Vaughan Gething accused of breaking Ministerial Code in cancer centre row

Martin Shipton

Campaigners have accused former Health Minister Vaughan Gething of breaking the Ministerial Code of Conduct after the Welsh Government admitted that false claims had been made about a report linked to controversial plans to build a new £725m cancer centre in Cardiff.

The Velindre University NHS Trust intends to build the centre in the Whitchurch district of the city on a popular green space known as the Northern Meadows. But local residents, environmentalists and clinicians argue that it should be co-located with a general hospital.

In arguing the case for a standalone facility in Whitchurch, Velindre and the Welsh Government have relied on a report commissioned from the highly respected health think tank the Nuffield Trust.

At the core of the case in favour of a standalone centre has been that the Nuffield report represented a “review” of the project as a whole and that co-location was rejected. Mr Gething, now the Economy Minister and a candidate in the Welsh Labour leadership contest, followed that line when he was Health Minister.

Review

But in correspondence with the Colocate Velindre campaign group, the Welsh Government has backed down and conceded that the Nuffield report did not amount to a review at all.

In an email addressed to current Health Minister Eluned Morgan, Colocate Velindre, which is run by a group of doctors, pointed out that Nuffield itself had stated in a letter to a Colocate supporter: “[We’ve] tried to be clear that it’s not a review…It would be regrettable if it was seen as anything other than the tightly defined advice that it is…[On] the question of the Northern Meadows site, our advice is limited to the clinical and research issues the decision to rebuild the hospital separate from a main hospital site pose.”

Colocate told Baroness Morgan: “Clearly Nuffield, therefore, did not see itself reviewing or digging up for review the appropriateness of the new cancer centre’s underpinning deliberations. You’ll agree, we trust, that rejecting the word ‘review’ for Nuffield’s work is not petty semantics. Otherwise Nuffield would not have gone out of its way to deny doing a review. Nor would the [Welsh] Government and Velindre have, seemingly, re-cycled the word.

“These strong standpoints surely arise because a ‘review’ really is a big deal. It is the radical testing of a proposal right down to its roots, a deep and comprehensive scrutiny encompassing location choice and much else. We can safely say no such expert, external, clinical ‘review’ has ever been done on the historic, undocumented, founding choice of a ‘standalone’ model for New Velindre. Certainly Nuffield never did one and could not go there.

“Therefore, we suggest it is unfortunate that the myth of a Nuffield ‘independent clinical review’ of the new cancer centre still circulates. It continues to mislead the public, even some in the cancer care community. It also still subverts expert clinical objections to the project which spring from an overwhelming, worldwide consensus. That consensus supports the dominant trend of only building new cancer centres beside acute and surgical services, normally at district general hospitals.”

Evidence

Colocate pointed out that Mr Gething, when Health Minister, had repeatedly referred to the Nuffield report as a review, including when he gave evidence about the project to the Senedd’s Health Committee in September 2020, at which he stated: “Well, as you’ve heard from the chief medical officer, there has been clinical engagement up to 2018; the chief medical officer has indicated that they should undertake and get a further independent review – that’s coming from Nuffield, and I don’t really think there’s anything more to add. We’ll have that and that will be considered as part of the advice that I get when the outline business case is provided to me. So, we’ll of course consider the different options available and the model that is being proposed.”

An official of the Welsh Government’s health department responded to Colocate stating: “Our response … was prepared and issued by officials of the Welsh Government and the reference to ‘independently reviewed by’ should have said ‘subject to independent advice from’ and I apologise to you for this inadvertent error. The same error was made in correspondence to the First Minister, which you refer to, and this is in the process of being corrected.

“This information was given to you in good faith and there was no intention on the part of either Ministers or civil servants to deliberately supply misleading or incorrect information. So while we apologise for the error, we are satisfied that neither the Ministerial Code, nor the Civil Service Code has been breached.”

Revision

A spokesperson for Colocate Velindre said: “No-one now contests that Nuffield made clear its project was not a ‘review’ at all. Rather, it was a narrow exercise focusing on the regional network’s management. For the panel, the cancer centre model was not up for revision.

“In the recent email trail, the government excused its previous deployment of the ‘review’ word as an honest, administrative mistake. Seemingly, its message should have said the Velindre model was ‘subject to Nuffield’. But even the department’s own emails do not contest the campaign response that this version too was erroneous. Put simply, Nuffield makes only scant reference to the standalone model at Velindre so cannot have addressed it. And a single administrative error does not explain the government’s long, persistent misappropriation of a key term.

“For campaigners, the exchange also raises a yet more serious question. Were the same kinds of now abandoned government claims about Nuffield’s scope deployed also to support Velindre’s bid for huge funding? This bid came to the Infrastructure Investment Board (IIB) on December 16 2020. The IIB’s minutes are secret but, it’s suggested, there’s a clue in a government email not long afterwards to what the IIB might well have heard.

“In that message, the health department claimed to a member of the public that the ‘clinical model for the proposed hospital has previously been independently reviewed by the Nuffield Trust as an appropriate right model for the hospital at Velindre’.The strong word ‘right’ stands out. No such language about the proposal of a standalone model is present in the Nuffield report. The panel makes clear that it was not there to consider that topic or pronounce on the new centre’s location.

“Surely, at the IIB meeting, any claim by Velindre management that Nuffield pronounced on the proposed standalone model (as opposed to colocation) would be a misrepresentation at the heart of a major funding bid.

“The seriousness of this deepens with the IIB’s subsequent recommendation to the then Health Minister Vaughan Gething for approval. Several times in a BBC radio interview with Gareth Lewis the Minister again wrongly and repeatedly called Nuffield a ‘review’. This generosity cannot just be a ’misspeaking’. It seemed the Health Minister showed little or no familiarity with Nuffield’s contract terms.

“The full email conversation reveals the campaigners’ aim as a full public retraction of misleading government narratives that have given the Velindre project an easy passage in the public mind. Only a full, comprehensive turnaround on these narratives could avoid infringement of the Ministerial Code of Conduct. So far, disappointingly, it seems they have not fully put the record straight and so have not yet placed themselves in the clear.”

Scrutiny

A spokesperson for the Welsh Government would only say: “The Full Business Case for the new Velindre Cancer Centre is currently going through formal scrutiny.”

A spokesperson for Velindre University NHS Trust said: “The development of the new Velindre Cancer Centre is critical in safeguarding the provision of crucial treatment and care for the 1.5 million people of south Wales over the coming decades.

“It will allow us to keep pace with increasing demand as the number of people referred to us with cancer grows every year. The current cancer centre is more than 68 years old and does not have the facilities or space necessary to meet the future needs and of patients.”