4. Will the Cabinet Secretary provide an update on the delivery of renal dialysis services in Betsi Cadwaladr University Health Board? OAQ52229

Thank you for the question. The Betsi Cadwaladr University Local Health Board and the Welsh renal clinical network are currently going through a dialogue process with service providers for chronic haemodialysis service. It is recognised that Wales leads the UK in terms of access to renal dialysis in ensuring that over 90 per cent of the population can access dialysis within a 30-minute travel time. In north Wales, we want to see an expansion of the service to further support this approach and continue to improve both access and outcomes for patients. 

Thank you for that answer, but I understand that the renal services are currently delivered either by the NHS, an independent provider or a combination of both. In February, the health board stated that the current independent provider was due to be recommissioned in the Bangor unit and the satellite unit in Alltwen. Following on from this, concerns were raised about potential changes to terms and conditions for staff taken on by whomsoever might win the next contract. Cabinet Secretary, I would like to know if the existing workforce will be guaranteed the same terms and conditions as they previously enjoyed and that patients will continue to receive the same high standard of care that they deserve as close to home as is possible. 

Thank you for the question. I know there have been questions about this broad area previously. I want to reiterate that the opportunity has been taken to look at the whole service to further expand and improve the service to make sure that care is closer to home for a greater number of people. So, patient representatives, trade unions and HR representatives have been invited into the process to develop renal services, together, of course, with clinicians. I'm happy to set out again that all specialist renal services and consultant care will continue to be provided by the national health service. No decision has been made on the final model, but I want to reiterate this very clearly: this Government will not approve the transfer of NHS staff into the private sector. I want to be really clear and upfront about that, because I do know that some members of staff are concerned about their future within the national health service. 

Thank you, Cabinet Secretary, for that clarification. Under the new arrangements, I think you've confirmed that there won't be any NHS staff moving to the private sector, but if there's any change at all with regard to staff moving from any NHS body to another third party, can you confirm that staff pension rights wouldn't be affected in that regard? Also, there are some concerns about a change leading to patients paying for additional services in Welshpool, and I wonder if you could comment on that. Some of the recreational and medical equipment that has been purchased for the renal unit has been supplied by the North Powys Kidney Patients Association. So, in any change, can I ask what the position would be on the ownership of these particular items? Can I also ask whether patient transportation will be affected in any way in any change?

I'm happy to reiterate the answers that I've given to Joyce Watson to try and deal with the points that you raise. In terms of pension rights, given that this Government won't approve a transfer out of the national health service of staff, the issue doesn't arise. If people choose to transfer and move their employment, that's a matter for them. We can't force people to stay within the national health service; people do move jobs from time to time, as we know, but there will not be a new service provision that requires people to move out of the national health service.

In terms of Welshpool, NHS services will remain commissioned and provided by the national health service. Even where there are partnerships with the independent sector, that doesn't mean that people would end up paying to go and have their treatment; it is an NHS service. So, I really hope that it's helpful to quash some of the rumours and some of the way in which this conversation has run around in areas—it just is isn't possible and there's no tenable reason to think that that would actually happen. To give that assurance to staff and to patients, it won't affect patient transport, it won't affect having to pay for services—it is a national health service—and it won't affect staff being required to transfer out of the national health service. I don't think I can be any clearer than that.

Cabinet Secretary, you just told us that staff and unions are part of negotiations about the future of the service, but I quoted yesterday to the First Minister a letter from staff saying, 

'It's a disgraceful way for a responsible employer to conduct itself in such a process.'

Because they are aggrieved that they have not had the engagement that you're potraying they are having. They say that 

'The staff feel that, throughout this process, the communication has been poor and not undertaken in a timely manner, effectively preventing union representation and causing serious distress and worry to all staff concerned.'

Now, I asked the First Minister yesterday whether he would look into this to give us assurances that this is not the case, or at least that, if it is, it will change. Can you also give us that assurance, please?

I'm happy to do that, because if there has been a problem with the way that staff have been engaged I expect it to be rectified. But I do know that health service trade unions have been engaged in and around the conversation with this service. Again, I say that national health service staff will not be required to transfer their employment; I expect staff to be properly involved, and their representatives, in conversations about their future. If there is a real problem—and I have read the letter from the Welshpool staff—then we will ensure that the national health service employer rectifies the process to make sure that people are properly engaged in the conversation about their future.

I think this is taking away from the success story of renal dialysis services in Wales. We have the best story to tell in the whole of the UK about the quality of care, about the outcomes and travel time. We are in a much better position than in Scotland and in England, and that is because of the hard work of the Welsh renal clincial network, the nursing and additional care staff, including healthcare support workers, who directly deliver this service. I'm proud of the additional investment we're making and have been making in this area since 2009. It's a programme that will continue and patients in Wales will get better care as a result.