Speeches recovered from the Conservative party’s online archive More…

Morgan: NHS Wales is facing deepening debts

Speech to the National Assembly for Wales.

"We are today attempting to highlight the appalling state of financial mismanagement in NHS Wales. As the Government was so reluctant to bring a debate forwards in its own time, we felt that we had little option but to use opposition time to exploit and consider the state of the NHS's finances and how this Government is failing to sort out the spiralling debts.

I am not alone in the opinion that if the Assembly's health department were a private enterprise, its shareholders would have condemned it and liquidated it years ago. From the moment the Assembly Government took charge of NHS Wales in 1999, public money, in the view of the people of Wales, has been squandered with utter contempt by both health Ministers, who believe that spending more equals investment. It simply does not. To get investment out of expenditure, you need reform, and we have seen little of that in the past seven years.

Far from driving out a deficit culture, the Welsh Assembly Government is speeding head on into a looming financial chasm that will take years to correct. This disturbing trend has culminated in an unacceptable financial position for NHS Wales, with its accumulated debts now totalling some £71 million.

This fact has been conceded by the chief executive of NHS Wales, the head of Brian Gibbons's department at Cathays Park, although, strangely enough, it has been questioned, and even denied, by members of the Assembly Government frontbench.

I must apologise at this stage; I was wrong about the £71 million, as was the chief executive of NHS Wales. It now looks as though the NHS's accumulated debt could reach at least £80 million.

Therefore, I suppose that we were right to hold the debate, although when we tabled the motion and the amendments the figures were somewhat different to those that we have discovered during the past couple of days. All of this has happened despite a record increase in public spending on the health service.

The Labour Party and the Labour Assembly Government may bleat during this debate about the huge dips that we have seen in waiting lists. What they fail to understand is that in 1997, 167,000 people were waiting to see a consultant or for treatment, and that was too many. Today, over 280,000 people are waiting, and that is after the dip that occurred after the previous Minister for health vacated her post and was replaced by Dr Brian Gibbons.

It was this Government that created the all-time high in terms of the waiting list position. Five or six years of devolution saw a rapid increase in the number of people waiting for treatment, despite the rapid increase in expenditure on the NHS. Only recently have we seen those waiting lists come down. When you consider the way in which the money has been spent by the Assembly Government, it is clear that Labour has demonstrated an Enron-esque regard for other people's money, by hoping that extra expenditure is somehow an excuse for poor performance.

How can anyone move from spending £2.6 billion in 1999 to £5.1 billion in the coming financial year and still manage to run up crippling debts among hospital trusts and local health boards? It is utterly absurd.

Having viewed the past weekend's proceedings in Swansea, they are a real testimony to the aptitude and capability of Welsh Labour, which was told by its Secretary of State that it needed to buck up its ideas to avoid having a Conservative First Minister. Peter Hain hit the nail squarely on the head with that one.

The NHS in Wales demands attention, and it is on the NHS that people will judge the Assembly Government next year. Consider the following statements:

'The financial position of NHS Wales is unsustainable';

'Delays in SCEP funding are not satisfactory and should not be repeated'; and,

'There is a risk that the large number of action plans announced by the Welsh Assembly Government have diverted resources away from front line services'.

Those are not my words but those of the Wales Audit Office and the Assembly's all-party Audit Committee. Incidentally, these are statements that Labour colleagues who sit with you, Minister, or do not sit with you as the case may be at the moment, have signed up to. You should accept the criticisms that your party has signed up to in the Audit Committee, namely that, for some reason, the way in which money is allocated within the NHS means that it has not gone through to front-line services in the way that we would have liked to have seen.

At the current rate, deficits could reach around £100 million by April 2007. I think that is a legacy that you, as Minister, would wish to avoid. Having worked with you, and sometimes against you, since your appointment, I do not think that you would wish to see the deficits held by those trusts and LHBs being somewhere in the region of £100 million by the end of this Assembly.

