The final FMQs of the 2016-17 Assembly term took place this afternoon and it's also the final FMQs covered on this site.
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Showing posts with label Roads. Show all posts
Showing posts with label Roads. Show all posts
Tuesday, 18 July 2017
FMQs: RIFW Redux, Tuition Fees & Parking Fines
The final FMQs of the 2016-17 Assembly term took place this afternoon and it's also the final FMQs covered on this site.
Thursday, 6 April 2017
Automation: Resistance is Futile?
Continuing the running theme of the backbench members debates this term - the "Fourth Industrial Revolution" - AMs turned to automation, something that was once science fiction but fast becoming science fact.
Tuesday, 4 April 2017
FMQs: Sport Wales, Gibraltar & Banks
This afternoon saw the final FMQs before an extended Easter recess, which will no doubt be taken up by local election campaigning.
Tuesday, 28 March 2017
FMQs: Article 50, NHS Deficits & Grass fires
The news that the Welsh Government will refuse to bail out four health boards dominated proceedings today, but the activation of Article 50 tomorrow also focused attentions.
Tuesday, 17 January 2017
FMQs: Brexit, Trains & Disability
There are two big non-FMQ related stories today. Firstly, the Senedd voting on a Legislative Consent Motion (LCM) for the Wales Bill. It's expected to pass and there's little to add. Just cross your fingers and hope AMs haven't been sold magic beans (either way).
Tuesday, 29 November 2016
FMQs : Sepsis, Letting Fees & Sport Wales
Sometimes AMs discuss stuff that only matters to themselves or those who lobby them. Sometimes they concentrate on things that have more topical relevance – as they did today.
Tuesday, 22 November 2016
FMQs : Circuit of Wales, Water & Tolls
The big story this afternoon is the emergence of a potential "cash for access" scandal. I stress "potential".
Thursday, 13 October 2016
Senedd rallies to get Wales moving
 |
| Only a third of Welsh schoolchildren get their recommended hour of physical activity a day. Pic : Road Safety GB) |
The latest backbench members debate was on the subject of physical activity, in particular walking and cycling.
Saturday, 8 October 2016
Plaid's Infrastructure Commission
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| (Pic : Plaid Cymru) |
On Monday, the Shadow Ministers for the Economy & Infrastructure – Adam Price AM (Plaid, Carms. E & Dinefwr) and Dai Lloyd AM (Plaid, South Wales West) respectively – launched a policy paper outlining their proposal to create a National Infrastructure Commission (pdf).
Tuesday, 4 October 2016
FMQs : Breakfast, Food & Cadw Merger
Another
Tuesday, another FMQs and, as usual, there was plenty up for
discussion.
Sunday, 28 February 2016
Fourth Assembly In Focus : Economic Profile 2016
In about ten weeks weeks time, those of us who will bother to vote will elect a new Assembly and a "new" Welsh Government. My 2016 election coverage starts today with a mini series over three weekends focusing on three key areas of devolved public policy and how they've changed over the last five years : the economy, health and education.
Friday, 29 January 2016
Thursday, 7 January 2016
Making the Metro
 |
| (Pic : BBC Wales) |
At the end of November
the Welsh Government launched the first publicity campaign for the
proposed South Wales Metro after the project was given a firm go ahead
earlier in 2015 (Metro a Go Go).
Wednesday, 21 October 2015
Thursday, 10 September 2015
Road to Somewhere?
 |
| With the latest section of the A465 dualling project set to fully open soon, it's worth reflecting on the short-term and long-term impact. (Pic : a465brynmawr2tredegar.co.uk) |
The latest section in the long-running project to dual the Heads of the Valleys road (A465) between Abergavenny and Hirwaun is due to fully open imminently (it's been partially open for a few weeks now). Section 3, which runs between Tredegar and Brynmawr, has cost £158million, with £80million of that coming from the EU.
Tuesday, 2 June 2015
Assembly Bans Smoking in Cars with Kids
 |
| (Pic : Wales Online) |
Within the last hour, the
National Assembly approved new regulations outlawing smoking in cars
when carrying under-18s.
Thursday, 21 May 2015
Bridge Over Troubled Water
 |
| While the Welsh Government and CBI have said the Newport M4 "Hart Bypass" will boost the economy, does the Port of Newport - which supports 3,000 jobs - stand to be one of the economic losers? (Pic : South Wales Argus) |
After Friends of the Earth Cymru's recent unsuccessful bid to stall the Newport M4 bypass, you would've thought that would be that. However, projects of this scale will always generate their fair share of problems, and I suspect the hurdles this particular project has to clear (political and physical) are beginning to become more obvious.
Monday, 2 March 2015
A St David's Day Deposit
 |
| Legend says the ground beneath St David rose so all of his audience could see and hear him. Like his namesake, the ground beneath David Cameron rose too, but it was a steaming mound of dung. |
Most people don't care about the constitution, what powers the Assembly has or the intricacies of how devolution works. They're more concerned about public services, and what the decisions made by politicians mean for themselves and their families.
Some of us realise the constitution determines what decisions politicians are able to make in the first place – all of which has a direct impact on the public.
As you probably all know, the Silk Commission published two reports between 2012-2014 as part of "the next step in Wales' devolution journey" etc.
