Binning Bad News: Health Minister Edwina Hart 'withheld NHS report'

Welsh Liberal Democrat leader Kirsty Williams produced the document in the Senedd

Health Minister Edwina Hart has been accused of withholding a consultants' report which criticises the Welsh Assembly government's NHS leadership.

Welsh Liberal Democrat leader Kirsty Williams made the accusation in the Senedd, producing a McKinsey document.

Mrs Hart had previously said there was "no formal document for scrutiny".

The assembly government said Mrs Hart misled no-one, there was no McKinsey report, and the document was an example of "numerous inputs and analysis".

The consultants' conclusions were made public by Welsh Liberal Democrat leader Kirsty Williams during First Minister's Questions.

She asked First Minister Carwyn Jones how he explained "the existence of this report, which I have here, commissioned by his health minister, written by McKinsey and company".

She said the report described the assembly government's strategic objectives as 'too numerous and are not prioritised so that none or the wrong objectives are implemented'."

Ms Williams said the health minister had previously stated there was no McKinsey report and accused her of having "misled" AMs and the people of Wales by not publishing the "damning" report.

Mr Jones asked Ms Williams to write to him if she had any complaint about earlier statements given by the health minister. 'Five-year plan'

In a later statement, a spokesman for the Welsh Assembly Government said: "The (health) minister has not misled anyone. There is no McKinsey report. "

Edwina Hart did not mislead anyone, says the assembly government

The spokesman said the document produced by Ms Williams was "one such example" of "numerous inputs and analysis" which formed part of a five-year plan for the NHS.

He added: "The minister has been transparent throughout the whole process."

The McKinsey document made public by the Welsh Liberal Democrats identified criticisms of the way strategies have been implemented in the Welsh health service.

It said: "Our discussions have highlighted several reasons why strategy implementations have fallen short in Wales."

It noted:

• strategic objectives are too numerous and not prioritised, so none or the wrong ones are implemented
• a gap between policy leads and operational delivery
• strategic objectives are politically unviable
• implementation lacks accountability
• initiatives are financially unaffordable
• lack of capability to deliver
  

The document also made a number of recommendations to make savings. These included:

• prevent interventions of limited clinical value
• transfer cost of non-essential items items to patients (e.g nicotine patches)
• shut elective care over Christmas period
• require non-clinical nursing staff to cover shifts
• reduce staffing levels e.g overtime
• freeze pay spend (in certain areas).

Analysis by Vaughan Roderick Welsh Affairs Editor

The row that's erupted over the McKinsey analysis of the Welsh health service is basically a battle of semantics.

For the Welsh Liberal Democrat leader Kirsty Williams, it was an open and shut case. The health minister had denied the existence of a report by the management consultants in two written answers to AMs earlier this year.

Her industrious staff then unearthed a 60-page document written by McKinsey, which she flourished theatrically in front of First Minister Carwyn Jones.

The assembly government's defence is clear and specific. It is not a report, merely a document which was part of a much wider five year framework for the NHS as a whole.

In a sense, you pays your money and you takes your choice.

But document or report, Mr Jones looked uncomfortable, and it's an early political hit for the Lib Dem leader on the first day of the new term.

Blast from the Past: Wigley on Morgan

Slow-retiring First Minister Rhodri Morgan made two big mistakes during his near decade in office, according to former Plaid Cymru president Dafydd Wigley.

In an article written for Ninnau, the North American Welsh newspaper that is largely complimentary about Mr Morgan, Mr Wigley singles out the scrapping of the Welsh Development Agency (WDA) and the first NHS reorganisation as serious errors.

Mr Wigley stated:

To my mind, one of the decisions taken by Rhodri Morgan back in 2004 undermined
the process of securing economic renewal. He decided, with support from all four
parties in the National Assembly, to axe the WDA. This body, at arm’s length from government, had been leading the work to secure economic development.

Since 1975, wrote Mr Wigley, the WDA had gained for itself a very significant international reputation and a brand image that was helpful for Wales.

