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Healthy debate?

Betsan Powys | 18:13 UK time, Wednesday, 20 April 2011

It's getting a little down and dirty out on the campaign trail.

Labour and Plaid Cymru are at loggerheads over the future of district general hospitals like Llandudno and Prince Philip in Llanelli. In the Llanelli Asda car park today I spotted Plaid's advertising van warning people that only a vote for them would protect the local hospital. No idea whether Mr Miliband spotted it too.

In short, Plaid say the absence of any direct commitments to keep DGHs in the Labour manifesto means that they are secretly planning to close them. This Plaid supporter is fully signed up to that narrative.

Health spokesperson Helen Mary Jones also said as much as she unveiled that ad van harking back to the period before the 2007 election when the disastrous Brian Gibbons-inspired hospital reconfiguration plans cost Labour very dear on the doorsteps.

Plaid's position has not gone down well with Labour, it's fair to say. They've decided mockery is the best form of rebuttal, taking to social media to speculate on what Plaid would close, based on the lack of commitments in their manifesto. The café on the top of Snowdon? The Wales Millennium Centre?

Carwyn Jones' response? Pithier. Plaid's claims are untrue - and they know they're untrue.

What's really going on here? Here's what Helen Mary Jones had to say this morning:

"If they are protecting that network of hospitals then they would have said so in their manifesto as we have. The absence of any reference at all to that speaks absolute volumes and it's our responsibility to warn people about Labour's lack of commitment to our network of hospitals."

Referring to the 2007 plans, she adds, "If we let Labour go into government that's what they are going to do again".

The future of Llandudno hospital was one of the most high profile battles of the 2007 campaign and Plaid's candidate in Aberconwy is keen to resurrect the narrative:

"There is only one way of ensuring the future of our hospital - and that is by returning a Plaid Cymru AM for Aberconwy."

The former Plaid Cymru AM for the area, the highly respected Gareth Jones, however, had a somewhat different take on it. When he spoke in the Assembly chamber on March 23 this year, after the announcement by Labour's Health Minister Edwina Hart of a £49m investment plan in Llandudno hospital, this is what he had to say:

"It is a matter that is close to my heart, a victory for the people of Llandudno and the surrounding area and an extremely important investment in medical services. It will also create new jobs and boost the local economy."

We rang the Betsi Cadwaladr Local Health Board. What current reviews or consultations are actually underway? They issued the following statement.

"Following an extensive period of engagement with a wide range of interested parties, the Health Board has developed and agreed an ambitious development plan for Llandudno General Hospital. A series of business cases for these developments are being prepared. These will be submitted for approval from the Welsh Assembly Government, who have already indicated that funding will be made available to support these developments.

"No further reviews of Llandudno Hospital are planned at this time and none of the other service reviews being carried out by the Heath Board involve services provided at the Llandudno site."

Under threat? You decide.

Heading south to Prince Phillip hospital in Llanelli, voters could be forgiven for feeling even more confused than those up North. Here, too, Plaid are warning that facilities there would be under threat under a Labour government.

Another rebuttal swiftly follows from Labour about Plaid scaremongering.

But opening a copy of the Llanelli Star today reveals a half page advert from the local Labour candidate Keith Davies and MP Nia Griffith entitled "Hands off our hospital"

Mr Davies tells readers, "While the Labour led Assembly funds Prince Philip Hospital, the local Health Board actually runs it. That is why I have marched alongside Nia Griffith MP and other organisations and individuals in support of the hospital and organised a petition insisting that we keep ALL the existing services at Prince Philip Hospital."

Hang on. If Plaid Cymru stand accused by Labour of scaremongering about the future of local health services, then what exactly is Mr Davies up to with his newspaper advert? A case of 'keeping up the pressure' on the Local Health Board said Labour.

Anyway, as far as Mr Davies is concerned at least, the services at Prince Philip would be safe with Labour. Plaid, too, would keep all services there?