The first report (Silk I) covered taxation powers for the National Assembly. Those powers are now on the statute book in the Wales Act 2014, meaning from 2018 the Assembly will have the power to set landfill tax, stamp duty and the aggregates levy. It also means the Assembly can call a referendum on whether they should have the power to vary income tax - which the First Minister is already attempting to scotch. This is despite the inclusion of a new funding review, which Carwyn Jones said would be required for his government to back a referendum.
Holding a referendum on such a technical subject is, as
Borthlas said today, "one
of the silliest ideas ever to be proposed by a government"
and very easy to lose.
As I've said before (Marching out of lockstep) a referendum on a general principle of fiscal powers - i.e. "Should the National Assembly have the power to fund devolved services by borrowing money and collecting taxes devolved to Wales?" - would be a juicer topic for the public to have a debate on and would definitely necessitate going to the polls to get a mandate from the electorate.
As I've said before (Marching out of lockstep) a referendum on a general principle of fiscal powers - i.e. "Should the National Assembly have the power to fund devolved services by borrowing money and collecting taxes devolved to Wales?" - would be a juicer topic for the public to have a debate on and would definitely necessitate going to the polls to get a mandate from the electorate.
The second report (Silk II) covered extra powers, which was taken forward by the Welsh Secretary, Stephen Crabb MP (Con, Preseli Pembs.), who set a deadline of 1st March – St David's Day – for a cross-party, cross-government consensus on Silk II's recommendations. You can read the full report, which was published last Friday to great fanfare, here (pdf).
Whisper it quietly, but I've been impressed with how Stephen Crabb has gone about his job. He's done more for Wales in 8/9 months than his predecessors have in the best part of a decade. I don't blame him personally for this brown whale, rising from the depths of the bowl to mock Ahab.
This may well be another "step forward on Wales' devolution journey", but it's also one last blast of Westminster's brand of constitutional Poodigree Chum out of the tradesman's entrance before the election.
What's been agreed?
- A reserved powers model, which should clear up what the Assembly's powers are by listing what the Assembly can't do. Except it won't clear anything up because of the piecemeal nature of Welsh devolution. Reserved powers would be like putting the current Schedule 7 in a mirror (if you see what I mean).
- Inter-governmental relations – Puts relations between the two governments on a more equal footing, with better co-ordination of policies in areas like training, economic development, cross-border rail routes and franchises as well as cross-border health services.
- Ports policy and development.
- Speed limits.
- Bus and taxi regulation, along with Traffic Commissioner functions.
- Places a duty on the UK Government to consult with the Welsh Government, and take into account Welsh energy policy, when approving energy projects of up to 350MW. This effectively means the Welsh Government will have a veto on "fracking".
- Sewerage and some aspects of water (with further negotiation).
- Marine licensing.
- At least one appointee to the Supreme Court should have an understanding of Wales.
- Local government elections.
- The Assembly itself – The Welsh Secretary will no longer have to appear before the Assembly, or have a right to participate in Assembly proceedings. The Assembly will also gain control over the age to vote in Assembly elections, the size of the Assembly and its name/branding. The National Assembly will also be recognised as "permanent".
- The First Minister should have the power to recommend appointments to Lord Lieutenancies (more on this from me later this month).
What's been taken off the table?
Some significant stuff – arguably the only significant powers outlined in Silk II.
- Youth justice and probation services.
- Policing (all aspects).
- There'll no longer be a review of devolution of the criminal justice system (courts, prisons, criminal law) in the 2020s.
- Drink-driving limits – this has already been devolved to Scotland.
- Network Rail funding – Scotland currently receives a population-based proportion of Network Rail's UK-wide funding (around 9%). In 2013, just 1% of Network Rail's budget was spent in Wales compared to a population share of ~5%. This means Wales will continue to, in nominal terms, "subsidise" English rail projects, resulting in significantly less than our "fair share" to invest here.
- The Crown Estate – It currently generates a £9.4million surplus in Wales, and is devolved to Scotland and Northern Ireland.
- State funding for S4C and appointment of S4C board members.
- Any and all aspects of social security - aspects of which will be devolved to Scotland.
- Responsibilities in relation to the Equalities and Human Rights Commission.
- Teachers' pay and conditions.
- The civil service.
What does this mean?
 |
| Thanks to the efforts of Nick Clegg and the "true party of Wales", the National Assembly is set to have power over shit. Literally. |
Not only are the UK
Government hamstringing devolution, but there are people in and around the
Assembly doing so as well.
The reason criminal justice powers have been taken off the table – the devolution of which would've finally put Wales on a near equal footing with Scotland – is because the Welsh Conservatives oppose it and must've vetoed it.
Welsh Labour probably did too, but they support devolution of policing at least (What's all this then?) – though Ed Miliband doesn't even want to go that far, promising some bizarre role in report-writing. It doesn't help that Owen Smith is arguably the most devo-sceptic Welsh Secretary-elect since 1999. He has to justify his position somehow.
The UK Government have also, quite literally, devolved shit to Wales. So we need to be grateful for the existence of Nick Clegg. Without Nick, Wales wouldn't have powers over faecal poltergeists and used tampons – but, at the same time, we're not good enough to run policing. Lib Dems should put that on their election leaflets.
I'm sure quite a few AMs from all parties will be underwhelmed by the St David's Day agreement, but this is a mess partly of their own making, as they put far too much faith in the "proper process" to the point of being gullible. In short, the UK never has been, and never will be, a union of equals; while constitutional reforms are pushed through in reaction to immediate threats to the status quo, not political consensus and grand commissions.
