Local Health Boards in Wales

Edwina Hart announced last week that the Plaid/Labour Welsh Assembly Government wants to remove the direct link between local authorities and local health boards.

I am gratified to see that my immediate reaction was the same as that of LibDem health rep. Jenny Randerson: "My great concern is that this is a further step in the Labour-Plaid government's centralising agenda. Welsh Liberal Democrats want to empower the experts and patients, not Assembly government politicians."

She went on: "I'm amazed that this major announcement has been snuck out while the Assembly is in recess. This consultation has major implications for the future of the health service in Wales and has emerged without warning, late on a Wednesday afternoon."

It is probably going too far to infer a move by Labour and Plaid to merge existing local authorities along the same lines. A regional super-power like Bridgend-Neath-Port Talbot-Swansea could form a challenge to the central authority in Cardiff, especially if Liberal Democrats form the largest group on it.

One of the stated aims of the reorganisation is to abolish the internal market. If this is the case, why stop at mergers of the LHBs? Why resort to this expensive (I trust one of the health policy research groups works out how many hip operations, or Sudent treatments, this reorganisation will cost) half-way house, when the government could sweep away the LHBs at one go?

The mergers would remove their main raison d'etre, the local connection. I have been impressed, in the couple of meetings I attended as a member of the public, by the positive approach to local health issues by the board members. I worry that, under the new structure, initiatives within Neath Port Talbot, like the Briton Ferry Health Centre, may be shelved as the agenda is taken over by Swansea.

Whatever system is chosen as a result of the consultation - perhaps even the status quo - must be the permanent one. With her limited budget, Wales cannot afford health reorganisations every time the government changes.

It must also include a means by which people can, locally, call health administrators and professionals to account, or, indeed, publicly commend them.