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Praise - and some advice - for Health Minister in second year in her job; Lesley Griffiths was appointed Wales' fourth health minister a year ago. Health Wales asked leading health experts and professionals what they think she has achieved.

PROFESSOR MARCUS LONGLEY, DIRECTOR OF THE WELSH INSTITUTE FOR HEALTH AND SOCIAL CARE, AT THE UNIVERSITY OF GLAMORGAN "This past year has marked the start of a new era for the NHS is Wales. The enormous new health boards were established to make tough decisions.

The new Minister has made it very clear that she expects them now to do so.

"Government will eschew the sort of micro-management that has characterised things up to now, we are told. Organisations with a budget of pounds 1bn and upwards of 15,000 staff can make their own decisions.

"This policy is about to be tested big time, as the health boards - starting with Hywel Dda in the west - now come to make the most controversial decisions imaginable about the future of our hospitals.

"The symbolism and the politics often outweigh the clinical implications of the changes being discussed. Critics will demand that the elected politician takes the decision, not an unelected quango.

"So, the big question is: will the Minister back the health boards, whatever they decide, come what may? "The timing is good - four years until the next election, and with our backs against the financial wall. If it can't be done now, can it ever be done? "Lesley Griffiths is generally acknowledged to be the most accomplished media performer of any of the four incumbents of her post since devolution.

"She is calm, clear and reasonable when confronted by a camera or microphone. But are people prepared to listen? She's going to need all those skills in the coming years, as she explains - in the teeth of political point-scoring - why change is not only necessary, but desirable.

"The ministerial honeymoon is now coming to an end. Ms Griffiths is the Minister left holding the baby when the money runs out, and when the big "to downgrade or not to downgrade" hospital conundrum is resolved.

"Good luck, Minister."

TINA DONNELLY, DIRECTOR OF THE ROYAL COLLEGE OF NURSING IN WALES "Lesley Griffiths has had some major issues to tackle this past year.

"She and First Minister Carwyn Jones promised that the number of whole-time equivalent registered nurses in the NHS in Wales would not fall - and indeed the overall nursing numbers have remained stable.

"However, nurses have experienced an ever-increasing workload and this is causing burnout and exhaustion. Staff are under stress because they are finding it difficult to meet patients' demands.

"Our members tell us they are working extra shifts without compensation or time back and it's still not enough, especially in neonatal services across Wales.

"Bliss, the neonatal charity, has said Wales needs an extra 82 nurses to meet the necessary nursing levels in special care baby units.

"Moreover, the Welsh Government claimed to ensure the people of Wales have health services - and access to health services - that match the best in the world.

"Cancer services across Wales are facing a number of challenges, including rising need, lack of funding, lack of capital investment in building and equipment and lack of appropriate staffing.

"In its recent cancer plan, there is no plan to monitor the recommended implementation of the plan or sanctions on health boards if they choose not to follow the guidelines. National service standards should be set which can be appraised annually.

"In addition, the vision of moving more healthcare from the acute sector into the community so people can be cared for in their own homes, has been unachievable. There has been insufficient government investment in community nursing to enable the shift to run smoothly.

"The Health Minister has promised to activate annual health checks for the over-50 population. How will this be carried out? Nurses have the direct experience to know what is going wrong or needs improvement and they are the ones who will most often have the advice and solutions to offer.

"Collaborative working will help improve the quality, safety, affordability and effectiveness of healthcare for all Wales citizens."

HELEN BIRTWHISTLE, DIRECTOR OF THE WELSH NHS CONFEDERATION "The Health Minister took on the health and social care portfolio at a pivotal point for the NHS in Wales.

"During the past 12 months the need for radical change in healthcare services has been highlighted. And the NHS is facing arguably the most difficult challenges of its 60-year history.

"The Welsh NHS Confederation has been saying for some time that there are difficult and potentially unpopular choices ahead.

"There is a pressing need to make quality and safety improvements to services, at the same time that demand for services and the cost of providing them is rising.

"The time for making those difficult decisions is quickly approaching.

"When the Minister launched Together for Health, the Welsh Government's vision for the NHS in the next five years, she clearly set out what she expects the health service to achieve.

"Health boards are currently gathering as many views as possible to develop proposals for how services will improve in line with this vision.

"While these discussions are ongoing, there is understandably intense scrutiny about what these plans might include.

"The NHS in Wales has a responsibility to demonstrate clearly why changes are necessary, and to involve the public in working through the choices that need to be made.

"But, as the Minister has said, it is important for everyone to understand that no change is not an option.

"While change is never easy, it does present opportunity as well as challenge. And there will always be reason to be proud of our health service and the excellent care our staff deliver day in day out.

"Over the next year, it will be crucial we remember this in the heat of debate and do not forget to show that real improvements have been and will continue to be made, for the benefit of the people of Wales."

DAWN BOWDEN, UNISON'S HEAD OF HEALTH IN WALES "The NHS is always a hot political issue, and in Wales the intensity of that debate has only increased over the past 12 months.

"During the year Unison has been one of many groups vigorously opposing the Tory-Lib Dem coalition's health reforms in England.

"We fear the UK coalition will dismantle the NHS as we know it, and that will now lead to the widespread use of markets to the detriment of the NHS in England.

"But it is also proposing policies like regional pay. So we can clearly see that there will be cross-border implications that could hit our members here in Wales.

"We are very pleased Lesley Griffiths has committed the Welsh Government to remaining true to the founding principles of the NHS.

"Unison believes this is possible while also modernising services to meet the challenges of the years ahead. We know that in Wales there is a shared determination to show there is a better way.

"Wherever possible Unison will continue to work in partnership with other stakeholders to help meet the health challenges facing Wales.

"Of course, this will not be easy given the financial constraints facing public services, including the NHS, in the coming years.

"Trade unions are major stakeholders in the NHS and we know that changing any major organisation takes time and patience.

The staff of the NHS in Wales will, as ever, be major contributors to those changes.

"Unison has 32,000 members in the NHS in Wales and rightly feels it is a major contributor to the care delivered by each and every health team in Wales. This includes nursing staff, technicians, porters, support staff, catering and maintenance teams. "The 12 months since the Assembly election of 2011 has been a period in which Lesley Griffiths has promoted the debate about the shape of health reforms in Wales.

"We will shortly be moving to a more critical stage and trade unions will be fully engaged in the process of speaking up for NHS employees in both the reform of, and we hope, delivery of a better NHS in Wales."


* Lesley Griffiths has won praise for committing the Welsh Government to remaining true to the founding principles of the NHS
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Title Annotation:Features
Publication:Western Mail (Cardiff, Wales)
Geographic Code:4EUUK
Date:May 7, 2012
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