Is reorganisation the way forward for the NHS in Wales?

Darren Millar AM says maintaining existing hospital services would be best for healthcare in Wales.

The Welsh National Health Service has been run by Labour since 1999; the start of devolution. Throughout those 15 years the shape of our NHS has changed dramatically, yet performance has deteriorated significantly. The last five years alone have seen emergency departments threatened with closure, hospitals downgraded and closed, services axed and minor injury units given the boot. In turn, more people than ever are waiting over nine months for a hospital appointment; a four hour A and E waiting time target hasn’t been met since 2009; and ambulance response times were so bad, that Labour Ministers scrapped them.

At the last Assembly election in 2011, Labour promised no hospital closures or downgrading. Yet since 2011, community after community has been forced to accept just that. Patients across the country must now travel further for treatment – it simply isn’t fair. The NHS workforce is not corporately at fault, nor will it ever be. It’s a national treasure and the hardworking staff within it deserve our support and thanks. The blame for these failures lies with those sitting around the cabinet table in Cardiff – Welsh Labour Ministers. It is here where a decision was made in 2010 to savagely cut the NHS budget in Wales in real terms – starving the frontline of more than one billion pounds over the past five years – and it is here where closures and reorganisation have been rubber-stamped and given the green light. I wholeheartedly disagree with many of those decisions and that’s why I’m promising no destructive reorganisation of the NHS under the Welsh Conservatives. Not only that – but reopening a number of key minor injury units closed by Labour would be an immediate focus for an incoming Welsh Conservative government.

No reorganisation. No hospital closures. More minor injuries units. That’s our pledge, just four months from a Welsh general election that will set the future direction for our National Health Service. We would maintain all existing emergency departments and re-establish minor injury units in community hospitals which have seen theirs axed by the Labour government – in Newtown, Tenby and Colwyn Bay and in the Rhyl/Prestatyn area. We would also re-establish paediatric and special care baby services at Withybush hospital, where Labour’s NHS reorganisation in west Wales has resulted in care for the most premature and sick babies being moved from Haverfordwest to accommodation which is not fit for purpose in Camarthen. Under Labour, the number of patients and relatives forced to travel further for essential services is rocketing. No more, under Welsh Conservatives. It’s time to put an end to this unwanted strategy and – with a fresh approach and effective funding – that’s exactly what we would do. In contrast to Labour’s legacy of cuts, closures and downgrades, we are making a commitment to secure, re-open and widen access to NHS services in Wales.

Not only would local services be safe with a Welsh Conservative government, but we would also work hard to expand the role of our community hospitals. Working with staff and health boards, we would provide funding to boost innovation and improve the patient experience. The establishment of a 20 million pounds Community Hospital Development Fund would encourage the innovative use of these sites across Wales.

We also need to address standards of care in parts of our health service. I have long called for an independent Wales-wide independent inquiry into the way patients are cared for here and its introduction would also be a top priority for a Welsh Conservative government. Recent years have seen too many scandals and too many horrific stories of neglect and mistreatment. We urgently need to root out bad practice and put measures in place to safeguard our health service for future generations. Labour has refused a full inquiry. I would introduce one.

We make these commitments alongside others we have already announced, for a properly protected health budget, one hundred new ambulance service staff, a five year 100 million pounds Cancer Patients’ Fund – introducing a national mobile treatment service and improving access to modern cancer drugs; these are just some of the plans that we have for our NHS and in the coming weeks there will be more.

May’s Assembly election will have a significant impact upon support for those working for our NHS and standards of patient care in Wales. The choice before voters will be simple – more of the same with a Labour government that’s ruled Wales alone or with junior partners for 17 years or a clear alternative and competent leadership with Welsh Conservatives.

Remember, there will be no NHS reorganisations, no hospital closures and more minor injuries units under a Welsh Conservative government. Staff and patients would come first and the axe that currently hangs over frontline services will be removed. Wales needs change and only we can deliver it.

Darren Millar AM is the Shadow Minister for Health. He is the Assembly Member for Clwyd West.

8 thoughts on “Is reorganisation the way forward for the NHS in Wales?

  1. We must not forget it’s the Election Time and our politicos will do their best to impress us with the endless promises between now and May of this year of a ‘Better Tomorrow’!

    I have only one question for Darren Millar and would be nice to have some Tory clarity where they stand on the following:

    For years now the senior medical consultants in Wales have been complaining to the Welsh Labour Government on the negative impact that the Welsh Language Measures have on recruiting quality medics to work in Welsh NHS and have also been calling to rename Welsh Health Boards with unpronounceable names with names that people can relate to in geographic terms – Both Mark Drakeford and his sidekick Vaughan Gething have publicly dismissed these demands out of hand and are not even prepared to discuss the matter.

    So the Question to Darren is ‘What will the Welsh Tories do on this – More of the same or the Welsh Tories will start respecting majority language of Wales and apply Welsh language support in the NHS on the bases of doing so when it’s practical and reasonable only’?

