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Come again?

Betsan Powys | 15:59 UK time, Thursday, 22 October 2009

"There's a billion pounds that we're not utilising appropriately."


"There's a billion pounds that we're not utilising appropriately."

Who's just said that? Paul Davies, chairman of the All Wales Directors of NHS Finance.

To whom? The Assembly's Finance Committee.

How come?

"We don't get it right now. Far too many patients end up in the wrong place, either being hospitalised when they shouldn't be, or they stay in hospital too long, or they stay in primary care, and they should be in hospital, all those mistakes...(are) extremely costly, very expensive.

"It's staff, it's capacity, it's beds, and it's basically trying to say - are we making the best use of the five billion pound (budget) and we're saying - we're not. There's a billion pounds that we're not utilising appropriately."


If they did manage to use it properly? "If we did, then we would see that improvement come through."

Made me sit up. Let's see what the Finance Committee makes of it.


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  • 1. At 7:03pm on 22 Oct 2009, John Henry wrote:

    Via a dongle on the M5.

    Who is the Minister for Health and Social Services, did I hear "Edwina", and you are considering giving her the keys to the treasury ........

    .... on your heads be it.

    .... Nuts springs to mind.

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  • 2. At 11:29pm on 22 Oct 2009, mapex55 wrote:


    Is it not a fact that many on your blog pages have been saying, more or less, the same thing, and without the 'Inside' knowledge possessed by
    Paul Davies.

    Sometimes, going against my own principles, mind you, I feel that the Welsh NHS could be better served by being privatised, or returned to Westminster control, as it is pretty obvious the Bay gang have not the most basic idea as to how the organistion should be run to the benefit of the people of Wales.

    Five reorganisations in ten years?, it must be a record of incompetance. As I said before, the Tories only managed to reorganise the NHS (across the whole UK) twice in twenty years.

    And look at the mess that turned the NHS into for quite some time.

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  • 3. At 10:44am on 23 Oct 2009, verymuchso wrote:

    It's election time. All public statements by senior politicians should be considered for their impact on the election chances of candidates.

    You do the maths.

    What's striking about this is that he isn't a politician, he's a civil servant. Presumably he thinks his job is safe even if the current Minister of Health gets the leadership. And doesn't care about the obligation of the political neutrality of public managers. Whatever next - the permanent secretary endorses ...?

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  • 4. At 4:01pm on 25 Oct 2009, Lyn David Thomas wrote:

    OK this 1 billion is a huge figure, but how much of that can be eliminated? How much is inherent in the system? Clearly bed blocking is an issue, but that is a problem with not enough bed space in local authority run convalescent homes or supported home help. To cure this resources need to be switched from the NHS to local councils. That is one issue. The local health board mirroring the local authorities was supposed to help give us joined up health/social care. It didn't. Its not just a matter of finance but administration. May I suggest that one way forwards is for a bed blocking summit, you know how we love all Wales conferences... see what can be done. If its any consolation the same problems exist in England and Scotland (though in Scotland on a smaller scale I think).

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  • 5. At 5:23pm on 25 Oct 2009, mapex55 wrote:

    message 4...

    Whilst I take the odd chance to relay things my wife has expressed to me re the matter of NHS funding, which she is deeply involved in being a manager in a finance department of the NHS, I cannot give out what I would dearly love to give out, as it would certainly lead to her termination of employment. Suffice it to say, her comments to me give me great cause for concern about the wastage and ineffective use of the funds handed to the NHS, or manipulated therein, by the WAG/Assembly.

    As I have said before, the level of incompetence is startling, which can be easily demonstrated by the fact the Welsh NHS is currently engaging in its FIFTH reorganisation since the Assembly took it over.

    If you can suggest one way forward I can suggest another... take the hospitals away from the Assembly, set them on a self steering course, put the Correct and Proper personnel in charge, and then let us see how these places should and could be run.

    Never mind piddling about with cosmetic alterations, dreamed up by idiots who think because they are in that greenhouse in Cardiff Bay they have the skills, knowledge and most importantly, the experience, to do it.
    They have shown time and again they are incompetent. and it is us the taxpayers, and ultimately the patients, again us, who are paying the price of their mismanagement and perpetual interference in a most serious matter.

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  • 6. At 5:29pm on 25 Oct 2009, mapex55 wrote:

    PS.... as I understand it, the matter you mention of the 'mirroring' with local councils. is that not what the present reorg is all about? Powys Health Board is to be absorbed by Powys CC, my wife will no longer be working for Powys Health Board, but for Powys CC, so she informs me.

    So unless I misunderstood what you were saying, then it would appear it is not, more or less, scrapped, as you seem to imply.

    extract from #4....