Many of us feel that it was a disastrous decision to abolish the WDA and to integrate its work into the civil service of the National Assembly. There are no two ways about it: this decision was down to Rhodri Morgan himself. He had been highly critical of the WDA’s lack of answerability over a couple of decades. That decision, to my mind, was fundamentally flawed and Wales will continue to pay the price until some similar structure is recreated.

Writing about what he sees as the other major mistake during Mr Morgan’s period in office, Mr Wigley stated:

The other disastrous decision was to create 22 Local Health Boards in Wales, a bureaucratic nightmare in a country of only three million people.

It is good that the Labour-Plaid coalition government has recently seen the folly of that decision and has replaced those 22 boards with a slimmed-down seven region structure which came into force in October this year.

Writing about the challenges facing the new First Minister, Mr Wigley states:

The new First Minister will have his or her time cut out in living up to the popularity of Rhodri Morgan. There will be huge economic challenges arising from the recession. The Assembly, as with all UK public sector bodies, will face a financial squeeze.

There will be tensions if, as expected, the next UK Government at Westminster is Conservative, with a very different agenda to that of the Labour-Plaid coalition in Wales.

All this will inevitably lead to calls for an early referendum to give the Assembly full parliamentary powers.

We are entering a new era of uncharted waters.

Hart attack: NHS 'spends £1bn of budget badly'

A billion pounds of the annual Welsh health budget is not being spent properly, according to finance chiefs. Full story here.

Welsh assembly members have been told that some patients are taking up beds needlessly, while others needed to be in hospital but were not.

Paul Davies, of the All Wales Directors of NHS, said a fifth of the £5bn annual health budget was not used correctly, with "extremely costly" mistakes.

The Welsh Assembly Government has been asked to comment.

Mr Davies told the assembly finance committee:

Far too many patients end up in the wrong place, either being hospitalised when they shouldn't be, or they stay in hospital too long, or they stay in primary care, and they should be in hospital.

All these mistakes .... [are] extremely costly, very expensive.

We believe there is at least 20% that we are not doing appropriately within the total budget, that if we did then we would see that improvement come through.

There's £1bn that we're not utilising appropriately.

Move the goalposts and score an own goal

As mentioned in my previous post. We're in need of a good story that not only demonstrates the inconsistency of those running the WAG machine, but also an example of the civil service not getting their own way and yet again promoting one of their own numbers from within.

The Western Mail reports the appointment of a freemason as the head of the NHS in Wales was attacked last night as inconsistent.

Paul Williams left his post as chief executive of Abertawe Bro Morgannwg NHS Trust at the end of last month on a two-year secondment during which he will be in charge of the Welsh health service. He is currently working a handover period with Ann Lloyd, his predecessor, who is retiring.

But a civil servant who contacted the Western Mail contrasted the appointment of Mr Williams with an earlier decision to block the appointment of Gerard Elias QC as the Welsh Assembly’s counsel general – partly because he was a freemason.

In 2004, Mr Elias, one of the best-known barristers in Wales, was personally vetoed by First Minister Rhodri Morgan after he was recommended for the post of top legal adviser at the Assembly by Civil Service Commissioners.

Mr Morgan’s refusal to appoint Mr Elias – and the revelation that he had unsuccessfully sought approval from the commissioners to appoint the candidate who came second, a former Labour parliamentary candidate – created a political storm at the time.

The Western Mail received a typewritten letter saying:

I am afraid this note has to be anonymous as I am a civil servant.

You might find it useful to ask the Welsh Assembly Government why it saw fit to debar Gerard Elias from the counsel general post on the basis of his rather inactive freemasonry but now sees no problem in appointing Paul Williams, a very senior and active freemason, to the post of head of NHS Wales.

No doubt the excuse will be that the counsel general offers advice on legal issues but there is no more sensitive post than head of NHS Wales.

I am not a freemason but I have no quarrel with that organisation. I have no axe to grind for or against Mr Elias, unknown to me, or Mr Williams, known to me but not well-known.

My beef is really with the inconsistency and – let’s face it the dishonesty – around decisions like this which devalue the whole Assembly position.

An Assembly Government spokeswoman said:

We appoint on merit and the best person for the job based on skills and experience. We do not have a policy of excluding individuals based on membership of the freemasons.

