Oral - Health Service Reviews

I wish to make a statement setting out information concerning two independent reviews of important aspects of the health service in Wales.

Health Commission Wales is an executive agency within the Welsh Assembly Government. It is responsible for the provision of those tertiary or specialist services that require a population base that is greater than that of any individual trust. Health Commission Wales works closely with local health boards, trusts and the National Public Health Service for Wales in planning and delivering services. The regional stakeholder panels ensure the engagement of stakeholders. A national commissioning advisory board oversees HCW’s commissioning plans and monitors their implementation, and The chair of the board is publicly appointed and is accountable to me.

Health Commission Wales often has to make very difficult decisions that affect individual patients who are suffering from acute and distressing conditions. Decisions must be based on evidence, must be made in way that patients understand and must be underpinned by an open and transparent appeals process.

In this highly contentious area, it is perhaps unsurprising that concerns are raised in public about the basis on which some decisions on treatments for patients requiring very specialist care have been made. Given that public confidence in this aspect of the health service is so important, I have asked Professor Mansel Aylward CB, chair of the Wales Centre for Health, to undertake a review of Health Commission Wales’s functions, including its decision-making processes and appeals mechanisms. Professor Aylward has been chief medical adviser to the Department of Social Security, chief medical adviser, medical director and chief scientist to the United Kingdom’s Department for Work and Pensions and he was also chief medical adviser and head of profession at the veterans’ agency of the Ministry of Defence. As a physician and specialist in rheumatology and rehabilitation, therapeutics and clinical pharmacology, he is a visiting professor at several universities in Europe and north America. As well as chairing the Wales Centre for Health, he is currently the director of the centre for psychosocial and disability research at Cardiff University. He is thus highly qualified to undertake this review, and has agreed to report his findings to me by the end of this calendar year.

The second review that I wish to announce concerns the implementation of ‘Agenda for Change’ in Wales, and, in particular, the consistency with which that implementation has taken place. ‘Agenda for Change’ involves a set of new pay and conditions for more than 70,000 NHS staff in Wales. Implementation of the new system has been extremely complex and lengthy. The process began in October 2004, and I am pleased to say that, working closely with trade unions, 94 per cent of national health service staff in Wales is now in receipt of ‘Agenda for Change’ pay. During the summer, however, as I carried out a series of hospital visits in all parts of Wales, staff raised concerns with me about what they perceived to be inconsistency in the way in which ‘Agenda for Change’ had been implemented in different health organisations. Consistency has to be an important principle in the Assembly Government’s approach to ‘Agenda for Change’. The implementation project, involving the service, trade unions and the Assembly Government, was charged with monitoring the issue.

I remain committed to ensuring that ‘Agenda for Change’ has been implemented on an equitable and fair basis for all staff. In response to the concerns raised with me, therefore, I have appointed David Jenkins, chair of the National Leadership and Innovation Agency for Healthcare and the Workforce Development Unit stakeholders’ board, to carry out an independent review of the consistency of implementation and outcomes of ‘Agenda for Change’ across the national health service in Wales. David has a distinguished career in public service. As well as being a previous general secretary of the Wales Trades’ Union Congress, he is chair of the Wales Co-operative Centre and of Opportunity Wales, a member of the employment appeals tribunal and the General Medical Council’s fitness-to-practice panel. He also served for many years on the Monopolies and Mergers Commission. I have asked him to report to me by December 2007.