MS: If health board leadership are “not up to it they can ship out and go somewhere else, because we don’t want them in North Wales”
A North Wales MS has slammed Welsh Government and Betsi Cadwaladr University Health Board leadership, saying they have “absolutely zero confidence” that Welsh Government targeted intervention would make ‘any difference at all’, adding “We need to kick the current leadership out that has been failing people for so long”.
The scathing response from Darren Millar MS came as the Minister for Health and Social Services gave an update on Betsi Cadwaladr University Health Board to the Senedd yesterday.
In the lengthy speech Minister Eluned Morgan MS said, “Further to ongoing concerns at Betsi Cadwaladr University Health Board, many of which have been raised in this Siambr, I asked the chief executive of NHS Wales to hold an extraordinary tripartite meeting on 26 May as part of the NHS Wales escalation framework. The situation in Betsi is unacceptable and it needs serious work and effort to correct. Services are not as good as they should be, and we are determined to improve the situation for the thousands of people in north Wales who rely on these services.”
“Following the tripartite meeting between the Welsh Government, Healthcare Inspectorate Wales and Audit Wales, the NHS chief executive has recommended that the targeted intervention status at Betsi Cadwaladr University Health Board should be extended beyond mental health and governance issues to incorporate Ysbyty Glan Clwyd, focusing in particular on the vascular service and emergency department in Ysbyty Glan Clwyd, and I have accepted that advice.”
“They did not suggest that we put Betsi back into special measures.”
The Minister added, “We will therefore ensure that significant new additional external clinical and practical expertise will be put in place to ensure that we embed sustainable change and improvements in the quality of the service.”
Detailing a range of effective demands she added, “I am asking the health board to do the following things: review current governance, audit and effectiveness capacity and work arrangements with Improvement Cymru to invest in a rapid education and support programme that will be put in place quickly in order to improvement skills.
“I have also asked the health board to ensure that a senior appointment is made to a director of safety and improvement post. This individual will support the new executive director of nursing to ensure that joint improvements are put in place across the health board. On top of this, the board must do better to connect with and engage with its staff and the public.
“There have been a series of concerns raised about workforce well-being, cases of harassment, bullying and staff feeling unable to speak out. The board must build on the work it has started in terms of its organisational development, and it must do this quickly. Given the seriousness and exceptional nature of this escalation, these arrangements will be monitored closely and reviewed early to ensure that progress is made.
“A further tripartite meeting will take place no later than the end of October this year.”
Darren Millar MS led the Welsh Conservative response, firstly slamming the ‘lack of courtesy’ of the Health Minster for not circulating a copy of the statement prior to the session.
Mr Millar went on, “You say that this is targeted intervention, but nothing could be further from the truth. It’s a scattergun approach that you are now taking in north Wales. We have targeted intervention already for mental health services, for strategy, planning and performance, for leadership, including governance, transformation and culture, and for engagement because of the poor engagement with patients, public, staff and stakeholders. Yet, today, you’ve announced even more targeted intervention, this time at Ysbyty Glan Clwyd in respect of its leadership, which is already in targeted intervention, we are told, its mental health services, which are already in targeted intervention, or so we’re told, and, of course, its vascular services now and emergency department. I have to say it’s long overdue in terms of intervention required for those.
“Some aspects of these services, which you say you are now putting into targeted intervention, have been in special measures or targeted intervention for seven years—seven long years. In fact, the seven-year anniversary is this week that mental health services have been in special measures. This week. It’s the same with the leadership issues. And yet, time and time again, we have Ministers here, including your predecessors, who come and say, ‘We’re determined to get things changed. We’re determined to kick things into shape. We need to move things on, with pace.’ That word, ‘pace’, seems to make all the difference in your ministerial statements, doesn’t it? Well, the reality is it doesn’t.
“When does targeted intervention on such a wide number of things actually become special measures? Because I don’t know, and I don’t think it’s very clear to the public either. You said that if there was not improvement in vascular services within three months, the health board would face consequences. Well, if this is the only consequence they are facing, another targeted intervention label, I don’t think they’ve got much to be concerned about, frankly, because we know that targeted intervention doesn’t work. It hasn’t worked for seven years, as I’ve already said.”
“If you’ve got a leadership of a health board that is absolutely incapable of making improvements, why aren’t you moving that leadership on? Why are you saying that we now need to appoint another executive director, at huge cost to the taxpayer, this time for safety and improvement? Why can’t the extremely highly paid executive team already in place at the health board deliver the improvements that they are employed to do? That is their job. And if they’re not up to it, they can ship out and go somewhere else, because we don’t want them in north Wales. We want a team that works, that delivers the improvements that we’ve been promised. Because people are being let down, patients are being let down, the staff are being let down with the appalling working environment that many of them are having to endure, as a result of this dysfunctional health board that you as a Welsh Government have also been incapable of turning around over all this time.”
Plaid Cymru’s Rhun ap Iorwerth MS was equally unimpressed, saying the Ministerial statement “…demonstrates once again how little understanding and how little appreciation there is within the Welsh Government of the gravity of the situation at Betsi Cadwaladr health board.”
“This is a very weak response to an extremely serious situation, I fear—an extension of targeted intervention, rather than a real rolling up of sleeves to deal with a problem that is causing so much anguish to staff and patients across the north. An extension of targeted intervention—why end here when there are so many problems right across Betsi Cadwaladr? The problems I’ve brought to your attention among nurses at Ysbyty Gwynedd and the fears of bullying and intimidation and working conditions that are not up to it in terms of retaining the staff, their knowledge and experience—why not include Ysbyty Gwynedd?”
The Minister replied, “I am extremely aware of the seriousness of the situation, and it is clear that the situation in Betsi, in particular in those areas we’ve highlighted, is unacceptable. This is something that I made very clear to the chief executive and the chair when I met them last week.”
Welsh Conservative Janet Finch-Saunders MS praised Darren Millar and Rhun ap Iorwerth MSs for “actually calling you out on this statement”, adding, “It is far too inadequate. I’ve been here 11 years, and, prior to that, I had dealings, going back over the years, with the Betsi health board, under the late Mary Burrows, when she was the chief executive. And we’ve had countless numbers of chief executives since, we’ve had countless numbers of chairs, and we’ve had several health Ministers, and yet, the fundamental problem we have here is that this health board is going backwards. There are no improvements that I believe that will be forthcoming.”
Plaid Cymru MS Llyr Gruffydd branded the contents of the Minister’s speech as ‘guff’, “How many times have we been here before on Besti Cadwaladr, Minister? How many times do we have to come here, and, quite frankly, listen to your cut-and-paste statements about more targeted interventions, more new directors, more tripartite meetings? You’re like a broken record. It’s a statement that you and your predecessors have made in various forms time after time, month after month, for the best part of the last decade. Front-line workers in north Wales are doing heroic work, but their Government is fiddling whilst Rome burns. Will you accept that the time has now come for a more fundamental consideration of how services are configured across north Wales? And, look, if the conclusion is that this current model is the best that we can be, then so be it—I’ll accept that. But until you as a Government instigate that discussion, then you will have to be dragged back to this Chamber month after month, to give us more of the same excuses and more of the same guff.”
The Minister replied, “I believe that reorganisation at this point would be costly, it would be a distraction from the significant issues in relation to planned care, it would divert resources, and my focus at the moment is on patient care. There is nothing ‘cut and paste’ about this statement; I can assure you I’ve spent a lot of time working on it. I think that I will retain my focus, as I’m sure the board will, on ensuring that we are doing the very best for the people of north Wales, and a costly reorganisation is not the answer.”
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