ON MONDAY, February 27, Health Minister Eluned Morgan announced that Betsi Cadwaladr University Health Board would immediately enter special measures.
The Health Minister said she reached her decision “because of serious concerns about performance, leadership and culture”.
SERIOUS QUESTIONS FOR WG
The move raises serious questions about the Welsh Government’s long-term involvement in the Board’s management. Over the years, it has presided over scandals, performance failures, and poor administration. The Welsh Government cannot insulate itself from the Board’s return to special measures as its civil servants have monitored the Board’s performance since the summer of 2015. Ministerial announcements since that date suggest close ministerial involvement in the Board’s affairs
The decision also raises an obvious question about the Welsh Government removing the Board from special members just before the last Welsh Parliamentary elections.
While the Welsh Government claims that the move was not politically motivated, events involving the Board since the election only added to the suspicion that the justification for taking the Board out of special measures was more electoral than clinical. The Board has had four CEOs since 2019. It is currently without a Chief Executive.
AUDIT REPORT FORCES MINISTER’S HAND
This time, matters came to a head following a scathing report from Audit Wales. The extent of the failings uncovered by Audit Wales’s team left the Welsh Government with nowhere to go with excuses and delays.
Audit Wales found a “breakdown in working relationships within the Board is fundamentally compromising its ability to tackle the numerous challenges the organisation faces”.
The report also found “fractured working relationships with the executive team”. It highlighted concerns about the erosion of independent Board members’ confidence in the executive team’s ability to deliver change and improvements.
In response to the independent members, Eluned Morgan dismissed all of them when taking the Board into special measures but kept the rest of the executive team in place.
In the independent members’ place, the Welsh Government appointed its own “independent” members to the Board from its quangocracy.
Dyfed Edwards will lead the non-executive team as the new Betsi Cadwaladr Health Board Chair. Mr Evans is a former Gwynedd Council leader and the Welsh Revenue Authority deputy chair.
The new Chair will focus on renewing the leadership and culture of the Health Board. He will be supported by Gareth Williams, Karen Balmer and Rhian Watcyn Jones as interim “independent” appointees.
Further direct appointments will follow in the next few weeks. A campaign to recruit new independent members to the Board starts later this year. After its treatment of the sacked independent board members, questions arise about who would be willing to take on the task. During that process, the Welsh Government’s understanding of the difference between “independent” and “biddable” will come under close examination.
“WHAT WILL IT TAKE FOR MINISTER TO CONSIDER HER POSITION?”
Responding to their dismissal by the Minister, the former independent members said: “We have no confidence in the Welsh Government’s grasp of the situation.”
Plaid Cymru’s spokesperson for health and care, Rhun ap Iorwerth MS, said: “A little over two years since the ill-fated decision to take Betsi Cadwaladr prematurely out of special measures – conveniently before the 2021 Senedd elections – and we now hear that the health board is being put back into special measures, and members of the Independent Board have been made scapegoats.
“This situation is as much a failure of ministerial leadership as it is leadership within Betsi Cadwaladr. All of this happened on Labour’s watch.
“The people in the north of Wales have witnessed damning report after damning report about their health service. They’re the ones that have been suffering under this dysfunction, incompetence and chaotic mess at the hands of the Labour Welsh Government.
“The patients and staff of Betsi Cadwaladr deserve better from their government. The least they deserve is an apology, but what we all need is the government to step up and take responsibility for the mess.”
Mr ap Iorwerth asked, “what will it take for the Health Minister to consider her position in the matter?”
“BOARD SHOULD NEVER HAVE BEEN REMOVED FROM SPECIAL MEASURES”
The Welsh Conservative Shadow Health Minister, Russell George MS, said: “The health board should never have been taken out of special measures. It had not demonstrated sufficient progress to justify the move and seems to have been made out of political expediency, occurring just before the election.”
Mr George continued: “Although it is frustrating to see the board return to special measures, it is necessary. However, the Labour Government needs to ensure that patients are put first.
“The Welsh Government has a lot to answer for after letting the situation degrade to this point. The people of North Wales deserve far more from their health board.”
Conservative MSs and MPs. They added: “We have no confidence that the current executive team will be able to deliver the improvements required. It is extraordinary that such a dysfunctional team is still permitted to lead this organisation.
“Welsh NHS leaders need to be more accountable to those they serve.
“The Welsh Government is collectively responsible for the Board’s failings.”
SACKED BOARD MEMBERS JUST “DOING THEIR JOB”
Former board members said they “tirelessly and repeatedly raised issues of concern, both to health board executives, Welsh government officials, and the minister”.
The sacked independent members pointed out the unusual situation in which those holding a failing operational executive to account – including launching a review of a £122m hole in last year’s accounts – lost their positions. Meanwhile, those they were supposed to hold accountable kept their jobs.
Geoff Ryall-Harvey, chief officer of North Wales Community Health Council, said he struggled “to understand the logic” behind the Minister asking the board members to go.
He said that, since 2013, Welsh auditors had asked independent members to be more critical of executives.
“This board has done that and this is the result,” Mr Ryall-Harvey said.