HEALTH boards in Wales are only at the beginning of what a Gwent NHS chief warned will be “a very bad journey” involving the consequences of having to make multi-million pound annual savings.

Despite saving upward of £150m over the past four years, Aneurin Bevan Health Board faces the prospect of trying to find another £150m in savings in the next three years.

As well as significant service changes, the health board has this week talked about measures that would require changes to national agreements regarding pay and working conditions, as a potential means toward balancing its books to the end of 2015/16. The workforce of more than 13,000 fills the equivalent of 10,700 full-time jobs.

Health board chairman David Jenkins said the size of its financial task, and the challenges facing public services generally, require a public debate.

“We need to have a public conversation about the continuing constraints on public spending, the ongoing expenditure squeeze and the impact of it.We are only at the beginning of a very bad journey. “

Resources available to bodies such as the NHS will continue to fall for some years and Mr Jenkins said that if demand continues to rise, the situation becomes increasingly complex, the decisions more difficult.

“Can we do a bit more with a bit less in terms of staff resources? Do we have people working harder for a bit less? Do we do less?” he said.

“We need to get into that debate: the configuration of services, where we do things, at how many sites. Even when we do all that, it is still a struggle within the resources available. It is an astronomically difficult struggle.

Changes to the way services are provided in Gwent have and will continue to be made by Aneurin Bevan Health Board, though the main change, involving building a Specialist and Critical Care Centre, still awaits Welsh Government approval.