Pay and treatment reviews for NHS

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Health Minister Edwina Hart has announced two reviews of the Welsh NHS.

She told AMs there will be an independent investigation of specialist funding treatment body Health Commission Wales (HCW).

Agenda for Change, a set of pay and conditions for 70,000 NHS staff begun in 2004, will also be reviewed because of staff concerns.

On Tuesday a review of the consultation process for plans to reorganise health services in north Wales was announced.

HCW, an agency of the Welsh Assembly Government, has been at the centre of rows over the availability of new medicines, such as the cancer drug Herceptin.

The announcement of the review came as a 47-year-old leukaemia sufferer from Flintshire learned he would now have a bone marrow transplant funded after previously being refused.

Decisions must be based on evidence, must be made in way which patients understand and which are underpinned by an open and transparent appeals process Health Minister Edwina Hart

Tim Tellett-Davies had accused HCW of a "death sentence" by not paying for the £90,000 treatment because it had decided he was too ill.

On this case, HCW said it could not comment on individuals, but decisions were reviewed when "additional evidence from clinicians is presented which demonstrates that the patient meets the criteria within the commissioning policy."

Ms Hart said the agency often had to make "very difficult decisions" which affect patients "suffering from acute and distressing conditions".

She said: "Decisions must be based on evidence, must be made in way which patients understand and which are underpinned by an open and transparent appeals process.

"Dealing in this highly contentious area it is, perhaps, unsurprising that concerns are raised in public about the basis on which some decisions about treatments for individual patients requiring very specialist care have been made".

'Root and branch'

Professor Mansel Aylward, chair of the Wales Centre for Health, will review the agency's functions "including its decision-making processes and appeals mechanisms".

Ms Hart appointed former Wales TUC general secretary David Jenkins to review Agenda for Change, a set of pay and conditions for NHS staff.

The system was introduced in October 2004 and 94% of NHS staff are now paid under the system.

Ms Hart said staff had raised concerns about what they perceived as "inconsistency" in the way Agenda for Change had been introduced in different health bodies.

Sadly, HCW seems to be acting on occasion as a barrier to modern medicines rather than one that anticipates advances in medical science David Melding, Conservative AM

"I remain committed to ensuring that Agenda for Change has been implemented on an equitable and fair basis for all staff," she added.

Conservative AM David Melding said a "root and branch review" into the role of Health Commission Wales was "appropriate and necessary".

"In the general health community in Wales there is a view that the commissioning role of this organisation is far too reactive," he said.

"Given the advances in modern medicine we are not quite up to the pace in Wales.

"When an NHS consultant recommends that a patient should receive a certain form of treatment there is an assumption that this should be made available.

"Sadly, HCW seems to be acting on occasion as a barrier to modern medicines rather than one that anticipates advances in medical science."

Liberal Democrat AM Jenny Randerson said "clarity" was needed over HCW's role.

She said: "They might be doing the best they can within they remit they've been given, I don't know. And I hope this review will find out".

The reviews are due to be completed by the end of the year.