The UK is a very dysfunctional "family" indeed.The Scots have proven that if you want something you need to rattle your sabres. In political terms that means electing nationalists but, unfortunately, even then Wales would have very few sabres to rattle.
I'm not going to use the same old tired clichés about Wales "being slapped in the face" or "insulted" or "offered third-rate devolution" because this is exactly the outcome I was expecting :
Nope, not going to happen. Again.
A cross-party commission's reasonable and proportionate recommendations have been watered down. Again.
Scotland is moving leaps and bounds ahead of Wales. Again.
Powers which, by rights, should be devolved (like abortion limits, medicine licensing, drink-drive limits, and Network Rail funding....because subjects like health and transport are devolved) have been taken off the table. Again.
The only person who has a right to be chuffed with this is the Llywydd, Rosemary Butler (Lab, Newport West). Her recommendations (Assembly Commission steps up to the oche) are included almost word for word.
So don't worry. The National Assembly might, in future be called Welsh Parliament because "National Assembly" isn't a good enough name for Wales....but it is for France, Greece, South Korea, Hungary, Pakistan and South Africa.
Oh, and all those 16 year olds chomping at the bit to vote may be able to (The X-Factor). Great stuff. Meanwhile, the "Assemblement" will be able to block "fracking" but won't be able to control any energy project that produces more power than a BMX dynamo. The UK Government will retain ultimate control.
I look forward to the recommendations of the Baroness Kirsty Williams Commission on Devolution for Wales in 2024, which will outline a lasting settlement and put the issue of constitutional reform to bed for....
The reason criminal justice powers have been taken off the table – the devolution of which would've finally put Wales on a near equal footing with Scotland – is because the Welsh Conservatives oppose it and must've vetoed it.
Welsh Labour probably did too, but they support devolution of policing at least (What's all this then?) – though Ed Miliband doesn't even want to go that far, promising some bizarre role in report-writing. It doesn't help that Owen Smith is arguably the most devo-sceptic Welsh Secretary-elect since 1999. He has to justify his position somehow.
The UK Government have also, quite literally, devolved shit to Wales. So we need to be grateful for the existence of Nick Clegg. Without Nick, Wales wouldn't have powers over faecal poltergeists and used tampons – but, at the same time, we're not good enough to run policing. Lib Dems should put that on their election leaflets.
I'm sure quite a few AMs from all parties will be underwhelmed by the St David's Day agreement, but this is a mess partly of their own making, as they put far too much faith in the "proper process" to the point of being gullible. In short, the UK never has been, and never will be, a union of equals; while constitutional reforms are pushed through in reaction to immediate threats to the status quo, not political consensus and grand commissions.
The UK is a very dysfunctional "family" indeed.The Scots have proven that if you want something you need to rattle your sabres. In political terms that means electing nationalists but, unfortunately, even then Wales would have very few sabres to rattle.
I'm not going to use the same old tired clichés about Wales "being slapped in the face" or "insulted" or "offered third-rate devolution" because this is exactly the outcome I was expecting :
The question there is if Scotland votes no in September, and as a result acquires further devolved powers or devo-max, Wales will be left behind yet again when - based on this report - Wales is tantalisingly close to achieving parity with Scotland (if criminal justice powers were devolved in future).
- See more at: http://www.oggybloggyogwr.com/2014/03/silk-ii-wrath-of-paul.html#sthash.TZafNehB.dpufThe question there is if Scotland votes no in September, and as a result acquires further devolved powers or devo-max, Wales will be left behind yet again when - based on this report - Wales is tantalisingly close to achieving parity with Scotland (if criminal justice powers were devolved in future).
- See more at: http://www.oggybloggyogwr.com/2014/03/silk-ii-wrath-of-paul.html#sthash.TZafNehB.dpufThe question there is if Scotland votes no in September, and as a result acquires further devolved powers or devo-max, Wales will be left behind yet again when - based on this report - Wales is tantalisingly close to achieving parity with Scotland (if criminal justice powers were devolved in future).
- See more at: http://www.oggybloggyogwr.com/2014/03/silk-ii-wrath-of-paul.html#sthash.TZafNehB.dpuf
04/03/2014 : "....if Scotland votes no in September, and as a result acquires further devolved powers or devo-max, Wales will be left behind yet again when - based on this report - Wales is tantalisingly close to achieving parity with Scotland (if criminal justice powers were devolved in future)."
The
question there is if Scotland votes no in September, and as a result
acquires further devolved powers or devo-max, Wales will be left behind
yet again when - based on this report - Wales is tantalisingly close to
achieving parity with Scotland (if criminal justice powers were devolved
in future).
- See more at: http://www.oggybloggyogwr.com/2014/03/silk-ii-wrath-of-paul.html#sthash.TZafNehB.dpuf
- See more at: http://www.oggybloggyogwr.com/2014/03/silk-ii-wrath-of-paul.html#sthash.TZafNehB.dpuf
he
question there is if Scotland votes no in September, and as a result
acquires further devolved powers or devo-max, Wales will be left behind
yet again when - based on this report - Wales is tantalisingly close to
achieving parity with Scotland (if criminal justice powers were devolved
in future).
- See more at: http://www.oggybloggyogwr.com/2014/03/silk-ii-wrath-of-paul.html#sthash.TZafNehB.dpuf
There have been several
opportunities down the years to put the devolved powers issue to bed
once and for all and ensure Wales has a settlement that would last
more than a decade. People like me can then shut up about independence and further powers, and AMs
can concentrate on running the country, safe in the knowledge that
they would be on a clearer footing within the UK's
constitution.- See more at: http://www.oggybloggyogwr.com/2014/03/silk-ii-wrath-of-paul.html#sthash.TZafNehB.dpuf
Nope, not going to happen. Again.