However, we are rapidly getting there, with no sign of the overall debt being reversed. Would the Minister for health describe this debt as manageable? I do not think that most people in Wales would describe it as such.

The British Medical Association, among others, has sought to provide reasons as to why our trusts and LHBs have faced these substantial debts. One of the reasons that it provided is the fact that the GP contract had been drastically underfunded, but that is something that the Assembly Government has refused to accept.

It told you, or rather it told your colleague, that elements of the contract had been underestimated, particularly with regard to the quality outcomes framework. Therefore, because of the underestimate regarding how successful GPs would be and what the financial constraints would be for LHBs, and because of your reluctance to listen to the professions, some LHBs in Wales are now facing significant financial pressures. Do you accept that? If so, how do you intend to resolve the pressure on our local health boards?

The Royal College of Nursing has said that not enough money has been devoted to ' Agenda for Change', and it believes that it is underfunded to the tune of £24 million. That is a significant amount of money and a significant amount of underfunding. The Royal College of Nursing is a significant professional body. It represents nurses who work at the coalface and is an organisation that you really ought to listen to. We heard earlier how the Labour Assembly Government is cosy with the unions and has a good working relationship with them.

Perhaps you ought to listen to Unison, which warns of significant hospital closure programmes across Wales, with wards closing and services deeply affected. Despite these warnings from the people on the ground and those who work at the front line of service provision, you, as Minister for Health and Social Services, have blundered in a cavalier fashion with a Nelson's eye on the NHS's bank balance, and it is you, as Minister, who ought to accept responsibility for this.

The very real impact of this problem is not just a political one for the Labour Party—although I hope that it will be next May—but this problem affects people. It affects not only doctors, nurses and people trying to run the NHS on a day-to-day basis, but patients. Wards are being closed and operations are being delayed towards the end of the financial year because of a shortage of money.

Doctors and nurses are prevented from fulfilling their roles because of the confetti of aims, targets and financial constraints. The bottom line, Minister, is that patients suffer. In November 2005, you said that you would be surprised if debts in Wales were as high as £40 million.

I imagine that the news that NHS debt is somewhere in the region of £70 million to £80 million, and rising, almost puts you on the cardiac waiting list. I am sure that most people in this Chamber would not like to be sat where you are today, facing this enormous task, for which you are partly responsible.

I urge the Assembly Government, and particularly the Minister for Health and Social Services, to sit up and realise that this situation is not just of the making of the LHBs and NHS trusts. I fully accept that they have to do their bit to work within their budgets to ensure efficiency and to bring down administrative pressures.

However, you, as a party, have to realise that you have been in Government in the Assembly for almost seven years. Yes, expenditure has gone up, but the debts have also gone up, and very little has been done to bring those debts down. This problem will not go away, Minister.

If you do not resolve this issue and show some strength in bringing down the huge debts that the NHS is incurring and the large number of pressures facing the NHS, then I do not think that the service has much of a future. For the sake of patients across Wales and the future of the NHS in Wales, something needs to be done, and done rapidly."

"Yr ydym heddiw yn ceisio tynnu sylw at y camreoli ariannol arswydus yn GIG Cymru. Gan fod y Llywodraeth mor amharod i ddod â dadl gerbron yn ei hamser ei hun, teimlem nad oedd gennym fawr o ddewis ond defnyddio amser gwrthblaid i edrych ar, ac ystyried, cyflwr cyllid y GIG a'r ffordd y mae'r Llywodraeth hon yn methu â chael trefn ar y dyledion sy'n prysur gynyddu.

Nid fi yw'r unig un sydd o'r farn, pe bai adran iechyd y Cynulliad yn fenter breifat, y byddai ei chyfranddalwyr wedi ei chondemnio a'i diddymu flynyddoedd yn ôl.

