Part of 4. Topical Questions – in the Senedd at 3:19 pm on 5 February 2020.
Thank you for the questions and comments. To start, I will deal with the comments you make about the organisation of the health board. I think it's often a tempting answer to suggest that reorganisation will deliver improvement in services, and anyone who wishes to run that argument—and there are arguments to be made; it isn't my view—will need to explain how that organisation would run and function, how quickly you'd start to see improvement taking place, and what you'd do about the framework. To go back to three separate organisations, I think you'd have three quite small organisations, and even if you had two organisations within north Wales, you'd have to decide what to do with the middle part of north Wales and Ysbyty Glan Clwyd. These are not simple questions to answer, so anyone who is an advocate for an entirely different framework and an entirely different footprint needs to consider what those look like, and how they would actually lead to an improvement in the quality and delivery of care, as well as of course the practical arrangements for separating the single organisation. I don't share the view of others that say that the health board is unmanageable and that it's unachievable to have an organisation that makes progress.
Turning to your five particular points, on secondment, it's entirely normal during secondments for wages to be paid by the organisation that is seconding someone out, then the employment comes to an end, but these are matters for the health board to set out and explain. I don't think that is unusual.
And in terms of the prospects, these are very practical choices that are made. When people leave senior leadership, there are choices about what is in the best interests of the organisation and being able to move on, and the health board has made a choice that they want to be able to move on and to begin the process of having a permanent chief executive in place.
On the interim chief executive arrangements, again, this is a practical point. Simon Dean has stood in at the health board in the past and, at the time, he stabilised the organisation. He's aware of not just that time there, but his role as a deputy chief executive means he has an awareness and knowledge of all the organisations within Wales. He has significant experience within the wider health service, but he also has a significant amount of respect from staff and wider stakeholders within north Wales. It's a very practical point, and we want to see the health board continue to make progress and not simply stalling over however long it takes to recruit a new chief executive.
In terms of that future chief executive, there will of course be comments about the way in which healthcare is delivered here in Wales and, in particular, in north Wales. They will also need to be given the licence of support from people across the political spectrum to actually take steps to improve the organisation. So, that means not being afraid to make choices about the future, to be able to have an open conversation with not just the team that they will lead within the health board, but with the wider public and their elected representatives. I appreciate there's going to be an election in just over 15 months' time, but healthcare will need to be delivered in that time, and I expect all people in this room who have an interest in the future of the health service in north Wales to engage openly and directly on that. And the chief executive, whoever they are, will understand that they're walking into an environment where there isn't just an election coming, but there's a need to see genuine improvement in the way that health and care services are delivered. It's what the staff and people themselves are entitled to expect and receive.
And on performance, I've set out the performance expectations in the revised special measures framework that I published in November. It sets out revised areas for the health board to make progress against to be able to move on from special measures, and then beyond that, too. I think the test that we set for the health board has to be a fair one. It has to be: what does this organisation have to do and need to do to move beyond special measures, then what else does it need to do to get to the position where it is what we would all hope to see, a high-performing healthcare organisation? And I don't think it would be tenable to expect them to move from special measures into that particular frame in the one single jump.
On the point about individuals and the point about collective responsibility, I regularly get the opportunity to set out my role in the system and to answer questions upon it, not just in the press but in this Chamber and beyond. I have always been clear that I've got political responsibility, ministerial responsibility for the health service, and that comes with accountability for it. I don't try to step into operational choices, but every time something happens within the health service, it's entirely possible that I'll get asked about it and I'll be expected to provide an answer to it. That goes with the territory and I don't resile from that, but I'm looking for new leadership to help change and set not just the tone about what they expect from the top, but how they expect staff and the whole team within the health board to actually deliver the cultural improvements and the performance improvements that, as I say, I recognise everyone in this Chamber and beyond would expect to see.