6. Will the Minister provide an update on the governance arrangements for health boards in Wales? OAQ54757

Health boards in Wales need to ensure they have robust governance in place and act in a manner that upholds the values set for the Welsh public service.

I'm sure that the Minister will agree with me that, ultimately, governance arrangements can't be separated from those appointed to perform the acts of governance themselves that are needed. The Minister himself, in the case of Betsi Cadwaladr, of course, plays a very active personal role. He's chaired the monthly accountability meetings since July 2018 and the chief executive, Gary Doherty, has made a couple of important appointments, in particular, turnaround director, Phillip Burns, who previously worked for the King's College hospital trust, in whose report for 2017-18 I see that a forecast deficit position of £38.8 million ended up at £142.3 million, forcing the chairman of the board, Lord Kerslake, to resign—hardly an endorsement in Mr Burns' skills at turning around any entity. He and Mr Doherty worked together in the Blackpool NHS board and he appointed also another staffer from Blackpool, Nick Varney, as a turnaround consultant. The Minister himself commented on Mr Varney in a special measures report in 2018, where he said:

'It has been disheartening and unacceptable that during 2017/18 issues have escalated in relation to the financial position and some key areas of performance'.

Blackpool itself at the time was under scrutiny from the Care Quality Commission during or just after the tenures of these three individuals. So, what investigative work did the directors at Betsi Cadwaladr and the Minister himself do to ascertain the quality of Mr Burns's and Mr Varney's work before taking them on as employees? Were the Minister and other directors aware that Mr Doherty, Mr Varney and Mr Burns were all networking buddies and staff at Blackpool NHS at the same or closely overlapping times? Does he agree that cronyism of this kind does nothing to increase public confidence in the governance arrangements for the NHS in Wales, and he and his party should be ashamed when these gold-plated appointments are persisted in being made at a time when nurses' terms and conditions in Bersi Cadwaladr have been eroded by scrapping—talks were going on to scrap their paid breaks?

I don't think the Member is in the greatest position to talk about cronyism in public life. When it comes to the position of the staff at Betsi Cadwaladr and the requirement to improve the finance function, our expectation is that staff are appointed in a manner that is consistent with our expectations and the requirements of the health board—it is not a nice-to-have, it is about them being objectively able to do their job.

In response to the point about the turnaround director's performance, actually, the initial view is that he is making a real difference to improving the finance function of the health board. That isn't just the view of officials here, it is the view expressed to us by officials in the Wales Audit Office too. There is significant distance to travel, but, actually, when he referred to Lord Kerslake, when he stood down from the King's College trust, he made it very clear that he did not think it was possible to manage with the sums of money available within the English system. He made the point about having a fair expectation for a fair funding settlement for the health service across the UK. You also highlight, of course, that the King's College trust, with a similar level of income compared to Betsi Cadwaladr, has a deficit of about four to five times the amount.

The challenges faced by the health board in north Wales are achievable to turn around, and it is my expectation they will do, but I'll be open and honest about whether they do so, bearing in mind the recent steps I've taken in setting out a renewed special measures framework for north Wales.

When it comes to governance, it's vital that the independent directors of health boards have a robust background, and understand how these large organisations run. Many have turnovers in excess of £1 billion. In the Cwm Taf case, report after report has indicated that there's been a breakdown in governance. What confidence, Minister, can you give us that your department, and yourself in particular, have learnt from mistakes that have happened in Cwm Taf to make sure that future appointments are robust, and the individuals that you put in place do have that intimate knowledge of how such large, intricate organisations work, so that we can get on top of some of these horrendous stories that come out of organisations such as Cwm Taf and the personal tragedies that have been inflicted in maternity services, sadly, on many expectant mums and families?

Well, there are some separate points there. The first is that I should remind everyone that independent members go through a public appointments process. It is a robust process, overseen by the commissioner for appointments, and that is not a devolved function, actually. The challenge then is about how they behave when they go to their organisations. There's a point about culture and leadership there, and that's part of the reason we've taken the steps that we have done, on not just induction, but the ongoing expectation for independent members and the way we expect them to behave. It's why David Jenkins's insight and report have been particularly helpful about the change in the nature of behaviour within Cwm Taf Morgannwg to properly recognise what they should be doing, to recognise that mistakes were made in the past, to recognise that insight, and then to be able to move on. But we're definitely changing where the induction takes place and the duties those independent members have throughout their period of time as a public appointment.

Thank you very much, Minister.