Monday, August 23, 2010

Health and Social Care in Powys

There are big changes afoot in how health care is delivered in Powys. Don't suppose they will receive the media coverage that they warrant, because the issue doesn't lend itself to an easy headline. But its so important to the people I represent that I want to post about it.

On my last working day before flying out of Manchester last week, I spent an hour speaking to both the Chief Executive of Powys County Council, and the Chief Executive of the Powys Local Health Board about the structure by which health and social services are to be delivered in Powys. Must admit that I've never thought a Powys Local Health Board to be viable - and that's how its beginning to appear. Mental health has already been transferred to other health boards, and the proposed renal dialysis unit in Welshpool is now being managed by the North Wales LHB.

Last September, both Powys County Council and the Powys tLHB decided to explore a merger of the two organisations by 2012. I was supportive of the principle, but sceptical of whether an acceptable agreement could be reached. Well it seems that the scepticism was justified. The sheer scale of the LHB's annual deficit, the costs of merger, restrictions arising from a policy of 'No compulsory redundancies' in the Wales NHS, and what are referred to as 'governance' issues have scuppered the idea of merger. But something must be done, and its being done tomorrow.

The proposal going to Councillors this week is that the Chief Executive of the Powys tLHB is going to also take the role of the Council's Director of Social Care and Well Being (answerable to the Powys Chief Executive). The idea is that such a merger at the highest level will lead to closer working arrangements at all levels of service delivery. If its approved and implemented this week, it will be reviewed in 9 months time. The aim is that the benefits of 'merger' can be achieved without the disbenefits. I accept that something must be done, and support what is being proposed. For the sake of the people of Powys, I hope it works.


Anonymous said...

How can it go to cllrs this week? If I'm not mistaken they don't meet until next week and Andrew Cottom .. Are you having a laugh?

JB said...


I am becoming increasingly concerned that throughout the public sector real and necessary refroms are being sidelined and the issues fudged under the guise of 'co-operation'. First the ELWa, WDA and Torism quangos were taken into the Assembly with a promise of £80m savings with, as far as I can see, little change More recently, Leighton Andrews has consigned to the long grass proper reform of the ridiculous structure comprising 22 LEAs in Wales using the same phrase. Now it appears that the same wooly thinking is going into Health.

We are facing major problems through financial constraint and real strategic leadership of root and branch reform is needed. Instead we have study after study carried out by the very turkeys who don't want to vote for Christmas.

Where are the savings!

Plaid Gwersyllt said...

I think that collaboration between health and social care needs to operate at the 'coal face' and not strategically i.e. Dr Chris Jones's recommendation in Setting the Direction. What is proposed in Powys seems very much like a glorified Local Service Board and how much service improvement through strategic alliances have they produced.