The Welsh NHS has for weeks been attacked in the Commons by Cameron and Hunt being described as failing and a shambles. Now, on a weekend when the independent Nuffield Trust reported that NHS Wales compares well with the other UK health systems, Cameron compounded the crime by telling the Tory Conference that the Welsh border separated life and death. Both should apologise to the House for misleading it and correct the record. Cameron should apologise to Wales for the “line of death” slur.
Faced with Nuffield Trust’s assessment on Radio Wales 11 April, Welsh Tory MP Alun Cairns was reduced to blustering that the massive failure of the Welsh NHS was all due to elective orthopaedic waiting times -supposedly longer in Wales.
He didn’t want to hear that cancer care was better in Wales. He didn’t want to debate the impact that the 1978 Barnett formula automatically has on reducing total expenditure in NHS Wales. As a result of the austerity agenda, NHS Wales now operates on £1,900 per person compared with the North East of England (similar to Wales in terms of “need”) which gets £2,100 – 10% more. He couldn’t admit that the cause of the problems in Mid Staffs were slashed nurse staffing levels as the Trust went hell- bent for Foundation Trust status – which doesn’t operate in Wales.
He won’t want to quote the outgoing English NHS boss rating NHS England only 5 out of 10. Perhaps too he doesn’t know that the massive re-organisation of the English NHS- never put to the electorate in either the Tory or Lib- Dem manifestos – has wrecked havoc with hospitals forced to compete rather than collaborate and commissioners forced to put NHS services out to tender. Spending on “regulation”, lawyers, and redundancies continues to rise. Will the manifestos of the Conservative and Lib Dem parties in 2015 proudly state “Vote for us and let us finish off the NHS“?
He couldn’t say if he supported propping up the NHS Barnett 10% shortfall by robbing large chunks of the Welsh education or social care budget to health. Anybody who knows anything about the inadequacies of Joel Barnett’s 35 year old “temporary” fix – which clearly doesn’t include Cairns and Cameron and the Welsh Lib Dems – knows that those are the unattractive options for plugging this huge gap in the funding of a devolved service taking about 40% of the total Welsh Government block vote.
And what of that orthopaedic waiting time figure? Cairns might be right that the reported figures show an average hip and knee operation waiting time in Wales of 170 days as opposed to 70 days in England.
However, reported figures do not necessarily indicate poorer treatment for real patients. First, English figures are not collected and reported on the same basis as Welsh ones. English waiting times rules describe many ways of “stopping the waiting times clock“. Some of the difference in waiting times is almost certainly down to England being better at gaming the data than being better at treating patients. Second, it is more important that patients are treated at the best time for them (and average figures are by definition a mix of short and long waits). For some patients, agreeing with their Welsh doctors the optimum time for such surgery and perhaps waiting a while so that future revision surgery some years hence is less likely, makes sense. Third, for as long as Wales gets 10% less than its English equivalent region, waiting times will inevitably suffer.
Welsh Health Minister Mark Drakeford was right to say that “Nuffield has shot Cameron’s Fox“. For the Prime Minister to lose one Fox in a term of Government is unfortunate. To lose both Reynard and Liam to different means of pest control is careless.
Tony Beddow is a former NHS Chief Executive in Wales and Secretary of Socialist Health Association (SHA) Cymru Wales. This piece is written in a personal capacity.
