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Wednesday, September 30, 2009

More on NHS debt

The Welsh Health Minister followed up her 42 page missive lastw week, in which she claimed the virtual eradication of debt within Wales' National Health Service, with a further announcement yesterday writing off £47 million of historic debt at two of Wales' largest NHS organisations.

She wiped out the £40 million debt that would have been inherited by the Hywel Dda Local Health Board from its predecessor organisations comprising the Hywel Dda NHS Trust and the Carmarthenshire, Ceredigion and Pembrokeshire LHBs. She has also told the North Wales NHS Trust that it will no longer have to pay off the £7 million it owes, sparing the new Betsi Cadwaladr LHB from additional cuts on top of those already planned.

However, there is no mention of the money owed by the Wales Ambulance Trust, who are failing to meet their targets, are in desperate need of more investment and yet have to find £40 million over the next two years in savings.

I raised this issue with the First Minister yesterday and quoted back at him the passage from the Health Minister's mammoth letter in which she said: NHS Trust debt has reduced considerably over the last two years from £42.8m in 2006-07 to £8.1m in 2008-09. However, all he had to say for himself is that he did not recognise the £8.1 million figure. Do government ministers ever talk to each other?

At a Royal College of Nursing event on emergency care yesterday it was made very clear to Assembly Members that problems at Accident and Emergency Units are building up. In many parts of Wales there are just not enough acute beds and staff are unable to move patients out of A&E to suitable care fast enough. They also said that patient transport is not available when it is needed to make use of beds in nearby hospitals.

As a result ambulances are starting to queue outside hospitals in greater numbers and for longer periods and we have not yet hit the pressures brought by the winter period! This has an effect on ambulance response times and may well lead to better performing areas such as North and South West Wales falling behind on their targets. That can only impact on patient care.

Writing off the debt of new LHBs is welcome but the Minister really needs to get to grips with problems faced by the ambulance service and emergency care very soon. She has assumed direct control of the NHS in Wales and the buck stops with her.
It seems to me that the problem for the man (or woman) in the street is knowing where the buck stops. We have health trusts, hospitals managers, the TV telling us that health is a Westminster issue and then we have the WAG. It is a recipe for obfuscation and spreading the blame while leaving WAG to take any credit which may accrue. Until we get a clear view of how the health service is delivered and who takes responsibility for what - the man in the street is unlikely to get to the 'Hart' of the matter and place the blame where it belongs.
What about Abertawe, Bro Morgannwg NHS Trust, what's happening with that Trust's Debt?
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