'Ministers appear to have made up their mind long before the consultation period ended, and... may even have done so before the public and health service had any say in it at all. That is not good enough'
Whether or not the creation of a single ambulance service for Wales improves patient care remains to be seen (see News, page 7). But it certainly says something about the cavalier attitude of the Welsh Office to consultation, and will send out a warning to those involved in the wider trust merger programme.
Welsh health minister Win Griffiths ought to justify his claim that the hostile views expressed by community health councils, medical staff, trust leaders and even Labour MPs were 'taken into account'. In what sense is this the case? Did they ever have a realistic chance of influencing the process?
Ministers appear to have made up their minds long before the consultation period ended, and, to judge by the forethought and planning which had gone into the merger at an early stage, may even have done so before the public and the health service had any say in it at all. This is not good enough.
Those who now have to get the trust up and running by 1 April may not be so concerned about all this, though some will surely feel a little disconcerted by it. They face establishing a new organisation and bringing about radical organisational change while making huge cost savings.
But elsewhere in the Welsh NHS alarm bells are ringing. Will any alliance of healthcare providers and users be able to deflect the government from creating a dozen or so combined trusts serving the whole of Wales? What arguments could they put which would have any effect? It is already clear that when the consultation documents go out in June they will be startlingly similar in their approaches and solutions. It does not take a cynic to conclude that there will be a similarly uniform feel about the Welsh Office's conclusions.
It is, of course, the prerogative of the government to reshape organisational arrangements for healthcare delivery as it sees fit. But to dress the decision up as the result, even partially, of public consultation when it blatantly is not is a sham and a disgrace to the democratic process.