'Why did the Welsh Government seek advice on health reform from discredited NHS England?'

Martin Shipton

Labour sources have said it was “extraordinary” that Health Secretary Jeremy Miles’ decided to seek advice about NHS reform in Wales from an expert panel, most of whose members have been associated with the discredited body NHS England.

UK Health Secretary Wes Streeting announced on March 13 that NHS England would be scrapped. He told the House of Commons: “Lord Darzi’s independent investigation into the NHS traced the current crisis back to the 2012 top-down reorganisation of the NHS by [then Tory Health Secretary Andrew Lansley]. The Darzi investigation said the reorganisation was, and I quote, disastrous, a calamity without international precedent.

“It scorched the earth for health reform, the effects of which are still felt to this day.

“The Health and Social Care Act established more than 300 new NHS organisations, created a complex and fragmented web of bureaucracy and, to quote the Darzi investigation, imprisoned more than a million NHS staff in a broken system.

“Well today we are putting the final nail in the coffin of the disastrous top-down reorganisation of the NHS.

“There are more than twice as many staff working in NHS England and the Department of Health and Social Care today than there were in 2010, twice as many staff as when the NHS delivered the shortest waiting times and the highest patient satisfaction in history.

“Today, the NHS delivers worse care for patients but is more expensive than ever before. The budget for NHS England staff and admin alone has soared to £2bn. Taxpayers are paying more but getting less.

“We have been left with two large organisations doing the same roles with an enormous amount of duplication. It is, especially in times like these, when money is tight, that such bloated and inefficient bureaucracy cannot be justified.”

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Scathing report

Mr Streeting’s comments came two months after the Commons’ Public Accounts Committee (PAC) published a scathing report on the performance of NHS England and the lack of innovative ideas coming from it.

Committee chair Sir Geoffrey Clifton-Brown MP said on publication of the report: “The current government has told the public that the NHS is broken. This will not come as news to NHS patients, nor to its hard-working staff across the country. Nor indeed does it to this committee, which has long warned of the systemic issues plaguing the NHS, issues which the government has transformative ambitions to address. We were aghast, then, to find amongst senior officials in charge of delivering these ambitions some of the worst complacency displayed to the PAC in my time serving on it.

“The evidence given to our inquiry exposes the perennial weaknesses with which those scrutinising this country’s health systems are now very familiar. We therefore have a simple message for those senior officials responsible for delivery. Truly fresh ideas and radical energy must be generated to meet the scale of what is required - on community healthcare, on prevention, on digital transformation. Given the position of the NHS, forcing this committee to wade through treacle by mouthing the same stale platitudes of incremental change is simply not going to cut it.”

Last October Wales’ Health Secretary Jeremy Miles appointed a panel of eight health experts to make recommendations about how to reorganise the NHS in Wales. Five of the eight have present or past associations with NHS England.

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Chief operating officer

Chairing the panel is Sir David Sloman, who was NHS England’s chief operating officer from December 2021 until September 2023.

Other members include Professor Tim Briggs, who became national director for clinical improvement and elective recovery for NHS England in November 2022; Adam Roberts, director of urgent and emergency care operational insight at NHS England; Ed Rose, who was director of delivery for NHS England's national cancer programme from 2021 until 2024 and NHS England’s director of elective, cancer, and diagnostics from 2023-24, previously having been adviser to Simon Stevens, chief executive of NHS England, from 2015 to 2018; and Dr Tara Sood, who is currently an NHS England national specialty adviser for same-day emergency care.

A Labour source told Nation.Cymru: “It really is extraordinary that Jeremy Miles appointed this group of people to advise on the future of the health service in Wales. He must have been aware that a big investigation was underway by the Public Accounts Committee, the leading scrutiny body at Westminster.

“Stephen Kinnock [who represents Aberafan Maesteg at Westminster, next to Mr Miles’ Neath seat in the Senedd] is a Health Minister in England, for heaven’s sake. Surely they speak to each other.

“I can’t imagine Wes Streeting is pleased that the Welsh Government is taking advice from people associated with NHS England.”

Significant experience

A spokesperson for the Welsh Government said: “The group was formed in October and members were appointed due to their significant experience. We look forward to receiving their recommendations shortly.”

The eight experts have been asked by Mr Miles to consider and form:

* a reflection of the current performance delivery position in NHS Wales, relative to other parts of the UK;

* an assessment of the processes in place at a system level to drive improvements in efficiency and productivity in NHS Wales;

* an independent view on priorities for improving performance and related targets;

* an assessment of how the NHS in Wales is responding to the delivery of productivity and efficiency measures and system variability in performance;

* an assessment of the current levers for change and of suggested improvements on increased productivity and performance from Welsh Government officials.