  2. Darren, here are a few more nettles an incoming administration (with backbone !) will need to grasp.

    1) Address the increasingly common place revolving door issue whereby NHS Board members, CEO’s and their senior entourage change over after just a few years in role. They arrive with a remit for change, soon decide that, though this was the basis on which they personally were hired, it can’t be done without a big ticket external consultancy project (their next employer ?). We go through a showcase of initiatives and then it all fizzles out with nothing really having been achieved except widespread disillusionment at the macro level and some personal advancement for a few. The event then culminates with blossoming golden parachutes to be repeated ad-nauseum. Industry is wising up to the destructiveness of these short cycles, the public sector needs to fast. Select good leaders then keep them in role for ten years.

    2) Face up to the systemic flaws of having management teams constituted by over promoted ex-nurses. Too often they demonstrably do not have the ‘smarts’ to fully grasp and adequately resolve the concerns of clinicians and patients to an acceptable standard.

    3) Address head on the unpalatable contractual issues surrounding delivery of private healthcare on the QT. The fact that consultants already earning circa £100K pa from their NHS employment can then also see lucrative private patients – even within their core NHS employment hours – is a conflict of interest other professions consider breathtaking. Consultants pay was raised with the expectation that efficiency gains would be achieved and this has simply not materialised. The biggest reason for people to ‘go private’ is so that they can see their NHS consultant faster jumping long queues. Go figure what a perverse incentive this is and ponder on the cost to the taxpayer and the economy at large !

    4) Run an enquiry into how, in the panic to reduce NHS Wales waiting list numbers prior to the assembly election, multi million pound contracts have been given to private consortia made up of ostensibly over worked full time NHS consultants to then see NHS patients at premium private rates. At the individual level, when there are potentially hundreds of thousands of pounds on the table through ‘moonlighting’ over and above the pay you get for your NHS day job it changes the way you think and act towards your primary employer – and not necessarily for the good !

  3. Impressed Lynne with your assertions and I assume you have made them based on your insider knowledge of the NHS and it’s workings workings both in England and Wales. I fully endorse all you said but changing attitudes and culture largely based on arrogance and priviledges needs guts and a vision , but not convinced that many Assembly politicians have either of those traits.

    I would add a point 5 to your list – Doctor training where GMC artificially controls ‘supply & demand’ ensuring that we always have a shortfall in the system irrespective of the NHS realities. NHS compensates by importing them often from countries where medical standards are far lower than what we can produce – Doctor training should be opened up as I have never been convinced that a process based on Three plus GCE-A Levels + as an entry requirement relates to being a good Doctor!

  4. There is a great deal that can be said about reforming the Welsh NHS. Increasing its efficiency and adapting to new demands and employing new technologies. Unfortunately Darren`s article doesn`t mention any of them. Maybe its all underwraps for the manifesto?

  5. What proportion of total Welsh government expenditure is taken by Health? I am sure it is over a third. Darren Millar seems happy to promise much more spending so what proportion of the total does he contemplate? Will half of Welsh government spending go on health – or more? Where will the money come from? The Conservatives want to get income tax devolved and cut that – costing tens, perhaps hundreds, of millions. Are we going to keep hospitals open by closing schools? I have no wish to be uncharitable but it is hard not to suspect DM of unfunded rabble-rousing. The NHS needs rationalisation. We probably need to close more hospitals and improve facilities for getting to them and accommodating visitors. We can’t tip ever increasing proportions of the budget into a black hole while cutting spending on things like housing and social services, cuts that will increase demands on the health service further. I’d rather see sensible, costed, proposals for running the NHS within a reasonable budget rather than this money-no-object talk.

  6. I think it’s wrong for Click on Wales to be used for party political posts – the above is just a long election waffle.
    Sadly DM has been carried away with his own sense of political self-importance.
    He starts by praising NHS – they are all collectively “a treasure” (does he mean collectively when he says corporately or is he really exonerating all those managers and bureaucrats from blame for anything?).
    Yet later on he talks of “rooting out bad practice” and “too many horrific stories of bad practice”.
    Can’t have it both ways.
    Some interesting follow-ups, though. At least raising real points of issue (although not sure the Welsh language does put medics off from opting for jobs in Wales myself).

  7. J Protic, I think you will find that the Welsh Language Measures you refer to are a non-issue when it comes to recruiting doctors. As is the case for the wider NHS, our medical service is already run by a high proportion of highly capable economic migrants, many from the Indian sub-continent. Their proficiency in the Welsh language (or a lack of it) simply doesn’t come into the hiring decision.

    Recruitment to peripheral regions is difficult in any country it is not just a welsh problem. For some hospital consultants in the right specialties the absence of a wealthy urban population generating a steady stream of private patients can halve overall earning potential. That reduces the number and calibre of applicants.

    Compared with the rest of the UK, Wales does seem to have a low number of medical schools per capita. Maybe a brand new med school in North Wales along the lines of the new Peninsula Medical School in Plymouth is the way to go. Grow more of our own. This is the sort of strategic thinking,(ideas transgressing the nations health requirements, raising the academic bar for HE and building a skilled job base), that Wales currently lacks.

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