Candidates are not obliged to declare membership of the freemasons. The issue of Paul Williams’ membership of freemasons is viewed as a private matter.

I couldn't help but contact one anonymous insider that contacted me a while back on another issue. I was told that "one senior civil servant didn't get what they wanted for Christmas" which I think amusingly falls foul of the tradition of Secret Santa.

Merry Christmas everyone.

[Pippa Wagstaff is currently on a blogging break and hopes to return in the New Year]

Free drugs don't work

Welsh Conservative Glyn Davies hinted that something big was going to be covered in the London-based media this weekend, that will be so juicy that it will run for a week. He wasn't wrong.

Today, he gives us his take on the story that has been published by a former Welsh-based journalist in the News of the World. Yes, I know it's the News of the World, but this is a warning that plenty in Wales have been aware of for some time. Described by many as an absolute disaster in policy making, the story has also been covered recently in the Welsh press. This new article takes it a step further - pulling the plug on free prescriptions.

I've said it once, so I may as well say it again. The Welsh Assembly Gimmick Government's main gimmick - in order to make it stand out from Westminster - isn't quite going to plan. We all know that the majority of those that need a regular prescription, or are frequent users of the service, were entitled to free prescriptions under the old system. However, if something is FREE then it's open to abuse from others.

People tend not to think twice when it comes to taking items when free of charge. After all, it's only human nature. This is why it needs to end, or at the very least a nominal charge be placed on prescriptions (except for those covered under the old system). Not sure how the coalition partner is going to handle this challenging part to collective responsibility. They supported the policy in the first place with little reservation, and we all should be in agreement that it's going to be an interesting week in the Senedd. The usual arguments will be made, and what are the odds on the government dismissing the idea of 'pulling the plug' at first, only to change their mind at a more suitable date?

If only we could put an end to the freebie and first-to-do culture of the Assembly Government. More thought is needed when it comes to policy ideas, not 'What would make us look good in the public eye and provide a headline grabber that will run all term?'.

Welsh End Free NHS Drugs

HEALTH chiefs are set to pill the plug on free prescriptions in Wales—because they are too EXPENSIVE.

The free-for-all policy was only brought in by the Welsh Assembly 18 months ago—but has cost far MORE than the anticipated £30MILLION.

Doctors have been dishing out prescriptions for normal over-the-counter products such as vaseline, milk of magnesia and aspirin. And thousands of English people have also taken advantage of the scheme by registering with Welsh doctors.

Figures this year showed there were 100,000 more people on Welsh GPs’ lists than actually lived in the country. It has all led to the NHS there being overwhelmed by the spiralling bill for the drugs, with it draining resources from the rest of the health budget.

The Assembly has admitted that it has no idea how much it will have to shell out this year—but it’s expected to be MILLIONS more than last year.

The crisis will spark fears in Scotland and Northern Ireland over their own plans to scrap charges.

Scotland is phasing them out by 2011, and Northern Ireland last week announced it would cut charges before abolishing them in 2010.

That would leave England as the only part of the UK where patients would still have to pay. A senior Whitehall source said: “In Wales they are running out of money for this and can’t continue.

“They are going to have to pull the plug on it. It’s the last thing anyone wants to do but the financial realities are so serious that they’re having to consider it.”

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.

Not Nice

Matching up expensive drug treatments with limited funds is not easy. Today Anna Wolfenden published her open letter to the Assembly Government health minister about a cancer drug that is not yet available on the NHS. She is not the first to complain about the decisions of NICE, the body with the difficult task of deciding which treatments can be funded.

During debates of this sort you can always rely on someone to invoke the ghost of Aneurin Bevan by mentioning the 'principles of the NHS' (namely that treatment is free at the point of need). But health expenditure is going to simply carry on rising all the time - and faster than our ability to pay.

Are these 'principles of the NHS' really fit for twenty-first century healthcare purposes? Surely equitable health outcomes for all might be a better principle to aspire to rather than holding fast to a mechanism for delivery that was not planned with these expensive drugs in mind. Anyway, in England (and for the moment in Scotland) you have to pay for your prescriptions, so treatment is already not free at the point of need across the NHS.