    '.....To cure this resources need to be switched from the NHS to local councils. That is one issue. The local health board mirroring the local authorities was supposed to help give us joined up health/social care. It didn't. ....'

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  • 7. At 6:04pm on 25 Oct 2009, John Henry wrote:

    #4 Lyn_Thomas writes .........

    OK this 1 billion is a huge figure

    The understatement of 2009, by my reckoning 1 billion is the level of recorded government incompetence, if the minister doesn't resign it will represent the level of contempt held by the Assembly for the electorate, such a sum would pay for all the gas and electricity used in domestic Wales for a year .....

    ..... resignation ......

    Via a dongle returned from the golden mile.

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  • 8. At 9:43pm on 25 Oct 2009, mapex55 wrote:


    Its so easy to simply throw out 1 billion, but how does it look when written in full?

    One thousand, thousand, million pounds.


    £1,000,000 X 1000 X 1000.

    Not as much as the odd Assembly member earns, per session, but slightly more than I get in pension per month.

    £309 .... if only I could tack on a further ten zeros!

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  • 9. At 10:14pm on 25 Oct 2009, Lyn David Thomas wrote:

    Powys is an exception, its not the pattern for the rest of Wales. While its easy to blame the National Assembly Government (please note not the National Assembly - you don't blame the House of Commons when the UK government mucks up) for this I wonder if the sum is not an inherent function of the split between community and hospital care. Rather than just engage in another round of Assembly bashing perhaps we can actually see what the root cause of the problem is. If as suggested a large part of this is about bed blocking then that is something that needs to be tackled, and I think you will find that it is exactly the same in England.

    Oh Stonemason, as you don't support the NHS at all why don't you just come clean and admit you want it abolished or fully privatised?

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  • 10. At 10:37am on 26 Oct 2009, John Henry wrote:

    #9 where you write Lyn_Thomas on behalf of me, it would be best if you used the truth.

    You wrote .....

    Oh Stonemason, as you don't support the NHS at all why don't you just come clean and admit you want it abolished or fully privatised?

    Nowhere have I written in support of either of the two options you write, but I would remind you the NHS uses private enterprise through its GP practice network.

    I am not sure how you can defend the waste of 1 billion pounds using the expression "... a large part of this is about bed blocking ...", the reality is that sums of this magnitude are lost to the electorate through miss-management, should it be Ms-management, how many reorganisations have there been during the last decade or so, it might have been prudent if thought had been given to best practice before the first re-organisation.

    via a dongle, ...... after considering the vast sums, with a headache.

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  • 11. At 12:55pm on 26 Oct 2009, Lyn David Thomas wrote:

    Stonemason, your opposition to the NHS is implicit from your mission statement on your blog -

    "I tend to support ......
    ...... maximum liberty in both personal and economic matters.

    I would advocate a much smaller government; one that is limited to protecting individuals from coercion and violence.

    I also tend to embrace individual responsibility, oppose government bureaucracy and taxes, promote private charity, tolerate diverse lifestyles, support the free market, and defend civil liberties."

    From that statement the role of government is to protect individuals from coercion and violence, this is the police, military and justice system. No place there for the government running the health service or education. So come clean and admit that you are against the NHS, either that or you need to alter your mission statement so as misunderstandings do not occur.

    From what I have read a considerable amount of that 1 billion is about bed blocking, which is about resources in the right areas. People are in hospital who shouldn't be there. However the total sum of money may be the same, just used in different areas.

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  • 12. At 1:57pm on 26 Oct 2009, John Henry wrote:

    #11 Lyn_Thomas you have written exactly the same elsewhere, and it was answered.....

    .... yet you persist.

    I am thinking......

    via a borrowed pc, ...... in Lancashire, Red Rose country.

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  • 13. At 2:22pm on 26 Oct 2009, West-Wales wrote:

    Lyn #11
    Accusing Stony of opposing the NHS is rather silly, and diverts from the fact that you are trying to defend the indefensible.

    The executive management of the devolved NHS is a disaster.
    The complexity and scope of the service, sensitivity and professionalism needed, is far beyond the capability or competance of the Assembly to deliver.
    Lets face it they can't even get the Ambulance service right.
    It would certainly be best for the people of Wales if control of the NHS was returned to Westminster.

    Bed Blocking is a weak political excuse.
    Those who block the beds are too infirm or ill to look after themselves.
    Saying that they should be under someone elses care is Accountants waffle, an argument about into which ledger the cost should be entered.
    They are still Welsh sick people who need to be looked after - the first duty of the NHS, and surely a responsiblity of the Assembly.

    There will always be patients in need of care, waiting for access to the appropriate place.
    That the places are not available or the bureaucracy screws things up is also a failure of the Assembly Government. - Not the NHS management.

