4. Statement by the Minister for Health and Social Services: Strategic Assistance for Betsi Cadwaladr University Health Board

Part of the debate – in the Senedd at 4:13 pm on 3 November 2020.

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Photo of Darren Millar Darren Millar Conservative 4:13, 3 November 2020

Thank you, Minister, for your statement and for sharing an advance copy with us. Can I first of all, Deputy Presiding Officer, put on record a tribute to the staff in the NHS in north Wales, who I think have been doing an absolutely sterling job to be able to cope under some very difficult circumstances as a result of the COVID pandemic? It's not always easy, particularly at times like these, but they have stepped up to the plate and really are delivering on behalf of my constituents and the constituents of other representatives in this Senedd, and I want to applaud them for their work.

It's been over five years now—we're into the sixth year of the special measures regime here in north Wales—and many people are very unhappy that it's taken this long to try and sort the problems out there. We know that the Welsh Government announced, when the health board went into special measures, that there would be a suite of 100-day plans to try and turn performance around. Well, it's actually feeling a little bit more like the 100-year war in terms of making progress there. The Minister alluded to the fact that the maternity services and GP out-of-hours services have both been taken out of the special measures regime, and I welcome the fact that they've been taken out, but we must not forget that it was as a result of the public marching on the streets that we saw the improvements in those maternity services and the security of the maternity services, particularly at Glan Clwyd Hospital, the hospital that serves my own constituency and, indeed, the constituents of yours, Deputy Presiding Officer. 

In terms of leadership as well at the health board, we've had something of a revolving door. We've seen chief executives come and go, we've seen finance directors come and go, we've seen mental health leaders come and go, and it really has been a little bit of a shambles. So, I really do hope that the new incoming chief executive, when she arrives in the new year, will be someone who is able to stick around, really get to grips with these problems and deal with them once and for all.

Now, if I can also take the opportunity today to really welcome this additional investment in north Wales from the Welsh Government. I have always said that I think that there's been a structural deficit, which the organisation in north Wales inherited when it merged with the other health organisations in the region, when it was set up. I do believe that the additional £40 million a year over the next three years will help it to get to grips with some of those problems that it's not been able to get to grips with because of a lack of resource and funding. Can I ask the Minister whether this funding of £40 million is an acknowledgement that there's a structural deficit, and if it is, whether that's something that will continue beyond these three years? We know that structural deficits have been identified in other significantly sized health boards—Hywel Dda in particular—and that funding was made available on a permanent basis there, and I do think there's a case to make this additional £40 million available on a permanent basis rather than just for a three-year period. 

Again, I welcome the £30 million that's being made available to try to help performance in terms of emergency services, and indeed to get to grips with the referral-to-treatment time waiting lists as well, but again, I'm not sure whether £30 million will actually completely deal with that problem or eradicate it. I know that the health board has got proposals that it's bringing forward that will require some capital investment in order to get to grips with some of these issues, particularly with referral-to-treatment times, which have absolutely spiraled out of control over the past few months because of the pandemic, but were already in very, very bad shape even prior to that, with people waiting for two years typically for orthopaedic surgery. So, can you tell us, Minister, in addition to this resource of £30 million to support unplanned and elective surgery, whether there will also be some additional capital investment that you'll be able to make in things like robotic surgery, which we don't have at the moment for urology patients in north Wales, and indeed in terms of helping to clear that backlog, perhaps with diagnostic and treatment centres that are separate from the services currently provided on our existing hospital sites?

And just finally, if I can turn to the mental health part of the statement today, obviously we know that there have been serious concerns about mental health services in north Wales for some time. We've seen some poor judgment used by the health board with 1,600 patients that were discharged from primary care services. I know that there's going to be some change—and there has been some change—in the leadership of the mental health directorate within the board, but it is obviously essential that we can have some confidence going forward that these services are an absolute priority. The Welsh Government has obviously taken a decision to invest in a new mental health unit at Glan Clwyd Hospital, which I'm very pleased to see and which is now in train, but I am concerned that obviously it's not just money on buildings that's required here; we do need to change the culture within the health board to make sure that people can get the services that they need. How confident are you that you'll be able to secure the sort of turnaround leadership for our mental health services in north Wales that we so desperately need to see? Thank you, Presiding Officer.