O'r funud y daeth Llywodraeth y Cynulliad yn gyfrifol am GIG Cymru yn 1999, mae arian cyhoeddus, ym marn pobl Cymru, wedi cael ei afradu gyda dirmyg llwyr gan y naill Weinidog iechyd a'r llall, sy'n credu bod gwario mwy yn gyfystyr â buddsoddi. Nid yw hynny'n wir. I gael buddsoddiad o wariant, mae angen diwygio. ac ychydig o hynny a welsom yn y saith mlynedd diwethaf.

Yn hytrach na dileu arferion sydd yn arwain at ddiffyg, mae Llywodraeth Cynulliad Cymru'n mynd ar ei phen i agendor ariannol y bydd yn cymryd blynyddoedd i ddod ohono. Pen draw'r tuedd annymunol hwn yw sefyllfa ariannol annerbyniol i GIG Cymru, sydd wedi cronni dyledion o ryw £71 miliwn bellach. Mae'r ffaith hon wedi ei derbyn gan brif weithredwr GIG Cymru, pennaeth adran Brian Gibbons ym Mharc Cathays, er ei bod wedi ei hamau, yn ddigon rhyfedd, a'i gwadu hyd yn oed, gan aelodau o fainc flaen Llywodraeth y Cynulliad.

Rhaid imi ymddiheuro yn y fan hon; yr oeddwn wedi camgymryd ynghylch y £71 miliwn, fel yr oedd prif weithredwr GIG Cymru. Mae'n ymddangos bellach y gallai holl ddyledion y GIG fod yn £80 miliwn o leiaf.

Felly, mae'n debyg ei bod yn briodol inni gynnal y ddadl hon, er bod y ffigurau braidd yn wahanol pan gyflwynasom y cynnig a'r gwelliannau i'r rhai a ddarganfuom yn y dyddiau diwethaf. Mae hyn oll wedi digwydd er gwaethaf y cynnydd mwyaf erioed yn y gwariant cyhoeddus ar y gwasanaeth iechyd.

Efallai y bydd y Blaid Lafur a Llywodraeth Lafur y Cynulliad yn hel esgusion yn ystod y ddadl hon drwy sôn am y gostyngiadau aruthrol a welsom mewn rhestrau aros. Yr hyn y maent yn methu â'i ddeall yw mai 167,000 o bobl a oedd yn aros yn 1997 i weld ymgynghorydd neu i gael triniaeth, ac yr oedd hynny'n ormod. Heddiw, mae mwy na 280,000 o bobl yn aros, ac mae hynny ar ôl y gostyngiad a gafwyd wedi i'r Gweinidog blaenorol dros iechyd adael ei swydd a chael ei disodli gan Dr Brian Gibbons.

Y Llywodraeth hon a greodd y sefyllfa lle'r oedd y nifer mwyaf erioed ar y rhestrau aros. Yn ystod pump neu chwe blynedd o ddatganoli, gwelwyd cynnydd sydyn yn nifer y rhai a oedd yn aros am driniaeth, er gwaethaf y cynnydd sydyn yn y gwariant ar y GIG. Yn ddiweddar iawn y gwelsom y rhestrau aros hynny'n lleihau. O ystyried y modd y mae arian wedi ei wario gan Lywodraeth y Cynulliad, mae'n amlwg bod Llafur wedi bod yr un mor ystyriol o arian pobl eraill ag y bu cwmni Enron, drwy obeithio bod gwariant ychwanegol yn rhyw fath o esgus dros berfformiad gwael.

Sut y gall rhywun fynd o wario £2.6 biliwn yn 1999 at wario £5.1 biliwn yn y flwyddyn ariannol sydd i ddod a dal i gael dyledion andwyol ymysg ymddiriedolaethau ysbytai a byrddau iechyd lleol? Mae'n gwbl hurt.