End is nigh for NHS Bureaucratic heaven

NHS trusts and local health boards will be scrapped in Wales under radical plans to transform the way the health service is structured and managed.

Health Minister Edwina Hart today announced plans to replace the current 22 local health boards (LHBs) and seven acute NHS trusts with just seven new organisations which will provide both community and hospital-based health services.

If the plans are accepted - a further consultation period will start in the autumn - Wales will follow the same system adopted in Scotland and Northen Ireland. Mrs Hart said the proposals for integrated health boards come after an earlier consultation this year to reduce the number of LHBs and end the internal market in the NHS. Many respondents said NHS trusts should also be scrapped.

About time. Bureaucracy rules the roost in the NHS, in Wales. The fact that some NHS Trusts have to deal with more than one Local Health Board has added to the problem.

Homegrown NHS law and badge recognition

Would be silly of me to let this day end without mentioning a further landmark in the future of Wales

The first piece of Welsh legislation in modern times is poised to become law.

Under the Government of Wales Act, the Welsh assembly gained powers to make legislation in some areas without permission from Westminster.

The NHS Redress Measure is set to be approved by the Queen, making it easier and quicker to claim compensation after negligent treatment by the Welsh NHS.

The legislation will also carry the Welsh coat of arms, or Royal Badge of Wales, for the first time.
This will be the first measure, or Welsh law, to complete the process. The Royal Badge of Wales will also appear on all future Welsh laws. It is based on the arms of the native princes of Wales, dating back to the 13th Century, and designed by the Garter King of Arms, Peter Gwynne-Jones.

U-turn on NHS violence law

The Ministry of Justice has reversed a decision to exclude Wales from a new law offering hospital workers extra legal protection against violence.

Welsh Assembly Government ministers had initially said there was no need for the law in Wales. The assembly government had told the Ministry of Justice it would set up its own policies to protect staff, although it does not have the power to change criminal law. But this prompted an outcry from Labour MPs and crossbench peer Baroness Finlay of Llandaff.

The assembly government will have a say in how the new law works in Welsh hospitals. Full story HERE.

Senedd Circular: Does there happen to be an election in May?

This article appears in The Wardman Wire:

This week, Miss Wagstaff has learnt that while the Assembly is away, the politicians will play. It may still be Assembly Recess (until 8 April 2008), but the build-up to local elections in May have got Labour and Plaid Cymru in a constant state of flux.

Going off tangent for a minute, the website of the National Assembly for Wales states that ‘recess’ is between 17th March to 7th April 2008, inferring that Members are back at work from Tuesday, 8th April 2008. A different set of recess dates was announced earlier in this third term. Shock, horror! Surely this gives AMs an extra day off when they should be back on Monday, 7th April to conduct constituency work [Mondays and Fridays have been allocated for AMs to conduct work in their constituencies]. Just a small matter, but important all the same. Perhaps someone can enlighten me as to why they don’t like this particular Monday.

Back to this week’s column, which is primarily concerned with political parties kicking off with the run up to the local government elections in May. Surprise, surprise, we’ll see the gloves coming off – some being eagerly ripped off - as apparently local government politics is different from National politics. Let me explain… Welsh Labour and Plaid Cymru may be partners in the Assembly, however, Plaid have a way around insulting Labour without it interfering with the coalition. ‘Labour in London’ or ‘Unionist Labour’ is seen as a good description for the ‘old enemy’, and the blame is placed on their weary shoulders when things go wrong, without damaging the friendly image of the handholding red/green coalition in the Bay.

Miss Wagstaff has a solution to Plaid’s problems of potentially upsetting their partner at government and unwelcome mistress at the upcoming local election. Perhaps Welsh Labour in local government will also see themselves tagged by Plaid in a particular way. Not beating around the bush - and it’s not going to cost them much – I offer ‘Local Labour’ or ‘Locality Labour’. I’ll get on to the Patient Office before anyone has any similar ideas. £1 for every mention could make me a very rich woman indeed.

