6. How does the Welsh Government assist health boards in the planning of healthcare in Mid and West Wales? OAQ52383

The 'NHS Wales Planning Framework 2018/21' sets out the principles that health boards should follow when developing their integrated medium-term plans. We have also set out our vision for the future of health and social care services in the long-term plan, 'A Healthier Wales', which was launched last week.

I thank the First Minister for that reply. As he knows, a significant part of Mid and West Wales is within the Betsi Cadwaladr health board area. As of the end of March, there were 5,714 patients that were waiting more than nine months for treatment in hospital. Under Betsi's current plans, many orthopaedic patients will still be waiting more than a year for treatment, and 4,200, generally, will wait more than nine months to be treated, whereas in Powys, that nine-month wait has actually been eliminated. Betsi also says that there's a systemic deficit of 13,500 patient pathways on the basis of patient demand, so that must mean that they are not being funded properly to provide a suitably comprehensive system of healthcare for the people of that region. Is it acceptable to the Welsh Government that, under Betsi's plans, this is a health board that is actually planning to fail?

The health Secretary updated Members last week on the progress made in some areas. He was also clear about the significant challenges that do remain, and the support that will be in place for the next phase of work. It's right to say that some services have been de-escalated. Maternity services, of course, in a very difficult place at one point, were de-escalated as a special measures concern in February, and that demonstrates what can be achieved with focused action and support, and that is the model that we plan to use in ensuring that there is further de-escalation in the months to come.

Of course, we do know a little bit better now what is happening in Betsi Cadwaladr, and what support the Welsh Government is offering that health board, simply because we have raised it here so many times that we've finally managed to get an answer. I wonder, now, First Minister, if you might be able to enlighten us as to the types of levels of support that the Welsh Government is offering the Hywel Dda health board, which, as you know, is in a form of special intervention. They've already been in it for over two years. We don't want to see their situation deteriorate or continue for as long as the Betsi Cadwaladr health board situation has. Surely the objective is that you go in, you give them the support, they put themselves right, and then they come back out of special measures. That's the way we should be running our health boards. So, perhaps you can just give us an overview of what you're doing for Hywel Dda health board, because I've found it exceptionally difficult to try to get some real, clear, crystal-clear answers on this matter from the Cabinet Secretary for health.

Well, I can say that in 2015-16 and 2016-17, we did provide Hywel Dda with additional non-recurrent funding of £14.4 million as short-term structural support in recognition of the financial challenges facing the board. On 23 May, the health Secretary announced the findings of a review that partially confirmed the view that Hywel Dda faces a unique set of healthcare challenges that have contributed to the consistent deficits incurred by the board and its predecessor organisations as well. As a result, £27 million of additional recurrent funding has been released to the health board during this financial year. That will place the health board on a sounder funding basis going forward, and of course it will help the board to develop and transform services in the future.

I don't know, First Minister, if you've had a chance to see the Public Services Ombudsman for Wales's report on the distressing case of Ellie and Chris James of Haverfordwest, whose son died in Glangwili hospital. There were a host of failings described in that ombudsman's report, compounded by the decision to describe their son's death as 'stillborn', despite the fact that he had signs of life after being born, and that in itself was as a result of several failings, including, for example, failing to monitor the heartbeat. This happened in Glangwili, with a young mother being taken from Withybush to Glangwili. A failure to escalate—something we were told wouldn't be happening when the services were taken from Withybush to Glangwili, of course. I hope you'll join with me in extending deepest sympathies to the family and the circumstances that they have suffered. But, in particular, I'd be interested to know what specific steps you're taking in line with the ombudsman's conclusions that the health board should implement the recommendations of this report now, and whether you're taking any further direct action to ensure that, there, we have the highest standards of neonatal care in our health board area.

Nobody could fail to be moved by what these parents have gone through. Of course I join him in expressing my enormous sympathy for what has happened to them—of course. All of us, I'm sure, in this Chamber will more than empathise with the situation that they find themselves in, of course.

Well, what should be done as a result? First of all, the ombudsman's report was clear in its findings that the care provided was unacceptable—by more than one hospital, but unacceptable. The health board has accepted the report's recommendations in full. They have sent their action plan to us. Officials will now monitor the actions taken by the health board to ensure that the recommendations within the report are implemented. There has already been a great deal of learning and improvement in practice as a result of what is, of course, a very sad case, and we will ensure that that continues. As part of the learning process, I can say that we expect all NHS organisations to reflect on this case to identify any learning to improve patient care within their own respective organisations as well. So, yes, Hywel Dda will take action. That action will be monitored by us.