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Friday, September 25, 2009

A redefinition of debt

The first week of the new Assembly term is barely over, Rhodri Morgan is still firmly ensconced in post and an e-mail plops into my in-box containing a 42 page letter from the Health Minister and candidate for the top job, Edwina Hart detailing all her accomplishments over the summer recess.

Tucked away on page 22 is a small section on NHS debt which boasts that 'NHS Trust debt has reduced considerably over the last two years from £42.8m in 2006-07 to £8.1m in 2008-09. All debt held by NHS Trusts (except the Welsh Ambulance NHS Trust) has either been repaid or extinguished, so that this will not be a burden for the new Local Health Boards to repay.'

She continues: 'Some Local Health Boards have received brokerage funding in previous years which is recoverable by the Welsh Assembly Government in line with previously agreed Financial Recovery Plans. This currently totals £29.6 million.'

This raises a number of questions. Firstly, why has the Welsh Ambulance Trust not had its debt written off in the same way as other Trusts? This is particularly important given the problems they are having meeting their targets and the need to deliver, whilst at the same time cutting £40 million from their budget over a two year period. It is as if they are being asked to fight on behalf of patients with one hand tied behind their back.

Secondly, if repayable brokerage funding is not debt then what is it? It is clear that some local health boards between them owe £29.6m. That means that the total debt is £37.7 million not the £8.1 million claimed.

Finally, I have to take issue with the impression this section gives that everything is hunky dory as regards the finances of the Welsh NHS. I don't have easy answers to the problems faced by the new LHBs but it does seem that they are being set an impossible task from the start.

According to this morning's Western Mail, the new Abertawe Bro Morgannwg University LHB with be starting life with a £30 million budget gap. Across Wales the new LHBs face having to chop £200 million off their budgets in the first few years. That will lead to service reductions, bed closures and bigger queues for treatment. I believe that they have been told that they cannot use compulsory redundancy as a management tool to effect this change.

The brave new world of NHS reorganisation looks very much like it might founder on some pretty severe financial rocks.
Because of the no redundancy policy that has been adopted, a significant number of NHS staff with very high salaries are not earning their salaries because there are no suitable jobs available for them. An efficient use of resources? Politicians appear to have been silent on this important issue.
You'll never know how depressing I find this Peter. For devolution was meant to deliver far better healthcare, tailored education and more meaningful services for the elderly. All devolution appears to have delivered is talking heads and an assorted group of Welsh language campaigners and other nutters. Oh, and you of course.

As you know I opposed devolution. I did so because I believed it would be an expensive talking shop that, even though it had the powers, would deliver next to nothing (when compared to England) on frontline public services. How wrong I was then. Hee! Hee! Hee!

People like me would actually like support to devolution. If only we could find reasons to support it, other than that BBC in Wales guff about "our Welsh national pride" and "Welsh national identity". For we had that before under the old system and it didn't cost so much. Why don't Labour and Plaid Cymru give us something to be really proud about? Like an excellent top quality National Health Service and education system within Wales.

A decade of devolution and what have we all got to show for it.

A Peter Black Blog that didn't cost a penny.
As someone who does a front line service in the NHS, I am someone who will be leaving the NHS when my contract comes to an end in December, I'm not on a great deal of money, just £15½k
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