Alun Cairns is Conservative MP for the Vale of Glamorgan. Follow Alun on Twitter.
The Health and Social Care Bill has completed its tortuous journey through the parliamentary process. Without doubt it has been dubbed by the press and the Labour Party as one of the Coalition government’s most controversial moves.
I am a strong supporter of the Bill for a number of reasons; I believe it will bring about fresh innovation and new approaches to healthcare that have the opportunity to drive efficiency and value for money in what is the UK’s most treasured public service.
Coming from Wales, however, my constituents won’t benefit from such changes. Labour’s criticisms throughout every part of the extended parliamentary scrutiny, failed to offer an alternative, leaving their model in Wales as an example of their policy outcomes: Cuts in NHS spending, longer waiting times, poor mortality rates and higher infection levels.
So what, if anything, can we learn from Labour’s approach to the NHS in Wales?
Wales is justifiably proud of Aneurin Bevan, the founding father of the NHS. We consider ourselves to be the greatest champions and guardians of the service. Therefore, over the last 15 years and particularly since the advent of devolution, the NHS has been the top priority of the nation and of politicians. Whatever funding was needed, the money would be found. It still accounts for two-fifths of the Welsh budget.
As an Assembly Member throughout that period, I recall Labour’s budgets in Cardiff Bay, increasing funding to a greater extent than in England. Spending more money was the solution. The increased budget, however, wasn’t matched with reform.
At one stage, health spend had increased by 50% in real terms but the numbers of operations had fallen.
Competition and private providers were dirty words and they were explicitly ruled out in their plan for government.
As a result, the structure diverged significantly from that in England – Primary Care Trusts and Foundation hospitals don’t exist.
Labour confused reorganisation with reform: moving from 5 Health Authorities to 22 Local Health Boards (to mirror local authorities) and 15 Trust hospitals only to revert back to 7 Local Health Boards when it all went wrong. The 7 LHBs are now the commissioners and providers of healthcare.
Waiting targets also differ. In England, the target is 18 weeks from GP referral to treatment. In Wales, the target is 26 weeks from GP referral to initial consultation. If the target is not met in England, provision in the private sector is a possibility. This is not an option in Wales. Patients simply have to wait.
The performance of meeting less stretching targets is also worse than in England, with nearly 8% of patients waiting longer than the 26 weeks, a figure that continues to deteriorate. Performance in Wales became so poor that the goalposts were moved to require that only 95% of patients are now targeted to be seen within the 26 week timescale.
It is not unusual for a patient to wait more than a year for treatment.
Patients in Wales attending some hospitals are twice as likely to catch an infection as the average in England. The number of deaths from C.Difficile are significantly higher compared to England, where the MRSA data has also improved significantly. Cross infection rates in Wales were originally better than in England.
Cancer patients are less likely to get the latest drugs in the absence of a cancer drugs fund. The Rarer Cancers Foundation reported last year that 24 new drugs prescribed regularly in England are not routinely available in Wales and English patients are five times more likely to get cancer drugs than their Welsh counterparts. Breast Cancer five year survival rates are higher in England and Northern Ireland than in Wales.
This appalling situation also needs to be taken in the context of a commitment by the UK government to grow its health spend in real terms over this parliamentary period whereas the Labour administration in Cardiff Bay plans to cut health spend by 8.4% in real terms by 2015. This will see the Welsh NHS cut by more than half a billion pounds in real terms over the next three years.
This reduced spending level also has to fund Labour’s priorities of free prescriptions for everyone, rather than the usual exclusions – children, benefit claimants and pensioners and also finance free hospital parking!
Whilst Labour has been quick to criticise the Health and Social Care Bill, its mismanagement of the NHS in Wales shows why it has been so reluctant to come up with solutions of its own.