Health Minister’s NHS proposals could cut Local Health Boards to eight

The Welsh Assembly Government has announced plans for major change in the structure of the NHS in Wales that could see the number of Local Health Boards reduced from 22 to eight.

Health Minister Edwina Hart AM, whose plans also involve dismantling the internal market system of NHS funding, said: “My ultimate aim is to improve patient care and the patient experience. Work is well under way in Wales to reduce bureaucracy and remove artificial boundaries within the NHS.”

The Minister gave the first clear indication of her intention to break up the system of 22 LHBs in September last year during an interview with Mental Health Wales, the quarterly journal published by patient group Hafal, which has been pressing the Minister for reform.

In the interview, Ms Hart said: “I think there are too many commissioning bodies…I don’t think this plethora allows us to have effective commissioning. People are getting lost in the gaps between providers of services. We need to do something about it. That is my view.”

Patient groups and others have been critical of the current system, in which each of the 22 local authority areas in Wales has its own Local Health Board which is responsible for the planning and management of services. The LHBs were created in 2003 and replaced five regional health authorities.

Campaigners have been calling for a more streamlined approach to the delivery of health services in Wales, arguing that the number of Local Health Boards had led to inconsistency in treatment and care while adding unnecessary expenditure and bureaucracy.

In the document outlining the proposals, the Minister makes it clear that a further consultation is to be announced on the future of mental health services in Wales. Mental Health Wales believes this may be based on the Minister’s choice between the solution proposed by the Burrows-Greenwell Review of Mental Health Services – the establishment of a number of mental health “legal partnerships” across Wales – and the creation of a single specialist mental health NHS Trust. The latter option has been spoken of favourably of Ms Hart.

Hafal, the principal Welsh charity for people recovering from severe mental illness and their carers, has long argued that patients’ needs are compromised by the current system.

Bill Walden-Jones, Hafal’s Chief Executive, said: “At present in Wales, health services are planned and managed by the 22 LHBs and social care by the 22 local authorities.

“This means that the provision of services vital to our client group, people with severe mental illness, depends on 44 separate local bodies.

“In evidence that Hafal has given to the Assembly’s Health and Social Services Committee, we have pointed out that this is causing day-to-day obstacles to service users and is an inconsistent, expensive way of delivering services to a population of 2.9m people.

“We therefore welcome plans which might lead to a more commonsense, streamlined system for providing patients in Wales with the care they need.”

Consultation on the plans will continue until June.

This map shows the eight proposed Local Health Board areas outlined in Edwina Hart’s NHS restructuring plan.

1. Anglesey and Gwynedd.
2. Conwy, Denbighshire, Flintshire and Wrexham.
3. Powys.
4. Carmarthenshire, Ceredigion and Pembrokeshire.
5. Bridgend, Neath Port Talbot and Swansea.
6. Rhondda Cynon Taf and Merthyr Tydfil.
7. Cardiff and the Vale of Glamorgan.
8. Blaenau Gwent, Caerphilly, Monmouthshire, Newport and Torfaen.