Well, maybe. Questioned about whether Plaid's policy would be to keep services in their entirety in all district general hospitals, Helen Mary Jones gave the following reply:

"It's absolutely affordable. We've worked it out carefully. We're not talking about freezing the services and keeping everything exactly the same. We know that some specialist services will need to be provided in one place and some in others.

"But basic services, like accident and emergency services, have got to be available in our communities when we need them and we will not tolerate having those services cut or reduced."

Hywel Dda LHB, who run Prince Philip, have decided not to put out a statement, citing political sensitivity, but point us to the consultation section of their website. So, as far as we know, there is a "Five Year Framework - Right care, right place, right time - every time" but it's not clear what impact it might have on services.

What are we to make of all this?

Hospitals, opened, closed, upgraded, downgraded, have been a political football in previous elections, as they'll be in future ones. Maybe the voters aren't really paying attention to this election knockabout - but believe me, the parties certainly are.


  • Comment number 1.

    Politicians cannot help themselves when it comes to the NHS. Thank goodness the shambles in England is not quite where we are in Wales, but there is a fundamental truth that cannot be ignored even here. Those who lead the Service have a vision for the future that looks very different to the expectations of the rest of us. Why do you need local hospitals when you deliver care in new ways they say. Anyway, they go on, the key professional groups have consistently revised their standards upwards which means that specialties can only be delivered through fewer, better resourced centres whatever we would like instead. It has to happen. The emotion of all this, which some politicians exploit as Betsan records, looks unlikely to hold back some unavoidable changes that will not be popular. And some poor politician (maybe even HMJ) will end up having to front it all whatever they would like...

  • Comment number 2.

    Hospitals? A very touchy subject, and the various politicos should remember that local health boards run local hospitals providing all the usual services, A&E etc. Would anybody want the Assembly to run them directly? I don't think so. The local health boards would have to completely detached from local needs not pay any heed. Now, specialist treatments, like brain surgery for example, are entirely different. By far and anway the best specialist units are the biggest ones, with many more specialist surgeons and theatre staff with a great depth of expertise. It is not possible to have this down the road in a cottage hospital. With this undrestanding a lot more people will be happier.

  • Comment number 3.

    Balance Betsan, balance. How about a little focus on the numerous members of the electorate challenging Plaid to come clean about its desire for full independence and the fact it won't be wanting the Queen as a head of state. Don't you think these are the two most significant nation changing policies that Plaid has? With the wedding coming up perhaps it's a good moment to take a look at the constitutional issue. After all you can't get a fag paper between the parties on most issues... yet here is this yawning, monumental chasm that exists between the real world and Plaid and we hear not a squeak about it. What are your thoughts, we wonder?

  • Comment number 4.

    I don't think Plaid's long term aim is in any doubt, and its there in the manifesto, however no on is thinking that this election is about independence. To suggest that voting Plaid will make Wales independent the next day is fantasy, its inconceivable that independence would be achieved without a referendum.

  • Comment number 5.

    You're right of course, Lyn. And you're right to mention the word fantasy. It's about credibility. How can a party extrapolate ad absurdum without being challenged on how they'll get there? I could promise all the riches in the world, you'd be disappointed and not a little angry when the riches never materialised. Parties need credibility. They get that by showing how they can meet their promises and then meeting them. If Plaid genuinely believes we can achieve independence, they'd better start doing the maths. If not, and people don't see how incapable they are of delivering their core pledge and raison d'être we are in danger of being represented by deluded or delusionial AMs.

    And I'm not even politically inclined. Just a simple businessman.

  • Comment number 6.

    If you are a Welsh nationalist who believes in independence you have two possible lines to take. You can say yes we'll be poorer but we'll be prouder so let's do it. That's straightforward but would not win support. Or you can say we want independence but we understand the Welsh people don't want to be poorer. So the first objective is to build our economy to the point where we could opt for independence without material sacrifice. If you take that line there's no need to argue over independence; everyone can agree they want to get rich and when they are the question can be put. Meanwhile everyone has the same objective. Evidently that is a better electoral line for Plaid though it would not please all their activists. I don't know why they can't just say it - shows their political ineptitude. Meanwhile LDT is right, independence is a non-issue at present.

