Betsi Cadwaladr report: Health expert says report changed over misunderstanding

Prof Harmer said what happened seemed on the surface 'totally bizarre'

The National Clinical Forum (NCF) chair has denied behaving inappropriately after rewriting an assessment of plans to reorganise north Wales health services.

Prof Mike Harmer was criticised after the warning that the Betsi Cadwaladr University Health Board plans were "unsustainable" was changed.

But he insisted to AMs the report was not changed to make it less critical.

He said it was because the panel had misunderstood the board's proposals.

Prof Harmer was giving evidence to the assembly's health committee, in the wake of criticism last November.

The NCF was set up just over a year ago as an independent advisory group for health boards over future service planning.

Prof Harmer said that the NCF had not been aware that the health board had decided to deliberately omit plans to reorganise secondary care - general hospital services - from its consultation document and focus instead on changes to primary care - GP and community hospitals - and specialist hospital services.

The original assessment, according to Prof Harmer, was highly critical of the lack of detail on secondary care but when told by Betsi Cadwaladr's chief executive that those proposals would be drawn up at a future date he said the forum had decided to redraft its evaluation accordingly.

'Totally bizarre'

"We were not aware that Betsi Cadwaladr Health Board had decided deliberately not to include secondary care as part of their consultation.

"We (the NCF) put in a submission that was clearly heavily critical of not putting that in.

"When we said significant areas needed reconsideration - that referred to district general hospital (secondary care) services"

"The chief executive replied suggesting we had missed the point - that it was a deliberate decision not to include secondary care. We all felt we should re-draft - looking at the document they had submitted but with the assurance that the concerns we had over hospitals would be addressed in a secondary process"

Prof Harmer admitted that what happened "on the surface seems totally bizarre".

But he rejected an accusation by the Conservative health spokesperson Darren Millar that he had behaved inappropriately in discussing the issue in private e-mails with the health board chief executive Mary Burrows.

Lack of transparency

"It was late. In order to get a reply from the chief executive out of hours - I decided to send to her private email address."

"Read that way it sounds very sinister - it wasn't meant to be sinister. I needed to know by the morning that I had addressed the concerns they had."

Ms Burrows also told the committee that she supported Prof Harmer's version of events but admitted a lack of transparency.

"There was nothing sinister in what we were doing ... could we have got the communication better? I think we both acknowledge that's the case."

'Sorry episode'

But the Conservatives health spokesperson Darren Millar AM said: "This rewritten report fundamentally undermined public confidence in NHS reconfiguration and none of the answers provided today are likely to satisfy the public that the process has been impartial.

"I welcome the chair's acknowledgement of how sinister his actions look. Rewriting the report in this way was inappropriate and communities across north Wales are understandably questioning the role of the National Clinical Forum in the reconfiguration process.

"Questions remain about the forum's independence and this whole sorry episode has been a disaster in terms of public relations"

BBC Wales also revealed, in November, that the NCF had also agreed to revise its submission on a second set of reconfiguration plans by the Hywel Dda Health Board "to ensure consistency of approach"

Both Hywel Dda and Betsi Cadwaladr Health Boards will finalise their plans to re-shape NHS services next week.