ANOTHER month and another round of dismal NHS statistics have landed in Cardiff Bay.
It would be a change to report that the picture is improving and that politicians have changed their usual schtick. However, the continuing dismal performance of both the Welsh NHS and the parties’ communications machines has ended any hopes that this would be the case.
DISMAL DATA
Let’s start with some facts before looking at the political responses.
The number of patient pathways increased from 791,511 in June to 796,631 in July, the highest figure on record—the equivalent of one in four of the Welsh population.
Around 616,700 individual patients were still waiting for treatment in July.
For the fourth consecutive month, two-year waits have increased. They now stand at 23,830 in Wales. The Labour Health Minister, now First Minister, Eluned Morgan, promised to eliminate these waits by March 2023 and again by January 2024 but failed to meet these targets. Strangely, Baroness Morgan had to make a special effort this summer to find out that lengthy waiting times were an issue for the public.
And, of course, that they are a major electoral issue for Labour in Wales.
At the end of July, the average (median) time patient pathways had been waiting for treatment was 21.9 weeks, an increase of 0.2 weeks from the previous month.
In July, only 51.8% of red calls (the most serious) received an emergency/ambulance response within eight minutes.
Performance decreased to 55% in July compared with 56.7% in June against the 62-day target for people starting cancer treatment.
Only one of Wales’s seven health boards is currently hitting any of the performance targets.
THE SAME OLD SONG
First out of the traps with a response was Jeremy Miles, the new Cabinet Secretary for Health and Social Care.
Like every predecessor, Mr Miles first hid behind the human shield of NHS staff to try to deflect criticism.
He said: “High-quality, lifesaving, and life-changing care is provided every day by hard-working NHS staff throughout Wales in the face of continued pressures on services.”
Every Welsh Government statement issued in the last twenty-five years about its dismal record of improving Welsh healthcare uses that formula. The Welsh Government wants the Welsh public to believe that criticising the NHS as an institution is the same as criticising doctors, nurses, and all other frontline health workers. It’s not, and it’s time to change the record.
“Despite record levels of demand, these figures show positive progress in cancer care, ambulance response time and emergency department performance.
“But there is much more to do – the public rightly wants to see waiting times come down and faster access to care and treatment.
“These figures show more than 2,000 people started treatment for cancer in July – the second highest figure on record – and almost 16,000 people received the good news they didn’t have cancer, the highest figure on record.
“There was an improvement in response times to the most serious 999 calls in August and a welcome fall in the number of people spending more than 12 hours in emergency departments before admission or discharge.
“These figures also show a reduction in long waits for diagnostic tests and therapies. However, it is disappointing the number of long waits for referral to treatment has increased for the fourth month, despite previously falling for 24 consecutive months.
“While the trend in long waits has shown a recent increase, we have seen continuous improvements in previously very challenging areas such as orthopaedics, with two-year waits continuing to fall across all health boards over the last year.”
Mr Miles’s opposite number on the Conservative benches, Sam Rowlands MS, was as predictable as the Cabinet Secretary’s.
Mr Rowlands said: “Waiting lists are completely out of control on Labour’s watch.
“Baroness Morgan cannot pass the buck for these statistics because she was Labour’s Health Minister for three years and promised to get them down.”
Fair enough, so far. Then…
“Instead of prioritising the creation of 36 more politicians, Labour should have been recruiting more doctors and nurses to end the staffing crisis and free up more cash by ending the Welsh NHS’ over-reliance on agency workers.”
The first part of that sentence is unnecessary cant, as it has been in virtually every single Conservative press release on NHS performance since 2022.
Mabon ap Gwynfor, Plaid’s Health Spokesperson, said the same as he and previous Plaid Health spokespersons have said before: “Labour lost control of the NHS a long time ago yet continues to blame everyone else for its own failings.
“With a staggering 600,000 people on waiting lists in Wales – the highest on record – it’s clear that Labour cannot keep doing the same things over and over and expect different results.”
CHANGING THE TUNE
So far, so familiar.
Then Mr ap Gwynfor came up with something comparatively new: “If the NHS is to live for another 75 years, it needs reforming.”
Pressing the button on some of Baroness Morgan’s more startling recent pronouncements, Mabon ap Gwynfor continued.
“The First Minister has made it clear that reforms aren’t on the cards until waiting lists come down.
“This week, the First Minister blamed health board bosses for these failures despite managing the health portfolio until very recently. She has also blamed the people of Wales for their health conditions and blamed patients for turning up to A&E. It seems that it is always someone else’s fault while this Labour Government refuses to take any responsibility.”
And we return to Baroness Morgan of Ely.
Jeremy Miles’s immediate permanent predecessor made it clear this week that she wanted health boards to improve their performance, hold their executives accountable, and delegate powers to boards to allow them to make improvements.
Baroness Morgan’s words caused raised eyebrows.
THE NHS BITES BACK
The director of the Welsh NHS Confederation, Darren Hughes, said: “We know that getting the NHS back on track is a top priority for the public, given it affects so many of us, including our loved ones. Nobody wants to provide timely, quality care and treatment to those who need it most more than NHS leaders and staff, all of whom work tirelessly towards this every day.”
Darren Hughes continued: “The First Minister knows all too well from her time as Cabinet Secretary for Health and Social Care that the NHS is treating more people than ever before and that there are a range of factors impacting the rate of elective recovery.
“Waiting lists cannot and must not be considered in a silo but as part of the whole health and care system, across primary care, community care, mental health services and social care.”
Mr Hughes added: “The ability to discharge medically fit patients from hospital remains a huge challenge for all health boards due to the immense pressures in social care, despite best efforts in joint working with local authority partners.
“In some hospitals, 20% of beds are unavailable as patients wait to leave the hospital. This is like trying to run the NHS with one hand tied behind your back – we’re doing all we can to work with local authority leaders and care providers, but the First Minister must be open about the scale of the challenge and what’s needed to put it right.”
PASSING A BUCK YOU NEVER HAD
Opposition politicians failed to pick up on what the First Minister said about ” delegating ” responsibilities to health boards.
For over a decade, Welsh Health Ministers have washed their hands of NHS performance, saying that provision is down to the individual health boards.
However, a government can only delegate the powers and responsibilities it holds. Either the Welsh Government has always had the power and responsibility to improve NHS performance, or it hasn’t. If it hasn’t, and ministers have previously been very clear about who carries the can for NHS performance (not them), Eluned Morgan’s words are empty.
If ministers have always had the power to improve the NHS by using the powers and responsibilities that they are only now passing over to those at the sharp end, you have to wonder why they haven’t used them until now and why it’s only now they’ve passed them off to health boards.
That is not a semantic point. It goes to the foundation of what Eluned Morgan says about making health a priority (as if it wasn’t before). It certainly adds some force to Darren Hughes’s observation that health boards are battling issues within the Welsh NHS with one hand tied behind their backs.