  • Comment number 7.

    Okay I think I follow... In which case there's all the more reason to focus on how Wales can possibly become a viable independent economy... beyond airy aspirations of tax breaks and a renewable energy revolution. I like leaders with the courage to lead with their convictions. Who knows, if they make a sound case they may lead us to this promised land.

  • Comment number 8.

    Wasn't Plaid, a few years ago, presenting Iceland as an example of the kind of country Wales could be? And in what condition is Iceland today?

    Regarding the debate over healthcare, it is very easy for politicians to pull on voters' heartstrings with emotive please like 'Don't close our hospital!' The question is, should this be the way our services are run - should emotion override reason? Obviously if there are good reasons to keep open a threatened hospital, then this argument does not arise but elsewhere it is, as we see, a fiercely contested issue.

    Healthcare is an incredibly complicated subject. The closest analogy I can currently devise would be to compare it to a war. In order to win battles, generals must take account of different factors - terrain, the numbers and firepower of the opposing forces, and so on. Likewise, in order to fight disease and improve health, the NHS must take account of population density and prosperity, economic stability, nutrition, social factors... I'm sure the list of considerations is very long.

    When one compares the battle to improve health to an actual battle, another element must also be considered: The possibility of failure.

    The plan is wrong. The measures imposed are not enough. The investment is not great enough. The strategy is misguided. The result is a worsening of public health, rather than an improvement. We have only to look across the border to England to see how fear of failure - either accidental or intended (as has concerned many about Mr Lansley's plans) - can create unrest and upheaval.

    For what it's worth, I think we do need a strategic healthcare planning organisation that is separate from government. Sure, the Assembly (or Westminster, in England) should set the strategic aims, but when it comes to tactics, that needs to be left to healthcare professionals. These must be people who know the different parts of Wales and understand what they need. These are the people who are able to devise the best plans to attack disease and deprivation (of health-related services). I would suggest that these would be professionals who have worked in healthcare, across Wales. They should devise not a single plan but several, taking into account the likelihood that only some of their tactics might be affordable straight away. An over-arching plan should be visible across all the possible schemes. These plans could then be sent to the seat of government (in our case, Cardiff Bay), where those who understand more than anyone else that politics is the art of the possible, can decide which plan they are able%2

  • Comment number 9.

    5. At 22:09pm 20th Apr 2011, Ben Andone wrote:

    “........ If Plaid genuinely believes we can achieve independence, they'd better start doing the maths.”

    I don’t think anyone is advocating Independence at the moment. So, on what basis would they “do the maths”? The financial situation in 10, 20, 30 years time, it can’t be done.

    You, as “just a simple businessman”, know this of course. When did you last do a 20 year plan for your business? You possibly plan three years in advance, tops, probably closer to 1 year. Plaid Cymru can only work in the world as it is at the moment, whilst still hoping for a world more to their liking.

  • Comment number 10.

    Yet again this blog cuts me off in my prime! My last comment would have continued:

    These plans could then be sent to the seat of government (in our case, Cardiff Bay), where those who understand more than anyone else that politics is the art of the possible, can decide which plan they are able to finance.

    That's the limit of my thinking at the moment. You will see that saving particular hospitals doesn't come into it. I would certainly be loathe to bulldoze any of them, though; only the most myopic of politicians would ignore the possibility that a currently-redundant service might be needed again.

  • Comment number 11.

    This is what happens when public services are put into the hands of politicians who want POWER,and will distort provisions to satisy public demands,even when they know,or should know that it is'nt making the best use of limited public funds. With a rapidly ageing population(include me in),and unfortunately in wales a fantastic growth in numbers of people who abuse their bodies and expect public funds to keep them going,together with fact that capacity of economy to fund such demands the future funding does'nt look healthy at all. What ever is said about the english "solution",it does seek to bring down costs/increase local management powers through GP's,and away from the 1945 solutions provided by WAG. What about the "growth" in private medicine in wales,whereby ordinary people(include me in),are circumventing LONG waiting lists and buying their way straight to specialists,even in NHS hospitals. It would be interesting to see what the NHS in wales would look like if it was left to professionals,rather than the politicians who do not have a good record of running anything in modern wales.

