Kirsty WilliamsKIRSTY WILLIAMS seems willing to risk martyrdom, writes Clive Betts from the Assembly press gallery.

The Lib Dem leader launched a cutting attack on the size of the health budget, its wastefulness and suggested the need for cuts.

Normally, health spending is absolutely sacrosanct for politicians. The only issue is how to find some more money; never how to cut the existing budget.

Much of the blame was placed by the Brecon and Radnor AM at the foot of health minister Edwina Hart – which sparked the query from a member of the press whether, if she couldn’t run her own department, how could be run the entire government as leader of the Labour group and hence first minister.

Ms Williams declined to comment on that point.

But her attack on Mrs Hart certainly raised questions about the minister’s competence.

It is not that Mrs Hart doesn’t make decisions. But that she rushes into them, without perhaps considering issues carefully enough.

Ms Williams claimed that that the health budget is spent very inefficiently; that about £50bn remains unallocated of this year’s budget. When asked in committee about that unallocated money, Mrs Hart had the gall to ask members whether they had any ideas of how it should be spent, according to the Lib Dem leader.

There’s also the big issue of cash savings from the massive reorganisation carried out last month, with number of NHS organisations reduced from around 37 to about 10.

Ms Williams said that no figure exists for expected savings. Perhaps that it because the rushed change was pushed through on the back of a no-redundancies agreement. How many senior officials are now sitting around doing nothing, but still getting paid, she asked.

Hence the Lib Dem demand for the NHS to face a need to meet during the coming financial year of efficiency savings which are 0.4 per cent higher than faced by other departments.

In return, the under-pressure further and higher-education sector would be given a better deal during the coming year.  We certainly hear quite a few moans from FE and HE – not only from the Lib Dems passing on their pleadings, but direct from the sectors themselves. But both sectors are quite well organised for public relations.

I admit I am surprised at the Lib Dem willingness to attack the health budget. The only reason I can see them getting away with it is that the health minister is not the most popular of characters politically.

Which says something about who should become the new Labour leader …

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ONE OF the problems with being a high-profile minister who thinks she knows how to get things done is that you get the blame for everything that goes wrong, writes Clive Betts from the National Assembly press gallery.

When the service is the NHS, one of the most centralised operations in the world – is it larger than Indian Railways ? – minister Edwina Hart is on a hiding to nothing.

So, Lib Dem leader Kirsty Williams opts to give her a hiding.

The initial reason for her comments was a statement by a former head of the ambulance service in Wales – there are surely half-a-dozen recent claimants for that spot, and Mr Roger Thayne created some headlines of his own – that services have worsened over the last two years.

Mrs Hart responded to his criticism that she “was not happy with the way the service is managed”.

Which is quite a damning statement.

Perhaps she is really saying that it’s time for a seventh head of service.

Ms Williams retorted, “She needs to put up or shut up.”

Mind you, the Lib Dem leader also put forward a list of policy proposals – financial stability; implement capital bids; provide more acute beds linked to A and E facilities; introduce a telephone triage service; and ring fence the rural service

The last items looks very like erecting barbed wire so that vehicles from towns such as Brecon -  a key town in Ms Williams’s constituency – are physically unable to attend calls in the Valleys.  Fine if you live in Brecon; not so good in Vaynor. And surely this sort of policy will raise costs substantially at a time of financial pressure

The most sensible suggestion from Ms Williams was a triage service.  Already it is apparently being introduced at the Cwmbran call centre; there are thoughts the same for Wrexham; but what about the South-West ?

Mr Thayne knew how to collect headlines when he headed the Welsh service. In retirement, he doesn’t seem to have forgotten.

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The Welsh Assembly Government is allocating a sixth (~£50million) of the new expenditure budget, more than to the high profile ‘transport infrastructure’, to preparing for the consequences of a flu pandemic. This is a huge slice of money for a single project  dwarfing  funding to any other similar project. So what is the basis or information on which this has been decided? What is it that they know that they haven’t been telling us and which now requires such massive resources devoted to it?

Now I happen to agree that (bird) flu is a very real and present danger to the human race and it is good that the WAG is apparently preparing for it in an intelligent and foresighted way. Nevertheless, it is also worrying that there has been no significant communication about this. I think the public needs to know if this threat is now more real or about to strike.

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 Ann Jones, normally a fairly amelioratory character, is spitting blood over health issues in the North. Words such as “ridiculous” are ejected with venom against a decision by her own party’s health minister Edwina Hart.

Unfortunately, the disagreements by Mrs Jones, AM for Vale of Clwyd, combine with the weak devolution beliefs of some Labour AMs to produce a toxic brew that will no doubt cause trouble for the Yes campaign when it comes to mount a referendum for Scottish-style powers.

The issue came to a head over the past practice of patients from the North being sent to hospitals in Liverpool for routine treatment of heart complaints. As part of a gradual restructuring of the fiendishly-complicated NHS operative and financial regimes, Mrs Hart is trying to build up centres of excellence in Wales. Unfortunately, for heart-surgery (the big problem in the North, where patients are accostomed to being referred to Liverpool and Manchester), they are in the South.

Simon Thomas, senior adviser to Plaid leader Ieuan Wyn Jones, pointed out to me that the series of issues that have to be dealt with includes the “fiendishly high” charges that hospitals in England make for treating Welsh patients.

Mrs Jones’s weak-devolution beliefs had already been expressed in her attempt to delay the onset of the smoking ban in Wales from April 2 last year to the July date adopted in England. That (failed) bid was launched jointly with Karen Sinclair (Clwyd South), another devolution sceptic.

Now, I hear that Mrs Jones’s bile is reaching written form. She has completed a pamphlet for the Wales 20:20 devo-sceptic group run by fellow-sceptic, Merthyr and Rhymney AM Huw Lewis.

“It’s the next one,” Mrs Jones told me, “unless someone else beats me to it !” Now, with all respect to Ann, there can’t be that amount of competition. I’m sure she’s just winding me up.

And, in any case, there’s another way to look at the problems which exist between Wales and England over who pays for treating NHS patients, and how much. The short piece in The Independent yesterday was written in the context that Bristol hospitals seem at blame in refusing to accept patients from Wales.

But that is hardly the argument that a Welsh devo-sceptic would want to hear.

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