A big day for health in Wales


Guest post from @TobyMasonBBC

There are few days in the Assembly at the moment where the state of the health service isn't in the spotlight - today was exceptional in that there were three major stories happening at once. They're at once separate but linked.

First up, the current top brass of Betsi Cadwaladr health board were in front of the Public Accounts Committee to answer some tough questions about the joint WAO/HIW report into governance. They got a pretty rough going over, not helped by the disclosure by consultants, hours before the hearing, of a claimed spike in mortality statistics at Ysbyty Gwynedd. The officials refused to confirm figures, but admitted they were urgently looking at the reasons behind "a drift up in numbers".

They also lit the fuse on a slow burn row - which was the admission that some acute and specialist services are unlikely to be viable across three sites in North Wales. It means that they're facing a similar controversy to that in South Wales around services at the Royal Glamorgan in the fairly near future.

There were also questions about cancelled operations at the end of the financial year, lengthening waiting list figures and tensions at the top of the organisation. It wasn't a surprise that the session ran well over its allotted time.

We also got a much better idea today about the future of another troubled institution in the health service - the Welsh Ambulance Trust.

Health Minister Mark Drakeford said he had considered dissolving it entirely - but rejected that because of the upheaval involved.

Instead, from now on, ambulances will be funded by a new National Delivery Body made up of the seven health boards in Wales, rather than by the obscure Welsh Health Specialised Services Committee, as before.

The idea behind this is simple - the new delivery body should be much sharper - laying down what it expects from the ambulance service in terms of performance in return for the funding that it gives out. Don't forget the Ambulance Trust has missed its key response time targets for each of the past 12 months. One nagging question remains - each of the health boards will naturally want the maximum resources for their area; it's not clear from the Minister's statement who will arbitrate between them in the event they can't agree.

The response from the opposition parties was a cautious welcome. The ambulance service, renamed or not, will face just as much scrutiny after this announcement as it did before.

And then, a few moments ago, came the announcement that could have the greatest impact in the coming months.

Giving the Welsh Government's response to the lessons that the NHS here needs to learn from the events of Mid Staffordshire, Dr Drakeford made the following announcement:

Jointly with the Finance Minister I will be undertaking a review of the NHS budget over the summer to ensure that it reflects the lessons to be learnt from Francis, the additional burdens which face the health service and to ensure that there is a proper match between the quality of care, patient safety issues and the budgets to support them.

Now that is stone that he will have thought very long and hard before turning over. The implications are potentially massive. The NHS in Wales consumes more than 40% of the total devolved budget. The health boards have been grappling with "cash flat" budgets for several years, being forced to meet inflationary pressures with efficiency savings or straight up and down cuts.

It's hard to see, on this basis, how any credible review won't suggest some increase in resources for health boards.

The timescale for this review means - critically - it will be complete in time for the start of this autumn's inter-departmental wrangling over the Welsh Government budget for the 2014-15 financial year. If it recommends any significant uplift in the £6bn NHS budget, even a small percentage, then the other portfolios had better look out.

The political implications could be huge. Remember the Finance Minister's options for getting the votes she needs to pass her budget have reduced sharply in the past month, with the announcement that Plaid Cymru and the Liberal Democrats will jointly negotiate to get their priorities implemented in return for their votes. Neither, historically, have put health spending top of their wish lists, opting for economic development and education respectively.

There is one party that has consistently called for significantly more of the Welsh Government's budget to be allocated to health - and they will be Labour's only other option if a Plaid/Lib Dem deal can't be made to work. They're the Welsh Conservatives.

Quite a day.

Betsan Powys Article written by Betsan Powys Betsan Powys Former political editor, Wales

A big day for health in Wales

A day of big health stories in Wales is capped with a potentially very significant announcement.

Read full article


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  • rate this

    Comment number 15.

    A Swansea GP writes that not al local parents have yet understood the message about measles and MMR.
    Must we wait for Darwinian survival of the fittest to reduce the numbers of such parents ??

  • rate this

    Comment number 14.

    Clinical staff know that it's there. By the time a medic reaches consultant level in most specialities he will be 40 with oldest kid ~ 12. Does he send the lad to a school where every other kid has had Welsh lessons for 8yrs ?? Does he heck.
    If he & her can afford public school, West Sussex is a lot closer to Eton and Glyndeborne and Regent Street.

