Peter Black and South Wales West Liberal Democrats

The Welsh National Health Service

Peter Black: I move amendment 1 in my name. Add as a new point at the end of the motion:

calls on the Welsh Assembly Government to revise its decision not to investigate the claim that up to a fifth of the health budget was not being spent effectively.

In moving this amendment, I support much of what Andrew R.T. Davies has said in proposing this motion. This motion and the amendment rise out of the expectation that we all had when the reorganisation of the health service took place. There were a number of people on this side of the Chamber who were sceptical about that reorganisation and were concerned about the overcentralisation of the health service into the hands of the Minister. The rationale given to us from the other side of the Chamber as to why that reorganisation should take place was that it would improve political accountability. The Minister would clearly be seen to be accountable for how these health boards would be operating and she would be running her own policy group or a group at the head of the health service that would help to direct the way in which the service was being run. As a result of the reorganisation, we would get greater clarity, transparency and accountability than we had previously. Unfortunately, as Andrew R.T. Davies has outlined, that has not been the case.

We have all had experience of tabling questions about various issues within the health service, only to receive the answer that either the information is not held centrally, which I accept, or that certain statistics cannot be collated in a particular way, or, more frequently, that it is a matter for the relevant health board and not for the Minister. I recently received a response to questions that I tabled on asbestos in hospitals in the Cwm Taf health board area, but the response that I received was that this is a matter for the health board, not the Minister. Clearly, that is frustrating for us as opposition Members, and it is also frustrating for those whom we represent, who are expecting the Welsh Government to initiate the sort of action that we came to expect from this reorganisation to deliver a better, more accountable and higher quality health service than we have had hitherto.

The other issues that have arisen from this reorganisation-which Andrew R.T. Davies has touched on and which I refer to directly in the amendment I tabled to the motion-relate to the expectation that I think we all had of that change. These expectations related to potential savings that could be channelled to the front line and, in the longer term plan, to the way that the health service would be reconfigured to make better use of the resources available to it. Andrew referred to the evidence from the chair of the All-Wales Directors of NHS Finance to, I think, the Finance Committee on the £1 billion per annum, a fifth of total NHS funding, that is being misspent and that could be spent better.

That does not mean that this money is being wasted; I have had to correct many people on this. It means that that money could be spent more effectively to deliver a better quality health service and to get better value for money in terms of the care and treatment people come to expect. It is to be hoped that it would also deal with some of the issues of waiting times and so on. It may involve some form of reconfiguration of the resources that health boards draw on with regard to the buildings or the services. It seems to me that the fact that the Minister effectively responded to requests to deal with that issue by saying that she had no intention of tackling it goes completely against the rationale for this reorganisation, which was that we would have a more accountable health service in the Minister's hands.

It seems to me that this is a political issue, and one that the Government needs to grasp. It needs to be able to talk to health boards and direct them in using those resources better to achieve better value for money.

Alun Cairns: I am grateful to Peter Black for giving way. I could not agree more with his point. Does he accept that any ministerial letter should be published, in the way that circulars were? In my region, and in his, a false sense of security was created with regard to Fairwood Hospital. There was an understanding that no hospital could close because of a Government-imposed moratorium. Only through written questions did we discover that a ministerial letter had been issued, completely in private, and therefore without the public being made aware that there is a procedure for closing hospitals. Whatever the pros and cons may be, the public needs to be made aware of this. Do you accept that a disingenuous Minister could use that process to conceal information?

Peter Black: Thank you. I hope that the Temporary Deputy Presiding Officer is going to give me a few seconds to answer that question. You are absolutely right that there needs to be greater transparency with regard to what is being published, so that we are all aware of the policies in place. However, we also need greater clarity about how the NHS is being resourced.

I have run out of time, but, very quickly, I want to refer to the role of senior managers who no longer have jobs in the NHS and the £4 million-a-year cost relating to them. We have no indication of how that resource will be utilised or whether that money will be reinvested in the front line. Again, we return to the issues of transparency and accountability, which need to be addressed as part of that.