  • Comment number 12.

    English solutions are not the answer in Wales. GPs in England want to be doctors not health administrators. There are companies waiting in the wings to take over the management of health in England. The result part privatisation of the service. And why should GP consortia be regarded as the people who should run the NHS? Its going to be costly (remember those private companies are there to make profits for their shareholders) and removes any democratic oversight.

  • Comment number 13.

    Ref. Message 3 Ben Andone.

    The coyness of the Welsh media about Plaid's rather sneaky views regarding total,
    stand alone, Welsh independence, is legendary.

    One has only to recall the appalling career crushing "Seimon Glyn" display on Question Time by Ieaun Wyn-Jones, which has NEVER been shown again. Compare that to the sight of John Redwood's daft but harmless attempt to sing/mime the Welsh anthem, which has been shown repeatedly over the years.

    Sadly, the one-sided viewpoints that pass for balanced media coverage in Wales will continue until the Welsh public wakes up and the smell of coffee is at last in our nostrils.

  • Comment number 14.

    11 Tellingme... and 12 Lyn

    I was agreeing with Tellingme... right up to the bit about buying private healthcare. As my previous post(s) show, I'm not keen on the health service being manipulated for political purposes; politicians should set the overal direction and budget and then stay out of it, I think.

    Having said that, I'm no fan of people who buy private healthcare to leapfrog waiting lists as I think that weakens the national service. Take that 'solution' to extremes and you'd have no remedy at all for long-running or complicated ailments; everyone would be served by a system which provides quick and cheap operations - possibly even when you didn't need them - for a fast buck.

  • Comment number 15.

    Ben Andone is right to attempt to point out the elephant in the room that is never acknowledged by the Welsh media. I can think of at least one other elephant that is also never questioned.

    Crossroads as well makes a valid point about the standard of the Welsh media. Try to imagine for one second being completely cut off from the UK/london media with it having no relevance to our lives. Now I accept that for someone living in a Welsh speaking village in Gwynedd they might feel it kind of all ready doesn't... but trust me, for the rest of us it is a pretty chilling thought!

  • Comment number 16.

    14 Mike.. The point I was trying to make was that even within our totally "socialist" medicine in wales there is a thriving and growing private sector,both within and exterior to the NHS .this at a point where for 10 years there has been almost unprecedent sums of public money spent on NHS and whilst improvements have been made the sheer weight of problems (no pun intended) is bound to force "rationing" big time on the service. The trouble is that within wales there is almost hysterical reaction to anything run by private companies/individuals that involves medical services,but no politician will grasp the nettle and tell people that the party is over.13+15. Spot on. The whole trouble is that by having a "local" media it tends to look down the wrong of the telescope,and takes virtually no notice of whats happening elsewhere. If wales was to get "Independence" then the prospects for freedom and objectivity would come to an end,as media in the main sem to be part of the "welshification" project where it wanted/needed. Just try and figures on the welsh speaking employment of senior executives etc in BBC CYMRU and I guess we would be amazed as to how the english language service has been taken over the bi-lingual stafff. The analysis the views of welsh speakers to devolution/welsh language policies etc shows they are much more supportive than english only speakers,and hence the drive for "more powers" gets through very easily.Its amazing how the vast majority of english only speakers have allowed themselves to be "marginalized" by the public media even though they pay for through Licence Fees and taxes for the biggest racket called S4C,which is watched by about 5 people!!

  • Comment number 17.

