£600 Million In. £0.5 Million Out

Since April 2021, the Welsh Government has given Digital Health and Care Wales approximately £600 million of public money. In 2024-25 alone, DHCW's total budget reached £196.48 million — and growing. At the current rate, the next five years would exceed £1 billion. (DHCW Annual Report 2024-25)

At the January 2026 public accountability meeting, DHCW's Director of Finance stated the organisation's total demonstrated return: £0.5 million in non-cash time savings from a single system.

That is 83p for every £1,000 invested.

Nine flagship programmes are under Enhanced Monitoring for delivery failure. Four more have been killed, paused, or stripped to design only. No per-programme spend breakdown has ever been published. This article sets out the arithmetic.

What £600 Million Bought

Welsh Government FOI response ATISN 26790, provided 13 April 2026, discloses DHCW's full funding since its creation. The money arrives through three distinct revenue streams — plus capital.

(Source: Welsh Government FOI ATISN 26790, Q1a revenue schedule and Q1b capital schedule, April 2026)

Core funding alone has risen 78% in four years — from £42.3 million in 2021-22 to £75.5 million in 2025-26. The year-by-year record:

(Source: Welsh Government FOI ATISN 26790, 2nd Supplementary Budget figures where available)

2025-26 — the year DHCW operates under Enhanced Monitoring — is the highest-funded year in its history. Funding did not follow performance. It grew despite it.

Nine Failing Programmes

On 11 March 2025, the Welsh Government moved DHCW from Level 1 — routine monitoring — directly to Level 3 Enhanced Monitoring, skipping Level 2 entirely. This was the first escalation in DHCW's history. (DHCW Annual Report 2024-25)

Seventeen months earlier, the Senedd's joint Health and Social Care and Public Accounts Committees had warned: "Slow roll out and a lack of direction is hindering the development of digital health services." (Senedd joint HSC/PAPA report, July 2023)

The Welsh Government's Level 3 Escalation Framework names nine programme areas where DHCW must demonstrate delivery:

(Source: Welsh Government Level 3 Escalation Framework, May 2025)

These are the systems every NHS Wales patient encounters. Every one is failing under Enhanced Monitoring. (For what that means for the 3.2 million people who depend on them, see No Plan B.)

No per-programme spend breakdown has been published for any of these nine areas. A Freedom of Information request seeking this breakdown — ATISN 26790, questions 2-4 — was refused on cost grounds. The public does not know how much of its £196.48 million DHCW allocates to any single programme. (For the full programme-by-programme delivery record, see Nine Programmes, Zero Results.)

Four More Killed, Paused, or Descoped

Alongside the nine failing programmes, DHCW's own 2024-25 Annual Report records four more that were closed, paused, or significantly reduced during the same period:

• Digital Maternity Cymru — closed nationally. Welsh Government switched to direct Health Board funding.
• National Digital Eye Care Programme — paused due to "funding challenges and commercial complexities."
• Welsh Intensive Care Information System (WICIS) — paused pending an independent review commissioned by Welsh Government. The review has not been published.
• Welsh Nursing Care Record (Paediatrics) — descoped from build to design only, due to funding reduction.

Nine programmes under escalation. Four more killed or nerfed. £135 million of Digital Priorities Investment Fund was specifically earmarked for these programmes over five years. Every programme it funded is now either failing, frozen, or dead.

The Return: £0.5 Million

At the January 2026 public accountability meeting, DHCW's Director of Finance disclosed the total demonstrated return from all of DHCW's investments: £0.5 million. Non-cash time savings. From a single system.

(Sources: Welsh Government FOI ATISN 26790; DHCW Director of Finance, public accountability meeting, January 2026; DHCW Annual Report 2024-25. For the full transcript of that meeting, see What They Admitted.)

For every £1,000 of Welsh public money committed to DHCW since 2021, 83p in demonstrable value has come back.

