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Radical reformation plans for NHS Minister unveils NHS boards cull
(about 17 hours later)
The number of local health boards (LHBs) in Wales could be cut from 22 to eight under proposals unveiled by the Welsh Assembly Government.The number of local health boards (LHBs) in Wales could be cut from 22 to eight under proposals unveiled by the Welsh Assembly Government.
The plans would also spell the end for the internal market in the NHS with direct assembly government funding.The plans would also spell the end for the internal market in the NHS with direct assembly government funding.
The Conservatives accused Labour of an "embarrassing climbdown" only five years after Wales' five health authorities were scrapped.The Conservatives accused Labour of an "embarrassing climbdown" only five years after Wales' five health authorities were scrapped.
The health minister said the proposals would help improve patient care.The health minister said the proposals would help improve patient care.
The plan is now out for a three-month consultation.The plan is now out for a three-month consultation.
In a statement released by the assembly government, Health Minister Edwina Hart, said her aim was to "improve patient care and the patient experience" and to have "administrative arrangements for the NHS that are effective".In a statement released by the assembly government, Health Minister Edwina Hart, said her aim was to "improve patient care and the patient experience" and to have "administrative arrangements for the NHS that are effective".
The proposals include abolishing the NHS's "internal market" by providing funding from the Welsh Assembly Government or an NHS Board for Wales directly to hospital trusts and LHBs.The proposals include abolishing the NHS's "internal market" by providing funding from the Welsh Assembly Government or an NHS Board for Wales directly to hospital trusts and LHBs.
HEALTH PROPOSALS Abolish the NHS internal market by providing funding for hospitals and health boards from the assembly government or an NHS Board for WalesReduce LHBs from 22 to eight, including Powys LHBThree options for establishing a NHS Board for Wales - a special health authority, a civil service board, or an advisory board supporting an Assembly Government NHS chief executiveSource: Welsh Assembly Government HEALTH PROPOSALS Abolish the NHS internal market by providing funding for hospitals and health boards from the assembly government or an NHS Board for WalesReduce LHBs from 22 to eight, including Powys LHBThree options for establishing a NHS Board for Wales - a special health authority, a civil service board, or an advisory board supporting an Assembly Government NHS chief executiveSource: Welsh Assembly Government class="" href="http://new.wales.gov.uk/consultations/currentconsultation/healandsoccarecurrcons/nhswales/?lang=en">Consultation document
CommunitiesCommunities
The only LHB which is guaranteed to remain under the proposals is that for Powys.The only LHB which is guaranteed to remain under the proposals is that for Powys.
The 22 LHBs were created in April 2003 by former Labour assembly government health minister Jane Hutt.The 22 LHBs were created in April 2003 by former Labour assembly government health minister Jane Hutt.
They reflected the map of local councils in Wales and were intended to bring decision-making closer to communities.They reflected the map of local councils in Wales and were intended to bring decision-making closer to communities.
Wales' five health authorities - Dyfed-Powys, Iechyd Morgannwg, Gwent, Bro Taf and North Wales - were abolished at the same time and £31m of debt was wiped out.Wales' five health authorities - Dyfed-Powys, Iechyd Morgannwg, Gwent, Bro Taf and North Wales - were abolished at the same time and £31m of debt was wiped out.
Ms Hutt at the time said the LHBs would provide "local solutions to local problems".Ms Hutt at the time said the LHBs would provide "local solutions to local problems".
Each was created with 26 representatives across health and local social services - including dentists, pharmacists, doctors and patients - looking at local needs.Each was created with 26 representatives across health and local social services - including dentists, pharmacists, doctors and patients - looking at local needs.
Such a major reduction in the number of health boards would be a dramatic policy U-turn by Labour.Such a major reduction in the number of health boards would be a dramatic policy U-turn by Labour.
