5. Statement by the Cabinet Secretary for Health and Social Services: Betsi Cadwaladr University Local Health Board — Special Measures Update

Part of the debate – in the Senedd at 3:55 pm on 6 November 2018.

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Photo of Vaughan Gething Vaughan Gething Labour 3:55, 6 November 2018

Finance remains a major concern with a £35 million deficit control total set. That in itself would not be a significant marker of success, because success is living within the budget, and I've been very clear about that since my appointment. But we want to set realistic improvement targets to meet that control total and then to move on to be able to live within their means in future years. That is why the turnaround needs to be accelerated. That is often about the short to medium-term improvement before longer term and medium-term transformation, but that is also why the finance delivery unit will continue to work alongside the finance team within the health board to try to make sure there is real purchase on delivering on those savings. That's why we've put in short-term support around the health board. Recurrent funding commitments will be made to health boards, as we need to do, but we're adding significant additional investment to help this health board through special measures.

On advocacy, I have undertaken to write to you, and I will chase it up to make sure that I do, because I recognise you've raised the point in the Chamber before, so I don't want to avoid dealing with that.

On Tawel Fan families, the remaining families are a small number but have significant challenges and significant unhappiness about the process as they have seen it and the outcomes of the report. They don't share and don't accept all of the outcomes into the care that their loved ones received. The great majority of families who are part of the HASCAS investigation have not contacted us and they're still unhappy and not content with either the process or the outcome. That does not mean that we won't take seriously the remaining families' concerns. That's why, in half term, I was in north Wales for an evening meeting that lasted much longer than originally planned for because it was important to have a full opportunity for them to express their concerns rather than simply me hitting the bell after a certain period of time and saying, 'I'm leaving'. That would have been entirely the wrong thing to do.

Within that meeting, the call for an Assembly inquiry was far from unanimous. A person made a call, there was some support within the room for that call, but other people made clear they did not want yet another inquiry. It is, though, for the Assembly to decide if it wants to take another inquiry; it is not for the Government to say there should be an Assembly inquiry. I've made clear that the Government's responsibility is to make sure that we do what we could and should do, and that the health board is held to account for what it could and should to to take forward the HASCAS recommendations. The plan they have to do so is a credible one; the challenge is that they need to deliver it. The plan looks like the right one, but they need to deliver it and they need to do so in a way that commands confidence, which is why the stakeholder group exists. It's why it's important there are some of the Tawel Fan family representatives on that group as well. So, it is not a group of cheerleaders for the health board—there'll be real scrutiny.

On your broader point about patient confidence, well, if the health board is regularly written about in terms that do not command patient confidence, it's hardly surprising people are concerned. And with a health board in special measures, I would hardly be surprised if patient confidence in that part of the country is different, say, to other parts of the country. However, I don't accept your statement that the complaints system is broken. The complaints system has a significant backlog, but, actually, the leadership of the nurse director has made a real difference to the complaints system. It is both important to learn from mistakes, but also to deliver the improvement that is required. And, actually, you don't need to take my word for it that the system has got better—the ombudsman has actually commented that he recognises that real improvement has been made, but he's also pointed out that that needs to continue and things are not perfect as they are now.

On the choice about the sub-regional neonatal intensive care centre, it was a decision the First Minister made with significant capital investment, and it came on the back of an evidence-led review by the royal college. There are people in this room who campaigned for a further review of the initial decision, and we took an evidence-led approach to do so. That has been the right thing to do, and, actually, it was only when the unit was delivered, and ready and open, as I said previously in the Chamber, that staff believed that it would definitely happen. It's a real positive. I think that the Government listened, listened to the evidence and we now have a new facility in north Wales for the people of north Wales. On the orthopaedic plan that you referred to, it is simply not true to say that the health board have been waiting for years for a response from the Government. Part of our challenge has been to get, within the clinical community within north Wales, an agreement on what to do between themselves as well as the health board that employs them, but, equally, to have a plan that can not just deliver more activity, but actually meet the demand and the capacity that exists now, let alone in the future. This Government or any other cannot be expected to spend significant sums of money not to meet the demand within the system. So, they have to have a plan that is approveable in the first place, and then the Government will have a choice to make about whether revenue or capital funding is made available. And I think that is entirely appropriate and what any Minister from any Government should expect from the service. But we are not afraid to invest capital within north Wales to deliver a better service. 

And that brings me to the Royal Alexandra proposals that finally went to board last week and have been approved by the board. They will now come to the Welsh Government investment board and I will then have a choice to make and I am determined to make an early decision. I can tell you that the most effective advocate, lobbyist and sharpest voice that you'd do well to listen to on this issue is, of course, the local Member, who happens to be sat in the Chair at this point in time. I will make the right choice for the service and I know that I will be tested on a regular basis by the local Member.