BCUHB in special measures “indefinitely”

With Betsi Cadwaladr University Health Board (BCUHB) having been in special measures for 3 years and 5 months, the statement made by the Vaughan Gething AM, Cabinet Secretary for Health and Social Care, and the debate that followed with Janet Finch-Saunders, Assembly Member for Aberconwy, highlighted the fact that BCUHB is to remain in special measures “indefinitely”.

Janet said:

“It is shocking that 3 years and 5 months on from our health board being placed in special measures and under the direct control of the Welsh Government, the end of special measures is still not in site.

“Whilst the Cabinet Secretary chose to speak positively about leadership and governance capacity, some progress in mental health, and staff engagement, extremely serious issues remain.

“Despite £10million an then an additional £1.7 million having been allocated to the special measures arrangements in July, the health board remains in a ‘challenging position’ financially.

“Even more alarming is the fact that the Cabinet Secretary had no choice but to acknowledge that the health board needs to focus on improving unscheduled care and referral to treatment.

“I know from my own increasing caseload that there is no let-up in the number of serious complaints coming in.  For example, some constituents are waiting 4 months for replies from the Chief Executive, one has already waited four and a half years for a hip operation, and whilst the management team is ballooning, the shortage of hospital staff and ward closures continue. 

“Those are few of the many examples I have that Betsi Cadwaladr is not improving, and that the Cabinet Secretary and Welsh Government are failing the health board, its staff, and all residents in North Wales.

“After years of work on this serious matter, it seems to me that whilst the Welsh Government continue to mismanage the board, it will be in special measures indefinitely.  This was highlighted to me by the fact that Vaughan Gething was unable to give a date for the end of the arrangement”.


Extracts from Senedd proceedings on Tuesday 6/11/18

Janet’s response to the statement by Vaughan Gething AM, Cabinet Secretary for Health and Social Services: Betsi Cadwaladr University Local Health Board—Special Measures Update:

Yes, and thank you for allowing me to speak. Cabinet Secretary, it's fair to say that over the past 12 months in particular, I've been extremely vocal. It's not wise for anybody to stand up in this Chamber and just pontificate or use anecdotal information here. When I speak, I speak clearly from what I receive coming into my office. And I can tell you, my casework file is—[Interruption.] There's no let-up in the number of complaints and the type of serious complaints that are coming in as regards this particular health board. Now, you'll be aware, no doubt, of my constituent, where it's just only been announced—. Can I carry on?

Seven hours ago today, one of my constituents, sadly, has passed away, through waiting for an ambulance for over four hours and bled to death. A 37-year-old constituent. That is just one of many people that I'm dealing with. Another lady, who had a very bad fall in Conwy, waited three hours for an ambulance then waited for 10 hours for treatment. She was taken to Llandudno hospital, and then, such was her bleeding on her leg, and it was a replacement knee joint, they had to cut her jeans off her, 10 hours later. So, she wrote to the chief executive. To date, she wrote to the chief executive in July. I followed it up, asking him where the response was, in August. We're now in November—no response.

We have dozens and dozens of complaints. You know, because sometimes, I get very frustrated because my constituents come to me in all good faith and they say to me, 'Janet, we don't want to get anyone into trouble, we don't want to criticise, we just want the people at the top running things to know just how bad things are', and they don't receive any response.

And I just find, if a chief executive or anybody working within a senior management team cannot put pen to an e-mail, a standard response even saying, 'I'm very sorry to learn of your experiences, but your information coming back helps us to improve the service'—. There's nothing like that. I've asked Gary Doherty, I've asked Andy Scotson, and, you know, things are so bad for my constituents that now we have a weekly phone session with a member of my staff to go through all the cases where they are just massively delayed.

I had an e-mail when I was sat in Plenary about four weeks ago. An elderly gentleman has been waiting four and a half years for a hip operation. He's in agony. He said he finds it hard getting out of bed. These are people who are not being supported by care. He lives alone. He just needs—. He's been told by the doctor, his GP, he's been told by his consultant he needs a hip operation. Luckliy, as a result of him contacting me, they are now prioritising him some treatment. So, please God that he gets his operation, and I think it's going to be fairly imminent.

But people are coming to me, and I want them to, but there's an awful lot of people out there who are not coming. There has not been any improvement, honestly, Cabinet Secretary, as regards their complaint processes.

Now, I know that the senior management team—

The senior management team—. Yes, it's quite noteworthy the number of new staff that have been taken on, but the old staff are still there. So, you've got this ballooning, ballooning, ballooning management team, and yet, Llandudno hospital have had to close wards—they can't get staff. There has been no improvement in the short or medium or long-term planning in terms of attracting nurses. Have you seen the number of vacancies now for nurses in the Betsi Cadwaladr health board? Things may be better on paper in some areas, but, frankly, as an Assembly Member, my workload is no less and the distress to my constituents, if anything, is growing. So, all I would say to you is you do need to look more at some of the other things.

But, the point that Michelle Brown made earlier, and also Helen made too, about—you can't guess when you might take this board out of special measures. It's been there the longest it's ever been in any of the four parts of the United Kingdom, three years and counting. You mentioned in June 18 months and you're still saying 18 months. So, it looks almost like it'll be the next election before we even consider it.

Can you just tell this Senedd and the Members here when you yourself, as a Cabinet Secretary, as a Minister in a Government of a nation, when do you see this health board coming out of special measures? But, more importantly, when do you envisage that being a situation where real improvements have been made? I will always have a casework load, I appreciate that, but when will we as AMs and my constituents and your patients actually say, 'Do you know what? Things have improved'? Just tell us a timescale, please.