Taking "flexibility" too far?
"Remarkable achievement": NHS Wales breaks-even.
That's what the glowing headline of the press release from the Welsh government says. It's just landed in my in-box and I'd agree that it is pretty remarkable. Because it isn't - as far as I can see - what the hard facts say.
Those of you who read this blog will know that this is an area to which I've come back time and time again. I've written pretty regularly about the financial health of the NHS in Wales and the utter certainty of the Health Minister that this was the year she would sort things out, this was the year that the seven Local Health Boards in Wales would break even without needing a bail-out from the government.
I should say a second bail-out. LHBs were given an extra £103m by the Welsh government last October. But after that they were warned - no more money, no more excuses. She seemed to me to be staking her reputation on the LHBs not running out of money. This was a line in the sand, the kind we don't hear very often from ministers.
I've quote Lesley Griffiths more than once. Let me do it again.
Here she is in today's press release: "Last October, I said NHS managers will be held to account for the financial management of their organisations, with strong action taken if financial targets were not achieved".
Here are a few more quotes for you. This is the Health Minister giving evidence to the Health Committee in February:
Vaughan Gething: Turning to a slightly different subject, looking at the money and each local health board's situation, we know that they have all had to make significant savings. Are you satisfied that they are on target to do that? ... I am interested to know whether you are still confident that each LHB will come in on budget, because you have been clear before that there is no money.
Lesley Griffiths: There is no more money. You are right; I have been clear and I have said that time and again. I recognise that what I am asking the LHBs to do is difficult. However, I am confident that they will come in on target.
Here she is in an interview on Radio Wales back in December of last year, not long after Local Health Boards had been given that extra £103m, by the way.
"We haven't got any more money and they know that and they really know that they have to hit their financial targets."
At the time the Welsh NHS Confederation said that LHBs were "working towards" breaking even but wanted us all to be clear that the scale of the challenge was huge. I'm absolutely certain they were right about that.
So today we celebrate? Today, do we join with the Health Minister in congratulating every single one of Wales' Local Health Boards on their "remarkable achievement" in not only breaking even in such tough times, deliver what the Health Minister insisted they would but more than that, come in with a surplus of half a million between them? My goodness, the NHS in Wales has made a profit! Doubles all round!
Or instead, do we look at the hard facts? And do we keep reading the press release until we get quite close to the end. And do we find that in fact, despite - I'm sure - every effort to spend every penny they had as wisely as they could, three of the seven Local Health Boards missed their targets and came in a combined £12m short? Broken, rather than break even budgets, in effect.
And do we find the one line that explains how the Welsh Government will undoubtedly justify that headline?
It says this: "This was never going to be an easy task and three of the seven Local Health Boards have been permitted to bring forward a small percentage of next year's funding to help meet their targets".
Twelve million isn't a lot in this context, she says - but let's be clear - it is only by dipping into next year's budget (in other words 2012 - 13) and giving these three LHBs even more stretching targets next year, that the Health Minister has avoided the embarrassment of having to admit that in fact, the targets were not met in three of seven cases - and they were sufficient to have taken the overall financial balance of the Welsh NHS down with them.
Read on again and you'll see that rather than doubles all round, what is actually in the pipeline for those three Local Health Boards, Aneurin Bevan, Cwm Taf and Powys, is an external financial review of their financial plans, commissioned "as a condition of this flexibility."
Now read that headline again and you tell me the point at which "flexibility" in a government press release becomes, well, something else - something "misleading", "unforgiveable" and "astounding" - as the opposition parties will argue in an urgent question in the Assembly later today.
With both sides passionately believing that they're in the right over this issue, it'll be interesting to see how this debate plays out in the court of public opinion.