Health board report 'serious, deeply concerning and sober'

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Merfyn Jones, the outgoing chairman of the Betsi Cadwaladr University Health Board (BCUHB), admitted that a report by the Healthcare Inspectorate Wales and the Wales Audit Office into serious failures of the health board was "serious, deeply concerning and sober", during a Public Accounts Committee on 18 July 2013.

BCUHB was set up in 2009 and runs all aspects of the NHS in the six counties of north Wales, from family doctors and dentists and runs 3 hospitals: Ysbyty Gwynedd, Glan Clwyd and Wrexham Maelor.

Healthcare Inspectorate Wales and the Wales Audit Office found a series of problems at the health board.

They included finding that the relationship between chairman Merfyn Jones and chief executive Mary Burrows had broken down and compromised the organisation.

The issues include:

  • Management failings, which are contributing to significant risks with hospital infections such as c.dificile being under-reported.
  • Big financial problems with the health board managing to avoid overspending sometimes only by delaying operations and letting waiting lists get longer.
  • Bosses have failed to plan ahead for big changes that are needed to hospital services with no clear plan for which services might be cut or reorganised.
  • Leadership at the board was "fundamentally compromised" with the relationship between the chairman and chief executive breaking down

Mr Jones answered a question from the chair of the committee, Darren Millar, who asked about one of the "most awful reports to read since the establishment" of BCUHB.

Mr Jones said that he recognised much of the report and said: "I offered to stand down as the chair, as the chair needs to take responsibility."

Mr Millar asked Mr Jones whether there were problems with communications on the board.

He replied that there were no "personality clash" but rather "structural and systematic problems with the board" and difference of opinions.

He added that there was "no clear split between exec and non-exec numbers".

Mr Jones was also questioned by the chair about the response from the Welsh Government and whether it had been sufficient.

Mr Jones' view was that they responded in a very active way and since January he had met the new Health Minister, Mark Drakeford.

Liberal Democrat member Aled Roberts asked what the Welsh Government had done apart from conducting daily phone calls between David Sissling, Director General, Health and Social Services, and senior officers.

The board were reminded of their financial responsibilities, according to Mr Jones and the government gave him support as a chair to try and change the system.

Mr Roberts also questioned Mr Jones about how often officers from Cardiff went to north Wales to see what was happening.

Mr Jones said that this was not happening daily, he added that David Sissling had been coming regularly but he could not be specific and said it was around "four to five times this year".

Plaid Cymru member Jocelyn Davies questioned Mr Jones' inability to stand down before the publication of the report if he was aware of the failures; this point was also raised by Labour member Julie Morgan and the chair Darren Millar.

Mr Jones said that he will "have time to reflect on this in months to come" and that he had been trying to address the "deep seated, structural and systemic problems".

Dr Lyndon Miles, Vice-Chair,BCUHB said that he too needed to "take responsibility in the board's failures" and that he had been attempting to address the issues over some time but came to a conclusion to stand down.

Mr Millar questioned Mr Jones and Mr Miles about the size of the health board.

Mr Jones stated that there were three major hospitals and 700,000 patients in the area.

He added that the scale of people and area of geography was one of his frustrations and the fact that there is no central administrative hub where all executives could meet and work.

He said: "Personally I don't think this is, or ever was, a sustainable model."

He added that distance was "a crucial factor".

Mr Millar later asked if they thought that the size of the health board was in fact too large.

Mr Jones said that the "scale of operation is challenging" but later said that it was "correct to have north Wales as one health board".

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