    Re who runs the NHS, it is worth remembering that the only elected person in the system is the Minister in the Welsh Government. I can see the merits of some detached and virtuous group making all the key decisions, but who would they be? So far as I can see, there is incredible factionalism in the NHS with considerable self-interest paraded by the different professional groups. And why make GPs the centre of everything, they are the ones who insisted on remaining private contractors when it was set up. Andrew Lansley has found all this out to his cost and too late. The way the different parties aim to handle this area indeed should be at the centre of the Welsh Election debate. We all will benefit or suffer from the strategy that wins out and its effectiveness.

  • Comment number 18.

    "Try to imagine for one second being completely cut off from the UK/london media with it having no relevance to our lives. "

    Oh Comeoffit Comeoffit. Who on earth is suggesting that?

  • Comment number 19.

    Is everyone else as bored as I am with the incessant, obsessional chippy ranting? However, it could explain the smog alert ...

  • Comment number 20.

    Best wishes to Plaid Cymru: from a Scottish perspective, Labour has no more good causes, very little to contribute for the good of society in general, and is simply a career vehicle for too many of the unscrupulous and self-serving.

    And I'll be interested to see if this gets through - Labour-dominated BBC Scotland seems unable to accept my posts to Brian Taylor's (Scottish politics) blog!

  • Comment number 21.

    Message 20 Freenonbrit

    You need have no worries on that score "Freenonbrit", for with a name like yours, as well as an opening line introduction of "best wishes to Plaid Cymru", you must already be feeling the warm glow from our Welsh media.

    Couple that with your obvious dislike of Labour, don't be too surprised if you're given a long white robe and a strange chair just a few months from now.

  • Comment number 22.

    Once again the conspiracy theorists are out in force fantasizing about some form of Fascist Welsh Language elite controlling the media - putting the paranoia aside, private medicine is rationing, rationing by wealth. The health service will never be funded to end all need, because the need increases all the time. The decisions about health are by their nature political, I would rather have a system of publicly accountable ministers and health authorities than private companies employed by a narrow section of health professionals. The purchaser provider split was a disaster in England, creating duplication and waste, coupled with a vast explosion in the bureaucracy - I am glad we have moved away from that in Wales. Since devolution there has been a huge improvement in the health service over all. Labour haven't got it all right, the multiple reorganisations haven't helped but at least the attempt to marry up social services with health was a good step, shame that 22 health boards were far too many.

  • Comment number 23.

    22 Lyn

    I'm with you on the 'Welsh language elite' idea. I've worked in the media here and never had the feeling that there was anything like that going on. Also agree completely about private medicine being rationing by wealth - that is an excellent description.

    I can't quite agree with you where you say the health service can't end all need because the need increases all the time - it's more that the need is extremely hard to predict because people don't have enough knowledge to understand fully what their needs in fact are. Government reports have shown that wealthier people are more likely to take advantage of preventative medical treatments, while the poor tend to visit doctors only when they know something's wrong - necessitating more visits until the problem, whatever it is, is cured or otherwise disposed of.

    As my previous posts show, I agree that publicly-accountable ministers and authorities should be in charge of planning/providing the service. Also that duplication and waste must be avoided, and that marrying health and social services is a good idea because they are natural partners.

    It could be that there are obvious boundaries for linked health/social services provision that have nothing to do with political borders. Perhaps cross-border authorities are the way forward. I mean, National Park authorities have responsibilities that would otherwise belong with county councils, so why couldn't there be health-sector authorities covering particular areas of Wales in similar manner?

  • Comment number 24.

    George Osborne has said he is confident the assembly election will deliver a "breath of fresh air" for Wales.

    Somehow, reading Betsan's thread here, I doubt very much it will happen, Wales in 2011 with anything other than mid 20th century socialism seems to be the low bar aspiration; when politicians decree that public provision good, private provision bad, they close a valuable door for progress.

    Politicians also perpetuate a lie, the lie that our NHS is a publicly provided service to the exclusion of private provision, and I am not writing of the odd supplier of services, our GP's, Dentists, Opticians and Pharmacy to name just four have their feet firmly embedded in private provision, they are businesses, check the car parks.

