Statement by Jane Hutt 2/2/2001
I am grateful for this opportunity of making a Statement to the Assembly, in advance of tomorrow's formal launch of the administration's Plan for the NHS in Wales.
The Plan will provide a sense of renewal and of purpose for the Service over the next ten years. In its detail, it will deal with all the major challenges which face us in improving health and well being in Wales and set out the essential building blocks through which the future can be shaped to the benefit of all our fellow citizens. I look forward to discussing its proposals with the Health and Social Services Committee next week and to the debate which we will hold upon it here, in Plenary, on 13 February.
This morning, I intend to focus upon one aspect of the Plan alone: the structural changes which will be introduced, as a means to achieving the ends which are the real focus of all our efforts. Because these changes are likely to command the initial headlines in reaction to the Plan, it has seemed right to me that the Assembly in Plenary should hear of them, in advance of the document being released to the Health and Social Services Committee and to all members via the Intranet. As the Business Manager said on Tuesday, the full Plan will be placed on the Intranet later today with the accompanying papers for Committee.
Underlying the approach which the Plan adopts are three key characteristics
which, as Health Minister, I have identified as necessary to the future of health
services in Wales. We need to design a service will be:
· simpler for patients to use and understand.
· accountable for the actions it takes and the services it delivers.
· and have a stronger democratic voice in the way it is governed.
In order for these characteristics to be given life, and for the Plan itself
to succeed, we need to strengthen our capacity at two different levels.
At the local level, we intend radically to strengthen and develop the role of Local Health Groups. Through consultation, a set of developmental milestones will be constructed and will show how, over the next few years, LHGs will take on new responsibilities for commissioning and delivery of health care in their localities. In a people centred, and participative health service, the power to obtain the services and support needed must be rooted locally. With new responsibilities will come the need for new forms of accountability and improved management arrangements. Membership of LHGs will, for example, be extended to include representation from local authority elected members. That is part of what I mean by strengthening democracy. The Plan, however, goes further than this in a series of important ways.
At the same time, at the national level, and in order to achieve a Welsh NHS that tackles inequalities and provides the best possible service, we need to ensure that the National Assembly itself provides a new sense of leadership, direction and oversight. The Plan will involve a new assertion of the National Assembly's direct democratic control of its health responsibilities.
A strengthening of the local and of the national capacity, means that we are able to look for additional ways in which the system can be simplified and made more accountable.
After full consideration I have decided to announce the abolition of Health Authorities in Wales. By stripping out a layer of administration, the structure of the service will be simplified and made more understandable.
A country as closely integrated as Wales with a devolved administration which is growing in authority and experience is well placed to be innovative. By removing a tier of bureaucracy, the NHS in Wales will be more transparent, more accountable and more responsive to its users than ever before. It is a radical new vision in keeping with the needs of Wales.
In the new arrangements, fresh, clear and strongly enforced lines of accountability will flow from the centre direct to NHS Trusts and to LHGs. Most importantly, the line of accountability which ought to link this Assembly to the patient will be shortened and brought into much sharper focus. Trusts, in particular, must become accountable servants of their local communities working in partnership with the National Assembly and local stakeholders/interests.
In the new arrangements, the Assembly's statutory responsibilities will be supported by a newly created and inclusive Health and Well-being Partnership Council chaired by the Minister for Health and Social Services. This will make tangible the Assembly's responsibilities for improving health services and engaging the full range of stakeholders. The Assembly will consult on proposals for the future management of the remaining Health Authority duties, including a regional capacity in line with evidence on service provision and use by patients.
The public health function will be overhauled and developed to meet the health
and wellbeing challenges of the 21st century.
The new structure will enhance the democratic voice in Wales, by making the elected National Assembly directly responsible for our health services. Locally, the role of local government will be enhanced. New Partnership Boards will oversee the development and delivery of those community services in which both health and social services play a joint role. The retention of Community Health Councils in Wales will complement these developments and local government will continue to play a vital role within them.
Let me be clear, in drawing towards a close, that this is the administration's plan. Partnership Government means that we are now able to make the necessary decisions through which services in Wales can be shaped and improved. The decision to abolish Health Authorities is a firm one. I was determined not to subject the Service, or its staff, to a prolonged period of discussion and debate about future structural arrangements. That is why the crucial decision about abolition has already been made. From now onwards, in implementing that decision, I will wish to have the maximum participation and discussion with all stakeholder interests, in putting into practice the changes which I have announced.
The assertion of the Assembly's direct oversight, the development of LHGs; new accountabilities for Trusts and the closer integration of local government are all important elements in the renewed NHS for Wales. Equally, important will be an inclusive and consultative programme of implementation which is sensitive to the needs of all staff, maintains services for patients and provides robust new management mechanisms.
In all this, the views of staff and the part which staff have to play in the future will be of very high importance. This Statement has focused upon the changes which will be brought about in the structures of the NHS in Wales. The contribution which staff make endures as the bedrock of the Service, however it might be configured. The practical strengthening of Local Health Groups, and the new strategic arrangements will both depend upon the skills and commitment which individuals now employed in Health Authorities will bring to their new roles and responsibilities. I look forward to working with them over the coming months and beyond.
To summarise: the changes I have announced this morning will produce a health service in Wales in which bureaucracy is reduced, accountability is clearer and the system is made easier to understand. The new arrangements will strengthen strategic decision making at national levels while moving service planning, delivery and accountability closer to communities and patients. I commend them to the Assembly as an example of what a reforming and radical administration can achieve for the people of Wales.