Betsi Cadwaladr: Riot act read to north Wales NHS bosses, says minister

Wales' health minister says she has read the "riot act" to some executives at a troubled health board.

Eluned Morgan has been under pressure after putting Betsi Cadwaladr into special measures for a second time.

She said she wanted to see "next steps" to "follow through" on the findings of an audit report, which last week found the executive team was dysfunctional.

Her decision on Monday triggered a row after she asked all of the health board's independent members to quit.

It raised questions as to why board members, who say they had raised concerns about the NHS organisation with ministers themselves, had been targeted instead of executives.

She told the Senedd a "process" would be followed with the executives who had legal rights to be respected, but she did not say what the process would be.

It comes after Ms Morgan told BBC Wales earlier on Tuesday that ex-Betsi Cadwaladr independent board members could not "shrug off" responsibility for how the service is run.

She said she lacked powers to make top managers quit but could intervene with independent board members.

Those board members say her actions expose patients to "significant risk".

Betsi Cadwaladr was already under "targeted intervention" from the Welsh government in a range of areas, including mental health services.

Just two years ago it came out of special measures, after 1,996 days of being under more direct Welsh government oversight.

In defending herself against opposition claims that she has sacked the wrong people, Eluned Morgan told the Senedd she doesn't have the power to get rid of senior executives at Betsi because she is not their employer.

However she repeatedly dropped heavy hints that she expected action to be taken by the newly appointed independent board members.

The first minister made a similar point in First Minister's Questions: "The fact that those actions were not taken yesterday should not be taken as meaning that no action will be taken at all. It's just that things have to be done in a way that respects people's legal rights and in a way that would stand up to external scrutiny."

So what could that action be?

The Clwyd South Labour MS Ken Skates inferred it could mean "huge change potentially within the executive team possibly further into middle management".

The health minister remains under fire, but she may be safer in her job than some of the senior executive staff at Betsi.

Last week, Audit Wales called the health board's senior executive team dysfunctional, following a recent string of failings, including on vascular and emergency services.

It is led by a group of executive directors, responsible for the day-to-day operation of services, and independent board members there to scrutinise their decisions.

In a stormy session of the Senedd Eluned Morgan said: "I can assure you that I very much read the riot act to some of those executives.

"I do not have the power to require executives to step down. I do not employ these people.

"They have legal rights that need to be respected, later adding: "There will be a process and they need to understand that process, I'm sure, will be followed."

She said she had stepped in with the board "when I don't think they've done the job that I needed them to do, which was partly to hold the executive to account, to take the next step, which they'd identified, and that didn't happen".

Ms Morgan told Senedd members she had asked officials to set up a group to look at how ministers can "improve accountability" across the Welsh NHS as a whole.

Welsh Conservative north Wales spokesman Darren Millar told the minister: "It's within the executive team that this [Audit Wales] report points to these problems, not with the independent board members who you forced to resign yesterday."

He said it was "appalling".

"I think it's about time that we have mechanisms in Wales to remove people like that, who do not accept their responsibility for failures when things go wrong."

Rhun ap Iorwerth, health Spokesman for Plaid Cymru, said the health board "has to go", reiterating calls for reorganisation.

"She tells us that breaking it up would be wrong when we are encouraging regional co-operation - Betsi can't even co-operate with itself."

"Let's have a fresh start," he added.

The former independent board members have said in a letter to the first minister that they had "no confidence" in the Welsh government's grasp of the situation.

Earlier, on BBC Radio Wales, Ms Morgan said it was not her "job to have a grasp on things" and the independent board "was in charge".

"It wasn't my job to have a grasp on things, they were in charge," Ms Morgan told BBC Radio Wales Breakfast on Tuesday.

"They can't shrug off the responsibility and say it's my responsibility. We've had concerns about the health board for a while.

"The straw that broke the camel's back was that Audit Wales report that made it very clear that the board was dysfunctional and, although there is a huge amount of criticism of the executive, with the current board it was clear that the relationships had broken down to such an extent that it didn't look they were able to make to make the changes that were necessary in the health board."

As part of the changes chairman Mark Polin has been replaced by former Gwynedd council leader Dyfed Edwards.

In their letter, the former independent board members alleged that responsibility for organisational culture, service quality and delivery "have been placed at our door without recognition of the limitation of our powers as independent members".

"The response to the Audit Wales report, and her focus on independent members rather than the operational executive and their delivery, exposes patients across north Wales, and the organisation to significant risk going forward," they said.

Last week, the Auditor General Adrian Crompton alleged that the executive team suffered from "dysfunctionality and factions".

He said independent members had scrutinised executives publicly, but that was seen as "hostile and inappropriate" by some.