    Consider the provision of ambulance services, and then consider logistics, this world has real experts in abundance, the ambulance service is not a pink and fluffy public arena, it is a world where the customer (patient) wants to get from "a" to "b" in the quickest possible time using the most appropriate vehicle, the patient is in fact, simply a parcel that has a beating heart, and the parcel will make a profit at a price the Ambulance Trusts might find difficult to achieve.

    Unfortunately the mindset we have in Wales politics, the political majority, is, "public good", "private bad". The current offering is definitely bad for the patient, most definitely bad for the taxpayers ...... they are the same aren't they.

  • Comment number 25.

    I have to say that although I have an instinctive preference for public delivery of essential services such as health, there are models in other countries which use various forms of private delivery that perform much better than the NHS in Wales.

  • Comment number 26.

    24 John Tyler

    Yes, certain aspects of healthcare have been provided by the private sector, and there is a debate about whether that has been a good thing. The problem for many people - especially those of us who live in Mid Wales which, due to the Inverse Care Law, has relatively poor healthcare provision - is that introducing the profit motive brings with it a postcode lottery for services, which would also drop in quality. How do you see private companies getting around that?

  • Comment number 27.

    I recognise that John and I come from different viewpoints, he supports a minimal state, indeed he has stated (since removed from his blog) that the role of the state, in an ideal world, should be confined to defence and justice, with all else being provided by either charities or by private organisations. I respect his consistency of argument, though I disagree with his world view.

    Yes the NHS has a large chunk of it provided by semi private organisations, technically GPs are self employed and contracted to provide services. Their mouths stuffed with gold, I think was the phrase.

    Inevitably private profit results in greater cost, as profit is taken out of the service. The counter argument is that the profit motive creates incentives to deliver better services. Well that only works if you have competition - and competition in health has proved costly and tends to create a greater underclass who can't get services (look at the US model for it at its worst).

    Certain things to my mind belong in the public sector, in my view that includes education and health.

    Mike I am coming to the conclusion that maybe we need to look again at the structure of democracy in Wales. We have 22 local authorities, 4 police services, 3 Fire Authorities and 7 heath authorities and one ambulance trust. Of these the local authorities are under direct democratic control, the rest are either nominated bodies or joint boards. I think there is a case for bringing the boards under direct control. The previous attempt at matching social services with health was the creation of 22 local health boards. Not a success. I think we might be better democratising this layer of administration by creating regional bodies bring together all these functions, police, health, fire, together with education and social services from the 22 local authorities into 5 new regional bodies, call them regional commissions if you like rather than councils. I would propose that boundaries be roughly (though not exactly) the current National Assembly electoral regions. They would be about 30 members elected by STV from fairly large constituencies. The Commission would form committees, ie health and social services, police, education, fire etc, which would be 2/3 elected commissioners and 1/3 health/social service professionals etc. I think this would fully democratise a layer of administration, retain the 22 most purpose authorities which some seem so passionate about while providing bodies that further powers could be devolved to from the Welsh government. For example funding and the administration of further (though not higher) education seems to be a natural extension of their role as education authorities. Giving all the emergency services the same boundaries could save money in administration and have obvious synergistic value. Likewise the marrying of social services with health.

  • Comment number 28.

    27. At 13:42pm 22nd Apr 2011, Lyn David Thomas wrote:

    “..... I think we might be better democratising this layer of administration by creating regional bodies ........ 5 new regional bodies, call them regional commissions if you like rather than councils. I would propose that boundaries be roughly (though not exactly) the current National Assembly electoral regions. They would be about 30 members elected by STV from fairly large constituencies.”

    Divide the regions by 8 (present Assembly constituencies?) and elect four from each. That would make 32 in total.

    Nice idea, but who would pay the election costs? If the candidates were political, then presumably the political Parties would. Very expensive for an Independent though. It would have to be by STV.

  • Comment number 29.

    RE 13 & 16

    "Sadly, the one-sided viewpoints that pass for balanced media coverage in Wales will continue until the Welsh public wakes up and the smell of coffee is at last in our nostrils".