    Lyn you need to start recognising the reality of the mess devolution has made of Wales.
    How unrealistic and impossible Plaids agenda and vision is!

    The wellbeing, freedoms, and welfare of the Welsh People, is more important than your naive ideology and nationalist aspirations.

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  • 14. At 4:27pm on 26 Oct 2009, Lyn David Thomas wrote:

    Well Stonemason you don't answer the question or defend your position. West Wales I don't think it does divert any attention, he is opposed to government being involved in anything outside a very narrowly defined sphere of activity, so he needs to justify anything he may say in the context of a service he doesn't believe should be provided by the government.

    I am not defending the indefensible, I am trying to find out what the problem is, and if the cure is within the NHS or would be solved by better coordination between local authorities and the NHS with the possible transfer of funding to local authorities from the NHS to deal with the problem. I am suggesting we need to bring all the players together to discuss the problem and devise solutions, how is this defending the indefensible? I am suggesting the problem is not peculiar to Wales or even the scale. I am asking for clarification of the figures. And the civil servant who started this row suggested a large part of the problem was bed blocking. Now the cost element of this is that hospital beds are expensive compared to beds elsewhere. This is a problem of administration, yes there may be some blame at the level of the Welsh Government (not the National Assembly - they are different institutions you know - you don't blame the House of Commons when a minister mucks up) but this is principally an issue of lack of coordination between local government and the NHS.

    Devolution has not made a mess of Wales it has brought many advances, yes and some failures, at least we have escaped the problems of PFI, massive health service privatisation and the culture of league tables that plague the English Educational system.

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  • 15. At 4:51pm on 26 Oct 2009, mapex55 wrote:


    In taking the comments below from you message, I would like a factual answer to the question below the extract...

    '....Devolution has not made a mess of Wales it has brought many advances,....'

    I deliberately left off the rest of the paragraph bits, as they do not impact overmuch on the first sentence, as extracted.


    What 'advances' are you referring to?

    More to the point, would Wales have really 'needed' such, whatever you seem to think they are, had the Assembly not been put in place?

    You see Lyn, you may see certain actiivities as 'benefitting' Wales but as I see the matter, Wales could have done just as well, and in the light of the last ten wasted years, a damned sight better without having the Crdiff Bay menage in place.

    The massive 300 billions poured into the Assembly over that period, and no doubt much more that has yet to be shown in the records, could have gone to the LA's, who had decades of experience on funding the requirements, instead of which it was handed to Cardiff Bay, on a plate, where little, if any, experience of regional funding had been gained.

    I ask you again....what advances?

    So do enlighten us all, and give us a list, as long as you can manage, outlining just what we have in the way of 'advances'.

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  • 16. At 6:47pm on 26 Oct 2009, Lyn David Thomas wrote:

    Again you make up figures - 300 billion was not spent on the Assembly, 300 billion was used by the National Assembly - advances like the Foundation phase in education, the abolition of league tables and excessive testing in education, the development of the Welsh Bac, the abolition of ELWA and other education and training quangos, free prescriptions, free buses for pensioners, legislation on the safety of school children on buses, a host of projects that improve the economic infrastructure of Wales, such as the Wales Millenium Centre, the National Botanical Gardens, Transport links - such as the Ebbw Vale railway, subsidising local councils to a greater extent than in England to ensure that the council tax is lower than in England, ProAct and ReAct, introduction of the children's and older person's commissioners, reform of the compensation procedures in the NHS etc... those are just off the top of my head.

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  • 17. At 10:56pm on 26 Oct 2009, mapex55 wrote:


    All of which could, and should have, been in the remit of local authority.

    Absolutely no need to have an overseeing Assembly to facilitate any of it.

    In other words you are trying to bullsh*t us with your nationalist crap.

    I asked you to provide evidence of 'advances' made by the Assembly, all you have provided is nothing more than what would have happened anyway, thorgh the work of the coun cils both large and small.

    There was already a joined up network between all county councils in Wales, then along comes this tripe in the Bay to stick it's oar in, and effectively negate those county councils etc. And at such a cost to us all.

    Sorry old fruit, you will have to do better than trot out your Plaid propaganda...

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  • 18. At 11:06pm on 26 Oct 2009, mapex55 wrote:


    I did say 'poured into the Assembly',.. not as you commenced your response with....'spent on the Assembly'

    If you are going to take quotes from my messages at least have the decency to quote correctly.

    I am informed what was spent 'on' the Assembly was 300 millions, a figure that would have been very welcome to council finances.
    Instead of which, we now have a architectural carbuncle in Cardiff Bay, and quangos all over Wales, that are depleting councils of both the money and power to act on behalf of their local constituents.

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