Small ... clever?
Wales is a small country.
It wants to become a small and clever one but for now, let's accept the challenges presented by being small, especially for a Health Minister trying to sort out the future of neurosurgery in Mid and South Wales.
It's a long story, that in its latter stages went something like this:
In 2006 Health Commission Wales conducted a Strategic Review of Neurosciences Services for Wales. It concluded that "the current organisation of neurosurgery services in South Wales is not clinically sustainable and is inefficient".
In other words, in a small country, there just weren't enough patients to keep open two surgical units in Cardiff and Swansea. Two units were unsustainable and Cardiff won out.
The protests started: patients, clinicians, local AMs and MPs in and around Swansea were up in arms.
The closure was put on hold by the then Health Minister, Dr Brian Gibbons until after the election. Ah, clever.
In July 2007 the new Health Minister, Edwina Hart, one of the AMs who had asked for a re-think, invites James Steers, an Edinburgh-based consultant neurosurgeon and past President of the British Society of Neurosurgeons, to lead a review on the future of neurosciences for Mid and South Wales.
This afternoon his recommendations were made public. It turns out that if you create "a single neurosurgery service" or a "neuroscience network" for which specialists on both sites work, you can keep Cardiff and Swansea open. The single service can guarantee the volume of patients needed - in a small country - to ensure standards are high enough and access is close enough to home to be acceptable to patients.
Cardiff claim victory thanks to this line: "A single neurosurgery service must be established at the earliest opportunity, co-located with Neurocritical care, complex and spinal deformity surgery, neurology and essentially paediatric neurological care including paediatric neurosurgery, which should be ... collocated in an adjacent child health setting with its own facilites, including paediatric critical care".
You'd be hard pressed to come up with a better description of the University Hospital in Cardiff, wouldnt' you? "I can see how some people might think that" says one expert diplomatically.
But Swansea evening papers and politicians are equally delighted that their unit remains open. They're celebrating victory for common sense and an approach, which, they say, was first suggested by Swansea-based clincians all those years ago.
Pretty clever, in a small country, to have both sides claiming victory ...
As I press the 'publish' button Peter Black AM hurries past to record an interview for Wales Today. He's read the report again, "particularly that bit about co-location" and he's not so sure now that the news for Swansea is as good as he'd first thought.
The Health Minister, by the way, won't be giving interviews.
I'm Betsan Powys, BBC Wales' political editor. I'll be blogging the inside track on 
© MMIX~RS~q~RS~~RS~z~RS~39~RS~)
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Why can't we treat neuro surgery patients from England in Cardiff or Swansea similarly to what happens in North Wales...patients go to Walton Hospital in Liverpool?
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It sounds like "Mirrors and blue smoke".
Will Plaid and Labour jointly be accepting the congratulations for a job well done? I wonder if Plaid will they be giving interviews in the absence of their partners in crime,? No, I didn't think so, no change at the Assembly then!
As Jimmy Breslin wrote ......
"The ability to create the illusion of power, to use mirrors and blue smoke, is one found in unusual people."
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So a Black cloud hovers then lol
I think that seems a great compromise
Everyones happy ,no one thinks they have lost .
And Mrs Hart says .............. silence
I think she should take a a bow She seems to be doing quite a good job in health. Now sort out the Ambulance quandry and she will be praised
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Why on earth you people stay with the NHS is utterly beyond me.
After suffering interminable delays, criminal inefficiency, and half-hearted treatment, I finally cracked and 'went private'.
I am now cared for by experts who look after me as if I were a pop star. For the first time in my life preventative treatment really means something.
Appointments are on time, any treatment is explained fully in language I can understand, there have never been any car park charges, and the 'free' coffee is superb.
NHS scares and Assembly squabbles are a thing of the past. Also, I can bask in the admittedly somewhat righteous glow that I am actually helping (in my own small way) by going private, to lessen the burden on the overworked (yet strangely overstaffed) MRSA ridden NHS.
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1.30 in the morning of the fifth of July 1948 this man was born, and the saved money to pay for the birthing was returned to a grateful man, his grandfather the collier.
Several years later the child and his mother both contracted TB, both returned home after many months of treatment cured.
Ten years went by and the child, now grown, contracted Meningitis, he was returned to his apprenticeship after several weeks cured.
And through my life there have been infrequent visits to my local surgery, all paid through our taxes, a shared commitment to a collective need.
Interminable, criminal, inefficiency, half-hearted, I don't recognise the words when related to my experiences, I remember, kind, quick, life saving, pain relieving.
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All very heart-warming and emotional, but time for some hard questions.
Are you in any way suggesting that private treatment be banned in the UK?