Senedd Snippets:

• Labour suffering from underexposure.
• Labour’s campaign calls for last orders.
• Plaid Conference at New port of call.
• Hardly Queensberry Rules.

Labour suffering from under exposure

The contest to be the leader of the biggest gang in the building [Welsh Labour] is not exactly boiling over with excitement in the Welsh media. The Western Mail reports that the likely leading contenders for Rhodri Morgan’s Triple Crown [Leader of Welsh Labour, First Minister, and only Privy Counsellor in the Cabinet] are being left trailing by Plaid Cymru in the TV exposure stakes.

The Plaid Cymru party machine has recently released statistical details of TV appearances made by the seven Labour and three Plaid Cabinet members since last May’s election. Unsurprisingly, the First Minister has appeared most frequently – 211 times in total, however, the next three leading positions were taken by Plaid Ministers – Deputy First Minister Ieuan Wyn Jones (188), Rural Affairs Minister Elin Jones (73) and Heritage Minister Rhodri Glyn Thomas (59). This reflects the Deputy First Minister’s more prominent position in Welsh politics and the new-found attention brought upon his two acolytes having been in the public eye due to the respective fallout from their roles, namely blue-tongue, foot-and-mouth, and the financial difficulties of the Wales Millennium Centre, and Welsh Language newspaper.

Labour’s Cabinet Ministers come in behind: Leadership hopefuls Counsel General and Leader of the House Carwyn Jones (24), and Finance Minister Andrew Davies (16), which doesn’t look good. Not that this bears any reflection on the future leadership contest and there’s one consolation in that the general public won’t be voting. Rhodri’s successor as Welsh Labour leader will be chosen by a party ballot. Whoever wins the contest will automatically lead the Labour-Plaid Cymru coalition, and gain their place as First Minister. Don’t hold your breath though, or even attempt to count the number of future appearances yourself, as our beloved leader isn’t standing down until next year. No doubt their visibility will increase in the run-up to that date.

Labour’s campaign calls for last orders

You may have got the impression by now that there’s an election on the horizon, and to no surprise, you’d be right, with 1260 seats up for the taking in Wales' 22 unitary authorities on 1st May. Labour has launched the beginning of its campaign for the local government elections with a pledge to fight antisocial behaviour throughout Wales, and believes that this early promise to the electorate that future Labour-run councils will be prepared to shut down shops and pubs that persistently sold alcohol to under-18s, will aid those major towns and cities to tackle low-level crime. Labour believes that can oust the Liberal Democrats from Bridgend, Cardiff, Swansea and Wrexham councils. Hold on one second. Hasn’t Labour been in power in the Assembly since 1999 in one shape or form? Hasn’t Labour been in a major position to influence councils in Wales? And hasn’t antisocial behaviour been a problem since 1999?

Meanwhile the Liberal Democrats propose to “end the Labour era”, who’s own launch was in Newport to the rallying cry (which just happens to sound like a supermarket slogan) of Lib-Dem led authorities being "safer, greener" and "better value". Ah well. It’s an election campaign - fair enough. Needs must and all that, and Labour need to desperately hang on to those seats they’ve already got, and the Lib-Dems need to convince the public of their record. Labour will be fighting hard in Newport after the number of Lib-Dem votes at the last Assembly election. Losing Newport would be embarrassing for the party, which leads me nicely into my next story…

Plaid Conference at New port of call

In the run up to Plaid Cymru’s Summer Conference the party launched the first of its policies for the May council elections. Collectively they are known as Innov8 (you see what they’ve done there with the letters and number), and the party intends to focus on new policies in the fields of public health and the environment. As the party puts it, “We are determined not to fall into the trap that other governing parties have suffered, by becoming more concerned about preserving power rather than delivering change.”

In one sentence this means ‘introducing bike sharing schemes in urban areas’ and ‘publicly owned land to be converted to community gardens and allotments’. The remaining Innov8 ideas will be launched over the coming weeks. Let’s hope they get better. Enough said.