This is not an early-stage investment awaiting returns. DHCW is in its fifth year. Its CEO wrote in the 2024-25 Annual Report foreword that the organisation is "embracing the opportunity that the increased focus and support in this area affords us." (DHCW Annual Report 2024-25, foreword) The "opportunity" is Level 3 Enhanced Monitoring — imposed for failing to deliver the programmes the £600 million was spent on.

In the same foreword: "quality is at the heart of everything we do, demonstrated by our ISO Standards and the achievement of a financially balanced position including recurrent savings." (DHCW Annual Report 2024-25, foreword)

The budget is balanced. The return is 83p per £1,000.

The Scissors: Admin Grows, Programmes Die

DHCW knows its programme funding is in structural decline. Its own Annual Report says so without qualification: "A lack of sustainable funding model for DHCW particularly relating to programmes funded via the Digital Investment Priorities fund has posed a risk to the organisation across the last 12 months which has subsequently posed a risk to staffing levels." (DHCW Annual Report 2024-25)

The DHCW Integrated Medium Term Plan 2025-28 shows the trajectory of programme-specific funding:

(Source: DHCW IMTP 2025-28)

Core operational funding — which pays for DHCW's administrative base, not its delivery programmes — moves in the opposite direction:

(Source: Welsh Government FOI ATISN 26790)

The scissors are open. Programme funding — the money that was supposed to build the systems patients actually use — goes to zero by 2026-27. The administrative base that has failed to deliver those systems continues to grow. By 2026-27, DHCW will cost £75 million a year to run and have zero programme funding to deliver anything.

On 16 April 2026 — the same week this funding cliff becomes visible — the Board approved a £226 million, five-year Microsoft licensing commitment by direct award. Programme funding goes to zero. The licensing commitment runs to June 2031. (For the full account of that 25-minute extraordinary Board meeting, see £226 Million. 25 Minutes. No Risks to Escalate.)

Programme funding → £0 by 2026-27. Admin funding → £75.5M and growing. Microsoft licensing → runs to June 2031.

What No One Will Tell You

On 15 April 2026 — the day before the £226 million Board meeting — the Welsh Government responded to a CareNHS Freedom of Information request seeking the conditions, milestones, and performance criteria attached to the approximately £600 million. The Welsh Government told CareNHS to "refine" its request, confirming that any refinement "will be treated as a new request" — resetting the 20-day statutory clock. (Welsh Government FOI response, 15 April 2026, ATISN 26790)

The information that would make the spending contestable remains unavailable. The public cannot answer the most basic question about £600 million of its own money: what was DHCW required to deliver in return?

DHCW's published accounts do not help. Their consultancy line reports £325,000 for 2024-25. A separate FOI response discloses 49 consultancy contracts totalling £8,943,015. Both figures are true within DHCW's own definitions. (See £8.94 Million on Consultants.) Software licensing of £48 million a year is disclosed as a single total with no supplier breakdown. (See £226 Million. 25 Minutes. No Risks to Escalate.) Per-programme spend on the nine failing programmes is refused on cost grounds.

The pattern is consistent: aggregate totals are published, the detail that would enable scrutiny is not. (See What They Don't Publish.)

What the Next Senedd Can Do

Wales elects a new Senedd on 7 May 2026. The incoming Finance Committee and Health and Social Care Committee have the power to compel:

• Per-programme spend for the nine named programme areas under Enhanced Monitoring.
• The Welsh Government Remit Letter of 14 March 2025, which imposed over 100 deliverables on DHCW.
• The conditions, milestones, and performance criteria attached to approximately £600 million of public funding.
• A value-for-money examination by Audit Wales — which has never been commissioned for DHCW.
• Publication of the DPIF allocation terms and the basis on which programme funding is being withdrawn to zero while no alternative funding model exists.

£600 million of public money. Nine failing programmes. Four dead. £0.5 million back. The committees have the power. The arithmetic speaks for itself.

CareNHS invites responses from DHCW, the Welsh Government, Helen Thomas, and Audit Wales. If received, we will publish them in full.