Janet Finch-Saunders

I’m pleased to contribute to this debate and to support the motion put forward by our group whip, Paul Davies, Assembly Member, following a very excellent presentation by Darren Millar, Assembly Member.

Today presents us with the opportunity to be very constructive in opposition by bringing forward some radical plans and policy that would seek to strengthen the health service here in Wales. Whilst also presenting us with the opportunity to accurately reflect on the health service as it is here in Wales after 15 years of devolution, led by the Welsh Labour Government. It does go without saying how grateful we are to those who have dedicated their lives to working within our health service, at whatever level and for over many years as they have witnessed significant change—change for the better in many ways, as we have all experienced the introduction of modern technologies, better diagnostic techniques, earlier intervention, and less obtrusive hospital procedures. Over these years, under the guise of care in the community and hospital reorganisation, they’ve made way for a new model of providing very specialist individual care, seeing the removal of beds, wards closed, hospital infections rise, people sent home alone at all times of the day or night, and treatment delivered very far away from home and from our loved ones. We have, rather sadly and much too frequently—and certainly of late—witnessed some extraordinary examples of poor leadership, bad management and serious governance issues.
In 2014 we announced plans to give patients a greater voice in the Welsh NHS with elected health commissioners, removing any political patronage that allows Welsh Government Ministers to appoint their own preferred decision makers onto our health boards. These proposals came after findings from a survey of more than 3,000 health service users across Wales. It identified the need for a culture change and, in particular, highlighted a high number of NHS staff members who describe themselves working in a culture of fear, while whistleblowing could see the end of your career. And we learned, too, and it was endorsed again, by the horrific Tawel Fan report, that a non-listening culture permeates the Welsh NHS currently. This again was backed up by Ann Lloyd in her follow-up report into governance issues at Betsi Cadwaladr University Local Health Board. An independent review into two hospitals in south Wales in 2014 found horrific examples of poor care, seeing patients without medication, food or water for days. Whilst the board and the First Minister apologised, they stopped short of committing to a full inquiry, and I’ve already mentioned the serious breaches of abuse in Tawel Fan.
Elected health commissioners would put the patient’s own voice at the heart of decision making, transferring this power away from central Government and into the hands of the patients and families themselves. These champions would be accountable to the individual needs of patients and the community. They would be best placed to stand up and take necessary decisions that wouldn’t compromise the safety and care of those they serve. They would be directly elected, directly scrutinised and directly challenged by their electorate under each election, and they would have the ability to determine local priorities and would eliminate the current silo-working mentality that currently exists within some senior management groups and clinician-patient groups of our health boards.
I’ll finish off with some findings from Ann Lloyd: nurses aren’t always listened to, even from chief of nursing to the board itself; the frequently dangerously low nurse training and education budget is often the first to be cut, as a soft easy target; the financial situation is very serious this year, delaying the HMRC payments, delaying the NHS pensions agency, and £66.4 million, added to that £30.3 million for 2016-17, is creating a cost pressure of £96 million, and it goes on. A previous 2013 Deloitte report, highlighting that £107 million could be saved, was never actioned, yet there is a board of 11 independent members, and up to nine executive directors—the board being described as not adding any value to the organisation. This new management structure alone is costing £2.6 million, with projected additional costs to make £5 million. I rest my case by supporting our proposals for a directly elected health commissioner, and I move.