Thursday, 30 October 2014

NHS Wales : The point-scoring has to stop

Playing political football with the Welsh NHS is likely to be as damaging as the political
football which has led to topics like immigration becoming "third rail" issues.
(Pic : reddit.com)
I wish politics was based on the strength of arguments and how good ideas are, debated rationally in language everyone can understand. That's the "Premier League of Politics". Unfortunately, we're stuck with the "Conference of Politics" in the UK, and there's been no better display of political semi-professionalism than the Cardiff-London spat over the Welsh NHS.

The content of the Daily Mail series is nothing we haven't heard before, but as it's dragged on-off for close to a fortnight - it looks like Y Byd ar Bedwar are going to come back to it again next week -  I suppose I've got no choice but to address it as well.

First off – as I'm sure you all realised - this was an attempt by the Daily Mail to embarrass Ed Miliband by flagging up the perceived incompetence of the UK's only ruling Labour administration.


Ed Miliband typifies the career politicians that have caused such a disillusionment with politics in the first place. He's been sheltered from the realities of everyday life and knows nothing but politics as he was born into it. The thought of him walking through the door of Number 10 as Prime Minister next May fills me with a sense of dread, and I don't need the Daily Mail to paint me a picture.



Unfortunately, the Welsh Government did something everyone on the internet should know not to do : they fed the trolls. W
hy the Welsh Government should even care about what happens next May when they have so many immediate problems of their own is something you'll have to ask them. I believe Johann Lamont provided the answer last week; something to do with "branch parties".



I never thought I'd ever say this, but I have to take my hat off to the Daily Mail. Not only was this a visiting Ivy League professorship in trolling, but the Daily Mail have done a better job of getting straight answers on health out of the Welsh Government than 30 opposition AMs have during the whole Fourth Assembly.

The soundbites from Cathays Park and Labour AMs have sounded North Korean, which tells me the Mail hit a nerve.

Why?

It's a PR disaster. The Daily Mail is widely-read across the whole of the UK and the Welsh Government know this looks bad. That's because their overall record on health isn't just bad compared to the rest of the UK, it's f**king atrocious. Because this row was was played out on a UK stage - where the Welsh Government and Assembly have no leverage - it makes it different to past rows.

The Welsh Government live in a comfortable "big fish, small pond" bubble here where they often don't have to answer questions properly, can bat away scrutiny by hiding behind rules/process and are confident of being in power forever.
If Labour were running England or Scotland in the same way they're running Wales though, they would've been booted out of office in a landslide after a single term.


They're not used to the kind of high-profile sustained attack they endured from the Mail. This was a smear from the big boys and girls. The Fleet Street titles would utterly break most AMs if they did this consistently, making even the most strongly-worded Western Mail editorial look like a brawl between George from Rainbow and Teddy Ruxpin in comparison.


Having said that, while there are things we can blame them for and should punish them for at the ballot box, there are plenty of things we can't blame them for.

The Welsh Government aren't going around telling people to stuff their own and their children's faces with junk food, work longer hours than is sensible, drink and smoke to excess, get no exercise, ignore the needs of our elderly neighbours and relatives, stigmatise people with mental illnesses, turn up to A&E departments with a stubbed toe or after a drunken fight, or hold up ambulances because we don't know how to drive or park. It's not their fault we have a legacy of industrial disease or disproportionate numbers of older people either.

The under-performance is relative not absolute. The Welsh NHS is nowhere near as good as it could be, and is being mismanaged. However, in the face of so many (mostly self-inflicted) challenges, the Welsh NHS remains one of the finest health systems in the world, and I believe figures showing satisfaction (but not delight) with NHS services in Wales will stand up.

Only an over-promoted cretin with absolutely no sense of perspective could describe the Welsh NHS as "second class" with a straight face.

