their performance. This is, as I've said to Angela Burns, about how do we have additional tools to intervene in and support bodies that are not meeting all of their duties. Sometimes, there will be a corporate challenge and not simply an individual service area or functional challenge, but sometimes even that service area or functional challenge may require support in a time-limited way in which Ministers could act promptly by appointing someone to work alongside the board or the executive team. And that is a proposal that has been well received in the consultation, and I just don't think that's particularly difficult to understand.

On your point about board representation and gender and the gender split, actually, as I said earlier, we actually, on a leadership level for chairs and chief executives, do rather well in the health field. A really good example is the recent appointment of Alex Howells to be the new chief executive of a new body, Health Education and Improvement Wales, and, in addition, Tracy Myhill moving across to be the chief executive of Abertawe Bro Morgannwg. She did that not just as someone from our system here in Wales but actually as someone the external assessor also agreed—and a high quality external candidate as well—Tracy Myhill was the best candidate, not just the best Welsh candidate but the best candidate, and that is someone who has done a significant job in turning around the ambulance service as well, and that is a real positive. This is being done on merit and it's being done because there's been some determination about how we develop and promote people, but we recognise actually, in other tiers within our service on executive-level leadership that we have a real challenge about the next tier down, about the middle tier and who is coming next. That is something that I'll have more to say on, but this is only partly about—. It's also then, of course, about our public appointments process, and I dealt with those comments in response to Angela Burns.

I just don't think that the decision around the previous in-patient mother and baby unit was driven by representation of women on boards. Actually, the concerns came from the staff in the unit at the time that they were not able to provide the care that they could and should have been able to. Those staff were women themselves who were saying, 'We don't think we can do the job that we could and should do.' We've looked again at the position. I said right at the outset of this particular inquiry—and thinking about the debate we had in this place two weeks ago, that brought to a close the inquiry of the committee, but the work of the Government and the health service certainly doesn't stop at that point, because we've committed to having in-patient care within Wales, not because of the number of women on boards across Wales but because we think it's the right thing to do and we have a way to deliver that care in a way that meets the needs of citizens across Wales, and this White Paper is about doing that. How do we meet the needs of citizens across Wales? Can we resolve some of our challenges by taking forward proposals for legislation in the White Paper? And that's what I'm committing to do, as I've outlined in my statement.