First Minister defends North Wales health board record following ‘assertions’ from former chairman

First Minister Questions earlier this week saw a clash over the local health board’s recent issues – amplified lately by the former chairman. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

The health board – which provides healthcare services to 700,000 people in North Wales – was put back into special measures by the Welsh government due to “serious concerns” over its ‘performance, leadership, and culture.’ ‌​‌​‌​​​‍‌​‌​​‌‌‌‍‌​‌‌​​‌​‍‌​‌‌‌​‌‌‍‌​‌‌‌‌​​ ‌​‌​‌​​​‍‌​‌​​‌‌‌‍‌​‌‌​​‌​‍‌​‌‌‌​‌‌‍‌​‌‌‌‌​​As part of the special measures announcement, the Welsh ​Government confirmed that health board Chair Mark Polin, Vice Chair Lucy Reid and independent Board members had ‘stepped down’ – however it appears they had resigned. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

Leader of the Welsh Conservatives Andrew Davies MS challenged the First Minister over recent ‘assertions’ by the former chairman of the Betsi Cadwaldr University Health Board Mark Polin, “…notably the concerns that were raised by him and the board members with the health Minister and the director general of the NHS here in Wales back in September, when he raised long-standing concerns and issues that simply went unaddressed—his words, not mine. Why did the Welsh Government not respond to these concerns and support the board at the time?” ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

First Minister Mark Drakeford rejected the point, “I don’t accept at all that those things went unnoticed, because the Minister and officials were in very regular dialogue with the Betsi Cadwaladr University Health Board, including the board. The board has responsibilities. You don’t discharge your responsibilities simply by telling somebody else that you’ve got a problem. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

“You have an obligation, as a board, to address the issues that are within your legal area of responsibilities. So, while there was undoubtedly a dialogue, and while the Minister and officials here were always responding to concerns that were raised with the Welsh Government, to simply say, ‘We told the Welsh Government about that’, as though that is the full extent of your responsibility, I simply don’t think that that is the way the system is ever intended to operate. ” ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

Andrew Davies MS came back, saying Mark Polin made ‘clear categorisation that he was not getting the support from the Welsh Government’, adding “He raised this as chair with the Welsh Government, which is the sponsoring body of any health board, because they send the cash and they set the priorities for the health board. I take it that you say that the former chair is not speaking the truth when he says that his concerns and those of the board were not responded to back in September, because that is quite an assertion from you, First Minister, if you believe that the former chair is seeking to mislead public opinion by saying that the Welsh Government stood back and didn’t support the board when those concerns and long-standing issues were raised with the Minister and the director general as well?” ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

The First Minister replied, “The assessment of the Minister and the Welsh Government was that the reports that we had received from independent bodies of the dysfunctional nature of the board could not simply be allowed to lie there without action being taken. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

“That is the culmination of a long dialogue between the board and the Welsh Government, a dialogue in which the Welsh Government took action time after time in order to support the board: significant additional investment above and beyond what its population share would have justified through the normal formula, intervention through national programmes, giving advice, attempting to support the board in the efforts it was making to improve services. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

“Nothing in what the Minister decided should be read as indicating that the board and its chair were not making efforts to put things right. It is simply that the conclusion of independent oversight was that those efforts were not succeeding and that it would have been impossible to put the board as currently, or as then constituted, in a position where it could successfully address those challenges. That is why action was taken. It was necessary action and it will lead, I believe, to a better platform for improvement in the future.” ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

The answer was not satisfactory for the leader of the opposition who came back again, “Why didn’t the Welsh Government offer the support when it was requested back last September? ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

“You’ve identified the audit report as being the flashpoint for intervention by the Welsh Government and making sure that the board changed and the chairman was removed. In the same article, the chairman highlighted that there were, in his words, clandestine moves to recruit replacement board members to form a new board at least four weeks prior to the publication of the audit report. So, if this clandestine recruitment was going on, can you today tell us when the recruitment process began to find new board members, even though the existing board was in place? And what would that do to give confidence that the Government was working with the then board to rectify matters in North Wales?” ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

The First Minister gave the final answer on the topic, “The Welsh Government supported the board through financial assistance £82 million over and above what the board would otherwise have had available to it. Secondly, the Welsh Government corralled a set of professional advice, available to the board through our national programmes, to make sure that the efforts that were being made could draw on expertise from beyond the board itself.” ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

“Thirdly, there was a pattern of continuous monitoring of the board. That’s the nature of the relationship between the Welsh Government and the board, and senior civil servants here were involved in that continuous dialogue. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

“Fourthly, the delivery unit—the arm of the Welsh Government that assists boards across Wales in addressing those difficult issues that boards face. The resources of the delivery unit were made available to the board as well. Any idea that the Welsh Government simply stood back and allowed the board to flounder would not be borne out by that continuous set of engagements…” ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

The answer was interrupted… “Well, I’m explaining to the leader of the opposition why I don’t accept that the board was simply left to its own devices. It absolutely and clearly was not.” ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

“As to the responsible actions that the Minister took in assessing her options, given the advice that had come from those independent sources, when the Minister was considering whether or not to remove some members of the board, it would have been utterly irresponsible to have done that without giving some thought to what would follow. ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​

“Imagine what the leader of the opposition would be saying to me today if the Minister had removed the board and had no plan at all for how those legal responsibilities were to be fulfilled. In planning ahead and assessing the options available to the Welsh Government, the Minister absolutely properly asked the question, ‘If the current incumbents are not to be there, do we have credible other individuals able to fulfil those legal responsibilities?’ It would have been a dereliction of her duty had she not done that.” ‌​‌‌‌​‌‌‍‌​‌‌‌​‌​‍‌​‌‌‌​‌​