CODE OF CONDUCT 2

Velindre: Complaint lodged with the First Minister

Dear First Minister,

We understand that any claim of breach of the Ministerial Code of Conduct goes to the First Minister, hence this letter comes before you now. It is uniquely marked by gravity and absurdity at the same time. This is because it raises the question of you yourself breaching the code when Health Minister, but incongruously finds you made arbiter over yourself by appointment to your new role.

At first, our correspondence with you of September to December 2023 merely pressed you as Health Minister to correct false information issuing from you and other ministers. We just sought a full, official, public retraction of a false narrative regarding the new Velindre Centre’s legitimacy.

Unfortunately, you went no further than a partial, and even contradictory, response, and added what we perceived as further breaches. We still await a reply to our closing evidence or an unqualified, public retraction. Until then, we see the infringements as live and active even now.

However, with political uncertainty ended over the First Minister’s office and cabinet, we feel justified in taking this extra step of an official complaint now. The questions of fact are not trivial, since they concern at least £1bn of precious cancer money splashed on a cancer centre model belonging in the past century. It is a record Welsh NHS capital debt for an asset that is shrinking.

In brief, evidence from the correspondence shows: 1) that you erroneously assured a correspondent that the decision for the new Velindre’s contentious clinical model (i.e. a centre away from a major hospital), was reviewed by the Nuffield Trust, 2) that your substituted version was nevertheless just as misleading. It still opted to say erroneously that the cancer centre model was ‘subject to the Nuffield Trust’ and 3) yet more erroneously, that you’d never raised the cancer centre model with us at all. We unpack these claims below (also in the file attached).

The backgroundto this claim of infringement of the ministerial code.

# 1. In 2020, clinicians regionwide, and the eminent Welsh External Advisory Board to cancer research, criticised Welsh Government’s plan to locate a new cancer centre away from a major hospital (a ‘standalone’). Calls clamoured for the skipped in-depth, clinical review to scrutinise this 1960s-style cancer centre choice, including the large-scale survey essential to high quality care.

# 2. In response, Health Minister Vaughan Gething, announced the Nuffield Trust ‘Advice’, but falsely announced it on more than one occasion as the needed review. However, the Trust itself made clear that its ‘Advice’ was no such thing. It neither intended, nor carried out, a revisit of the cancer centre model decision. Rather, its focus was the allied cancer network management risks.

# 3. Mr. Gething was forced to withdraw his claim of a Nuffield review. His 2021 plea that it was a misspeak is contradicted by his repeated infringements, misleading even Senedd members and health officials.

The origins of this complaint for infringement of the ministerial code.

# 1. The complaint arises from the correspondence mentioned above, especially the response to an email addressed to Eluned Morgan as health secretary and to her First Minister. Asked directly, officials gave reassurance that their replies reflected ‘the Welsh Government’s position’ [on the new Velindre cancer centre clinical model]. That, of course, is the position you led on.

# 2. Hence, your stance derived from the highest political level, not from officials. 

# 3. The medical campaign group Colocate Velindre had sought only an official, public retraction of apparently dishonest statements. The group saw these as misleading the public over the new Velindre’s safety, future-proofing and fitness for purpose. But as the correspondence unfolded, it yielded two further narratives from you, just as misleading as earlier ones (see the next section). 

A summary of the substanceof this complaint of infringement of the ministerial code.

# 1. In September 2023, an email to you was met with a reply reinstating Mr. Gething’s already retracted and discredited assertion in 2021. As a written piece it was intentional not a misspeak.

# 2. Challenged on this,you fell back on a re-casting. Now, apparently, the health minister only meant to say the cancer-centre model had been ‘subject to Nuffield.’ But Nuffield’s terms of reference and report did not evidence any intent to re-open the cancer centre options appraisal.  

# 3. However, we pointed out, the Nuffield authors did indicate New Velindre’s true place in their work. This lay in the risks it ‘posed’ to managing the cancer network, i.e. not the standalone decision but its consequences. In fact, the decision formed the indisputable assumption of their work. Hence the authors were ‘subject to’ the cancer centre model not the other way round.

# 4. Now, by abruptly re-setting the terms of the conversation,you implicitly caved in to our rejection of the new term ‘subject to Nuffield’. You took refuge in claiming that your emails had always meant the cancer network model was ‘subject to Nuffield’. Too late, we suggest. This rabbit-out-of-the-hat is totally implausible. It flatly contradicts our entire previous conversation. What’s more, the network model had never been controversial or challenged by anyone.

# 5. Thus, you suddenly dropped your own, unambiguous claim at the start, that Nuffield had addressed the cancer centre model’s appropriateness, the original topic, chosen by you. The correspondence’s last email, therefore, finally exposes not just a single misrepresentation, but a serial one. This state of things remains live now, still awaiting your explanation to the contrary.

Impartiality

We trust you to recognise that you cannot make the call on this unique complaint. We understand why, instead, you might just be tempted to turn to Mr Drakeford to do this. But unfortunately, he has already disqualified himself. He too disseminated the same false information in almost identical words, a point not challenged by you. To Mr. Gething then? But he was shown in the correspondence to have excelled you both in misleading the public. Your department has already retracted the core of his position (see above). Given your status as First Minister, we humbly suggest no Labour MS or other official has the necessary detachment to publicly adjudicate on this complaint.

Three First Ministers are involved, and we therefore formally urge you to recuse yourself and direct our complaint to a body that is truly independent and impartial in the eyes of the public. Could this move not be an early, presumably welcome, opportunity to show the people of Wales you really are turning a new page as promised at your appointment as First Minister?

You yourself are well aware that the code dictates that where breach of conduct by misinformation is exposed, the minister resigns. This does not apply to Mr. Gething as he is no longer a minister. But it does apply to the current First Minister and Health Minister. Given such gravity, surely it is urgent to get the complaint processed without stalling or partiality. We’ll assume that since the above is already in the public domain nothing restricts it’s circulation.

The essential primary, email evidence is attached in pdf file and redacted of all names originally copied in. It is also reconfigured chronologically for easier narrative reading. If any part is considered open to challenge regarding faithful transmission, we can provide the original email thread to an independent investigator, but it may need to be redacted of names. However, you have not so challenged it. Source references are sometimes added beyond in-text sourcing.

Yours sincerely,

Penny Owen (Dr)

Roy Kearsley (Dr [not medical]) 

[Representing Colocate Velindre.]

*The Colocate Velindre core group is primarily but not exclusively, editorial, involving 5 senior clinicians experienced in cancer care (plus a comms non-clinician) including at NHS director level. Some of them continue to work in patient care. However, CV supports, defends and amplifies the overwhelming consensus of cancer clinicians and eminent academics regarding cancer centres. These clinicians include the External Advisory Board to cancer research in Wales and those clinicians who have driven every new cancer centre in the UK in the 21st century (except, of course, Velindre). Also followed are 160+ regional senior clinicians working in cancer who in turn represent many more colleagues. Further categories could easily be added. The core five editors, then, draw on a deep and wide, dominant consensus and routinely referee, or collaborate in, all CV’s major comms to news media. CV really can claim only to reflect an authoritative, cancer clinical consensus in UK on new cancer centres and even a worldwide one shown in current WHO research and publishing.