A cross-party commission's reasonable and proportionate recommendations have been watered down. Again.
Scotland is moving leaps and bounds ahead of Wales. Again.
Powers which, by rights, should be devolved (like abortion limits, medicine licensing, drink-drive limits, and Network Rail funding....because subjects like health and transport are devolved) have been taken off the table. Again.
The only person who has a right to be chuffed with this is the Llywydd, Rosemary Butler (Lab, Newport West). Her recommendations (Assembly Commission steps up to the oche) are included almost word for word.
So don't worry. The National Assembly might, in future be called Welsh Parliament because "National Assembly" isn't a good enough name for Wales....but it is for France, Greece, South Korea, Hungary, Pakistan and South Africa.
Oh, and all those 16 year olds chomping at the bit to vote may be able to (The X-Factor). Great stuff. Meanwhile, the "Assemblement" will be able to block "fracking" but won't be able to control any energy project that produces more power than a BMX dynamo. The UK Government will retain ultimate control.
I look forward to the recommendations of the Baroness Kirsty Williams Commission on Devolution for Wales in 2024, which will outline a lasting settlement and put the issue of constitutional reform to bed for....
Thursday, 23 October 2014
Hart Bypass returns to the Assembly
 |
| The issue of the Newport bypass has returned to the Senedd, and the Environment Committee had a few choice words for Edwina Hart and the CBI. (Pic : Wales Online) |
- Welsh Government's reprioritised National Transport Plan (7.12.11)
- M4 Newport consultation and rail upgrades in Gwent (11.3.12)
- A Cunning Infrastructure Plan (26.5.12)
- Newport's M4 coronary bypass (5.10.13)
- Cold and drafty Wales Bill (7.1.14)
- Newport's M4 debate painted black and blue (10.7.14)
- Newport M4 - Smell the Glove (17.7.14)
- Newport M4 : The Committee Strikes Back (21.7.14)
- M4 Newport : Edwina's Response (25.9.14)
It's back again....
Yesterday, the National Assembly debated the Environment Committee report into the proposed M4 bypass of Newport (Newport M4 : The Committee Strikes Back [pdf]) and the Welsh Government's response (M4 Newport – Edwina's Response [pdf]).
The Senedd's Heart to Hart
Alun said one issue "not given due attention" was the impact of electrification of the south Wales mainline and the South Wales Metro. The Committee believe these proposals weren't taken into account adequately when considering future travel patterns. He said the total costs of the bypass remain unclear, and funding sources were, "shrouded in uncertainty". He concluded that on basis of current information, the long-term value for money case is yet to be made.
Antoinette said there were "grave concerns" over the consultation process, in particular the lack of distinction between the three options and the exclusion of the Blue Route. She said it was important that the Welsh Government were "above reproach" on this due to international significance of Gwent Levels, and there was a lack of public confidence in way the process was handled. Antoinette said the Minister hasn't been prepared to be "transparent and scrutinised properly" on this, and she doesn't believe the Minister, "has the support of the public for this project".
Llyr believes the financial detail of scheme should be more widely known to ensure scrutiny on the basis of value for money, with the quoted costs having a massive margin of error, standing between £600million and £1billion. He said adopting the black route, "gave the impression to the people of Wales that it was a done deal" when there's a long way to go.
He said it was "beyond question" that the M4 through Newport isn't fit for purpose, but all options need to be considered. He said it was a shame the answers came so belated from the Minister. However, he said the Blue Route is as open to debate as the Black Route and we should, "let the evidence speak for itself". Williams also stressed the need for other solutions, emphasising that people need to get people out of cars and onto integrated public transport.
She said every effort should be made to avoid the "disastrous impact" on the environment, but they also need clarification on how much of the borrowing will be spent on the bypass. She also said comments (from the First Minister - clip of the FMQs exchange on 30th September 2014) about traffic lights on the Blue Route were irrelevant as they would be replaced by grade separated junctions.
Russell George AM (Con, Montgomery) was....surprise,surprise....disappointed the CBI didn't give evidence. He added his view that the Welsh Government ignored the environmental concerns and that any Newport bypass would have a knock-on impact on infrastructure projects in the rest of Wales – picking out improvements to the A55 and A40 in particular. Russell accused the Welsh Government of failing to look at Welsh transport infrastructure "in the round".
Former Environment Minister, John Griffiths AM (Lab, Newport East), said the Gwent Levels are unique, and that their importance and historical significance are "beyond doubt". Although he's now one of the more high profile opponents to the bypass, he said he didn't support the Blue Route either due to the possible air pollution and noise problems an urban expressway would cause. John would prefer "carrot and stick" public transport solutions.
He also raised the valid point that there's a new environment since the Scottish referendum, offering veiled criticism of the UK Government's caveat that early access to borrowing be dependent on funding a bypass.
In her response, the Minister for Economy & Transport, Edwina Hart (Lab, Gower), said her letter addressed the Committee's concerns. She regretted not giving evidence in person, but the statutory decision-making process is "very strict" and she repeated her defence that she couldn't give evidence until after the consultation. She agreed with William Powell that this process may need "looking at".