Almost 5 million people in the UK have private treatment, what do you think would happen to an already struggling NHS if all their treatment was taken over by that same NHS.
People pay EXTRA for private healthcare. Please don't forget those same patients still pay the same amount of taxes as they would if they received all their treatment from the NHS.
Anyone who goes abroad for a holiday,(if they've got any sense) pays for private healthcare for the duration of that holiday. Do you also frown on that ?
I also thought long and hard about the 'moral implications' before going private. The fact that I would still be contributing exactly the same amount of taxes whether joining or not, coupled with some appalling treatment from the NHS, made the decision for me.
I also made absolutely sure that none of my 'paid for' treatment would ever be carried out on NHS pemises. I fully appreciate that if and when I reach a certain age, the possibility of severe long term illness increases dramatically. The treatment for this, would in all probability be carried out by the NHS. I see no problem whatsoever with this, as at least I would have saved that same NHS the cost of treating me in my younger healthier years. While throughout my life contributing just as much (if not more) in taxes as anyone else.
Lastly, where do you think the vast majority of our sanctimonious politicians receive their healthcare ?
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The comments by Noah are absolutely valid in that the number of people I know who have had to resort to "private"medicine even after a lifetime of work is staggering,especially when considering the vast levels od expenditure on the NHS in Wales. I recently requested that one of my AM's find out from WAG the exact level of private provision in Wales. The reply from WAG was that they did not keep such figures. Well theres a surprise!!. The position is that the current NHS in Wales will look after you on the principle of waiting lists,which Ben Bradshaw stated basically was "not as good as it is in England". I suppose free prescriptions/free carparking are priorities,however they can also be seen as bribesto the electorate so as to make the Assembly seem relevant.
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Noah_sembly, your .....
"heart-warming and emotional", not at all, just grateful to my ancestors for having the vision to extend the Rhondda valley model out to the general population.
Your .....
"Lastly, where do you think the vast majority of our sanctimonious politicians receive their healthcare?"
..... who cares, my aged aunt received a new hip during February this year, 88 years of age, there was no "appalling treatment from the NHS", only a great deal of care before and after the successful procedure. Who paid for it, you did, thank you very much, of course I paid as well, and every other tax payer, thank you all.
It's easy to criticise, particularly when the criticised are unaware and unable to respond to the criticism.
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Stonemason.
First of all I sincerely wish your aunt all the best after her 'op'. At 88 any such operation can prove difficult, though as I assume she is also of good Rhondda stock she probably took it in her stride !
Your "who cares about politicians", my aunt is more important, implied comment, strikes a chord. I care about my family as well, so want to provide the best for them. This without lessening my 'donation' to the NHS by even a penny, while (obviously in a small way) lightening their workload.
Your last sentence..."It's easy to criticise, particularly when the criticised are unaware and unable to respond to the criticism"
There is no doubt whatsoever that the NHS is well aware of it's much publicised shortcomings, though far too often little action is taken to correct those shortcomings.
As for the NHS being "unable to respond to criticism" are you aware of just how many public relations/media gurus/trust spokesmen/non-medical management etc., the NHS lavishly employ?
And all the while the MRSA germs under the beds, in the basins and the operating theatres, are quietly multiplying.
(Nothing like a dollop of over the top fear and horror to end a post) !
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Maybe what Wales needs is a 'second city' which is in a more convenient place for the whole nation.
It could be built somewhere in the middle, with handy 'mini-motorway' connections.
My suggestion would be to call it 'Byrmingham'...
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At Last a Poll
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Re: 10
Geography is often inconvenient. A tourist in Ireland once asked a local in the west of the country, for the best way to Dublin. He got the reply... "Would you be going to Dublin? I wouldn't want to be going to Dublin if I was startin' from here!"
About a century ago, when Wales had no capital city, and needed one for the purposes of establishing a national museum and a library, it was suggested by someone in the Commons, that Shrewsbury might be eminently suitable. Its a shame that its in Shropshire, parts of which county, from the several Welsh place names there, were at one time Welsh.
The Assembly has a limited, defined, budget, pathetic legislative powers, and no revenue raising powers. It can't be blamed for trying its best, and failing, to square a circle as far as NHS specialist provision is concerned.
Its back to the old argument. Decades of distant government has left our nation in a state of relative impoverishment. Other small western countries have been able to develop their economies so that they are able to provide good services for their people. Yet, there are those who say that Wales would be the exception, and is incapable of so doing. It wouldn't survive on its own, they say. They would condemn us to decades more of the same diet that Wales has received from successive Labour, New Labour, and Tory governments. Reduced to begging for more, like Oliver Twist, and getting a clip around the ear for impudence.
The Scots are waking up to the fact that they have been sold short. Its time that we did too.
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