6. Statement by the Minister for Health and Social Services: Escalation and further intervention to improve the quality of services in Betsi Cadwaladr University Health Board

Part of the debate – in the Senedd at 4:06 pm on 28 February 2023.

Alert me about debates like this

Photo of Rhun ap Iorwerth Rhun ap Iorwerth Plaid Cymru 4:06, 28 February 2023

I'm going to start with where I agree with the Minister—that's on the placing of Betsi Cadwaladr in special measures. But it's pretty clear, isn't it, that it shouldn't have been taken out in the first place, conveniently and prematurely. But the Minister wanted to apportion blame too. She says the recent Audit Wales report was the straw that broke the camel's back; it spoke of the dysfunctionality of the board. She referred in a Radio Wales interview this morning to the huge amount of criticism of the executive board members, but it's the independent members, of course, that she decided to very publicly hang out to dry yesterday. She's defended her actions, saying, 'I don't have the powers to intervene directly in terms of the executive.' She's said that again this afternoon. But that's exactly what special measures allow the Minister to do, effectively running the health board, even supporting the chair and independent members if that's what she wanted.

Now, we have a sugar-coated description, don't we, of what happened yesterday in the Minister's statement—'spoken with the non-executive members. As a result, they've decided to step aside.' Let's be a little bit more direct, shall we, for anybody else who may be considering taking up an appointment by this Government and considering what kind of backing they can expect. The Minister may want to confirm that, having summoned them to the meeting, she told them they had 50 minutes to resign or she'd sack them, and in so doing bar them from other public appointments for two years, and that, even before the 50-minute deadline was up, a draft letter of termination had been handed to them, just to press the matter home. How could they not resign? But their dignified response will have resonated with many. In a damning public letter to the First Minister, they said,

'We have no confidence in the Welsh Government's grasp of the situation.'

Now, that was put to the Minister this morning, and let me tell you what she said:

'It wasn't my job to have a grasp'.

This is the health Minister.

'It wasn't my job to have a grasp, they were in charge', she said. Responsibility and accountability ends with the Minister. She did actually agree with that, but said that she delegates down to others. And by the way, this isn't an unconditional defence of the independent members; this is to show the glaring difference between blame apportioned to them and the complete denial of any responsibility by the Minister.

Let's return to that meeting yesterday. I believe that the Minister told the independent members that their role was to hold the feet of the executives to the fire. But didn't they do that over vascular, urology, Ysbyty Glan Clwyd, with their judgment being found right time and time again?

Let me read more from that statement of theirs after their resignation. They say they

'uncovered serious failings in the financial management of the Health Board. We commissioned a specialist review...which confirmed our concerns, found evidence of serious malpractice, and resulted in a counter fraud investigation.‌‌​​​‍‌​‌​​‌‌‌‍‌​‌‌​​‌​‍‌​‌‌‌​‌‌ This is underway, but has serious implications for other NHS organisations and the Government.'

You, Minister, will be aware, no doubt, of the questions that some are asking about possible links between that and the actions taken yesterday. I will read on. 'We have also previously and repeatedly escalated concerns to Welsh Government as evidenced by way of correspondence to the director general at the start of September, which highlighted many of the matters captured in the Audit Wales board effectiveness report, which has our full support, and yet we did not receive a response, let alone support in reply to those escalations.'

That's very strange, isn't it, not receiving a response on such serious matters. Perhaps the Minister can confirm that. You'd have thought that the Minister would want to work with and listen to anyone raising concerns of that kind. I told you the Minister said her actions yesterday followed the publication of the audit report. Perhaps the Minister can confirm suggestions that there was a search on for new independent board members as much as five weeks ago, before the audit report. Now, I must say that I found it very troubling indeed that the first message I got this morning, via someone close to that audit report, was this: 'The Minister has got rid of the wrong people.' And do you know what? I think they might be on to something and I think many others will conclude that too, just as many have concluded, as I have, that Betsi, in its current form, is beyond repair.

The Minister refers to culture problems within Betsi, but I tell you that this cultural dysfunctionality runs to Betsi's core. It's years since I said, if things can't be turned around, Government should look at breaking up Betsi into smaller, more manageable parts. Well, the sand on that particular timer ran out years ago. It's been clear to me, and many staff and patients, for some time that Betsi has to go. Successive Welsh Governments, health Ministers, have tinkered, but they haven't taken that decisive action, saying, as the Minister says again today, that this would

'take attention away from the need to focus now on providing the best possible service'.

But we're going around and around in circles, spending more money on failed attempts to get things right than we would on reorganisation. She tells us that breaking it up would be wrong when we're trying to encourage regional co-operation. Betsi can't even co-operate with itself.