She confirmed the Welsh Government have submitted their defence to Friends of the Earth Cymru's legal challenge and they're waiting for the court's decision. Edwina also confirmed that no detailed design work will be until after a full environmental impact assessment, and she expects more detailed financial information to be provided at any future public inquiry (which will take place in late 2016/early 2017).
Unsurprisingly, she said it would be inappropriate for her to comment further on other matters while these processes were ongoing.
Concluding the debate, Alun Ffred Jones said he was disappointed the government "always has a reason for not giving details or answering basic questions", and he was "none the wiser" after the Minister's response.
He said the Committee weren't opposed to finding a solution to the Newport problems; but it has to be the right decision after all reasonable options have been considered, and because it would have a knock-on impact to infrastructure spending. The Committee simply wanted to, "ask pertinent questions about the process and not discuss the merits of the routes".
He therefore upheld the Committee's recommendation that the Welsh Government should restart the consultation process with all of the route options included.
Total Eclipse of the Hart
 |
| The Black Route isn't quite a done deal yet. (Pic : M4 Newport website/Me) |
Some very large obstacles were placed in the way of the Environment Committee in the process of this inquiry.
Firstly, Edwina Hart and the CBI refusing to give evidence; secondly, Plaid Cymru's predetermined support for the Blue Route which threw everything off balance; and thirdly, the sudden/curt announcement from the Minister in July that the Black Route has been selected.
The Blue Route isn't quite dead yet, but you get the impression the Minister is doing her best to kill it off. It seems the only way you can get comprehensive responses from the Welsh Government nowadays is a Daily Mail headline.
Having said that, the media – maybe myself included – might have given the impression that the Black Route is (as Llyr Gruffydd pointed out) "a done deal". That's wrong. All that's happened is the principle of a complete M4 bypass of Newport that follows the black route has been agreed, but the design could change significantly between now and the start of construction, depending on the outcome of the further environmental reports and any future public inquiry.
The problems facing the Black Route continue to mount. I wouldn't at all be surprised if the environmental impact report will make grim reading and lead to serious questioning of the Welsh Government's supposed commitment to *groan* "sustainable development".
Secondly, there seems to be growing opposition amongst Labour backbenchers to the project – notably from John Griffiths and Alun Davies AM (Lab, Blaenau Gwent), who are two former ministers with responsibility for the environment. You can probably include Julie Morgan and Jenny Rathbone AM (Lab, Cardiff Central) in there too, while Mick Antoniw has reservations by the sound of it.
Thirdly, as the South Wales Argus have covered, Newport Docks is going to have a whacking great big bridge built over it. I'd like to think that someone would've considered whether that proposal might have an impact on port operations. Newport Docks is Wales' most important cargo port and according to ITV Wales supports some 3,000 jobs.
Last but not least, as you might've noticed, the CBI were rightfully given a kicking from all quarters. When you consider they're often mouthing off to the press about the state of Wales, the fact they couldn't be bothered to give evidence on something they consider so vital - so important that it stands to become the single largest capital investment a Welsh Government will ever make - was nothing less than an insult to all of us. Up yours, Digby.
I certainly respect the work the Assembly's committees do, and it's not as if the CBI would ever consider snubbing a Westminster equivalent.
Tuesday, 7 October 2014
Why are Welsh ambulance response times so poor?
The Wales Ambulance
Service Trust (WAST) has failed to hit and maintain its response time targets (65%
of the most serious [Category A] 999 calls responded to within 8
minutes) for around 24 months in a row.
The latest figures, from August 2014 (pdf), show that 56.9% of Category A calls were responded to within 8 minutes; that rises to 66.8% within 10 minutes and 83% at 15 minutes. That means for 17% (almost 1 in 5) of life-threatening calls in Wales, an ambulance takes near double the target time to reach the patient. Summer is traditionally quiet in terms of demand for ambulance services, so these figures are particularly bad.
Although this is one of those issues which Assembly Members get very hot under the collar about, nobody's ever considered the precise reasons why the ambulance service is missing its targets so consistently. Opposition AMs huff and puff over the figures and turn it into a political football, while ministers almost never give straight answers.
Most of this is going to be guesswork and inductive reasoning with very little hard evidence to back it up. But I do believe that – concerns from the McClelland Review about management aside - some of the reasons might not be sexy enough for politicians to score points off each other in the Senedd chamber or press, but do make sense.
Where are the problems?
Before considering why response times are poor, it's worth looking at performances at a local level to see if there are any patterns we can draw conclusions from. As you can see from the map below, response times vary wildly across Wales.
Four local authorities actually hit or exceeded the target – Swansea (65.1%), Conwy (65.9%), Bridgend (69.3%) and Wrexham (70.3%). Neath Port Talbot (62.8%) and Denbighshire (63%) came close. So despite criticism elsewhere, it looks like ambulance response times in the Abertawe Bro Morgannwg local health board are significantly better than the rest of Wales.
In terms of poor responses, there are two distinct clusters.
The first cluster are rural local authorities, with Monmouthshire (50%), Anglesey (51.5%) Powys (53.3%), Vale of Glamorgan (53.5%) and Carmarthenshire (54.7%) standing out, with the likes of Pembrokeshire, Ceredigion and Gwynedd not doing much better.
The second cluster consists of Cardiff (58.1%) and the south Wales valleys. Response times in Caerphilly (44.8%), Rhondda Cynon Taf (46.4%), Torfaen (47.6%), Merthyr Tydfil (51.3%) and Blaenau Gwent (52.8%) are much, much worse than the rest of Wales. The difference between bordering local authorities like Bridgend and RCT is stark, though – as I'll come to – there may be unorthodox explanations as to why this is the case.
