Welsh Government slammed for ‘woefully inadequate’ handling of Betsi Cadwaladr problems

The Welsh Government has been slammed after its handling of problems at the health board responsible for providing services in North Wales was branded “woefully inadequate”.

Betsi Cadwaladr University Health Board was put back into special measures earlier this week in the wake of a damning audit report and longstanding issues with vascular and emergency services.

Last week, Auditor General Adrian Crompton said the board’s executive team was “dysfunctional” and hampering improvements to healthcare in the region.

Following the report, Health Minister Eluned Morgan reportedly gave independent members of the board, who are responsible for scrutinising the executive, an ultimatum to quit.

The board’s chair, vice chair, and independent members have since stepped aside, with new people set to be appointed in their place. ‌​‌‌​​​‌‍‌​‌​‌​​​

However, in a letter, they criticised the Welsh Government’s “grasp of the situation” and raised doubts about the Health Minister’s response. ‌​‌‌​​​‌‍‌​‌​‌​​​

According to the members, the responsibility for service quality and governance had been placed on their door without recognising the limitations of their powers as independent members.

Ms Morgan made a statement in the Senedd yesterday (Tuesday) on the measures being taken to improve health services in North Wales.

During her comments, she said she was responsible for appointing independent members and her own powers were limited in dealing with the board’s executive.

The Health Minister said: “I can assure you that I very much read the riot act to some of those executives.

“I do not have the power to require executives to step down. I do not employ these people.

“These have legal rights that need to be respected, and there has to be a process that it is gone through.

“I think it’s really important that people understand the system and understand that this is the first step of many.”

Ms Morgan has faced calls to consider her position as Health Minister following the latest developments.

Earlier on Tuesday, she said she would remain in the role as long as First Minister Mark Drakeford had confidence in her.

But she came under repeated fire from her opponents in the Senedd, including Clwyd West MS Darren Millar.

The Welsh Conservative politician said: “I listened very carefully to your statement, minister, and I didn’t hear an apology to the people of North Wales for the failure of this Welsh Government to sort out the deep-seated problems in our health board in the region.

“It should never have been taken out of special measures; I still believe that that decision was political, no matter what you have said today, and it should never have happened.

“We called in this chamber last June for the organisation to go back into special measures, and you refused to listen to our calls.

“It wasn’t just the calls of these benches; it was the calls of every single person representing a constituency in north Wales and every single person representing that region.

“We know what goes on in that health board. We see the letters that come in from constituents, and we see the whistleblowing letters that come in from staff as well. And frankly, your response to date is woefully inadequate.”

He added: “We need new leadership both in the health board on the executive team, and, frankly, we need a new government, because this government is incapable of being able to sort these problems out.

“Can I ask you, minister, why on earth would you get rid of the independent members who’ve been doing their best to try and hold to account that executive team in recent months?

“Why on earth would you ask them to resign and not ask for the resignations of those executives who have been collectively responsible for these failures?”

Ms Morgan responded that while she is responsible for the NHS, that responsibility is then delegated to independent boards.

She said it was the job of independent members to hold the executive to account rather than her own.

The Health Minister said: “That is why I appoint them. When they fail to do the job that we’ve asked them to do, holding the executives to account—because it’s their job to do that—then I have to step in, and that’s what I did.”

Ynys Môn MS Rhun ap Iorwerth raised concerns over the way in which independent members were asked to resign.

He alleged that they were told by the minister that they had 50 minutes to quit or she’d sack them and bar them from other public appointments for two years.

The Plaid Cymru health spokesperson said: “She referred in a Radio Wales interview this morning to the huge amount of criticism of the executive board members, but it’s the independent members, of course, that she decided to very publicly hang out to dry yesterday.

“She’s defended her actions, saying, ‘I don’t have the powers to intervene directly in terms of the executive.’ She’s said that again this afternoon.

“But that’s exactly what special measures allow the minister to do, effectively running the health board, even supporting the chair and independent members if that’s what she wanted.

“We have a sugar-coated description of what happened yesterday in the minister’s statement—’spoken with the non-executive members. As a result, they’ve decided to step aside.’

“Let’s be a little bit more direct for anybody else who may be considering taking up an appointment by this government and considering what kind of backing they can expect.

“The minister may want to confirm that, having summoned them to the meeting, she told them they had 50 minutes to resign or she’d sack them, and in so doing bar them from other public appointments for two years, and that, even before the 50-minute deadline was up, a draft letter of termination had been handed to them, just to press the matter home.

“How could they not resign? But their dignified response will have resonated with many. In a damning public letter to the First Minister, they said, ‘We have no confidence in the Welsh Government’s grasp of the situation.’

He added: “Responsibility and accountability ends with the minister. She did actually agree with that, but said that she delegates down to others.

“This isn’t an unconditional defence of the independent members; this is to show the glaring difference between blame apportioned to them and the complete denial of any responsibility by the minister.”

Plaid Cymru has repeatedly called for the health board to reorganised, but the suggestion was again rejected by Ms Morgan yesterday.

She said: “I think it’s important that people understand that I have the power to dismiss the board; I do not have the power to dismiss executives.

“They have rights; they have employment rights. I do not employ them; I cannot dismiss them. That is the reality of the situation.

“I’m not sure what exactly you want me to do. Do you want me to directly employ all 105,000 people who work there?”

The Health Minister added: “Plaid’s answer to everything is reorganisation, new structures, more managers—that’s what we need: more managers. I want more front-line people.

“You will be getting more managers if you restructure, I can tell you. That is the consequence of restructuring.

“I want to focus on the front line. I want to focus on getting through those waiting lists. I want to get those cancer referral times down.

“I want to make sure that people in north Wales can get the service they require, and I don’t think that a massively distracting reorganisation is going to help in that task.”

Clwyd South MS Ken Skates called on his Labour colleague to consider the possibility of allowing the people of North Wales to directly elect board members.

Ms Morgan said: “I think it’s really important that we engage with the citizens of North Wales. We do need to, first of all, give confidence to them that, actually, these services, the day-to-day work, will be carrying on.

“If we go down the directly elected route, I think there are issues that we need to consider there because we do need people who understand governance and accountability, and they’re not necessarily the people who can win elections.

“I think we’ve just got to do some thinking around that. But I am very interested in looking again at the accountability within the system.”