Fourth Assembly Committee Legacy

Your contact details

Name:	Gwenan Roberts
Are you responding as an individual or on behalf of an organisation?	On behalf of an organisation
Organisation (and role if applicable):	Head of Corporate Services Cwm Taf University Health Board

Question 1

Thinking about the past five years, in your view:

- to what extent has the Health and Social Care Committee had an impact on health and social care in Wales?

The Committee has probably had an indirect impact on health and social care in Wales through its scrutiny of policy function. The reports published by the Committee cover a very broad range of topics and have drawn attention to key issues that affect this important area of Welsh Government responsibility. However, whilst the Committee has provided a high level of scrutiny and challenge to policy, it is not clear whether this has resulted in any tangible, measurable impact or how far its findings and recommendations have been addressed. It could also be argued that the role of the Committee is to hold to account which is not necessarily the same as having an impact on health and social care.

Given the breadth of subjects they have considered, (for example, ranging from substance misuse, wheelchairs, nurse staffing levels and stillbirths), members cannot be expected to have a specialist, indepth knowledge of every area.  Taking expert witness evidence will have helped the Committee to develop its understanding and come to a balanced view of an issue. However, in practice, it may be difficult to ensure probing and analysis is sufficiently robust to ensure an accurate, rounded, unbiased picture can be obtained.

- what has been the Committee’s biggest achievement?

It is important that the work of Welsh Government is open and transparent. The Committee has a valuable role in enabling this to happen. In particular, by engaging directly with operational and clinical staff, it brings people closer to the machinery of government, enabling them both to make a contribution and influence policy but also understand more fully the process involved in legislation and scrutiny etc.

- if the Committee could have done one thing differently, what would it be, and why?

In addition to its important role in examining legislation, much of which will have major implications for health and social care in Wales in the future, the Committee has undertaken a significant number of inquiries and produced numerous reports over the last three years. However, many staff and members of the public are probably unaware of what has been done. The visibility and profile of the Committee’s work, together with the outcomes achieved, need to be communicated more effectively across all stakeholders.  Ensuring that an overview/key messages are widely publicised and accessible would promote the work of the Committee and also encourage people to follow up and take account of the detailed reports where appropriate.

- has the Committee’s work struck the right balance between scrutiny of policy, finances and legislation?

The Committee appears to have struck a reasonable balance, but we are unsure whether any, or sufficient, consideration has been given to quality of service and outcomes for people. The scale of the legislative programme being undertaken, and the weighty nature of the areas being addressed, have implications for the capacity of members, the workload of the Committee and the amount of time/balance that can be given to the various components being scrutinised.

Question 2

Looking ahead to the next five years, in your view what will be the three biggest challenges for health and social care in Wales?

1. Ensuring the costs of health and social care are recognised and identified alongside the policy intent, together with understanding and articulating the cost to the individual. Challenging population demographics, for example, of an older population, will intensify at a time of increasing financial austerity.

2. Implementing the significant whole system and cultural changes needed as a result of key legislation and policy direction eg Social Services and Wellbeing Act, Wellbeing of Future Generations Act. Delivering genuinely integrated services and holding organisations to account will be challenging.

3. Ensuring consistent, high quality standards across health and social care and rationalising the plethora of different performance management and outcome frameworks.