What might the problems be?
The quality of the
road network - The poorest response times are in the south Wales
valleys where there are a lot of very narrow side streets consisting
of tightly-packed terraced houses, usually on steep inclines. There's
often very little room to park if you live on these roads, let alone enough
room to attempt to get an ambulance up them at high speed.
Local authorities which have the better response times, like Swansea, Bridgend and Wrexham, are quite car-friendly. Swansea city itself, for example, has been designed with road traffic in mind since the Luftwaffe flattened it, while Bridgend and Wrexham have large housing estates served by high-quality spine roads and dual carriageways.
So as much as AMs might want to pin the blame on the government or the WAST's management team, it could be equally down to dodgy junctions, potholes, poor car parking, ill-considered one-way systems or unnecessary sets of traffic lights and speed humps.
Perhaps consideration should be given to the creation of designated "ambulance-friendly routes" in the valleys that are cleared of any and all obstructions where practical.
Rurality and the distance travelled to 999 calls – This is something you can easily infer from the map, and it's so blindingly obvious even the harshest critic of the Welsh NHS will have to accept it as an unavoidable hazard.
The further you are from a hospital or ambulance station, the longer the ambulance will take to reach you – simple. The problem will be more acute in north west, mid and west Wales (as well as some south Walian local authorities like Monmouthshire and Vale of Glamorgan). The catchment areas for Ysbyty Gwynedd and Bronglais Hospital, for example, are huge, and often cover difficult terrain.
Farming and fishing are probably the most dangerous jobs around. Workers in these sectors are at higher risk of suffering serious accidents, and these jobs are also more densely concentrated in these areas.
Also, people who move to idyllic-looking farmhouses to retire don't factor in that – as they get older and inevitably get sicker too - ambulances might struggle to reach them at the end of gravel tracks off a picturesque winding B-road in the Welsh Desert. And air ambulances might be tied up elsewhere.
Ambulances are too heavy and too slow - In 2013, around £9.5million was spent upgrading the Welsh ambulance fleet. Although they now carry very high-tech (and heavy) equipment – before factoring in the weight of paramedics themselves and patients – the ambulances are still glorified transit vans that can't negotiate corners particularly well and accelerate slowly. Over longer distances this will add up.
If you want an analogy, it's a bit like refurbishing the interior of a train or bus to business class standards, but the bus/train itself remaining a clapped out diesel from the 1970s.
There's little the Welsh Government and Ambulance Trust can do here, and the onus is on ambulance manufacturers to create faster, lighter vehicles. Perhaps there should be more use of motorbikes and cars for first responders, while using larger ambulances solely to transport patients to hospital and stabilise complicated conditions.
Delayed
transfers at Accident & Emergency departments – Now this is
something you really can criticise the Welsh Government for. It's their job to ensure there are enough
medical staff, and that hospitals are well-resourced enough, to see
whoever comes through the door.
Every minute an ambulance spends outside A&E departments waiting to discharge patients is a minute that ambulance is out of action. There are acute problems in Cardiff in particular, and it occasionally happens at other hospitals, such as Morriston Hospital in Swansea and Princess of Wales Hospital, Bridgend.
With the forthcoming centralisation of specialist services in south Wales, I'll actually expect this problem to get worse, as treating capacity hasn't been dealt with. They might stand a chance of being seen by staff quicker, but as far as I can tell there'll be the same number of beds to treat them.
This is the main reason why, in my opinion, you end up hearing of extreme cases of people waiting hours for an ambulance to show up. It's simply because all the ambulances are tied up outside A&E departments waiting to offload patients.
Compassion fatigue & "false alarms" - "Compassion fatigue" is a mild form of post traumatic stress disorder that affects people who deal with harrowing things every single day (like paramedics and A&E doctors), and it even affects the general public when we're bombarded with bad news or sob stories. We eventually get used to it to such an extent we don't care anymore. How many times have we been told the Wales Ambulance Trust are over-worked, under-staffed and poorly-managed?
For medical staff this becomes cynicism and a lack of genuine compassion for patients. This in turn may lead to complacency in care and poor morale. I doubt you would ever get paramedics to admit it because the trade unions will go ballistic and on the defensive. But I'm willing to bet on some calls they'll let standards slip because they've had enough crap for one day.
Then there are people calling for an ambulance when they don't really need one, tying up more resources. It's easy to criticise people who do this as time-wasters or hypochondriacs, but it's often better to be safe than sorry. Welsh Government public information campaigns on this have clearly failed.
The targets are too ambitious – Not all
Category A 999 calls need to be responded to within 8 minutes. With
improved medicines and treatments, things that would've once killed
people – like heart attacks and strokes – are now increasingly
survivable, even if a patient doesn't reach hospital in the "golden
hour" (which some academics and medics have called a "myth").
That's no reason to be complacent, and there is evidence that suggests the sooner an ambulance reaches a patient who's suffering a heart attack, the greater the chance of survival (Pell, Sirel, Marsden et. al 2001).
However, just to point out how silly the 8 minute target is (as pointed out in the McClelland review), if an ambulance reaches a patient within 8 minutes and they die, they've met the target. If they reach them in 8 minutes 30 seconds and save the patient's life, they've missed the target. That's ridiculous, and no wonder paramedics must hate their job (Price, 2006) when those are the twisted standards they're held to by managers and politicians.
