Labour's control over Welsh NHS questioned as three failing health boards face intervention

Welsh Health Minister Eluned Morgan speaking at the Senedd with regards to escalation and intervention procedures for health boards.

Welsh Government intervention at three failing local health boards has been described as "shocking" but "not surprising."

Speaking in the Senedd, Welsh health minister Eluned Morgan told members yesterday afternoon (Tuesday, 23 January) how Hywel Dda, Swansea Bay and Aneurin Bevan were all facing escalations.

It has left Plaid Cymru questioning whether the Labour Welsh Government’s monitoring framework is “fit for purpose” and the Welsh Conservatives saying it is "stuck playing catchup".

Those in the sector say the latest developments show the "scale of the challenge" faced by the NHS in "balancing financial constraints and ever-increasing demand for services".

Ms Morgan told members of the Senedd the entire Hywel Dda University Health Board in West and mid-Wales is now in "targeted intervention" because financial and planning "challenges" are impacting its performance.

Ms Morgan added the level of escalation at Swansea Bay University Health Board is being escalated to "targeted intervention" for "performance and outcomes" and it will remain in enhanced monitoring for budget and planning.

The emergency department at Grange University Hospital in Cwmbran is of particular concern to Ms Morgan. She says Aneurin Bevan Health Board will face "enhanced monitoring" for "performance and outcomes related to emergency care pathways" at the Grange.

In December, a report by Healthcare Inspectorate Wales (HIW) revealed serious concerns about Singleton Hospital's maternity services in Swansea.

Many of the issues uncovered in the HIW report were first raised in a Wales This Week documentary in October.

Healthcare Inspectorate Wales listed several concerns including one emergency theatre space being described as 'unfit for purpose' and pain relief was 'not always timely'.

Have you heard our new podcast Talking Politics? Every week Tom, Robert and Anushka dig into the biggest issues dominating the political agenda…

Last month (December 2023), Health Minister Eluned Morgan announced an independent review would take place "in order to maintain public confidence in the care being delivered."

Ms Morgan, provided an update to Members of the Senedd yesterday afternoon (Tuesday 23 January) she said: "Before Christmas, I escalated maternity and neonatal services at Swansea Bay University Health Board to enhanced monitoring status, but I'm also concerned that we have not seen sufficient progress in terms of planned and unscheduled care.

"Waiting lists are challenged and there are unacceptable ambulance handover delays. So, to support further improvement, I have decided to escalate performance and outcomes to targeted intervention, but the health board will remain in enhanced monitoring for planning and finance."

The Welsh government's monitoring framework is also facing scrutiny from members of the opposition at the Senedd.

Sioned Williams MS, Plaid Cymru Member of Senedd for South Wales West, said: “The issue here is whether this monitoring framework is fit for purpose to ensure the improvements needed, given that, although various layers of enhanced monitoring were in place from 2016, they were not sufficient in preventing serious failings in its maternity services back in November 2020, the fallout of which is only now belatedly being addressed.

“When the Health Minister herself admits that success looks like health boards coming out of additional government monitoring when intervention levels are having to creep higher and higher, it really begs the question of how much control the Labour Welsh Government has over the NHS in Wales.”

"Eyebrow-raising" is how Russell George MS, Welsh Conservative Shadow Health Minister has described the announcement.

He said: “All of Wales’ health boards had already been escalated to some level due to their finances and we now see that status of three health boards has now been increased – with the whole of Hywel Dda now in the second highest level.

“Swansea Bay’s maternity service has been escalated again, having only just been escalated last month due to long waits and well-documented safety concerns – it’s clear that the Labour Government is stuck playing catchup.

“Aneurin Bevan has been raised due to the ongoing financial difficulties, not helped by the Labour Government’s cuts to the health service this year and these cuts are now impacting performance and patient outcomes at the new Grange University Health Board.

He added: “The Welsh Conservatives want to see Healthcare Inspectorate Wales fully resourced, with Labour’s cuts reversed so that they can support this new framework by spending the full uplift for health on our Welsh NHS.”

The Welsh NHS Confederation says it is working closely with the Welsh Government "to ensure health and care needs can be met during these challenging times".

Its director Darren Hughes said: “These latest developments show the scale of the challenge the NHS and the whole public sector faces in balancing financial constraints and ever-increasing demand for services.

“The NHS and social care are intrinsically linked, so heightened pressure on any one area of the system has a knock-on effect on demand and patient flow."

A Swansea Bay University Health Board spokesperson told ITV Wales: “We remain committed and focused on improving our performance, and welcome this additional support to help us do this as quickly as possible for the benefit of our patients.”

Hywel Dda University Health Board's Chief Executive Steve Moore is "disappointed" with the "expansion of the scope of the targeted intervention", but he recognises how important it is to find "a way forward" to address the issues raised by the Welsh government.

He said: “Like all health boards across the NHS in Wales, we are facing intense pressures on our staff, our systems, and our finances.

“While the expansion of the scope of the targeted intervention status by Welsh Government is disappointing, we recognise that it is a supporting mechanism to enable us to address the issues we face and that we cannot tackle these challenges in isolation.

He added: “We look forward to working with Welsh Government to identify the way forward and what steps we can take, within the budget we have, to make improvements for the benefit of our patients, staff and broader communities."

Aneurin Bevan University Health Board says it has already put in place "enhanced management arrangements to drive the focus and improvement required".

A spokesperson said: "This is not a situation that we want to be in, but it reflects the current extreme pressures on the NHS health and social care system in Wales and across the UK and the challenges that we are continuously facing as a Health Board.

"Our financial deficit has been caused by rising costs over the last few years through the Covid-19 pandemic, increased demand for NHS services, and the extra resources we are using to catch up."

Want a quick and expert briefing on the biggest news stories? Listen to our latest podcasts to find out What You Need To know...