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How Has Dr Gibbons Fared During His First Year in the Job?

Posted on: Tuesday, 17 January 2006, 12:00 CST

By MADELEINE BRINDLEY Western Mail

It has been a year since Dr Brian Gibbons succeeded Jane Hutt as Health Minister, taking control of what some have described as the 'poisoned chalice' of health in Wales. While he appears to have had an easier ride than his predecessor, has Dr Gibbons made a difference to the NHS? Health Editor Madeleine Brindley asked NHS staff representatives for their end of year reports: NURSES: Tina Donnelly, director of the Royal College of Nursing in Wales It's a mixed bag for us - there are some positives and there are some areas for improvement and some that haven't moved as quickly as we'd like. Dr Gibbons has clearly demonstrated commitment to the ban on smoking in public places, which we're delighted with as it was called for in our manifesto. And we're absolutely delighted that we are now beginning to see NHS walk-in centres now coming to the fore. Ministers have also asked the RCN to look at independent nurse prescribing, which to me is a positive move. In terms of the recruitment and retention of nurses, we've seen an increase of about 100 whole-time equivalent nurses across the board in Wales, over and above the rate of attrition.

But this is not enough - the Assembly Government's target is for 6,000 more nurses by 2015, if we're only recruiting 100 a year then I can't see us achieving that target.

We're also still extremely concerned about violence and aggression in accident and emergency departments - not enough is being done, or quickly enough, to curtail the number of nurses who are affected by this.

They need assurances about safer working environments.

We're still waiting for a report on the review of emergency care services in Wales.

We're still not achieving the 95% target for patients to be seen within four hours.

And although waiting times have been reduced, it has not been fast enough for us.

Ten thousand people are still waiting more than a year for their first outpatient appointment and that's unacceptable.

Marks out of 10: 5

Mike Ponton, director of the Welsh NHS Confederation

In the year since the Minister came to office all NHS organisations have worked hard to deliver government targets and the resulting dramatic improvements in areas such as waiting times.

In the first year of Dr Gibbons's tenure the NHS in Wales has delivered a fall of over 93% for people waiting over 12 months for inpatient treatment compared to a year ago.

Nearly 65% fewer people are waiting more than 12 months for a first outpatient appointment.

Patients are being treated far more quickly than a year ago, even though almost the same number of people are on a waiting list.

During the coming year there are several areas that need to be addressed by the Minister with the same clarity, focus and determination as was given to waiting times.

These include the management of long term chronic illness, health commissioning and the reconfiguration of NHS services across Wales.

All of these are signalled in the government's strategy Designed for Life and will involve changes and improvements in the shape and delivery of health services in Wales that will lead to a better and affordable future.

A clear and determined start with plenty still to do.'

Marks out of 10: 6

Dave Galligan, head of health for Unison in Wales

Dr Gibbons has managed to get himself a better press than his predecessor got on the basis of no huge sea-change on waiting lists.

The matter does not seem to have hampered him as much as it did Jane Hutt.

In some respects, he has at least allowed a debate to take place on the wider agenda, rather than it just being based on waiting lists.

Some of these debates about opening up healthcare needed to take place, but I think he's missed an opportunity to have a more critical examination of the existing structures in Wales, especially the 22 local health boards and three regional offices.

This is a cumbersome structure that is not user-friendly for patients or people who work in it and it consumes too much resource.

I'm disappointed that this has not been as high on his agenda as it ought to be as there is significant scope for some reorganisation to get more economies of scale from the current set up. I'm also disappointed he has continued with initiatives but not put money up for them - cleaner hospitals, for example, will cost money. You can put as many people in charge and call them anything you want, but unless this comes with some sort of resource, all the trusts know that there is not enough money in the system to allow the initiative to develop in the way it should.

He is a hostage to fortune and is faced with the increasing challenge of people looking across the border to a very different healthcare system and not comparing like with like.

Getting people to realise that they live in Wales and we have Welsh solutions for Welsh problems is probably his biggest challenge. Marks out of 10: 6 Dr Tony Calland, chair of the British Medical Association's Welsh Council He has had a reasonable first year - waiting lists are coming down, he's been party to the launch of Designed for Life and there are plans for a couple of new hospitals. But he has inherited a system that is in a complete, chaotic mess, which is unbalanced and lacking in capacity, although it would be unrealistic to expect a dramatic change in the first year.

Although the waiting lists for inpatients has come down, the waiting lists for diagnostics - which is, in ways, even more important - is still hopelessly long.

It is playing a major part in the number of emergency admissions of patients, because they become so ill while they are waiting for the diagnostics they should have had months ago, that they end up as an emergency admission to hospital. That really needs to be addressed. The whole system is unbalanced in as much that hospital trusts are powerful compared to the local health boards (LHBs) - there are too many hospital trusts and far too many LHBs.

We consider the whole LHB experiment has been a failure, primarily because the whole commissioning system has completely broken down. Some LHBs have done some very good work locally, but that has been on a community level and was not what they were primarily put in place for. Marks out of 10: 6: DR BRIAN GIBBONS: FIRST YEAR REPORT CARD:Nurses A mixed bag - there are some positives and there are some areas for improvement and some that haven't moved as quickly as we'd like - Tina Donnelly Hospitals During the coming year there are several areas that need to be addressed with the same clarity, focus and determination as was given to waiting times - Mike Ponton Unions He is a hostage to fortune, faced with the increasing challenge of people looking across the border to a very different healthcare system and not comparing like with like - Dave Galligan Doctors He has inherited a system that is in a complete, chaotic mess, which is unbalanced and lacking in capacity. It would be unrealistic to expect a dramatic change in the first year - Tony Calland:

Source: Western Mail

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