Speaking at the Welsh Conservative conference in Llandudno on 11 April David Cameron claimed that the Welsh border was “the dividing line between life and death”. However, a Nuffield Trust report published on the same day demonstrated the dishonesty of his rhetoric.
At the same conference the English Health Minister Jeremy Hunt claimed the Welsh NHS was “sleepwalking to a mid-Staffs tragedy”. David Cameron went further, telling Welsh Conservatives the Welsh NHS was a “national scandal” and Offa’s Dyke “has become the line between life and death”.
In fact a thorough comparison of the UK health systems by the independent Nuffield Trust – showed that overall, NHS Wales compares well. Challenged on the discrepancy BBC Radio Wales, Vale of Glamorgan Tory MP Alun Cairns was keen to bluster about longer waiting times for hip and knee operations. He didn’t want to hear that cancer care was better, and acute admissions for chronic conditions were falling. Indeed, the Nuffield Trust report found that there was no evidence Wales was “lagging behind”. That it was “broadly in line” with the rest of the country on “avoidable deaths”.
Overall, the Nuffield study showed Wales’ (far less privatised) NHS was improving faster than England’s – on less money. Wales gets less funding per person than areas of England with similar levels of ‘need’ like the North East of England. There, the NHS gets allocated £2,100 per person – 10 per cent more than Wales, which gets £1,900 per person.
The Barnett formula which works out how much money Wales gets was established as a temporary fix – in 1978. Now, 35 years later, its inadequacies are clear to all – except the Tories and the Welsh Lib Dems.
Plugging the gap with funds from education or social care are unattractive options. The devolved Welsh NHS uses about 40 per cent of the total Welsh Government block grant, so the impact of the unfair allocation on its NHS is huge.
And what of that orthopaedic waiting time figure? Reported figures show an average hip and knee operation waiting time in Wales is 170 days as opposed to 70 days in England. However, they do not necessarily indicate much poorer treatment.
The English figures are not collected and reported on the same basis as the Welsh. The English rules allow the English waiting times “clock” to be stopped in different ways. Some of the difference in reported waiting times is almost certainly down to England being better at gaming the data rather than being better at treating patients. Rob Findlay, an expert on waiting times, has observed that it is “striking” how often the clock is stopped in England just before the 18 week target and suggested some English NHS trusts are “systematically” misusing the system of “clock-stopping”.
Average waiting times are in any case a crude indicator. Patients should be treated at the best time. For some patients discussing with their doctors the optimum time for such surgery, it may make sense to wait a while so that revision surgery some years hence is less likely.
Cameron and his fellow pro-marketeers are keen to disparage NHS Wales because it has not followed England’s path of dramatically expanding the amount of private involvement in health provision. But as Welsh Health Minister Mark Drakeford said, the Nuffield report “has shot Cameron’s fox good and proper”.