On the first week back – the report that was not

The first week back of term at the Welsh Assembly has been an eventful one especially for health. It’s been difficult to avoid discussion of the McKinsey ‘report’.

Last year the Health Minister commissioned management company McKinsey and Company to examine the Welsh NHS and make recommendations based on their findings. The main remit of the report was to look ahead to the next five years and suggests ways to improve the finances of the Welsh NHS.

Unlike the English report, the Welsh Assembly Government commissioned McKinsey in such a way that its findings would not have to be published and made available to the public. The Government have referred to it as a commission and called it a ‘process’ serving to inform the Welsh Assembly Government’s decision making, rather than culminating in a final report.

This meant that the general public, as well as professionals working in the health sector, were unable to view and scrutinise the documents that these decisions were based upon.

In Wales, McKinsey’s findings were set out in a document named Delivering a Five-Year Service, Workforce and Financial Strategic Framework for NHS Wales. This document sets out the Government’s strategy for the Welsh NHS for the next 5 years.

The Welsh Liberal Democrats along with other bodies have been asking to see the McKinsey document for some time and now that it has been revealed, I can see why the government was so keen to keep it under wraps.

It lists numerous shortcomings in the Welsh NHS. It states that ‘strategic objectives are too numerous and not prioritised, so none or the wrong ones are implemented’. It points out a ‘gap between policy leads and operational delivery’. Possibly most damming of all the document states that initiatives, set out by the Government, are ‘financially unaffordable’. With a copy of the report now placed in the public domain, questions to the Health Minister were dominated by ‘McKinsey’.

Assembly debates this week have pushed into harsh light the lack of transparency in our government. Documents of this nature need to be in the public domain so that they may be publically scrutinised. Only then can the recommendations be discussed by those who are affected by them and those who have to implement them.

These views are shared by Andrew Dearden of BMA Wales. He has contributed to the document but hasn’t even seen it himself. He told BBC Radio Wales: ‘In our view, as the BMA Wales, we have asked for copies of the document, we have asked to review it because we were actually asked to give evidence, so if it was full of positive comments, I suspect it would have been made public.’

Of course, this isn’t just about a document. This is about people and a service that we all rely on every day. It seems to me that frontline staff have been completely ignored. The document even says that frontline staff ‘do not own’ strategies set out by the government. It is essential that they have a say in a service that they have to implement.

I intend to press the government on this issue. By asking questions and continuing to talk to frontline staff I will attempt to get to the root of the substantial problems the NHS in Wales is facing.

The McKinsey document has unveiled the need for serious change in the Welsh NHS. This document will have come at a substantial cost to the government. Its criticisms were substantial and worthy of public debate. Equally they are worthy of a substantive government response. So far the Health Minister is refusing to answer detailed questions about the McKinsey report. It is incumbent on her to do so.

Sadly though, I fear that ultimately it is not the Government who will pay the price, it is the people of Wales who will bear the real cost of the government’s ineptitude.


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