    "The analysis the views of welsh speakers to devolution/welsh language policies etc shows they are much more supportive than english only speakers,and hence the drive for "more powers" gets through very easily.Its amazing how the vast majority of english only speakers have allowed themselves to be "marginalized" by the public media even though they pay for through Licence Fees and taxes for the biggest racket called S4C,which is watched by about 5 people!!"

    The idea that the Welsh Media has some bias toward delvolution and for Welsh Independence can only be garned from those who are at the far margins of British Nationalism. Take Betsan's People's Assmebly that was continually consulted during the recent referendum. Their make up was overwhelming wheighted toward the No vote and completly add odds with the wishes of the Welsh people and only a month later take the Royal Wedding, the BBC's fawning coverage would not go amiss in North Korea.

    What you don't understand is that devolution is now the settled will of the Welsh people (George Osbourne called the referendum result "overwhelming"!), therefore, why should the Assembly's existence be continually questioned when the people of Wales don't question its existence? Indeed it was clear from the referendum results, across Wales, that it is you who are out of touch with the Welsh people (both English and Welsh language speakers) and not the media.

  • Comment number 30.

    Any elections are bound to be political, choices and priorities are political. The institutions exist but are either nominated, part nominated or appointed by council leaders. Id rather not expand the patronage of council leaders or ministers and have an elected body make the decisions.

  • Comment number 31.

    27 Lyn

    I think your idea about regional commissions might open a rather large debate on the role of local government. Take police, health, fire, education and social services and build a dedicated body around them, and there's very little left for county and town/community councils other than the bread-and-butter work of waste collection/recycling, street lighting, pavements and the like.

    Also, if you think yet another tier of elected representatives is going to be welcomed with open arms by our tired and confused legions of voters, I think you're likely to get a shock!

    Having said all that, I do think there is merit in your idea. Perhaps, rather than have the electorate vote yet again for the members of these new bodies, county councils should decide among themselves who they send to be part of them. That would leave us with a problem with the police, fire and health services, as they do not currently have elected bodies overseeing them (other than Cardiff Bay or Westminster). Turn it around and it's an opportunity to get accountability into these services, and it would certainly be more meaningful than the elected police commissioners that are currently on the drawing board at Westminster.

    I don't think the possibility of these regional organisations can be dismissed because of the size of the areas they would cover and the difficulty that would arise for members attending meetings, because it is high time democracy accepted the information technology age and allowed for virtual attendance at meetings.

    Definitely something worthy of further consideration.

  • Comment number 32.

    Okay, it seems my intrusive remarks into this health debate were red rags.

    the contributors have conjured media conspiracy and conversely thinly concealed nationalism to reinforce their points. I subscribe to neither view.

    A businessman costs short term but plans long term. A nationalist must do the same or he's a fool. And I don't believe Wyn Jones is a fool.

    So if you want to lead a nation where you believe it needs or wishes to go you damn well lead with the conviction and share the vision. If however you know full well you'd be booted into touch for your ideas you instead deceive and mislead.

    There's little honour in that is there?

    And don't confuse anyone's wish for an assembly with a desire for full independence.

    You ask people living in North England is they want some localised power - yes they say. Ask them if they want independence? No chance.

    Wales's politics is poorly developed. many on the left have not come to terms with a depleted state income and its inability to match an expanded state expenditure. In short they cannot balance the books ... nor promise what they used to... And still they try.

    We need honest leaders. Leaders who can deliver pain with the confidence of better beyond. Leaders who know what Wales is capable of and to lead us there.

    Instead we are in danger of getting leaders who promise the world and can deliver very little, who believe our future lies in independence but who know the majority of us do not have the wish to go there. If 'nationalism' is a point of such pride, why don't we hear it in every key message from Plaid? If you're not happy with what we have, tell us what is better, tell us how to get there and get us there. Unless you think we will reject you of course...

    Clearly I am of the view that

  • Comment number 33.