The Tories - and their little helpers like Danny Alexander - are single-minded, borderline autistic accountants reducing everything to a cost and a price. That includes me and you. They see public services as lines on a balance sheet. Too much red is bad, even if it makes a difference to peoples lives; while too much black means it's either better off in the private sector's hands or can be cut to the bone.

The Coalition's morbid obsession with the Welsh NHS comes across like a rubbernecking driver who's just passed a pile-up, hoping for as much bloodied asphalt as possible so they can tell exaggerated stories to the people back home and feel more alive. That doesn't mean they're always wrong.

Waiting times are longer in Wales. We don't have access to the same cancer drugs as patients in England. Large numbers of Welsh patients receive treatment in England (for geographical reasons, mainly). We really do have a recruitment crisis. Morale amongst NHS workers is through the floor. An ambulance is likely to take significantly longer to reach you in Wales compared to elsewhere in the UK. Meanwhile, care standards in some Welsh hospitals have been roundly criticised and the NHS complaints system is an utter shambles.

Have the Welsh Government taken steps to improve these things? Sort of.

Is it working? No, not urgently enough. Labour in Wales never treat problems with the seriousness they deserve, instead chucking money at issues to a point where the Welsh NHS is becoming a fiscal black hole. They also commission numerous low-level, over-specific investigations (like Trusted to Care) which result in reports that recommend sticking plaster solutions.

Sometimes all you need to do is address problems as they arise, but there's never been a comprehensive review of the Welsh NHS - from top to bottom - that addresses wider systemic challenges and forces the Welsh Government into action.

I don't believe that should be an "inquiry", because it's too quasi-judicial and implies there's someone or something to blame.

The OECD have been appointed to carry out an independent investigation comparing the UK's health systems, and the Welsh Government should co-operate fully. If that means the results are published at a time that inconveniences Ed Miliband and the Labour Party - hard lines. They shouldn't play politics with our health and well-being.

"We have an alternative!" I hear you cry.

I'll give the Welsh Lib Dems and Plaid Cymru credit for restraining themselves and coming up with their own ideas instead of just joining in the game of British Bulldog. Kirsty Williams has a Bill coming soon on minimum nursing levels and her party have called for a Williams-style Commission for the NHS; while Plaid want to integrate health and social care and address recruitment through their proposed tax on sugary drinks. Those are things for debate in 2016, not 2015.

During this row, however, both parties pretended to be above the Tory-Labour mudslinging while in the past they've often pressed for similar answers to similar questions using similar language. It hints at an inconsistency.

The Daily Mail is a Viz for Hyacinth Buckets, the hard of thinking and the highly-strung. But I'm willing to bet if it were the Western Mail, Independent or The Guardian slanging the Welsh Government's record along the same lines, the Lib Dems and Plaid would be marching down from the moral high ground singing a different tune.

The Greens will offer something that sounds high-minded but is incredibly impractical; while I'd imagine UKIP's vision for the NHS – if they even have a coherent idea between them in Wales – will be straight out of a Carry On film.

We can take a few things from this spat :

  1. The Scots made a humongous mistake in September.
  2. The popular press still have an important (Post-Leveson) role in holding governments to account.
  3. AMs are getting a good taste of what "getting more coverage in the UK media" will look like (and they should perhaps shift their focus back to coverage in the "nicer" Welsh media as a result).
  4. The last thing we need in Wales is to be dragged down to Westminster's level.
When you unnecessarily emotionalise a incredibly complex issue you tribalise the debate. It'll turn the Welsh NHS into a "no go area", handing "ownership" of the issue to those on the extremes, and resulting in discussions which resemble a pub car park fight - like immigration often does.

We deserve better than that, and we've been let down by the media and our politicians who keep spinning issues to such an extent that they barely resemble reality.


I realise this is the standard of debate we're used to from Westminster and the sorts of arguments we've come to expect from the Welsh Labour Government, but it's making it all the more tempting to give next May's election a miss altogether, and I doubt I'm the only one.




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