  • rate this

    Comment number 13.

    Yeah - news stories are like buses... You wait for ages then 3 come along at once... Like buses, you have to get on the right one...

    Failed NHS in Wales is hardly news - that's more like a circular bus that just goes round and round all day and every day...

    Ys-butty Gwynedd might do better if it was called Gwynedd Hospital - then the specialised staff they can't recruit might know it's there!

  • Comment number 12.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • rate this

    Comment number 11.

    How to fix the Welsh Ambulance Trust? Re-name it - problem solved!
    How to fix the high mortality rates at Y G? Refuse to discuss matter - problem solved!
    How to fix the failures of the WA? Get Woodsey to tell us all ok - problem solved!
    What budget deals will be done with the PC solely to protect the Bay gravy train

  • rate this

    Comment number 10.

    the people of wales need their hands held every where they go and in everything they do....the health of this nation is a shocking joke and is the responsibility of each person to themselves....as long as they don't have to pay then they will not change or learn and our services will become even more useless than they are now.

  • rate this

    Comment number 9.

    6.Lineguist. Its not just Bangor as virtually all welsh towns/cities have great social problems with welsh UNDERCLASSES.The cost to public purse is enormous and that money is taken from workers and retired who still pay TAX. There is nothing FREE,and all NHS should be subject of some form of charging as in IRELAND!!.When the English end the Barnett racket we'll soon find out what WE can afford!!!

  • rate this

    Comment number 8.

    The HCA Review. The great cycle spins slowly. Higher standards needed. All nurses graduate - SRN. Too expensive. Introduce SENs. Higher standards needed. Increase training. SENs secure pay-rise. Too expensive. Introduce unqualified Care Assistants. Problems. Higher standards needed. Propose increased standards, qualifications, registration.
    Give it 5 years for new unqual grade to be slid in.

  • rate this

    Comment number 7.

    'These same people will be queuing up at the A&E units of the future and presumably expecting the NHS to repair the damage'.
    So is this purely a Welsh problem?? and what would you suggest an American system where you not treated until you show your Medical Insurance. So you don't think an ageing population is a major problem?

  • rate this

    Comment number 6.

    "North Wales has a lot of inward migration with a high % retired I wouldn't
    call them reckless and over-indulgent"

    Perhaps you should stroll through Bangor on a Friday or Saturday night and watch the recklessness in action. These same people will be queuing up at the A&E units of the future and presumably expecting the NHS to repair the damage.

    I'm nearly retired - so I don't bother competing.

  • rate this

    Comment number 5.

    reckless and over-indulgent lifestyles of so many people.
    Didn't realise this only happened in Wales and the English NHS had none of the above.
    North Wales has a lot of inward migration with a high % retired I wouldn't
    call them reckless and over-indulgent

  • rate this

    Comment number 4.

    I live in rural North Wales and, purely from a financial perspective, the current profligate "Free care at any cost" is simple unsustainable - especially when you factor in the reckless and over-indulgent lifestyles of so many people.
    The Welsh chickens are indeed coming home to roost - and I suspect a large number of their eggs will have to broken to make anything like a workable omelette.

  • rate this

    Comment number 3.

    We really be going back to 1945 and pre NHS if we integrated with England and allowed the right wing Westminster Government to privatise the NHS
    If you run out of a constructive argument then blame the language.
    Trouble is the Tories are stuck in pre 1948

  • rate this

    Comment number 2.

    The welsh chickens are coming home to roost,and with public funding to be controlled for decades the whole 'welfare state' is going to collapse. The real question is why are we managing the NHS of a WALES basis,rather than integrate with ENGLAND on a population basis. When you add the welsh language 'issue' its a lethal combination. The trouble is our politicians are stuck in 1945!!

  • rate this

    Comment number 1.

    The North Wales situation once agaain will highlight the problem with democracy: everyone votes in favour of free Xmas turkeys: no-one votes for taxes to pay for them.
    If specialised services at three centres along the A55 are not affordable, and the Welsh taxpayer won't pay for them, then the Welsh patients can't have them - whoever they vote for.



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