Wedi gweld y trafodion y penwythnos diwethaf yn Abertawe, gallaf ddweud eu bod yn tystio i fedr a gallu Llafur Cymru, a hysbyswyd gan ei Ysgrifennydd Gwladol fod angen iddo afael ynddi er mwyn gochel rhag cael Prif Weinidog Ceidwadol. Yr oedd Peter Hain wedi taro'r hoelen ar ei phen wrth ddweud hynny. Mae'r GIG yng Nghymru'n galw am sylw, ac ar fater y GIG y bydd pobl yn barnu Llywodraeth y Cynulliad y flwyddyn nesaf. Ystyriwch y datganiadau canlynol:

Mae sefyllfa ariannol GIG Cymru yn anghynaliadwy;

Nid yw'r oedi wrth roi cyllid dan y Cynllun Newid Strategol ac Effeithlonrwydd yn foddhaol ac ni ddylai ddigwydd eto; ac

Mae perygl bod y nifer mawr o gynlluniau gweithredu a gyhoeddwyd gan Lywodraeth Cynulliad Cymru wedi troi adnoddau oddi wrth wasanaethau'r rheng flaen.

Nid fy ngeiriau i yw'r rhain ond geiriau Swyddfa Archwilio Cymru a Phwyllgor Archwilio trawsbleidiol y Cynulliad. Fel y mae'n digwydd, mae'r datganiadau hyn yn rhai y mae cyd-Aelodau Llafur sydd yn eistedd gyda chi, Weinidog, neu'n peidio ag eistedd gyda chi fel y gallai fod ar hyn o bryd, wedi eu derbyn. Dylech dderbyn y beirniadaethau y mae'ch plaid wedi eu derbyn yn y Pwyllgor Archwilio, sef, am ryw reswm, fod y dull o ddyrannu arian yn y GIG wedi peri nad aeth drwodd at wasanaethau'r rheng flaen fel y carasem weld.

Fel y mae ar hyn o bryd, gallai'r diffygion gyrraedd tua £100 miliwn erbyn Ebrill 2007. Yr wyf yn credu y byddech chi, fel Gweinidog, yn dymuno gochel rhag canlyniad o'r fath. A minnau wedi gweithio gyda chi, ac weithiau yn eich erbyn, ers eich penodi, nid wyf yn credu y dymunech weld y diffygion sydd gan yr ymddiriedolaethau a'r BILlau hynny'n cyrraedd tua £100 miliwn erbyn diwedd y Cynulliad hwn. Er hynny, yr ydym yn prysur gyrraedd sefyllfa o'r fath, heb unrhyw arwydd bod y ddyled gyffredinol yn gostwng. A fyddai'r Gweinidog dros iechyd yn galw dyled o'r fath yn un hawdd ei thrin? Nid wyf yn credu y byddai'r rhan fwyaf o bobl yng Nghymru'n ei disgrifio felly.

Mae Cymdeithas Feddygol Prydain, ymysg eraill, wedi ceisio cynnig rhesymau dros y ffaith bod ein hymddiriedolaethau a'n BILlau wedi wynebu'r dyledion sylweddol hyn. Un o'r rhesymau a roddodd oedd bod contract y meddygon teulu wedi ei danariannu'n ddybryd, ond mae Llywodraeth y Cynulliad wedi gwrthod derbyn hynny.

Dywedodd wrthych chi, neu wrth eich cyd-Weinidog yn hytrach, fod amcangyfrif rhy fach wedi ei wneud o rai elfennau yn y contract, yn enwedig y rhai sydd yn ymwneud â'r fframwaith canlyniadau ansawdd.

Felly, am fod amcangyfrif rhy fach wedi ei wneud o ran llwyddiant meddygon teulu a'r cyfyngiadau ariannol ar BILlau, ac am eich bod yn amharod i wrando ar y gweithwyr proffesiynol, mae rhai BILlau yng Nghymru'n wynebu pwysau ariannol sylweddol. A ydych yn derbyn hynny? Os ydych, sut yr ydych yn bwriadu datrys y sefyllfa o ran y pwysau sydd ar ein byrddau iechyd lleol?

