Public Accounts and Public Administration Committee
- Started
- 13:51
- Contributions
- 116
- Words spoken
- 10,383
- Where
- Committee Room 4 - Tŷ Hywel
Summary
The Public Accounts and Public Administration Committee heard two Audit Wales briefings. The first covered the 2025-26 NHS accounts, including seven regularity qualifications and the breach of the break-even duty by six health boards. The second covered the additional learning needs report, including gaps in data on demand, cost and outcomes. The committee will take evidence from three health boards on 12 October and will discuss next steps on additional learning needs in private.
Themes
- Accountability for NHS finances and governance
- Whether the 2014 NHS finance legislation is working
- Gaps in data on additional learning needs
- Lack of evidence on outcomes for public spending
4. Audit Wales Brief: NHS accounts 2025-26
Audit Wales briefed the committee on the 2025-26 NHS accounts. Members asked about accountability, the effectiveness of the break-even legislation and how serious the financial position is.
- Anthony Veale (Audit Wales) said the 12 accounts received clean true and fair opinions but seven regularity qualifications, six of them for breaching the three-year break-even duty. Asked by Andrew Griffin (Reform UK) whether this had become normalised, he said qualification should be by exception but is becoming the norm.
- Alun Cox (Plaid Cymru) said the duty to break even has not worked, that there has been little accountability, and that senior pay above thresholds at Cwm Taf Morgannwg must have been a deliberate decision. Anthony Veale said Welsh Government approval is required to exceed pay bands, that boards have repeatedly not followed the process, and that he saw it as an oversight. Alun Cox replied that he saw a pattern suggesting boards do not feel accountable.
- Matthew Mortlock (Audit Wales) said the National Health Service Finance (Wales) Act 2014 has not had the impact expected and raises questions for the Welsh Government. He added that the escalation and intervention arrangements are under review. In response to Andrew RT Davies (Welsh Conservatives), Anthony Veale suggested Scotland and England as points of reference, while reluctant to call either good practice.
- Anthony Veale said NHS Wales received £12.39 billion in revenue funding, up £823 million, while the in-year deficit across six health boards was £199 million and the cumulative deficit £506 million. Matthew Mortlock said the growing share of the Welsh budget going to the NHS is not sustainable. Asked by Cai Parry-Jones (Reform UK) how serious this is, Catherine Mealing-Jones, the Auditor General, said there is no credible plan to turn it around and it is a structural issue.
5. Audit Wales Brief: Additional Learning Needs (ALN)
Audit Wales briefed the committee on its additional learning needs report. Discussion centred on whether the system remains adversarial and on gaps in data on demand, cost, outcomes and Welsh-language needs.
- Asked by Andrew Griffin (Reform UK) whether the system remains adversarial because of implementation or design, Sara Leahy (Audit Wales) said there was little evidence the original aim of a less adversarial system had been achieved. She said tribunal data shows some signs of fewer appeals, but stakeholders did not report a less adversarial experience. Matthew Mortlock said the children's commissioner still sees this area heavily in casework.
- Alun Cox (Plaid Cymru) said demand costs are unclear and that the share of learners with ALN ranges from 6 per cent to over 17 per cent between counties, which raises the question of whether definitions are understood. Sara Leahy said there is a gap between legislation, the code and local interpretation, that 22 councils run 22 systems, and that not everyone has yet reached a full understanding.
- Shav Taj (Welsh Labour) said the national schools census does not cover Welsh-language needs and asked whether a single data framework should be recommended. Matthew Mortlock said there is scope for better data across the system and uncertainty about which actions the Welsh Government is now committed to. Sara Leahy said a single framework would be welcomed, but collecting data for early years and post-16 learners outside formal education is harder.