5. Statement by the Minister for Health and Social Services: Update on Betsi Cadwaladr University Health Board

Part of the debate – in the Senedd at 5:03 pm on 4 June 2019.

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Photo of Vaughan Gething Vaughan Gething Labour 5:03, 4 June 2019

Thank you for the comments and questions. It's good to see you back in the Chamber, Angela; we have missed you. I should point out—and you haven't been here for some time, and I really am pleased to see you back—we've had this on the business statement for some weeks that I would be making a statement today; it hasn't been produced as a strategic attempt to try and spike the debate tomorrow, and it's entirely appropriate for the Government to be making a statement in the week of the fourth anniversary of this health board going into special measures. It is an unusual length of time. The Medway NHS Foundation Trust in England was in special measures for just under four years, Barts Health NHS Trust in England was in special measures for just over four years on quality grounds and is still in special measures on financial grounds. So, it is unusual within the UK setting, and we've never tried to hide from the fact that that is the case. I've said before, and I say again at the start, before dealing with your points—to come out of special measures, the health board has to show not just progress, but show a level of confidence about its ability to sustain that progress and still continue to improve. And the framework that I've set out previously has been designed to show clearly the areas it needs to improve upon, and show real and sustainable progress. But the independence of the advice that I receive before I then have to make a choice—it's not someone else's choice; it is still my choice—comes from that tripartite process involving the NHS Wales chief executive, the Wales Audit Office and Healthcare Inspectorate Wales. The points that I've made on the progress that has been made come from the independent sources around the board, not the board marking its own homework. So, the points that you make about mental health services and out-of-hours—out-of-hours is no longer a special measures concern because of the advice that we've had about the sustained improvement that has been made. Indeed, the comments that I made in my statement, not just about CAMHS but about adult mental health services—again that comes from the feedback both from NHS Wales Informatics Service alliance and also Healthcare Inspectorate Wales, and I pointed that out in my statement too.

On your broader point about when we'll see the progress, well, actually I can't tell you now where exactly the board is, given that I'm waiting until autumn 2019 to see how much progress has been made against the framework. That's what I said—I'd form a judgment on the work that they've done, but, obviously, the progress they've made through that time will be considered when the tripartite escalation meeting takes place in its normal time frame over the summer.

Now, when it comes to leadership, there has been a significant change in the executive team, and indeed in the independent board members, since the health board went into special measures. The chair and the vice-chair are different, and I think there are six different independent members and eight different executive members. So, it's been a real turnaround. We've now seen that the finance director has left the organisation. We're recruiting a new medical director, and that's a key post for, actually, the ability to deal with the clinical services strategy. Because, actually, in west Wales what we've seen is that having a strategy is not something that is done in a quick and easy manner—you have to bring your staff and the public with you, and even then, with lots of investment and time to do so, it is something that is still controversial, where people always have a view on whether they want to see that happen, because it requires you to look at the way you deliver services now and the way you want to deliver services in the future, and that requires change and reform. But without that, the board will only be able to go on on a year-to-year basis, so it's a longer term objective that they need to make progress towards. But on the progress they do need to make in the here and now—on turnaround, we are looking to have new people come in. That's what I signalled in my statement. The Public Accounts Committee have made clear their view, and, in fact, it's a fortunate coincidence in terms of the position the Government and the health board are already in. The chair had recognised that already. There've been conversations with Government on improving the turnaround function, having external advisers' support to do so, and the Public Account Committee recommendations reinforce the need to do so.

Your final point was about general practice in north Wales. I'll have more to say generally about general practice and our ability to train and recruit staff in general practice in every part of Wales, but in north Wales the picture is much more positive. We have not just filled all three of the training schemes in north Wales—we've overfilled two of those, and I've announced earlier this year that there is the capacity to overfill across Wales by at least 24 places. I'm looking to reset our ambitions and our capacity to have GP training here in Wales, following advice we've had from Health Education and Improvement Wales, but I'm making a statement on that in the coming weeks, before summer recess.