Part of 2. Questions to the Minister for Health and Social Services – in the Senedd at 3:08 pm on 13 March 2019.
Well, when we talk about how we transform and change the system, I'm not sure that there's a great track record in the conversation about who can sack who. Actually, that doesn't generate the sort of system transformation we want to see. If that were the case—you look at the system in England, where, actually, chief executives of acute NHS trusts have an average life span of less than two years—and that's no way to run a system. In fact, it was very interesting to hear—. Sir Bruce Keogh, in his leaving speech—not in his speech while he was looking forward to many more years in post at the NHS Confederation conference—when he was leaving NHS England, talked about that challenge, the way in which leadership, in the English system, has been brutalised and it doesn't allow people longer term choices to deliver the sort of paths to deliver the value that each of us wants to see. That's absolutely why having a joint health and social care plan is so important. It's why the transformation programme really matters—to get to the point where there are models to scale up.
I've been really clear about my expectations. The way in which we do it will not be a simple pulling of one lever or me going around and potentially threatening people with their employment if they don't do as I want. That is not the way to deliver change in the system. It will be a combination of different things depending on where each partnership is. In different parts of Wales, they're more aligned to come and do that somewhere together. So, in Gwent, we see a real commitment to transforming children's services across health and social care. I think they'll get somewhere. They won't need me to stand over them to encourage them to do it. They want to take the lead in those areas. That's the cultural change that we need to deliver because that will be much more effective in delivering outcomes that she and I and everyone else in this Chamber wish to see.