Echoing what was said in the McClelland review, the target should be based around the patient's outcome (for argument's sake, all Category A patients should be admitted to hospital within 40 minutes of the 999 call with a chance of survival), not a stopwatch.
What are the Welsh Government doing about it?
You've got to say that if these are the sorts of problems facing the ambulance service, then there's very little the Welsh Government can do other than implementing some of the recommendations from the McClelland report and keeping their fingers crossed.
Ditching the 8 minute target – however rational it would be - would be an absolute god-send to opposition AMs. It would probably send the Tories in particular into screams of ecstasy on the Senedd benches, as it'll be on every election leaflet in 2016, accompanied by a photo of an elderly actor/actress having a "chest-clutcher" on the stairs. So it's unlikely to happen due to politics, even if shifting the goal posts is in vogue at Cathays Park.
However, in the last fortnight or so, the new Deputy Minister for Health, Vaughan Gething (Lab, Cardiff S. & Penarth), made a major announcement on this.
The Welsh Government have earmarked around £5million towards the creation of an Emergency Medical Retrieval and Transfer System (EMTRS) service. In English, that means an expansion (you could even say a part-nationalisation) of the Wales Air Ambulance - dubbed "Flying Doctors" after the cheesy 1980s Australian drama, though it's probably more comparable to M.A.S.H. It'll operate for 12 hours a day, and will be based in Swansea and Welshpool.
The idea's that trained doctors and consultants will be airlifted to serious incidents with equipment so patients can be treated at the scene instead of waiting for an ambulance to take them to hospital to be treated. If it works, it's said 95% of the population will now be within 30 minutes of doctor-led emergency care.
The EMTRS is probably an act of desperation, but as an idea it's incredibly sensible, practical and I'm surprised it hasn't been attempted a lot sooner.
The latest figures, from August 2014 (pdf), show that 56.9% of Category A calls were responded to within 8 minutes; that rises to 66.8% within 10 minutes and 83% at 15 minutes. That means for 17% (almost 1 in 5) of life-threatening calls in Wales, an ambulance takes near double the target time to reach the patient. Summer is traditionally quiet in terms of demand for ambulance services, so these figures are particularly bad.
Although this is one of those issues which Assembly Members get very hot under the collar about, nobody's ever considered the precise reasons why the ambulance service is missing its targets so consistently. Opposition AMs huff and puff over the figures and turn it into a political football, while ministers almost never give straight answers.
Most of this is going to be guesswork and inductive reasoning with very little hard evidence to back it up. But I do believe that – concerns from the McClelland Review about management aside - some of the reasons might not be sexy enough for politicians to score points off each other in the Senedd chamber or press, but do make sense.
Where are the problems?
Before considering why response times are poor, it's worth looking at performances at a local level to see if there are any patterns we can draw conclusions from. As you can see from the map below, response times vary wildly across Wales.
 |
| Ambulance response times by local authority - August 2014 (Pic : StatsWales/Welsh Government) |
Four local authorities actually hit or exceeded the target – Swansea (65.1%), Conwy (65.9%), Bridgend (69.3%) and Wrexham (70.3%). Neath Port Talbot (62.8%) and Denbighshire (63%) came close. So despite criticism elsewhere, it looks like ambulance response times in the Abertawe Bro Morgannwg local health board are significantly better than the rest of Wales.
In terms of poor responses, there are two distinct clusters.
The first cluster are rural local authorities, with Monmouthshire (50%), Anglesey (51.5%) Powys (53.3%), Vale of Glamorgan (53.5%) and Carmarthenshire (54.7%) standing out, with the likes of Pembrokeshire, Ceredigion and Gwynedd not doing much better.
The second cluster consists of Cardiff (58.1%) and the south Wales valleys. Response times in Caerphilly (44.8%), Rhondda Cynon Taf (46.4%), Torfaen (47.6%), Merthyr Tydfil (51.3%) and Blaenau Gwent (52.8%) are much, much worse than the rest of Wales. The difference between bordering local authorities like Bridgend and RCT is stark, though – as I'll come to – there may be unorthodox explanations as to why this is the case.
What might the problems be?
 |
| These aren't exactly ambulance friendly street layouts. (Pic : Wales Online) |
Local authorities which have the better response times, like Swansea, Bridgend and Wrexham, are quite car-friendly. Swansea city itself, for example, has been designed with road traffic in mind since the Luftwaffe flattened it, while Bridgend and Wrexham have large housing estates served by high-quality spine roads and dual carriageways.
So as much as AMs might want to pin the blame on the government or the WAST's management team, it could be equally down to dodgy junctions, potholes, poor car parking, ill-considered one-way systems or unnecessary sets of traffic lights and speed humps.
Perhaps consideration should be given to the creation of designated "ambulance-friendly routes" in the valleys that are cleared of any and all obstructions where practical.
Rurality and the distance travelled to 999 calls – This is something you can easily infer from the map, and it's so blindingly obvious even the harshest critic of the Welsh NHS will have to accept it as an unavoidable hazard.
The further you are from a hospital or ambulance station, the longer the ambulance will take to reach you – simple. The problem will be more acute in north west, mid and west Wales (as well as some south Walian local authorities like Monmouthshire and Vale of Glamorgan). The catchment areas for Ysbyty Gwynedd and Bronglais Hospital, for example, are huge, and often cover difficult terrain.
