Dr Dan Boucher, Dan has stood as an Assembly and Parliamentary Candidate in Wales. He lives with his family in Swansea.

During the 2011 Assembly election campaign I well remember a lady telling me that if I hoped she was going to vote Conservative I must have another thing coming to me – given the state of the NHS in Wales. I said that I shared her concerns but thought they provided a very good reason for voting Conservative because the current situation was the result of fourteen years of Labour’s stewardship of the NHS.

The lady looked a little confused and so I explained that since May 1997 Labour had run the NHS in Wales, first, on account of the fact that Labour won the 1997 General Election and then on account of the fact that health had been devolved to the Welsh Government from the very beginning of devolution in 1999 and that throughout, the health minister had always been from the Labour Party.

Its record up to that point had certainly been none too inspiring. Labour inherited five health authorities from the prior Conservative administration but embarked on a radical restructuring programme, exchanging the five health authorities for twenty-two local health boards from April 2003. It argued this would bring health care provision closer to the people!

However, in 2009 the party performed a spectacular u-turn, explaining that the new structure was too bureaucratic and introduced an equally radical reform agenda in diametrically the opposite direction. Replacing the twenty-two local health boards with seven health authorities, it effectively conceded that the previous Conservative formula had been rather better.

Things did not improve thereafter. Between 2011 and 2016 the Welsh Government decided not to increase health spending in Wales proportionately in line with the increases introduced in England, costing the Welsh NHS approximately £800 million. This placed real strain on the system and in 2015 Betsi Cadwaladr Health Authority had to be moved into “special measures” where it remained for five and half years, the longest duration that any health authority has been put in that position anywhere in the UK.

In January 2020 – immediately prior to the outbreak of Covid – five out of our seven health authorities were subject to either “special measures”, “targeted intervention” or “enhanced monitoring.” Moreover, in that month the numbers of patients waiting 12 hours or more in A&E broke a new record, increasing by 1,590 patients compared to January 2019. Over a similar period the numbers waiting more than 36 weeks for hospital treatment almost doubled, increasing from 12,982 in December 2018 to 25,549 in December 2019.

In the last year, of course, the NHS in Wales, like the NHS across the UK, has faced the previously unimaginable Covid challenges which have demonstrated the heroism of our doctors and nurses as never before. In this context, however, Labour’s management has again been the cause of real concern. In March/April last year over 13,000 shielding letters were sent to the wrong addresses and then in August identifying details of 18,105 Welsh residents who had tested positive for the Coronavirus were uploaded onto the Public Health Wales website.

At the same time there has been less willingness to focus on addressing non-Covid health challenges than in England. Between December 2019 and December 2020 there was a tenfold increase in people waiting more than two years for a procedure on the NHS and the Health Minister has now acknowledged that it might take a full parliamentary term to clear the backlog.

Concerns came to a head in January as a result of the First Minister’s statement that rolling out the vaccination programme against Covid “is not a sprint.” Given that the proportion of people vaccinated in Wales at that time was significantly less than in England, and that the sooner people are vaccinated the less chance they will have of contradicting the disease, this generated huge public pressure for a change of approach.

In assessing the significance of Labour’s stewardship of the NHS in Wales as we approach the upcoming Welsh Parliament elections on May 6, it is important to appreciate just how central health is to Welsh devolution. Nearly 50 per cent of the Welsh Government’s budget, over £9 billion, is absorbed by health. While health might be only one of nine cabinet positions, therefore, the truth is that in monetary terms it is nearly half of devolution.

Moreover, what was true in May 2011 has continued to be true, namely that while in coalition, some ministerial posts have been held by the Lib Dems or Plaid, the Minister of Health position (along with that of First Minister and a majority of ministerial positions at any one time) has always been held by Labour.

In this context the question facing the Welsh electorate in May (or whenever the election takes place) is, in an important sense, more a question of health than anything else and in seeking to answer it the people of Wales must ask whether Labour’s record justifies another five years? Would Wales benefit from twenty-six years of Labour running the Welsh NHS, and indeed the wider Welsh Government? Now is surely the time for a Conservative administration in Cardiff Bay.