Mae Coleg Brenhinol y Nyrsys wedi dweud nad oes digon o arian wedi ei neilltuo i'r ' Agenda ar gyfer Newid', ac mae'n credu bod y cyllid ar gyfer hynny'n gymaint â £24 miliwn yn brin. Mae hynny'n swm sylweddol ac yn danariannu sylweddol. Mae Coleg Brenhinol y Nyrsys yn gorff proffesiynol o bwys. Mae'n cynrychioli nyrsys sydd yn gweithio yn y rheng flaen ac mae'n gorff y dylem wrando arno.

Clywsom yn gynharach mor agos yw Llywodraeth Lafur y Cynulliad i'r undebau a bod ganddi berthynas weithio dda â hwy. Efallai y dylech wrando ar Unison, sydd yn rhybuddio am raglenni helaeth i gau ysbytai ledled Cymru, gyda wardiau'n cau ac effeithiau dybryd ar wasanaethau. Er gwaethaf y rhybuddion hynny gan rai sydd yn y fan a'r lle a'r rhai sydd yn darparu gwasanaethau yn y rheng flaen, yr ydych chi, fel y Gweinidog dros Iechyd a Gwasanaethau Cymdeithasol, wedi bwnglera'n ddi-hid gan gau llygad ar fantolen y GIG, a chi, fel Gweinidog, a ddylai dderbyn y cyfrifoldeb am hyn.

Nid problem wleidyddol yn unig yw hon o ran y Blaid Lafur—er fy mod yn gobeithio mai felly y bydd fis Mai nesaf—ond un sydd yn effeithio ar bobl. Mae'n effeithio ar feddygon, nyrsys a'r rhai sydd yn ceisio rhedeg y GIG o ddydd i ddydd, a hefyd ar gleifion. Mae wardiau'n cael eu cau a llawdriniaethau'n cael eu gohirio tua diwedd y flwyddyn ariannol oherwydd prinder arian.

Mae meddygon a nyrsys yn cael eu rhwystro rhag cyflawni eu rolau oherwydd y nodau, y targedau a'r cyfyngiadau ariannol dirifedi. Diwedd y gân, Weinidog, yw bod cleifion yn dioddef. Yn Nhachwedd 2005, dywedasoch y byddech yn synnu pe byddai dyledion yng Nghymru cyn uched â £40 miliwn. Gallwn dybio bod y newyddion bod dyled y GIG tua £70 miliwn neu £80 miliwn, a'i bod ar gynnydd, wedi peri braw o'r mwyaf i chi. Yr wyf yn siwr na fyddai'r rhan fwyaf o bobl yn y Siambr hon yn hoffi bod yn eich lle chi heddiw, yn wynebu'r dasg aruthrol hon, yr ydych yn rhannol gyfrifol amdani.

Yr wyf yn annog Llywodraeth y Cynulliad, a'r Gweinidog dros Iechyd a Gwasanaethau Cymdeithasol yn enwedig, i ddeffro a sylweddoli nad y BILlau a'r ymddiriedolaethau GIG sydd yn gyfrifol am y sefyllfa hon yn unig. Yr wyf yn derbyn yn llwyr bod rhaid iddynt wneud eu rhan i gadw o fewn terfynau eu cyllidebau i sicrhau effeithlonrwydd a lleihau pwysau gweinyddol. Fodd bynnag, rhaid i chi sylweddoli, fel plaid, ichi fod mewn grym yn y Cynulliad ers bron saith mlynedd. Ydyw, mae'r gwariant wedi cynyddu, ond mae'r dyledion wedi cynyddu hefyd, ac ychydig iawn a wnaed i leihau'r dyledion hynny.

Nid oes dianc rhag y broblem hon, Weinidog. Os na wnewch ddatrys y mater hwn a dangos rhywfaint o benderfyniad drwy ostwng y dyledion enfawr sydd gan y GIG a lleihau'r pwysau mawr sydd ar y GIG, yna nid wyf yn credu bod llawer o obaith i'r gwasanaeth. Er mwyn cleifion ledled Cymru a dyfodol y GIG yng Nghymru, rhaid gwneud rhywbeth, a hynny'n fuan."

Keyboard shortcuts

j previous speech k next speech