Farming and fishing are probably the most dangerous jobs around. Workers in these sectors are at higher risk of suffering serious accidents, and these jobs are also more densely concentrated in these areas.
Also, people who move to idyllic-looking farmhouses to retire don't factor in that – as they get older and inevitably get sicker too - ambulances might struggle to reach them at the end of gravel tracks off a picturesque winding B-road in the Welsh Desert. And air ambulances might be tied up elsewhere.
Ambulances are too heavy and too slow - In 2013, around £9.5million was spent upgrading the Welsh ambulance fleet. Although they now carry very high-tech (and heavy) equipment – before factoring in the weight of paramedics themselves and patients – the ambulances are still glorified transit vans that can't negotiate corners particularly well and accelerate slowly. Over longer distances this will add up.
If you want an analogy, it's a bit like refurbishing the interior of a train or bus to business class standards, but the bus/train itself remaining a clapped out diesel from the 1970s.
There's little the Welsh Government and Ambulance Trust can do here, and the onus is on ambulance manufacturers to create faster, lighter vehicles. Perhaps there should be more use of motorbikes and cars for first responders, while using larger ambulances solely to transport patients to hospital and stabilise complicated conditions.
 |
| There's at least 8 ambulances I can see that can't go on another urgent 999 call. (Pic : Morriston Hospital via cardifflocalguide.co.uk) |
Every minute an ambulance spends outside A&E departments waiting to discharge patients is a minute that ambulance is out of action. There are acute problems in Cardiff in particular, and it occasionally happens at other hospitals, such as Morriston Hospital in Swansea and Princess of Wales Hospital, Bridgend.
With the forthcoming centralisation of specialist services in south Wales, I'll actually expect this problem to get worse, as treating capacity hasn't been dealt with. They might stand a chance of being seen by staff quicker, but as far as I can tell there'll be the same number of beds to treat them.
This is the main reason why, in my opinion, you end up hearing of extreme cases of people waiting hours for an ambulance to show up. It's simply because all the ambulances are tied up outside A&E departments waiting to offload patients.
Compassion fatigue & "false alarms" - "Compassion fatigue" is a mild form of post traumatic stress disorder that affects people who deal with harrowing things every single day (like paramedics and A&E doctors), and it even affects the general public when we're bombarded with bad news or sob stories. We eventually get used to it to such an extent we don't care anymore. How many times have we been told the Wales Ambulance Trust are over-worked, under-staffed and poorly-managed?
For medical staff this becomes cynicism and a lack of genuine compassion for patients. This in turn may lead to complacency in care and poor morale. I doubt you would ever get paramedics to admit it because the trade unions will go ballistic and on the defensive. But I'm willing to bet on some calls they'll let standards slip because they've had enough crap for one day.
Then there are people calling for an ambulance when they don't really need one, tying up more resources. It's easy to criticise people who do this as time-wasters or hypochondriacs, but it's often better to be safe than sorry. Welsh Government public information campaigns on this have clearly failed.
 |
| The McClelland review recommended that the 8 minute target be ditched. - something AMs have conveniently forgotten. (Pic : Telegraph and Argus) |
That's no reason to be complacent, and there is evidence that suggests the sooner an ambulance reaches a patient who's suffering a heart attack, the greater the chance of survival (Pell, Sirel, Marsden et. al 2001).
However, just to point out how silly the 8 minute target is (as pointed out in the McClelland review), if an ambulance reaches a patient within 8 minutes and they die, they've met the target. If they reach them in 8 minutes 30 seconds and save the patient's life, they've missed the target. That's ridiculous, and no wonder paramedics must hate their job (Price, 2006) when those are the twisted standards they're held to by managers and politicians.
Echoing what was said in the McClelland review, the target should be based around the patient's outcome (for argument's sake, all Category A patients should be admitted to hospital within 40 minutes of the 999 call with a chance of survival), not a stopwatch.
What are the Welsh Government doing about it?
You've got to say that if these are the sorts of problems facing the ambulance service, then there's very little the Welsh Government can do other than implementing some of the recommendations from the McClelland report and keeping their fingers crossed.
Ditching the 8 minute target – however rational it would be - would be an absolute god-send to opposition AMs. It would probably send the Tories in particular into screams of ecstasy on the Senedd benches, as it'll be on every election leaflet in 2016, accompanied by a photo of an elderly actor/actress having a "chest-clutcher" on the stairs. So it's unlikely to happen due to politics, even if shifting the goal posts is in vogue at Cathays Park.
However, in the last fortnight or so, the new Deputy Minister for Health, Vaughan Gething (Lab, Cardiff S. & Penarth), made a major announcement on this.
The Welsh Government have earmarked around £5million towards the creation of an Emergency Medical Retrieval and Transfer System (EMTRS) service. In English, that means an expansion (you could even say a part-nationalisation) of the Wales Air Ambulance - dubbed "Flying Doctors" after the cheesy 1980s Australian drama, though it's probably more comparable to M.A.S.H. It'll operate for 12 hours a day, and will be based in Swansea and Welshpool.
The idea's that trained doctors and consultants will be airlifted to serious incidents with equipment so patients can be treated at the scene instead of waiting for an ambulance to take them to hospital to be treated. If it works, it's said 95% of the population will now be within 30 minutes of doctor-led emergency care.
The EMTRS is probably an act of desperation, but as an idea it's incredibly sensible, practical and I'm surprised it hasn't been attempted a lot sooner.
