Health Service: Judge, Jury and Executioner

The Minister for Health, Edwina Hart AM has been accused of a "personal takeover" in her latest reform announcement of the NHS. She had intended the organisations would be in place by April next year.

Mrs Hart is to to chair a new NHS Wales advisory board despite suggestions in consultation that an "arms length" body would be more appropriate. She said the board would meet in public and "the buck stops" with her.

SUMMARY OF NHS PROPOSALS:

• A National Advisory Board, chaired by the health minister, will be established
• A separate delivery board will also be created, chaired by the NHS Wales chief executive, responsible for the day-to-day operational performance of the seven new NHS local bodies
• Further work will be undertaken on whether the seven new bodies will be allocated some of the responsibilities of Health Commission Wales, the specialist commissioning body
• A unified public health organisation will be formed, with executive responsibility for public health being vested with the seven NHS local bodies and at a national level.
• A strengthened public health presence within local government

Conservative health spokesman Jonathan Morgan warned the advisory board would mean the "the politicisation of the health service in a way that I never thought possible".

"I do not understand why a government minister needs to be so involved in the day to day delivery of services,"

Liberal Democrat health spokeswoman Jenny Randerson said she completely rejected what she branded a "socialist model of the NHS".

Ms Randerson said the minister had "undermined the whole process of consultation by ignoring the wishes of those who responded to the consultation" by calling for a body that was a step away from politicians.

She accused Ms Hart of "going through the motions" and producing "the most centralising announcement in the assembly's history".

"I have immense regard for Edwina's energy and abilities but that does not stop me worrying hugely about the scale of this personal takeover," she said.

Health gimmick taken up in millions

As the BBC and Western Mail have reported, the Welsh Assembly Gimmick Government's main gimmick - in order to make it stand out from Westminster - isn't quite going to plan.

The number of prescription items dispensed in Wales rose by 2.9m in the first year of free prescriptions, official figures show.

The number of dispensed items rose 5% from 59.1m in 2006/7 to 62m in 2007/8, the
equivalent to 20 items per person.

The chief medical officer said it showed there was more preventative work and more cancer drugs prescribed. But the Lib Dems said the figures proved their concerns of introducing free
prescriptions.

The figures follow a five-year general trend of an increase in items dispensed.

The National Statistics on GP prescribing showed the net cost of the prescribed items was £584m - an increase of 1% on the previous year - and equivalent to £188.90 per head.

Wales' £3 prescription charge was abolished in April last year by the Labour and Plaid Cymru run assembly government.

Wales' Chief Medical Officer Dr Tony Jewell said:

We know that in Wales we have more people with long term illnesses than England. These figures reflect the fact that more preventative work is being undertaken, with GPs prescribing medicines which are helping people manage their chronic conditions and keeping them out of hospital, reducing the cost and pressure on the NHS.

We are also issuing more medicines used to treat cancers, as cancer therapy has improved to a point where, for a number of patients, it is now a chronic condition, plus GPs are helping more patients with diabetes manage their condition under the new enhanced contract.

The figures also show we are increasing access while reducing costs. The net cost per prescription item decreased from £9.80 to £9.42.

But Welsh Lib Dem health spokesperson Jenny Randerson said:

We warned the (assembly) government that giving free prescriptions for all would be disastrous and today's figures have vindicated our position. A 5% increase (in items claimed) is disastrous when the (assembly) government is refusing to fund vital lifesaving drugs. The cost of this gimmick will be with Welsh patients for generations.

While millionaires claim their free paracetamol, the health service will continue to be to stretched to provide life saving services.

Shadow Health Minister Jonathan Morgan, Tory AM, said the figures showed people in Wales were becoming increasingly reliant on prescribed medicine:

The number of prescriptions being issued for cardiovascular problems for example has risen by 141.5% and these are often for the largest, most expensive items. Rather than micro-managing the NHS, the assembly government should be looking at improving the nation's health. Only then, as we become a healthier country, will costs fall.

Opposition politicians immediately said the figures were evidence that the Welsh Assembly Government’s flagship £30m-a-year policy had been a disaster. But doctors said the 2007-08 increases were in line with previous year-on-year rises in prescriptions in Wales and reflected the ongoing poor health of the nation.

Health: Fears over security of NHS patients’ data

Jonathan Morgan AM, Assembly Shadow Health Minister has raised concerns following the Western Mail's disclosure last week that a Wales Audit Office specialist was sent on “gardening leave” the day before he was due to start an investigation into allegations that an NHS body called Health Solutions Wales had passed patient identifiable information to research company Dr Foster in possible breach of the Data Protection Act.

Contradictory statements about whether this confidential information relating to Welsh patients has been passed to a private company have led to a demand that Health Minister Edwina Hart should make an urgent statement.

Andrew Hurley, a £54,000-a-year IT specialist, has not returned to work since being sent on leave in October 2005.

Hugh Morgan, Director of Health Solutions Wales, told the Western Mail his body had not released patient identifiable information to Dr Foster. But he added, “Dr Foster does receive the equivalent information from England.”

Mr Morgan’s statement raised questions about whether patient identifiable information had been passed to Dr Foster relating to Welsh residents being treated in English hospitals.

Dr Foster issued a statement confirming that patient identifiable information had been passed to one of its departments by the Assembly Government. The statement said:

Imperial College has a PIAG (Patient Information Advisory Group) clearance to receive data from the Secondary User Service for certain research purposes. Under this clearance, Imperial College is permitted to disclose pseudonymised data to Dr Foster Intelligence.

Dr Foster does not hold patient-identifiable data – it holds pseudonymised patient-level data from English hospital providers which includes some patients resident in Wales.

The Imperial College Unit at Dr Foster were commissioned by the Welsh Assembly to do some research work and obtained PIAG permission to hold patient-identifiable Welsh data for this purpose. Dr Foster Intelligence does not have access to this data.

But the Assembly Government maintained Dr Foster had not been passed information which could enable patients to be identified. A spokesman said:

Neither Health Solution Wales nor Welsh NHS Trusts have released patient identifiable information to Dr Foster. In relation to Welsh patients with English providers, we have no evidence that this information has been released and therefore the Minister cannot comment, but we have initiated an investigation.

A spokeswoman for the Department of Health in London said:

There are strict procedures in place to ensure no patient identifiable data is passed from the NHS to Dr Foster. Dr Foster only has access to anonymised data.

Shadow Health Minister Jonathan Morgan, the Conservative AM for Cardiff North, said:

I will be calling for the Minister, Edwina Hart, to make an urgent statement on this matter. After a number of recent scandals, there is widespread public concern about the failure to protect confidential private information relating to individuals. The contradictory statements made on this issue means there must be a clear statement of the actual position.

Patients in Wales have a right to expect that their personal information will be protected by the NHS. If there is any question of passing identifiable information on to a third party, there must be a clear reason for it and people should have an opportunity either to give their consent for disclosure or to withhold permission.

At present the NHS is seeking to introduce a new computer system under which it would be possible for many health professionals to gain access to personal information relating to patients. Most people would probably support that so long as there are robust information-sharing protocols in place to ensure personal details are not disclosed inappropriately. But public confidence has been badly shaken by this series of disclosures. I don’t think there is now an appetite for the Government’s proposed national ID card.

Mr Morgan said he was also concerned the Wales Audit Office had apparently abandoned the inquiry that Mr Hurley had been about to undertake:

Although the WAO says its employee’s suspension was unrelated to the inquiry he was about to start, I find the circumstances highly suspicious. I would have expected the inquiry to be undertaken by another member of the WAO staff.