‘It’s time for change’: Politicians call for restructure of North Wales health board
Politicians have called for Betsi Cadwaladr University Health Board to return to special measures or undergo restructuring in a bid to address “failings” and improve health services across the region.
The North Wales health board was placed into special measures seven years ago due to “serious and outstanding concerns about leadership, governance and progress” after targeted intervention did not work.
In December 2020, the then Health Minister, Vaughan Gething, announced that the escalation status at the board would return to targeted intervention.
However, despite being removed from special measures, there have been repeated calls for action from the Welsh Government to improve the situation at Betsi Cadwaladr.
Earlier this week North Wales Members of the Senedd gave a damning verdict on its current position, with Darren Millar MS arguing that “we need to kick the current leadership out that has been failing people for so long”.
It came after Health Minister Eluned Morgan announced that targeted intervention measures had been extended to cover Ysbyty Glan Clwyd.
The decision followed a tripartite meeting after ongoing concerns relating to the health board in a number of areas – with a particular focus on the vascular service and the emergency department.
Speaking during a Senedd debate on Betsi Cadwaladr on Wednesday (8 June), North Wales MS Sam Rowlands criticised the hospital and ambulance waiting times for people across the region.
Figures released last month revealed that the number of people waiting to start treatment in Wales reached record levels, increasing to 700,000 in March.
In North Wales there are 156,245 patients waiting to start treatment.
Betsi Cadwaladr University Health Board also recorded the worst waiting time for those accessing the region’s emergency departments.
Sam Rowlands MS said: “With Welsh Labour failing to deliver adequate health services for the people of Wales, I propose it’s time to slap a health warning on this government.
“The side effects may include one in five people on waiting lists, 10,000 people waiting for more than 12 hours in A&E, over 70,000 people waiting more than two years for treatment, 42 per cent of cancer patients not starting treatment within two months, and a 50:50 chance of getting an ambulance in the time that you need it.
“It’s time for change, and it’s time for new solutions.”
Darren Millar MS, who tabled Wednesday’s debate, questioned how long it would take for the Welsh Government to “wake up to the fact that Betsi is broken.”
Plaid Cymru MS Rhun ap Iowerth called on the Welsh Government to commission an independent review to consider the possible benefits of replacing Betsi Cadwaladr with new structures to deliver healthcare in the north of Wales.
Health Minister Eluned Morgan has resisted calls for a restructure of the health board, saying that now is not the right time for such a discussion.
However Rhun ap Iowerth said we “owe it to the people of the north of Wales to have that conversation on how we could bring healthcare back closer to the people.”
He said: “I hear regular concerns of patients and staff worried about the un-sustainability of services.
“I was discussing a constituent’s case this morning. Her son had a fit, she couldn’t get an ambulance, she couldn’t praise staff enough as they treated her son in the corridor in the ED whilst 13 ambulances waited outside – I think it was 14 yesterday according to a physician.
“Are these Betsi Cadwaladr problems or are they just wider NHS issues? You see, the problem we have is that we have a fundamental lack of confidence that this cumbersome health board is the best way of delivering healthcare in the north of Wales.
“And it gets worse, that lack of confidence, with every report. At the end of the day, it’s about patient safety. Staff leave, recruiting is difficult, patients complain.”
Jane Dodds MS echoed calls to explore restructuring the health board, adding: “There is never a good time to reorganise. There are never the right situations or conditions for a massive review.
“But, reluctantly, it feels to me like this is the only time, because, as has been said, when is the right time?
“I’ve heard that time after time here in this chamber, and that’s why I’ve been reluctant to comment, but in representing the views and the experiences of the people that I represent— and I know you do as well, health minister, and others do, it feels like they cannot be ignored any more.
“I do want to put on record my thanks as well to the staff at Betsi Cadwaladr, it is the staff and patients who are being let down right now.
“Staff have been working hard in difficult circumstances and it is important that we have a frank and honest conversation about the failings and what must be done to provide confidence to the staff and the public we all represent.”
However, the health minister said neither a return to special measures or a restructure of the health board was on the cards.
She said: “Special measures had a negative impact on the culture within the organisation, as they relied on others to make key decisions, rather than the health board developing their own solutions.
“And while we and the health board recognise that there are significant and serious failings, it is important to build confidence and support the organisation to be more aspirational, to be more ambitious, and to look forward to a better future.
“It’s important that we support the health board to continue its improvement journey, and to promote an open culture, where problems are acknowledged and investigated, and we want to promote learning.
“A special measures designation will not achieve that. But, of course, if we don’t see improvement, then that is still on the table as an option.
“Significant improvements have taken place across the health board over the past seven years and the institution is fundamentally different from the one that was placed under special measures.
“The executive team has been renewed, including a new chief executive and medical director, among others.
“The way that the health board engages with staff, partners and the public does demonstrate that there is greater maturity and increasing efficiency within the board.
“That can now support their work in delivering the long-term strategy for clinical, integrated services and the service transformation related to that.
“We must bear in mind that over 19,000 members of staff care for the population of north Wales every day and, for the majority, the care is good, be that in a GP surgery, in out-patient clinics, in the community or in hospital.
“Although the institution is now under a higher level of targeted intervention, I would like to reassure the patients and communities served by the health board and the staff who work in that health board, that services and day-to-day activities will continue as usual.
“However, there are significant areas of concern that must be carefully addressed by the board, and I will ensure that they are monitored.”
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