Janet:
I would actually like to just pay some tribute to Gary Doherty for what he has attempted to do. Clearly, when anyone takes on such a responsible role, they do so with the the hope that they are going to make those necessary improvements. And I think it is rather coincidental that Gary came to a health board in Wales from an English health board setting, and that it's to an English health board service that he has gone back to—whether that speaks some volumes. But we now have a situation in the Betsi Cadwaladr University Health Board where it is being described as being in crisis by the very front-line nursing staff to patients. I have, on regular occasions, constituents coming to me, and they say, 'Janet, we are frightened. We are frightened about our actual chances when we go into hospital.' That's a very profound statement, when people haven't got confidence in that health board. We have, as Jack Sargeant has quite rightly pointed out, fantastic front-line nursing staff, and we have fantastic consultants that are there, but the frustration, the chaos, the mismanagement, continues after five years.
Now, Mark Polin, the chairman, is correct to acknowledge that performance in some areas is not acceptable. And I think, really, if any Member has taken you to task over Betsi Cadwaladr health board, I hold myself up there as being one of them, because we are on the front line, on a Friday, in our constituency offices, and it's heartbreaking to witness some of the cases that we see, the people that we talk to. These are individuals whose lives are being affected by the poor performance of this board. And it breaks my heart, I'll be honest with you. Now, this is despite the fact, Minister, that this particular health board has no less—and I gained this from an FOI—than 63 highly-paid directors. Sixty-three directors. Sixty six per cent of patients were seen within the critical four-hour period in December. And, last month, there were around 2,900 patients waiting for orthopaedic procedures at Ysbyty Gwynedd, with a waiting time of around, approximately, 114 weeks. Compare this to England, where the waiting time is 18 weeks. And shockingly, only yesterday, from an FOI—. I asked a simple question: how many planned operations were cancelled due to non-clinical reasons between September and December? If I was to say, 'Hazard a guess'—do you know, Members, do you know how many planned operations were cancelled due to non-clinical reasons between September and December? The figure is 2,463, and some of those are my constituents.
Now, when the health board was placed in special measures in June 2015—five years ago, nearly—one of the areas of concern was leadership and governance. Those leadership and governance concerns are still there now. Now, when I've spoken to senior people within the board—and it's a bit embarrassing, really—they tell me that it is, in fact, your Government's interventions that are causing some of the issues as to why they cannot actually get back on track. So, will you be looking again at your own model of special measures and Government interventions to see whether you are in fact supporting them, or whether you are hindering the process?
According to the improvement framework, it is asked that leaders understand the challenges, and ensure relevant expertise and capability across the system are addressing the barriers. Now, I put an FOI in on how much has it cost so far: £83 million for these special measures Government interventions. How many operations could that have actually paid for? How many staff, new nursing staff, could that have employed? I'm going to be honest with you now: the brand— Betsi Cadwaladr University Health Board is now a toxic brand. And I feel very, very sorry for the memory and for the family members of Betsi Cadwaladr. Because to have my name associated with such failure—if I was alive, but certainly long gone—is not a legacy that I think is one that you as a Welsh Government Minister should be proud of.
Do you plan to provide Simon Dean with additional support, and, if so, what? The Simon Dean walking into this board now will be the same person, but the challenges will be different to five years ago. Will he be expected to provide a compelling vision for the health board that is understood, recognised and accepted from top to bottom of this organisation? And might it actually be the case that the chief executive role of this toxic health board is, in fact, a poisoned chalice, and that the board now could be in special measures for an immeasurable amount of time?
Minister for Health and Social Services:
There were a good deal of comments, but I think there were really only a couple of questions. And, look, just on intervention from the Welsh Government, you can't have it both ways. You can't, on the one hand, say, 'Do more, be more active, get involved', and then, on the other hand, say, 'You're doing too much, get out of the way, let them get on with it'. You can't have it both ways. The challenge is actually how we get people who understand the operational challenges of running and delivering the service, who can deliver on improving the relationships between staff across the organisation and with communities.
And, on your points about Simon Dean, he will have all of the support that he requires and asks for. He will also have the opportunity not just to go in from his own understanding of being the deputy chief executive and working with all of the health boards and trusts within Wales, but his time on the ground, to provide an idea of, if there are additional challenges from that perspective, where the Welsh Government could be helpful or not. But, really, the future plan and the longer-term vision is for the next chief executive to actually deliver, together with the team. We're not looking for Simon Dean to stay within the health board for another year—it's a much shorter interim period I'm looking for, so a new chief executive is in time and has time to actually deliver that vision and to work with the team who are there. And the team isn't just around the executive table; it's around the whole health board.
There are 19,000 people who work for Betsi Cadwaldr, people rooted within their local communities—a source of knowledge, a source of understanding, and, for other members of the community, really important views about where the health board is going. And, actually, it's encouraging that, in the last staff survey, there was significant improvement in people who are proud to work for the health board and actually recognise that the health board was actually starting to improve. Now, that's a challenge that you need to see reinforced time after time. It's the objective evidence from staff themselves. That's hugely important for the wider community, and I look forward to, again, having an entirely honest conversation with people in this place, and when I regularly go to north Wales, about where the health board is, what more needs to be done. And I'm looking forward to the journey through and beyond special measures, because that is what people in north Wales expect and deserve.
