Campaigners accuse Welsh Government of ‘democratic outrage’ as work starts on controversial hospital

Martin Shipton

Campaigners have accused the Welsh Government of committing a democratic outrage by allowing work to start on a controversial new cancer hospital before the Full Business Case has been approved.

Members of the Save the Northern Meadows group have argued that the New Velindre Cancer Centre in Cardiff should be built next to an existing general hospital rather than as a standalone unit on a much-loved green space that has now been destroyed.

They say the decision to start work on the site before the Full Business Case has been approved is a failure of both democracy and scrutiny of Welsh Government spending.

The Welsh Government insists it has done nothing wrong.

Sign off

Mark Drakeford, the former First Minister who is now the Cabinet Secretary for Health, wrote to South Wales Central MS Rhys ab Owen on August 16, confirming that the Welsh Government has yet to sign off the project which has spiralling costs approaching £1bn.

He wrote: “Velindre University NHS Trust’s board has approved the full business case for the new Velindre Cancer Centre and is expected to formally submit it to the Welsh Government later this month. Significant work has been undertaken to date to review and scrutinise the draft full business case with the aim that once the final document is submitted, a decision can be made promptly.”

But despite the democratic scrutiny of the project not having been completed and the project not yet being formally approved by the Welsh Government, Velindre Trust and their contractors began construction work on May 27 2024, causing the irreversible destruction of a 23-acre Site of Importance for Nature Conservation.

Outrage

A spokesperson for Save The Northern Meadows said: “What has happened is a democratic outrage. A Full Business Case brings to completion the process by which any large and costly construction project that the Welsh Government wishes to fund from public money is subject to a detailed democratic scrutiny process. This process ensures the planned project is necessary, the best solution for the problem and that it is value for money. When the democratic scrutiny process is completed, the Welsh Government then takes the decision whether to approve the Full Business Case and the expenditure, and only then does the construction work start.

“Detailed scrutiny is particularly important for the new Velindre Cancer Centre as many significant clinical, financial and environmental concerns have been raised about the project. For example, is this the best use of scarce public money when in 2020 a policy paper for the Welsh Government acknowledged that this ‘like-for-like’ replacement Cancer Centre ‘is not intended to meet projected increases in demand for treatment on its own.’ That is, the new Velindre Cancer Centre will not be able to bring down waiting times for cancer treatment.

“In addition the Senedd Public Accounts Committee has yet to complete its scrutiny of Velindre Trust and NHS Wales’ decision to appoint a consortium headed by Kajima and Sacyr, two companies convicted of bid rigging, and whether this broke the law.

“Even by the standards of the Welsh Government and Velindre Trust’s total disregard over the last 20 years of all the many serious clinical, financial and environmental objections raised to this project, this takes their misuse of their political power to dizzying new heights.

“By Mark Drakeford’s own account, the democratic scrutiny of the new Velindre cancer centre project has not yet been completed nor has the project been signed off, but construction work has been going on for the last three months. During this three months a heartbreaking and terrible destruction of nature has been allowed to happen.

“Velindre Trust told us to think of the project as being funded by a mortgage. Well this is the strangest mortgage we’ve ever heard of – moving into the house before the bank has even agreed the mortgage, while getting someone else (us) to pay the mortgage for the next 25 years.

“If the Welsh Government does understand the importance of politicians abiding by the rules of democratic government, with openness and transparency, then it needs to answer all the questions below as a matter of urgency. Because devolution was meant to make us better than this.”

* Who gave approval for the New Velindre Cancer Centre construction work to begin prior to the Welsh Government approval of the Full Business Case (FBC)? Who gave approval for the irreversible destruction of a Site of Importance for Nature Conservation before Welsh Government project approval?

* The cost of the construction work undertaken so far since May 27 2024 will be many millions of pounds. Given the FBC has not yet been approved by the Welsh Government, who is funding the construction work undertaken since then?

* Scrutiny of the FBC by the Welsh Government cannot be completed until after the final documents have been formally submitted to the Welsh Government by Velindre Trust. By construction work commencing on May 27 2024, before the FBC has been formally submitted to the Welsh Government, has the democratic scrutiny process in Wales been undermined?

* If Acorn Velindre Ltd or the Acorn Consortium is funding the construction work undertaken to date, what reassurance has the Welsh Government provided to Acorn Velindre Ltd or the Acorn Consortium that its costs to date will be reimbursed or underwritten? Has the Welsh Government supplied a letter of intent or similar to Acorn Velindre Ltd or the Acorn Consortium until the FBC is approved?

* If the Welsh Government is funding the construction works undertaken since May 27 2024, which budget is the funding coming from?

* Does the FBC process have statutory status in Wales?

* Has the Auditor General scrutinised the cost and value for money of the FBC and the Mutual Investment Model contract? [MIM is a variation on the Private Finance Initiative favoured by the Welsh Government}.

* Has the Welsh Government, through the 15% shareholding the Development Bank of Wales has in Acorn Velindre Ltd, contributed to the funding of the construction works that began on May 27 2024?

* Why is the Welsh Government using the finance route of a Mutual Investment Model (ie Private Finance Initiative) to fund this project, when PFIs are already much discredited in England and Scotland?

* Why have successive Health Ministers failed to reply to the detailed concerns of many cancer care specialists regarding the standalone model of care proposed for the new Velindre Cancer Centre?

Decision points

A Welsh Government spokesperson responded: “‘The new Velindre Cancer Centre Full Business Case approval has been split into two parts, with two decision points. The first decision point was the strategic aim of the MIM Contract, which was approved by Ministers in March 2024.

“The second part is the capital budget element. This has yet to be submitted by the Trust. When it is submitted, it will then trigger the next decision point in this scheme.

“Approval to start enabling works on the site (which is outside of the Site of Special Scientific Interest area) and is not a Nature Conservation area was given in 2021 with the approval of the Enabling Works Business Case, following extensive collaboration with other partner agencies such as Natural Resources Wales and local authority planning teams.”

According to the Welsh Government, Part 1 of the FBC is around the strategic aim and the commercial and financial aspects of the MIM Contract (The Construction Element).

Part 2 of the FBC is the strategic aim and commercial and financial aspects of the capital spend element of the scheme. This mainly relates to medical equipment, digital equipment and the Trust staffing to deliver the scheme.

The MIM Contract elements were approved by Ministers in March 2024, contract signature (financial close) was achieved at the end of March 2024 and the scheme commencement started. The signature of the MIM contract (Financial Close) was the stage where contractual assurances were given to the contractor.

Responding to the Welsh Government’s statement, the spokesperson for Save the Northern Meadows said: “This makes no sense. It completely contradicts Mark Drakeford’s statement of August 16. They’re making it up as they go along again.”