Oral - Update on the NHS Reforms

I have made two recent statements to the Chamber on the future of the NHS in Wales, the first in July, at the end of the consultation period, and the second at the beginning of this term. My aim throughout has been to ensure that Members are kept fully informed of developing decision making, and to answer any questions that may arise. Today, I want to update Members on several issues that I agreed to consider further.

First, I have been giving considerable thought to the legal format or personality best suited to the new NHS bodies that we are creating in Wales. After careful consideration, the legal model that I intend to adopt is that of a local health board. The local health board model is one made in Wales. It emphasises co-operation and engagement. In comparison with the 1990s trust model, it offers a much better 'fit’ with the key Assembly Government policy objective of abolishing the internal market in the health service. All Members have agreed in the Chamber that we must have a system that encourages and promotes partnership working, whereby the NHS is able and committed to working with local government and the third sector. The local health board model will allow for that to continue and ensure that we can build further on the partnership working that we see, for example, in the production of the health, social care and wellbeing strategies.

I am also grateful for the chance to discuss the issue of timing. I have been reflecting on the views expressed by several Members in the Chamber that it is better to get this right, even if that means taking a little longer over the implementation. That argument was made, for example, by Jonathan Morgan in September, when he also urged me to consider establishing arrangements for shadow boards, which was a suggestion originally made by Helen Mary Jones. I am grateful for this advice, and I have decided, subject to consultation, which will take place between December 2008 and February 2009, and to the making of the necessary legal Orders and regulations, to establish the new NHS local bodies in shadow form from June 2009, with a view to them becoming fully operational from October 2009.

The national advisory board will be in place by April 2009, before the establishment of the new NHS local bodies later in the year. This will ensure the minimum of disruption to NHS services and NHS staff. Members on all sides of the Chamber have emphasised the importance of maintaining stability in the NHS. I will achieve that by establishing the national advisory board at this stage to oversee the implementation of the reforms.

There are a number of remaining issues of detail on which I will now, as I indicated earlier, consult further, issuing a further consultation paper in December 2008. I look forward to as much positive engagement in this part of the process as was apparent in the first stage of consultation in the spring. While this consultation paper is being considered, I am minded to start the public appointments process for the chairs and vice-chairs of these seven new NHS local bodies at perhaps the end of this year or the beginning of next year to ensure that we have people in position to lead these new bodies as soon as possible.
As to the boards of the new organisations, I will consult on a model that combines the best of both local health board and trust experiences. I want boards that represent key interests and are capable of taking decisions. I also propose the establishment of a larger non-statutory stakeholder group alongside the board that provides advice to it. In addition, I am giving active consideration to the creation of professional fora at each new organisation. I want to ensure that the voice of practitioners is heard as fully as possible in the new system, and that advice of this sort is readily available to the new boards. 

I will want to discuss this proposition further with the relevant staff organisations and others. In doing so, I am also determined that we open up membership of the boards to a wider range of individuals than has been the case hitherto. There is a pool of talent in Wales that we need to foster, and then to deploy. There are a number of different ways in which we can reach out to make these important jobs more widely accessible, such as taster sessions for potential board members and training sessions in which interested individuals can prepare themselves better to take on new responsibilities, which is a point that David Melding made to me during an earlier discussion. I intend for this approach to become embedded in how we do business in the new NHS in Wales.

In setting up these local bodies, it is fundamentally important to me that they are able to improve patient care by reducing bureaucracy and removing artificial boundaries within the NHS, allowing more money to be channelled into front-line services, and for the planning and development of services to be joined up more effectively in the context of both community plans and the Government’s strategic direction for healthcare in Wales.

In September, Jonathan Morgan said that we want to see a national health service that is more streamlined, not as bureaucratic and less costly to administer. I agree. What is also important to me is achieving simple but robust lines of accountability to and from NHS bodies and from them to local communities, together with transparency in the operation of these bodies to the public. The national advisory board and the seven local health boards will allow me to improve patient care by creating a simpler planning system that ensures that stakeholders and partners are part of the planning process and able to exercise an influence on the direction of future policy. I will also be able to ask the stakeholders and partners for advice on any areas about which I have concerns.

In September, Jonathan Morgan said that we want to see a national health service that is more streamlined, not as bureaucratic and less costly to administer. I agree. What is also important to me is achieving simple but robust lines of accountability to and from NHS bodies and from them to local communities, together with transparency in the operation of these bodies to the public. The national advisory board and the seven local health boards will allow me to improve patient care by creating a simpler planning system that ensures that stakeholders and partners are part of the planning process and able to exercise an influence on the direction of future policy. I will also be able to ask the stakeholders and partners for advice on any areas about which I have concerns.