Progress made but concerns remain over Betsi Cadwaladr health board

(Title Image: Betsi Cadwaladr University Health Board)

Three years ago this week, the Betsi Cadwaladr health board (which serves northern Wales) was put into special measures by the Welsh Government to “support and stabilise” positions of concern. The Health Secretary, Vaughan Gething (Lab, Cardiff S. & Penarth), used the anniversary to update AMs on what was happening.

The area of concern which triggered special measures – maternity services at Ysbyty Glan Clwyd – has seen improvements to such an extent it’s no longer deemed a special measures issue. Improvements have also been made in complaints management, mental health and board governance.

The areas where there are new or deepening problems include clinical leadership, service design and finance. There are also issues relating to waiting times for some specialities, which the Health Secretary was “intensely concerned” about. New short-term (18 months) and long-term (until 2022) plans to turn around the board are being developed.

Darren Millar AM (Con, Clwyd West) said the statement would bring little comfort as the board’s performance has gotten worse over the last three years and its fiscal deficit has ballooned to £38.8million.

He also wasn’t convinced that complaints handling had been improved as AMs representing north Wales have been inundated with letters and e-mails saying the board are taking too long to respond. Darren didn’t blame the staff; it was a Welsh Government failure and must be the longest time a health board has spent in special measures in the UK.

Rhun ap Iorwerth AM (Plaid, Ynys Môn) believed the length of time that board’s spent in special measures was becoming a sign of permanent underperformance and we should’ve expected more than “some recent progress” by now. He questioned whether the current structure – one board covering six local authorities – was fit for purpose.

Michelle Brown AM (UKIP, North Wales) was also unimpressed by the reported improvements. She believed the investment in improving Ysbyty Glan Clwyd was a sign that politicians had stuck their heads in the sand for years instead of making sure the facilities matched population growth.

Mark Isherwood AM (Con, North Wales) referred to complaints, saying constituents believed the health board has resorted to “risk aversion and legalistic responses” when prior to special measures the health board had taken steps to build bridges with the community. He also criticised the “stripping out” of beds at community hospitals like Blaenau Ffestiniog Flint and Tywyn, which he said will have put pressure on general hospitals.

Janet Finch-Saunders AM (Con, Aberconwy) mentioned a letter she’d recently received from a constituent saying their 85-year-old relative had been waiting 74 weeks (~18 months) for a knee replacement and could wait up to 106 weeks (2 years 2 months) before being considered for an operation. This was a “scandal” and she demanded to know why orthopaedics had been excluded from targets which state that nobody in the health board should wait more than 36 weeks for a referral to treatment.

The Health Secretary admitted that orthopaedics was excluded because the health board knew it wouldn’t be able to meet the target within the timescale offered (by September 2019).

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