NHS Wales spends £17m on staff payouts
Over £17m has been spent by the Welsh NHS in four years on staff payouts which include confidentiality clauses.
More than 600 so-called compromise agreements have been signed since 2009, figures obtained by BBC Wales show.
Ten years ago NHS Wales said the agreements - which can ban ex-employees from talking about their jobs - should only be used rarely.
The agreements can be used when the relationship between an employer and employee has broken down.
But they can also be used when there is a restructure, during redundancies or when an employee has brought a grievance, such as discrimination.
The Welsh government said there is "clear guidance" on their use but it has been urged to review the issue.
Even though members of staff are prevented from talking about the details of their previous employment, they can raise concerns about patient safety.
The figures obtained by BBC shows since 2009 there have been 612 compromise agreements signed by Welsh health boards costing almost £17.5m.
Over half the agreements - 313 - have been made by Betsi Cadwaladr health board in north Wales at a cost of over £9m, while none have been signed in Hywel Dda health board, which serves mid and west Wales.
The vast majority of Betsi Cadwaladr's agreements were signed under what is called a "voluntary early release scheme" (VERs), which means staff voluntarily choose to leave.
Employees leaving the NHS under this scheme are required to waive their rights to pursue claims in the courts.
In England, health service bodies must first seek the approval of the Treasury and the health department in Westminster to make a compromise agreement.
However, in Wales the responsibility for managing the agreements lies directly with each health board.
In 2003, the then-director of the NHS in Wales, Ann Lloyd, said that on the "rare occasion" organisations might need to consider using a confidentiality clause, they should be regarded as "novel and contentious and consult with the NHS Wales department".
Welsh Liberal Democrats are calling on the Welsh government to look into the guidance surrounding the agreements.
"They need to review whether the directives of the previous NHS director are being followed," said leader Kirsty Williams.
"They need to issue new guidance to limit the number of these agreements and to ensure also that local health boards are reporting correctly the number of these agreements they're working on.
"We should not be spending Welsh taxpayers' money on these agreements when we know there is such pressure on NHS resources."
Tina Donnelly, director of the Royal College of Nursing in Wales, said she believed the spending on compromise agreements was the result of previous government policies to reorganise the health service in Wales and the costs incurred when shedding staff.
Ms Donnelly added: "Constant reorganisation, every two to three years, does have a price.
"We would have concerns if people were having to sign a compromise agreement where you were not able to speak out, and I'm not aware that happens in Wales.
"But I do think, when you look at the number, questions should be asked as to the frequency with which those are issued as opposed to keeping people in employment and putting them into other employment in the local health board."
Jonathan Morgan, an independent health consultant and a former AM, said the clauses should only need to be used rarely in the NHS.
He said: "If I was still chairing the public accounts committee, as I did in the last assembly term, I'd be asking the auditor general to review why such a large sum of money has been spent, what the circumstances are, what lessons can be learnt and what changes could be made to ensure that these agreements are used as a last resort."
The Welsh NHS Confederation said it understands that the vast majority of agreements within the given figures relate to staff who have requested VERs.
"We are concerned that the current interpretations of these figures is misleading...," a spokesperson said.
"VERs are cost effective and cheaper than alternatives. Funding to support them is provided by Welsh government as part of the Invest to Save initiatives.
"Within such an agreement there is a clause that prevents staff from returning to work in NHS Wales for a stipulated period of time or claiming benefits that could have been accrued had they remained in work.
"The purpose of such a compromise agreement is to safeguard remaining staff and avoid misuse of public money."
The Welsh government said most agreements since 2010 have been part of the voluntary early release scheme, which was developed to support the 2009 NHS Reform Programme in Wales.
"The scheme has been designed as part of the service modernisation programme to assist staff in making a personal decision regarding their future employment," a spokesperson said.
"Where staff volunteer to leave their NHS Wales employment and their post will not be replaced they receive an appropriate compensatory severance payment."
The spokesperson added: "While health boards undergo change, we would expect the number of VERS agreements to increase, and this is being reflected in these figures."
Betsi Cadwaladr's chief executive and chairman stood down last month following a damning report by government watchdogs.
The board is forecasting a debt of £3.9m by the end of this financial year.
BBC Wales research has found that since 2010 the health board has spent £9,073,165 on compromise agreements.