4. Statement by the Cabinet Secretary for Health and Social Services: Update on Betsi Cadwaladr University Local Health Board

Part of the debate – in the Senedd at 4:11 pm on 5 June 2018.

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Photo of Darren Millar Darren Millar Conservative 4:11, 5 June 2018

Can I thank you, Minister, for your statement? But I have to say that it will bring precious little comfort to people in north Wales, because in spite of your claims of improvement, even in some areas, I do regret that that improvement is not being discerned by many of the patients in north Wales, and I think the statistics speak for themselves.

This is a health board that was put into special measures three years ago, and yet, over that period of three years, it has deteriorated in terms of its performance in its emergency department against the four-hour target, it has deteriorated in terms of the 12-hour target, the referral-to-treatment times have gotten worse for the 26-week target, and they've got more patients waiting in excess of a year for treatment than there were three years ago when this health board was put into special measures. In fact, they're not only worse than they were three years ago, they are the worst in Wales against all of those measures.

One of the other indications of the difficulties that the health board faces is in terms of its financial management, and you made reference to its financial management just now. Its deficit has ballooned from £26.6 million, in the year immediately prior going into special measures, to £38.8 million, in the financial year that we have just closed. And you may say that we're making more money available to deal with some of these aspects of performance, but the reality is that you clawed back £3.13 million just a few months ago. So, you can't give on the one hand, take it back with the other and expect improvement the other end, because it's not working. Your intervention simply isn't working.

You've claimed some progress on mental health, and yet, just a few weeks ago, we saw a HASCAS report that said that they couldn't guarantee that any situation would be different for a patient going into the system now than it was when the Tawel Fan ward scandal broke all those years ago. In addition to that, you made reference to complaints management processes improving. Well, I can tell you from my postbag, and no doubt other north Wales Assembly Members will too, that they are not hitting the 28-day target at all in terms of the Putting Things Right measure that's in place. In fact, many patients are waiting for years for their complaints to be addressed.

You made reference to primary care being improved. This, of course, was one of the key areas for which this health board was put into special measures, and yet we have seen general practitioners handing back the keys to their practices and bailing out of the system because of the pressures in it. And it's worse in north Wales than it is anywhere else. Now, I welcome the extra investment that's gone into some of the capital infrastructure, but when are we going to see some doctors so that people can get appointments with those doctors in their GP surgeries? They're not able to get them at the moment. You made reference to investment in some of the hospital estate. Again, I welcome the investment in the hospital estate, but where's the promised brand-new hospital in Rhyl, for example, in the Royal Alexandra, that was promised back in 2011? We're here eight years later, nearly, and there's no sign of any progress on that site—there's not a single bit of work that has been undertaken in terms of improving that particular site. Can you give us an update on that, Minister, perhaps, today?

You made reference to the fact that we need to turn this situation around. They've only just appointed a turnaround director. We're three years into the situation. Their mental health strategy was only signed off last November. This is not the sort of progress that the people of north Wales deserve. We need to see more rapid improvement in the Betsi Cadwaladr health board.

I want to pay tribute to the staff that are working hard, grafting on the front line, trying desperately to deliver the services that they want to deliver, but I'm afraid that there has been an absolute failure by the Welsh Government to sort the problems in this health board out over a three-year period, now. You've set out an 18-month period ahead in which to turn things around. This is probably going to be the longest example of any NHS organisation ever in the UK being in special measures for such a long period of time. I think that's a shameful thing for you and for the Welsh Government that you haven't managed to turn these situations around.

So, when are we going to see the improvements? When can we expect your targets, which you set as a Government, to be hit in terms of referral-to-treatment times, in terms of emergency department times? When can we see Betsi moving from being the worst in Wales to at least being one of the average ones in Wales in terms of performance against those things? And when are we going to see the fundamental improvements in mental health care that people expected a rapid result on in the wake of the Tawel Fan scandal? 

One final question: you made reference in here to the need for them to accept the recommendations in the Ockenden report—I assume that that's the new Ockenden report, which is yet, of course, to be published. I assume, therefore, you've had sight of that report and the recommendations that it makes. When can we have sight of that report? When are we going to be able to see that? When are the public going to be able to see that, so that they can have some confidence in this system that is yet to deliver the improvements that they need to see?