Hywel Dda health board facing bigger deficit

The health board in Wales with the highest level of overspending has seen its financial situation worsen.

The projected deficit this financial year at Hywel Dda, which covers west Wales, has increased to nearly £70m.

The health board blamed increased pressure on services in the autumn for the overspend, which follows deficits of £49m in 2016-17 and £31m in 2015-16.

Welsh ministers said they had "significant concerns" about Hywel Dda's financial management.

The combined overspend of £149m over a three year period is by far the largest out of all of the Welsh health boards.

Betsi Cadwaladr University Health Board, which covers north Wales and is in special measures, is due to record a deficit of £36m this year.

It will have overspent by a total of £86m over the same three year period.

By comparison, Cardiff and Vale University Health Board is set to overspend by £62m over a two year period.

Abertawe Bro Morgannwg, which covers Swansea and Bridgend, has a forecast deficit of £36m.

All four health boards have already been placed under an increased level of scrutiny from ministers due to doubts about their ability to tackle the financial challenges they face.

Ministers say they will not bail any of them out, and that the Welsh Government will cover the debts on the basis the heath boards pay the health boards in the future.

In a report published last summer, the auditor general found "significant workforce challenges" at Hywel Dda, high levels of nursing and medical vacancies, long standing recruitment difficulties and increased service demand.

In 2015-16 there were 250 nursing vacancies, £23m was being spent on agency staff and 6.7% of total pay going to temporary/agency staff, the highest of any NHS body in Wales.

On the latest deficit figures, Hywel Dda finance director Stephen Forster said: "During quarter three of 2017-18 we encountered increased pressures which were reported to the public board meeting on 25th January 2018.

"In light of these the board, after consideration of the ongoing challenges, agreed to increase the deficit forecast to £69.6m for the year 2017-18."

A Welsh Government spokesperson said: "The board were given a clear target to not exceed their planned deficit of £58.9m but it was not until December that they said they would miss this target.

"There are still significant concerns with financial management and reporting within the board, which we are following up in detail with them.

"We are confident the [Welsh] health budget will still balance overall in the current year, even with this increased deficit in Hywel Dda."

These figures confirm how the finances of our health boards are under as much pressure as every other element of the Welsh NHS.

And they pose a particular problem for the Health Secretary Vaughan Gething who has insisted there will be no bail out.

In other words, the Welsh Government expects these health boards to start going into surplus in future years.

Any cursory look at the finances of these organisations tell you how difficult that is going to be.

These stats also show the extent of the problem for Hywel Dda.

It is Betsi Cadwaladr which is in special measures, and yet it is the health board in west Wales facing the greatest financial difficulty, which will no doubt feed into the wider debate about the proposed re-organisation of services in Carmarthenshire, Ceredigion and Pembrokeshire.