Something seems to have stirred inside the Plaid party machine this year by their decision to hold their conference in Newport. The originality of this lies with Plaid wanting (and needing) to broaden their appeal. As Plaid Leader, Ieuan Wyn Jones puts it, “Plaid has gone to Newport to show that it is a party for the whole of Wales”. Meaning that if the North West and West Wales is the heartland and home of Plaid, then Newport must be the opposite. Charming thought if you’re from that area.

Ieuan, a man once described by a colleague and friend [Adam Price MP] as a ‘good country solicitor’ placed himself as preacher, preaching to the converted, but it remains to be seen as to whether they now believe.

He had a lot to defend: the party moving into coalition; Plaid’s performance while in government for the first time; the delivery of Welsh Assembly Government [One Wales] policies - “Wherever you look, in health, education, housing, the environment, childcare, the economy, transport, agriculture, culture, the Welsh language – the fact that Plaid is part of the Government in the Assembly makes a difference and helps improve the quality of life of the people in Wales”. There may have been moves in the right direction in terms of rural affairs, but it must have been hard for the party to stomach his defence of other areas such as transport, heritage, and the referendum to name but a few. Apparently, both he and Rhodri Morgan still intend to honour the agreement and have a referendum before 2011, but now with the added explanation of, “That’s provided, of course, that we’re satisfied that we can win it”.

Ieuan will have to hope that loyal voters understand his new catchphrase, “as a party of government, Plaid now had to make some tough decisions”. Or as a mother might put it – having to say NO to your children for the first time in your relationship.

Good luck to him rallying current supporters and saying the right things to the swinging voters watching the highlights on the Welsh news (Plaid currently has 173 councillors). He’s going to need it. If all else fails the party could predictably copy Labour and warn of a Tory government in Westminster. Looks like they have.

Hardly Queensberry Rules

Whoever said, “All is fair in love and war”, did they forget to include politics?

Plaid Cymru and Labour have this week found themselves embroiled in a row over which party can lay claim to one of Welsh history’s most potent political movements – The Chartist Rising in Newport.

Meanwhile, in the Rhondda, a Plaid Cymru council candidate has been accused by her local Labour MP, Chris Bryant of hating the community she comes from. Bryant’s allegation is based on his reading of an article written by Treorchy Plaid candidate Sera Evans, when she was an Oxford University student six-and-a-half years ago.

Mr Bryant said, “I am amazed that someone who clearly hates the Rhondda so much wants to stand for the council in the Rhondda. Ms Evans defends herself well in the Western Mail, but also leaves the door open for Plaid Cymru AM Leanne Wood to retaliate further, “I’m not surprised that Chris Bryant is unable to identify with Sera’s account of her experiences in the Rhondda. Maybe he should share his recollections of his private education and his journey to Oxford where he became an active member of the university’s Conservative Association.” OUCH! Play fair ladies and gentlemen.

And finally…

The NHS has always been one to stir-up passion in Wales. Last week the Assembly Government rejected the idea of following England to offer staff working in Welsh hospitals extra legal protection from violence and abuse. The decision not to get Wales covered seems like a bit of a public and staff relations cock-up, as it cannot be right that NHS workers in Wales have any less protection than those in England, just because there may be a ‘Welsh’ option on the agenda. This appears to represent devolution at its worst.

In a week that has brought in the start of free parking at Welsh hospitals, it does seem to have taken the public’s mind off the once controversial story [on 1st April] of three new NHS Trusts becoming operational after the merger of seven Trusts, and the newly proposed health map of Wales.

Makes you want to take a deep breath in the world of NHS management and wait for the world to stop spinning.

Blogging will be light

I guess this new found experiment does take up a lot of time when you get going. Blogging will be light over the next few weeks as I'm having to deal with a few family matters in addition to spending even more time with the family in the process, which is a blessing in disguise.

I leave you in the capable hands of Dotcommentator and Senedd Whip, and note that the freebie and first-to-do culture of the Welsh Assembly Government hasn't diminished. Nice gesture, but will it impact on budgets? - I can think of plenty of areas that the money could be spent on within the NHS (or other policy areas) and so can you, but suppose an easy-pleasing headline-grabber is needed by Welsh Labour pre-election. God help us!

You can still contact me in the usual places, if not by email (top right).

Pippa x