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It shouldn’t happen to a Health Minister

IT’S NOT easy being a Welsh Government Minister.

There are so many new words to learn when you get into office and so many old ones to forget.

For example, take the word ‘cut’. It’s a very simple three letter word. But once you become a Welsh Government Minister, you are not allowed to use it.

Instead, at least as far as Welsh Government policies go, the word ‘cut’ has to be replaced with the far more unwieldy ‘transformation’ or the two-word mouthful ‘transformational change’.

ANGRY ANGELA ATTACKS

As you will see elsewhere in this newspaper, Hywel Dda UHB – to nobody’s surprise – has been caught on the hop by people discovering that when it talks about ‘transforming clinical services’ it means ‘cuts and closures’. You could argue that cuts are in themselves transformational, at least in the same way that being guillotined was transformational for the French aristocracy.

On Wednesday​ (Jan 24)​, Vaughan Gething was faced with a barrage of topical questions, which he confronted with the enthusiasm and delight of Louis XVI on his final journey to Place de la Révolution.

You wouldn’t want to get on the wrong side of Angela Burns, the Carmarthen West and South Pembrokeshire AM who speaks for her party on Health in the Senedd.

Crikey Moses! After a brief initial question, she tore into the Health Board, the Welsh Government, the First Minister, Labour backbenchers, Mr Gething and almost managed to get to Uncle Tom Cobley and all in a positively breathless display of genuine outrage.

Picking up a copy of the Parliamentary Review of Welsh Health Services, unanimously backed by Senedd members the previous week, she handled it between two fingers as though it was a particularly badly soiled nappy.

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It was quite bad enough, Mrs Burns said, for the First Minister and his backbenchers to behave in a supercilious and arrogant fashion towards members raising their constituents’ concerns, it was quite another to obtain cross party agreement on the strategic direction of Welsh health services and then ignore the very principles that underpin it.

Mr Gething got to his feet and momentarily looked shell-shocked. Unlike the First Minister, there were almost no Labour members present to prop him up, bray, and snipe at the opposition with sarcastic remarks. However, the Cabinet Secretary is nothing if not smooth and polished. More than capable of bandying around banal generalities, Mr Gething soon adjusted himself into his usual smooth delivery of assurances about ‘meaningful consultations’.

Demonstrating the same sort of faulty memory that could yet come to unglue his leader, Vaughan Gething continued by saying that his boss had not been in any way supercilious.

Mr Jones’ stock in trade is supercilious.

Perhaps Mr Gething had not been paying attention; because having watched the previous day’s First Minister’s Questions and the business statement which preceded Mrs Burns’ questions, you would have to say that Mrs Burns had it pretty much nailed on.

ASK ME NO QUESTIONS

It didn’t get much better for Mr Gething, despite his stream of soothing words and assurances of good intentions. There used to be a saying that you couldn’t knit fog. Well, you certainly couldn’t weave whole fabric out of Mr Gething’s non-answers.

Mr Gething was very clear that he couldn’t answer direct questions because of protocol and the risk that he might have to make final decisions on a consultation which had not yet started. Which was very odd, because the previous day Carwyn Jones had decided he wouldn’t comment because the consultation was ‘open’. Open or closed, Mr Gething was prepared to fall back on the ‘all changes are difficult’ line. As an alternative tack, he attempted a switch to ‘difficult choices have to be made’.

So often did he repeat these lines, or variations on them, that it appeared as though poor Mr Gething had got stuck in one of those time loops beloved of science fiction programmes that need to create a cheap episode to make up for blowing the make-up budget on Slurb the Invincible or some such in a preceding one.

WHERE’S HELP WHEN YOU NEED IT?

Paul Davies had a go after Mrs Burns. Mr Davies doesn’t really do splenetic outrage, but he was clearly peeved – testy even. In a calm and measured way, he berated the Health Board for even proposing, never mind contemplating the closure of Withybush Hospital.

In response, Mr Gething tried a different tactic. While he appreciated that local sentiment was strong, it would be the same across Wales as tough decisions – hard choices – had to be made everywhere across the nation. This was, Mr Gething suggested, a national issue.

