The worst places in Wales to get sick
The Welsh Government clearly has no meaningful plan to get through the Welsh NHS backlog
Hello everyone,
I need to start this week with an apology to all the people who subscribe to this newsletter for free.
Last week you will have received an email from “me” trying to convince you to upgrade to paid membership. It opened with the line “I’m Will Hayward, one of Wales’ leading journalists”. I just wanted to be clear - I did not write that. I would never describe myself as “one of Wales’ leading journalists”. It was a well meaning marketing email from one of the team here who went a bit further selling my expertise than I would have done.
I have written all of the other newsletters myself. All journalists have an ego, mine hasn’t yet reached that level.
Anyway, on to the newsletter! This week we have some pretty shocking NHS data involving children.
Let’s start with the NHS…
The place in Wales with the longest NHS waiting list
The state of the Welsh NHS has been a consistent theme of this newsletter. We know that waiting lists have been stubborn but there are differences across different parts of Wales. To try and understand it I broke the data down by health board and the results were depressing and insightful.
This graph shows the number of people waiting over two years for an appointment:
There are a few things to note here:
North Wales health board Betsi (which is also the largest) is not far off double the level of some others.
Though Cardiff & Vale and Aneurin Bevan (Newport/Gwent area) had a smaller peak during the pandemic they have plateaued and have even seen a small rise in the last year.
England currently has no waits over two years. Wales does count differently to England but not differently enough to account for this difference.
All health boards except Betsi are essentially at the same level based on population.
Numbers were creeping up before Covid (though obviously it didn’t help). The point is there were serious issues before the virus.
This is not inevitable. A decade ago there were virtually no two year waits.
The focus by the health service on getting down the two year waits has also meant that the number of people waiting over a year is also creeping up:
Areas like Cardiff and Vale, who have actually made great strides in reducing ambulance waits compared to other health boards, are seeing significant increases in people waiting over a year.
So why is the health service struggling to get the waiting lists down further?
Well it appears to be because of the nature of the appointments.
More of the pathways are now at the treatment stage compared to two years ago (51% January 2024 compared to 44% in April 2022). It takes more resources to close treatment pathways than pathways that close after outpatient appointments or diagnostics. As you can imagine, it is easier to work through 10,000 MRI scans than it is to work through the same number of hip replacements.
This of course will be small comfort for the person waiting in pain. Whether you are waiting for an op or a consultation for your arthritic joint the pain is much the same. Nothing illustrates the need to dig below the stats as when you look at the figures for children.
The lines on the chart below represent the waiting lists of under 18s in Cymru:
The headlines are:
Almost 2,000 kids are waiting over two years for an appointment and this figure has barely changed in six months.
Over 3,500 kids are waiting over a year for their first appointment.
An astonishing 7,000 children have waited over a year for an appointment.
Can Vaughan Gething’s Welsh Government really tackle this?
Fixing this is the Welsh Government’s responsibility. What they are doing at the moment clearly isn’t working or at best isn’t working fast enough. But I have absolutely no faith that a Gething administration is going to be any better than a Mark Drakeford administration at tackling this issue. Here is why:
The same people are in charge. One of the only people who stayed in the same post after Mr Gething reshuffled the cabinet was Eluned Morgan who remained in health. Vaughan Gething himself was the health minister before that and had been involved in the health department (either as a minister or deputy) since 2014.
There is no real change here. So forgive me if I am sceptical that there will be any real change in the Welsh NHS
.
Mr Gething’s statements about the NHS during his leadership campaign. Perhaps the most indicative demonstration of how there are no plans to radically change how the Welsh NHS tries to tackle this backlog was Mr Gething’s comments during the leadership campaign.
Unless I am missing something, he barely acknowledged the challenge of the NHS backlog and his comments were the ultimate lip service to the issue.
I heard him make two main pledges:
The Welsh NHS will remain in public hands.
Spending on health per head will never fall below England.
Well duh. Obviously a Welsh Labour leader will not privatise the NHS and of course spending in Wales won’t fall below England - we get proportionally more money than England and have an older population!
This second promise is all the more meaningless because if Wales were to match funding per head with England when it came to health our NHS would be in a terrible state because there is so much more demand.
It is possible for Mr Gething to reduce funding to the NHS in Wales and still keep this promise. It means nothing. At a time we need bold plans and meaningful direction, the people of Wales are instead subjected to these vacuous promises from the only person really in a position to do anything to resolve the situation.
Wales isn’t going to get any more money in the near future
Every time, and I mean every time, you ask a Welsh Labour politician why the NHS in Cymru has underperformed in the last decade the answer has always been “the Tories have cut our budget”.
Now to be fair, their budgets have been massively cut in real terms since 2011. This was always going to have a negative effect on the delivery of healthcare.
But there is absolutely no reason to believe that things are going to get better when it comes to increased funding any time soon. Unless something bananas happens in the next nine months, Keir Starmer will be in Downing Street by the end of the year and he has been steadfast in refusing to promise any additional money for Wales.
Thanks very much for reading. I am hoping to put out a second newsletter later in the week.
As always, any feedback is very much appreciated.
Take care
Will