Friday, 4 November 2011

Together for Health - Labour's latest 5-year plan for the Welsh NHS

This isn't the first time a Welsh Government has promised a "world class" NHS and Health Minister, Lesley Griffiths (Lab, Wrexham), unveiled the latest five-year plan/vision to boost NHS performance.

To call it a "plan" is over-egging it a little. It's more like a rallying call or a rather grand ministerial statement. There's more promises of "delivery" that Carwyn Jones has said would be at the heart of his government. There's more promises of "sustainability" too, while accepting there are clear problems down the line such as an aging population, budget pressures and difficulties in recruiting the right staff.

There's an acknowledgement that the general public need to take better care of themselves and that some specialist services need to be centralised.

Lesley Griffiths accused Elin Jones (Plaid, Ceredigion) and Plaid Cymru of scaremongering over "downgrading hospitals", but Lesley's trying to dodge the issue. If services are to be centralised from several hospitals to one or two then the services at those several hospitals have clearly been downgraded in most people's definitions. Elin Jones is correct and isn't scaremongering at all, just telling the truth.

Before I'm accused of being partisan, in my opinion the Welsh Government's policy on centralisation is correct too. This blog isn't a criticism of Lesley Griffiths, the new vision, or trumpeting Elin Jones or Plaid in any way shape or form – quite the opposite.

Centralisation makes sense in many cases. There's nothing fundamentally wrong with "downgrading" certain functions at district hospitals, or redefining district hospitals role, or providing more care at (or closer to) home instead of general hospitals - if it can improve the quality of patient care and patient outcomes.

Wales is overly reliant on hospitals to provide rudimentary and long-term care (like managing illnesses such as diabetes and arthritis) at the expense of district hospitals and primary care centres. If we really want a world class NHS, we're going to need world class centres of excellence. This means that our larger hospitals are going to have to focus more on highly specialist, critical and expert care, while our district hospitals might lose such services but in turn become far more important in managing treatment and recovery.

"None (district hospitals) will be downgraded" is bollocks. There'll be clear "winners and losers" from this process, but in the end, I don't believe patients will be losers - despite the inevitable psychological threat "downgrading" poses.

She doesn't need to shirk debate to justify it, as long as she puts across a good enough case. She can call it what it is – downgrading - she's in charge after all.

Lesley Griffiths has arguably the toughest job in Welsh politics. As soon as "downgrading" is out in the public domain by any means other than her own mouth - and local councillors start getting in on the action - she's toast. She needs to be honest and up front now, not when the first services are centralised. Being Health Minister isn't one of these roles where you can pretend to be everybody's friend.

The general public rightly criticise politicians for not telling it like it is. Why are the Welsh Government afraid of defending their own policies properly?


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