Mr Gething’s words would have had more weight on that score had he been accompanied by members of the Welsh Assembly from his own party. Apart from Mark Drakeford seated to his right, Mr Gething appeared terribly alone. The rest of the chamber was devoid of a Labour presence, demonstrating just how seriously west Wales’ concerns were being taken by all those south Wales AMs upon which the party depends for its majority.

Simon Thomas, incongruously seated next to Neil Hamilton, was next to tackle Mr Gething’s dead bat defence.

Pointing out the way in which the First Minister had sought to use the Parliamentary Review in an effort to deflect either criticism or inquiry, Mr Thomas told the Cabinet Secretary that the review was published too late to influence any proposals advanced by Hywel Dda.

After ungallantly pointing out that Labour’s candidate in the 2015 General Election, Paul Miller, had stood on a platform of restoring the paediatric services to Withybush – which had been removed temporarily without consultation – and had still not returned, he suggested this was the opportunity to test the strength of the Parliamentary Review’s framework.

NO STOPPING A CONSULTATION

Mr Gething lost his way a little as he said it wouldn’t be right for him ‘to attempt to instruct’ the health board to stop its consultation now. That would be the consultation that has not started, as the Cabinet Secretary had previously made clear just minutes before.

Difficult conversations needed to be had, tough choices had to be made, and the public would be properly engaged in the process of helping to make those tough choices after taking part in those difficult conversations.

You could see the cogs clicking away as Mr Gething spun new golden platitudes out of old strawmen.

Joyce Watson, whose support for retaining services in the past was less than fulsome, said it was very important that the public was told Withybush was not closing immediately. As this had never been suggested anywhere, it was hard to see what point Joyce Watson was trying to make; but having been thrown a life preserver, Mr Gething clung to it. He agreed that there was no plan to close Withybush in the immediate future. A relief for those attending outpatients next week to have their bunions filed.

Mr Gething then proceeded to point out that other hospitals were also mentioned in the options that had been leaked and that there could be those hard conversations and tough choices to be made in respect of them. But never mind, there would be a genuine and meaningful consultation and, if not, there would be a meaningful and genuine one. That’s what he expected the Board to do. Although, of course, he couldn’t tell them that was what was needed, because he might end up having to make one of those difficult choices after hard and tough conversations.

HAMILTON’S FORK

Neil Hamilton was next. Reaching for his pantomime pitchfork, he rather nastily skewered the Cabinet Secretary on its tines.

Remarking on Mr Gething’s status as the government’s fire blanket for successive health board failings everywhere, he posed the rather more difficult question of whether the threat to Withybush could be boiled down to death by a thousand cuts?

Tellingly, he suggested: “It must be regarded as a ridiculous proposal to close Withybush—even in contemplation in the medium term, let alone the short term. The health board should, when it produces the list of options for people to discuss, avoid causing unnecessary alarm and consternation by producing extreme proposals that are not going to be followed through.”

He then rather neatly suggested the real problem was a complete lack of accountability in the health service. Community Health Councils, Health Boards, were not elected bodies and the truth was that everything ended up on the Health Secretary’s desk. ‘People on the ground feel they have no voice at all,” Mr Hamilton said.

Vaughan Gething could see the home stretch coming.

There would be a meaningful conversation about tough choices in a difficult consultation, in which the views of clinicians would be heard as well as those of the public. It would be rather mean to point out that there is a difference between hearing and listening.

Particularly as those conversations will be tough, difficult, hard, meaningful, and genuine.

Then Mr Gething concluded on a point that he must now be grateful he did not open with.

Concluding he volunteered​,​ he didn’t want to be in the position in the future where the Government will be asked​:​ ‘Why didn’t you do something about a part of the service that really has gone wrong?’

That remark rather fortunately leaves the question unasked as to what all the previous tough choices after hard conversations and meaningful consultations over the last twelve years were actually for.

That would be a difficult – if not unanswerable – question.

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