The former chief executive of the Board of Community Health Councils in Wales says he's experienced a culture of 'entitlement, gagging, bullying and unfairness' in the Welsh NHS.
Speaking exclusively to ITV Wales, Tony Rucinski says he was told at the beginning of 2016 not to speak to the media 'on the behest of the [Health] Minister' and that a closeness between Welsh Government and the NHS means that difficult conversations about what needs to happen in the health system are not taken forward.
The health minister at the time was Mark Drakeford AM, who is now Finance Minister.
After being suspended, Mr Rucinski was then dismissed from his position with the Board of Community Health Councils (CHC).
According to the Community Health Councils website, "CHCs represent the independent voice of patients and the public who use health service in Wales and play an important role in influencing the way services are planned and delivered."
Mr Rucinski said: "The reality is that you discuss some hard topics, but then comes in what I would call the small country conundrum."
He added: "You end up finding that there's an awful lot of closeness [between the Welsh NHS and government] and the people who choose the people who choose the people, a lot of it seems to feel a bit locked in.
"What that means is you get to situations where you're in meetings and you'll come up with a discussion or viewpoint and somebody will say 'we can't say that because the minister wouldn't like it'. And that's the end of that discussion."
Mr Rucinski says he was 'gagged' from speaking out on issues affecting the NHS. He says he was told that this decision was made by the health minister. "I was told you're being stopped from talking to the media on the behest of the minister," he said.
"My boss said the minister had told her to keep me out of the media. I objected to that because in my point of view it's A, in my job description and B, we're an independent organisation and we shouldn't be responding to political instructs to stay away from the media."
The methods and tactics used by Welsh Government in order to prevent Mr Rucinski from speaking out, he says, are "just the tip of the iceberg".
The 'close' relationship between government and senior figures within the Welsh NHS, says Mr Rucinski, could be seen through the frequency with which the health minister would meet with other NHS bosses and himself. "When I was in position, the chairs [of the CHCs] would meet with the minister at least every fortnight. So a very close relationship. I would see the minister on a ridiculously large number of occasions."
He added: "On the one hand you could say it's a huge privilege, what a good idea because the minister can really keep a tab on things and make sure things happen but the flip side of that is if you've then got a culture where people are too afraid to speak out because it's so close you don't get the conversations being had that need to be had."
Mr Rucinski was also critical of what he called 'the small roundabout of senior jobs in Wales'. He said: "In order to get your next seat on that roundabout you have to recognise that there's a very close relationship between those senior positions and the politics in Wales and that if therefore you come out of line you might put at risk your ability to get that next seat on the roundabout. Therefore the temptation is almost irresistible for a lot of people to not say the things that would highlight stuff that might put that next seat at risk."
Responding to the comments, a Welsh Government spokesperson said: “Tony Rucinski’s comments are simply not true and we do not recognise the picture he paints of the culture within NHS and the Welsh Government. Dr Rucinski was initially suspended from his post. Following full independent investigation he was subsequently dismissed from his role as CEO of the CHC Board.
There was no evidence found to support Dr Rucinski’s claims of political interference in his role as CEO of the CHC Board following an independent review commissioned by Welsh Government.”
The Board of Community Health Councils have also been asked for comment.
Reacting to the claims made by Dr Rucinski, the Welsh Conservatives said they were 'shocking'.
Plaid Cymru's Shadow Cabinet Secretary for Health Rhun ap Iorwerth said: “The comments made by Mr Rucinski paint a picture of an insecure Government that won’t accept criticism."