Betsi Cadwaladr: 'Unhelpful' comments about health board

Glan Clwyd Hospital is part of Betsi Cadwaladr University Health Board

The head of Wales' public spending watchdog wrote to the Welsh government two years ago saying ministers were making "unhelpful" comments about north Wales' health board.

The auditor general raised concerns about words from previous health minister Vaughan Gething.

He implied he "received direct advice" from Audit Wales about Betsi Cadwaladr leaving special measures in 2020.

Plaid Cymru has called on the Welsh government to set the record straight.

But Eluned Morgan, the current health minister, said she would focus on seeing "improvements happening on the ground in Betsi for the future".

The troubled Betsi Cadwaladr University Health Board returned to special measures in February after a string of failings, including on vascular and emergency services.

A damning report had heavily criticised the way it was run at the top.

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The board had been taken out of special measures in 2020, in a move that was heavily criticised by opposition politicians at the time.

It is the highest level of government oversight Welsh ministers can impose when trying to fix problems in the NHS.

In the Senedd the day after Betsi Cadwaladr returned to special measures, First Minister Mark Drakeford dismissed Plaid Cymru's accusation that the board was taken out of special measures with "an election looming".

Mr Drakeford said: "The decision, and it is a decision of ministers, to take the board out of special measures was because we were advised that that is what we should do by the auditor general, by Healthcare Inspectorate Wales and by Welsh government officials whose job it is to provide ministers with the advice."

Auditor General Adrian Crompton told Plaid Cymru by letter that his organisation had not given such advice.

Replying to a request for clarification from Plaid Cymru leader Adam Price, Mr Crompton said: "In response to your specific question on whether there was advice from me or my staff to the minister to de-escalate the health board from special measures at that time, I can be very clear, there was not."

Mark Drakeford faced accusations he misled the Senedd over comments he made about north Wales' health board

He explained that Audit Wales shared findings and intelligence from its work through the process that informs Welsh government officials, who advise ministers.

However, he did say that in discussions Audit Wales staff did recognise that "after five years the special measures 'label' itself was increasingly becoming a hindrance to improvement at the health board given its negative effect on crucial areas such as external recruitment, internal engagement, and staff morale".

Plaid Cymru said the first minister had misled the Senedd - a claim denied by Mark Drakeford.

In an interview with BBC Wales, Mr Drakeford said the process on special measures was a "complicated system for those who are not used to it".

"It begins with the auditor general, the civil service and Health Inspectorate Wales coming together to discuss whether or not an organisation needs to have any extra intervention," he said.

"Separately, civil servants then advise ministers and the third step in this chain is ministers decide."

Speaking in the Senedd following the decision to remove Betsi Cadwaladr from special measures in November 2020, Vaughan Gething, the health minister at the time, said: "They've considered the extra information that has been provided, and that group of people - the chief executive of NHS Wales, Healthcare Inspectorate Wales and Audit Wales - have given clear advice that Betsi Cadwaladr should move out of special measures, and that is the basis for my decision."

In a separate letter to Plaid Cymru, the auditor general said he wrote to the Welsh government at the time "to indicate that it was unhelpful for the minister to imply that he had received direct advice from me or my staff on the escalation status of the health board".

Betsi Cadwaladr University Health Board manages north Wales' district hospitals

Asked on the BBC's Politics Wales programme, if the ministers needed to correct the Senedd's record, Health Minister Eluned Morgan said: "The first minister has clarified the position just to make sure everyone understands what is a complex process.

"The system means that the advice that is given by the civil service is undertaken partly as a result of the discussions that are undertaken by Health Inspectorate Wales and the auditor general.

"The auditor general, and I quote from their words, 'Audit Wales staff recognised that after five years of special measures the label itself was increasingly becoming a hindrance to improvement'.

"I think that what we need to do is just make sure we focus on the future. That's what I'm interested in.

"I'm not interested in semantics of two years ago.

"I want to see the improvements happening on the ground in Betsi for the future - that's what the public care about."

Plaid Cymru's health spokesman Rhun ap Iorwerth said: "They did mislead the Senedd.

"We're asking government for transparency, we're asking government to put their hands up and say, 'we got this one wrong'.

"Because at the heart of this is a struggling, is a troubling, a failed health board and we need to know why government took various decisions at various points in time to try to resolve the issues.

"They've failed and here we have government ducking responsibility, saying it's semantics.

"They might think it's semantics, the auditor general doesn't."

Welsh Conservative MS for Clwyd West Darren Millar told Politics Wales: "We need to take ministers, frankly, out of the picture when it comes to intervening in our health services.

"We've got to get the politics out of this situation so that people can get the services that they deserve.

"We've got a health board in north Wales which is failing and has been failing now for a very long time."