There are two certainties about prime minister’s questions, that weekly screeching ritual that makes you makes you want to weep for those who fought for democracy in Britain. First, David Cameron will at some point turn a shade of crimson; and second, when scrutinised over his government’s NHS record, he will immediately launch into a savage counter-attack on Welsh Labour’s handling of Wales’s NHS. The state of the Welsh NHS “is a scandal”, bellows the prime minister; adding that the English border with Wales is the “line between life or death”; and – as his health secretary Jeremy Hunt puts it – the Welsh NHS is “second class”.
It makes perfect political sense, of course. It is “look over there” politics at its finest. Think we’re cocking up the NHS here? Check out what our critics are doing in Wales! And it helps confront one of the only stubborn leads the Labour party has on any issue, which is the NHS. And so we stop considering the staggering fact that the Tories’ top-down privatisation – a policy voters weren’t consulted on, and which came with what Labour claims is a £3bn price tag to boot – has been disowned by the party’s senior figures as their biggest mistake in government. Apparently they didn’t understand it: it was “unintelligible gobbledegook”. Alas, we all make mistakes: it’s only the institution keeping many of us alive, after all. Competition laws created an expensive mess in the NHS, according to its former boss Sir David Nicholson. A million patients are now stuck waiting for more than four hours in A&E – a level unseen since 2003/4. The longest real-terms squeeze on NHS funding in its history, privatisation, an ageing population, cuts to local care budgets: all this is heaping more and more pressure on a creaking NHS.
It’s not just the Tories, though. In the last few days, the Daily Mail has subjected the Welsh NHS to a relentless battering. There will be far more to come in the runup to May.
Picking on the Welsh NHS might seem a bit peculiar. Surveys show that 91% of Welsh citizens are satisfied with the last appointment they had at a NHS hospital. According to a study by the Nuffield Trust earlier this year, none of the UK’s four countries were consistently ahead of each other in NHS performance. The number of “avoidable deaths” in Wales was broadly the same as anywhere else. Yes, Wales has more specific challenges than England which make a fair comparison hard: a population with more needs, including a higher proportion of older citizens, at a time of cuts to local care services.
There is the issue of cuts. According to the King’s Fund last year, NHS spending in Wales was projected to have fallen by 8.6% between 2010-11 and 2013-14. But Wales has been left with an extreme lack of room to manoeuvre. The coalition has slashed the Welsh government’s budget by 10% or £1.5bn – since the government came to power. Given that around 40% of the Welsh government budget goes on the NHS, in practical terms the NHS has been given relative protection, and now Cardiff is spending an extra £425m over two years. According to the Welsh government, Wales is still spending more per head on health than England is.
But the substance of the Daily Mail’s attack has received a strong counterblast from the Welsh government. The Mail’s claims that about half of Welsh cancer sufferers have to wait six weeks or more for many scans and tests, compared to less than 6% in England: not true, says Cardiff. Some 87.4% of Welsh cancer patients on the “urgent suspected cancer route” received treatment within 62 days after a GP referral earlier this year, compared to 84.1% in England. And 98.1% of newly diagnosed cancer patients “not via the urgent route” began treatment within 31 days, compared to 97.8% in England. Rather than Welsh patients fleeing to English hospitals, in areas such as Powys, patients were simply using their local hospital provider, which is across the border.
Does that mean turning Wales’s NHS into some sort of glowing utopia, a privatisation-free idyll unlike a disintegrating English NHS? No, and those of us who believe in the NHS should always advocate reform, as long as it is not a synonym for “privatisation” and “cuts”, but rather about meeting patients’ needs. But while the Welsh NHS is certainly not perfect, the Tories cannot get away with using it to avoid being scrutinised over their own disastrous record.
