Charlotte Leslie is a member of the Health Select Committee and MP for Bristol North West.
You can often tell the cause of a problem, when the issue is revealed, by the reaction of those who created it. Seldom has this been seen more clearly than in the revelations about the state of the Welsh NHS. Last week, it was revealed through a FOI Request that the Chief Medical Officer for England, Sir Bruce Keogh, had written to his counterpart in Wales, advising that mortality rates and diagnostic waiting times were sufficiently concerning to warrant a Keogh-style inquiry.
The reaction from the Welsh politicians in power, and the left-wing establishments tells you all you need to know about why public services in Wales are in such trouble. It is all horrifically reminiscent of the last Labour Government’s reaction to what they seemed to see as ‘blasphemous’ revelations of bad news at hospitals like Mid Staffs, and why hospitals with worrying mortality data went unchallenged for almost a decade (though we have irrefutable evidence that ministers and civil servants did know all about it).
Last year, Sir Bruce Keogh wrote to Chris Jones, his Wales counterpart, to highlight not only worrying mortality data in six hospitals, but also the extraordinary statistics on diagnostic waiting times. If you have a suspected heart condition in England, there is just under a one-in-a-hundred chance that you will have to wait longer than six weeks for your echocardiogram (ECG) – a diagnostic tool that can be life-saving. If you are in Wales, however, you have a one-in-three chance of waiting longer than that crucial six weeks to check out your heart.
Can you imagine if this was the case in England? There would be (quite rightly) a public outcry, and Labour would be baying for Conservative scalps and screaming that evil blood-sucking Tories are killing people.
But it seems that if this sort of thing happens in Wales, it’s absolutely fine, and the only fault is with these evil Tories (again) who have the audacity to criticise the NHS and the Welsh System. Ed Milliband’s silence on this scandal screams volumes. Is the roaring silence on this because Welsh lives are somehow of much less value than English lives, and so a few deaths here and there on the diagnostic waiting list is ‘just one of those things’? Or is it that, just as under the last Labour Government, maintaining the image of ‘the system’, and the reputation of those in power, is far more important than the lives of those the system is supposed to serve?
It is probably the latter – and that is communism: a political system in which realities must be buried, obscured, twisted, to ensure that whatever the cost, the ‘System’ and those leading it are protected; If a Sochi Olympic snowflake does not open on the Big Night, the truth must be expertly covered by pre-rehearsed footage so that the people do not see a flaw in ‘The System’; and if people are dying on waiting lists, or in substandard hospitals, the priority must be to cover up the evidence and accuse those trying to shout the truth of ‘trying to bring down the regime’ – to protect ‘The System’. It’s a script so tragically repeated throughout the history of communism that you can almost write the next lines.
In response to these revelations, Labour’s Welsh Assembly Members have dutifully adhered to this script with practiced panache. Instead of actively engaging with Sir Bruce to take up his offer of help in constructing an investigation to find out the extent of the problem, and how to solve the issues, the Welsh NHS and Labour Assembly simply ignored the email from England’s Chief Medical Officer.
When I made all this public last week, the reaction of the Labour Health Minister on Newsnight was “cold fury”. Not cold fury that people were dying on waiting lists – no, “cold fury” that it should have been revealed. He wheeled out the same wounded “righteous indignation” that Andy Burnham now uses so regularly if anyone points out the scandals that Labour repeatedly smothered, and – surprise surprise – used the hackneyed ‘this is a malicious conspiracy by those who want to bring down the regime’ line that we see as the auto-response of any dictatorial regime responding to the unrest of its population who want truth and freedom.
The next stage is to say the data isn’t valid – just as West Midlands Strategic Health Authority did with the damning mortality data on Mid-Staffs. Instead of acting on it, they commissioned a report from, yes, the local University, Birmingham – also connected with the local hospitals – to say it was invalid. This report was later found to be flawed by Harvard, which confirmed the data should have been the trigger for urgent investigation.
So back to Wales and, yes, you’ve got it: Labour in Wales dutifully say that the data is not sufficiently valid to be acted upon. They take Bruce Keogh’s words out of context to do this.
In the spirit of openness and transparency, the his full email is below, and I will ask readers to decide what they think Bruce Keogh is asking NHS Wales to do:
“From: Keogh Bruce (NHS ENGLAND) Sent: 28 November 2013 09:39
To: firstname.lastname@example.org Cc :[redacted under Section 40(2) FOIA]
Subject: Medical Leaders
Good to talk to you. Firstly, through this email I am copying [redacted under Section 40(2) FOIA] who co-ordinates the Medical Leaders Group. It would be great if you could join.
Secondly, as I explained I am worried about the broader political implications of the data that has been shared with me by Ann Clywd. The data falls into two categories, mortality (RAMI) and diagnostic waiting times.
There are six hospitals with a persistently high mortality which warrant investigating. I do not have adequate data to form a view. The RAMIs are high but I don’t have a comparative statistical analysis.
Waiting times in A&E are considerably worse than England, but the real concern is around prolonged (6 weeks) waiting times for diagnostics which, of course, translates to delayed treatment.
I present these as investigation: % Waiting longer than six weeks in Wales, then in brackets % waiting longer than 6 weeks in England:
MRI, 48.6 (0.9)
CT, 14.9 (0.3) Non obstetric ultrasound 41.4 (0.4)
Echocardiography 38.9 (0.9)
Urodynamics 80.1 (7.8)
Colonoscopy 47.8 (2.3)
Flexible sigmoidoscopy 50.7 (1.4)
Cystoscopy 49.6 (3.0)
Gastroscopy 46.4 (1.8)
I cannot vouch for the veracity of these data but they are worrying. Given that they represent a potential diagnostic delay and may underpin some of the mortality concerns, it would seem sensible to investigate.
Please let me know if there is anything I can do to help.
With best wishes, Bruce”
Most of us would interpret “it would seem sensible to investigate” as a statement that it would seem sensible to investigate – not least to check whether these alarming statistics are in fact true. If that investigation confirmed they were, then urgent action would need to be taken. If it proved that in fact they were not, and there was no waiting time problem, or issues with care, then so much the better.
Almost entertainingly ( if the issue weren’t so serious), I also received a letter from the ‘Socialist Health Association Wales’ who were also ‘asked’ to write to me, to defend the system. They don’t seem to have got to grips with the concept of the Freedom of Information Act yet, and tried to accuse me of ‘hacking’ into professional correspondence, bless.
Then – yep – they tried to say that the investigation shouldn’t happen because the data isn’t valid. Rather touchingly, they also added that they had “released this letter to the press”. I thought it was such a telling letter that I helped their efforts and have also done so.
As this scandal has unravelled, the Royal College of Surgeons has also stepped in to raise their concerns that patients in Wales are not receiving adequate care and, late last week, we found that NHS Wales has, on the quiet, recognised they have a bit of an issue, and commissioned the private Spire Hospital in Bristol to take on some of their cardiac cases…I wonder what the poor Socialist Health Association Wales will make of that.
Contrary to what the dedicated ‘Defenders of the System’ may try to claim, the welfare of patients in Wales is all of our business, whether we are Welsh, whether our home constituency (like mine) over-looks Wales, or whether or not our MPs’ constituents (like mine) have friends and family in Wales. So we will continue to try to speak out, on behalf of those living across the border, for an investigation into Welsh healthcare, regardless of what the Labour regime try to say. We have had enough of a socialist, communist cover-up: it has cost too many lives. The era of dictatorial regimes oppressing its people should be over. This year, it is time for a Patients’ Spring.