7. Will the First Minister make a statement on the quality of NHS management? OAQ54188

The Health and Social Care (Quality and Engagement) (Wales) Bill will support a system-wide approach to quality in the NHS, with NHS management being required to deliver a culture of openness and honesty, and improved and continual public engagement in the design and delivery of integrated health and social services. 

I'm grateful to the First Minister for his answer, but does he acknowledge that there's widespread concern about the capacity for certain sections of NHS management in Wales to deal effectively, particularly with the handling of complaints and concerns and with whistleblowing? And does the First Minister agree with me that, in addition to the legislation that he's mentioned, we now need a national values-based set of core competencies for our managers in the NHS in Wales, and that those managers should need to be on a national register, where they have to prove that they continue to be competent, just as our doctors and nurses do, to avoid a situation where people can move around the system? When they've failed in one place, they can pop up somewhere else. We do know that that happens.

I thank the Member for that and look forward to hearing her set out at greater length her ideas in this area tomorrow. It is an important area for debate, and I think tomorrow will be a valuable contribution to that. There will be a set, as she knows, I'm sure, of complex questions that will lie behind the headlines: the need to be able to define what we mean by a 'manager' in legislative terms, to learn from some of the experiences we've had in the social care sector, where we've had competing regulatory frameworks, for example, for care home managers who are also registered as nurses. Which of the two systems under which they operate are they to be held accountable? How, within a managerial workforce would you distinguish, for example, between someone who has responsibilities for the workforce and somebody who is responsible for managing the budget of a health body? So, I think it's an important debate, but I think it's a complex debate as well, and I look forward to hearing what the Member says tomorrow. In the meantime, the Bill that the Government will bring forward, I think, will make some significant inroads into the general issues that Helen Mary Jones began her question with, and that, too, will be scrutinised through the Assembly and no doubt improved as a result.

My colleague for Mid and West Wales has made some very good points, but leaving it for a debate tomorrow, for thought over the next few months, the next few years, I don't think gets to the nub of the current crisis we have.

First Minister, you know as well as I do we have a number of health boards that are in a dire state. We've got a lack of fresh blood, we have the same team going around, with chairs being reappointed to new health boards who've been in existence in already struggling health boards. We've got chief executives, we've got whole management teams, we have a health Minister who you absolutely have faith in and you say that the problem is not with him. Well, if the problem with our NHS does not rest with you, your Government, your health Minister, the rest of your Cabinet colleagues, then surely it rests with the senior management of the NHS, because they are paid the big bucks to deliver the services our patients require, and they are paid the big bucks to be accountable.

What I would like to understand, through this question, is what accountability and quality measures are there currently in place, not what might come down the road in months and years to come, but now, today, so that we know we've got the best team working at it. Because when you look at the postbags that we all have coming through our doors, we don't see the evidence on the front line.

Well, Llywydd, here is the Welsh NHS, which, at the end of March, at the end of the annual cycle of reporting, had the lowest waiting times since 2013, fewer people waiting more than 26 weeks than for the last five years, a health service in which 30 per cent more people are treated within waiting times for cancer than they were five years ago, and where survival rates are better than ever before at one year and five years, a health service in which delayed transfers of care, in 2017 and 2018, were the two lowest years since those figures were ever collected. This is the health service that the Member wishes to describe as being in a dire state. It is simply not true. It simply does not reflect the state of the service that millions of people, year in and year out, get from the Welsh NHS. Caricaturing it in the way that the Member does does nothing to bring about the—[Interruption.]—nothing to bring about the improvements that we and she would wish to see. And those improvements that I have outlined are partly the result of the efforts that managers in the NHS make, as well as clinicians and others. We want a clear accountability system and we want to make sure that we have a system focused on quality. We already have one; we want to improve it further. That's why we're bringing forward legislation, and the legislation needs to be based on the facts of the health service in Wales, not a sort of general attempt to denigrate its reputation, where the evidence for that simply isn't available.

And finally, question 8—Huw Irranca-Davies.