Edwina Hart has been forced to try and repair the damage caused to the NHS by her colleague Jane Hutt Jonathan Morgan AM, ConservativeEdwina Hart has been forced to try and repair the damage caused to the NHS by her colleague Jane Hutt Jonathan Morgan AM, Conservative
Conservatives and Plaid Cymru criticised the move at the time, claiming it would increase bureaucracy.Conservatives and Plaid Cymru criticised the move at the time, claiming it would increase bureaucracy.
There has been criticism since that the LHBs are simply too small, with expertise spread too thinly and were not big enough to deal with the NHS trusts, who manage hospitals.There has been criticism since that the LHBs are simply too small, with expertise spread too thinly and were not big enough to deal with the NHS trusts, who manage hospitals.
The idea of the internal market was to promote competition between trusts to provide services, and therefore make them more efficient.The idea of the internal market was to promote competition between trusts to provide services, and therefore make them more efficient.
In reality, LHBs very rarely commissioned from hospitals outside their areas, so the "market" was largely non-existent.In reality, LHBs very rarely commissioned from hospitals outside their areas, so the "market" was largely non-existent.
Health economist Marcus Longley told BBC Wales cutting the number of LHBs was politically pretty embarrassing because it was a Labour assembly government that introduced them.Health economist Marcus Longley told BBC Wales cutting the number of LHBs was politically pretty embarrassing because it was a Labour assembly government that introduced them.
NEW HEALTH MAP 1 Conwy, Denbighshire, Flintshire and Wrexham2 Anglesey and Gwynedd3 Carmarthenshire, Ceredigion and Pembrokeshire4 Powys5 Bridgend, Neath Port Talbot and Swansea6 Cardiff and Vale of Glamorgan7 Merthyr and Rhondda Cynon Taf8 Blaenau Gwent, Caerphilly, Monmouthshire, Newport and TorfaenHow the map of new LHB areas might look, according to the proposalsNEW HEALTH MAP 1 Conwy, Denbighshire, Flintshire and Wrexham2 Anglesey and Gwynedd3 Carmarthenshire, Ceredigion and Pembrokeshire4 Powys5 Bridgend, Neath Port Talbot and Swansea6 Cardiff and Vale of Glamorgan7 Merthyr and Rhondda Cynon Taf8 Blaenau Gwent, Caerphilly, Monmouthshire, Newport and TorfaenHow the map of new LHB areas might look, according to the proposals
The LHBs were set up to match the number of local councils across Wales, but now there was potential for conflict.The LHBs were set up to match the number of local councils across Wales, but now there was potential for conflict.
The consultation also looks at three options for establishing a NHS Board for Wales.The consultation also looks at three options for establishing a NHS Board for Wales.
It could be run along the lines of a special health authority, a civil service board or as an advisory board to support an assembly government NHS chief executive.It could be run along the lines of a special health authority, a civil service board or as an advisory board to support an assembly government NHS chief executive.
Conservative health spokesman Jonathan Morgan said: "This is an embarrassing climbdown by the assembly government.Conservative health spokesman Jonathan Morgan said: "This is an embarrassing climbdown by the assembly government.
"Edwina Hart has been forced to try and repair the damage caused to the NHS by her colleague Jane Hutt.""Edwina Hart has been forced to try and repair the damage caused to the NHS by her colleague Jane Hutt."
Mr Morgan said LHBs lacked capacity and expertise and Labour had made a "catastrophic mistake" when the 22 bodies were introduced.Mr Morgan said LHBs lacked capacity and expertise and Labour had made a "catastrophic mistake" when the 22 bodies were introduced.
Liberal Democrat health spokeswoman Jenny Randerson said they did not believe the current system was sustainable.Liberal Democrat health spokeswoman Jenny Randerson said they did not believe the current system was sustainable.
"However we've serious concerns that any new system must keep strong links with local authorities," she said."However we've serious concerns that any new system must keep strong links with local authorities," she said.
"My great concern is that this is a further step in the Labour-Plaid government's centralising agenda.""My great concern is that this is a further step in the Labour-Plaid government's centralising agenda."