    32 Ben

    "So if you want to lead a nation where you believe it needs or wishes to go you damn well lead with the conviction and share the vision. If however you know full well you'd be booted into touch for your ideas you instead deceive and mislead."

    That rings true at the moment, because it's what we all saw the Conservative Party doing during last year's General Election campaign (shame on them). This in turn is why some of us think it is very important that the electorate should punish the Conservatives (and not just the Liberal Democrats who turned their backs on us to prop up the Tories) at this election.

    Sadly there are complications to this. Some people seem to think that the Conservatives are doing the right things; some seem to think that, okay, they lied last year but this year will be different (how?); and some seem to think that even the Tories would be better than the other parties. I wonder if ignorance has a large role to play in this - would these people be better able to choose if they knew more about what each party is planning?

    All of this brings me to your closing comments about Plaid. I find I tend to agree with you.

    Also, you were cut off at the end there. Unfortunate, but I'm glad it doesn't only happen to me!

  • Comment number 34.

    Mike I was not so much cut off in my prime as cut and paste careless.

    I don't mind who leads. I see a framework for social care, justice and responsibility and measured economic nurture as the two key ingredients of any government. They are not either/or. They must both come. But in Wales we spend too much time promising the former and too little time delivering the latter.

    Politics drifts inevitably to the lowest common denominator... Clear leadership pulls us the other way.

  • Comment number 35.

    Wales is a strange place politically. Labour is entrenched on the back of a history of heavy industry and struggle for the rights of working class people. In the Assembly we have a group of politicians which is too small to have a high number of competent let alone forward thinking and innovative members. Labour needs to renew itself yet what is Wales going to do? Vote Labour! (What am I going to do? Vote Labour).

    This is a paradoxical death wish for the nation, a national tragedy. I, and hundreds of thousands like me, are wringing their hands at seeing a government that remains complacent and in denial about its failures; not Ideological failures but failure to deliver.

    Another Assembly election; Conservatives say what Conservatives say...smaller state....more private involvement.....deregulation and promise that these things will bring improvement. Plaid pitch their usual strident appeal for "Our Communities" and a veiled but never explicit appeal to the idea of Nationhood with the odd spasm of anti-Westminster, anti-London, anti anything vaguely English rhetoric. They play at socialism from a stand of entrenched culture and Language Conservatism.

    Libdems? Well they can say anything they like to be honest, they are going to get the smacking they deserve for cheating the UK in the General election (and on a daily basis ever since).

    But Labour? this is the tragedy, can they raise their game? On May the sixth (or seventh) will they suddenly turn to the WAG and say "NO MORE COMPLACENCY deliver or else." And will there be the drive to make it happen from the politicians?

  • Comment number 36.

    Agreed, sedwot, almost all the way. What we need is a new party, perhaps.

    A Welsh party uniting a diverse nation's aspirations.

  • Comment number 37.

    Ben both Plaid and Labour claim to be that Party. Labour from history as the party that represented the views of the most people in Wales (not a majority in recent years though) and Plaid as its whole reason for existing.

    I can see things in all four major party's manifestos that I like but what is missing is vision. Again the closest that comes to that is Plaid.

    We don't need another 4/5 years of manigerialism, we need some change. Firstly we need to replace the Barnett formula to a needs based one. Second we need to negotiate end of term flexibility with finance - over £300 million grabbed back by the treasury is simply not acceptable. Thirdly we need to investigate taxation and borrowing. No other legislature in the world has so few fiscal powers. That will begin to make the finances of the National Assembly fairer and create more responsible governments. If we gain control over corporation tax then its possible that we may have some of the levers that can aid increased prosperity.

    In terms of the economy the National Assembly is weak, very few powers and most of the control and influence at Westminster. That is why its right for Plaid to attack Westminster for the failings of the Welsh economy, its largely due to their inaction that the Welsh economy has been on a downward spiral for the last 100 years. The National Assembly and the Welsh Government can only nibble around the edges at present.

  • Comment number 38.

    30. At 21:25pm 22nd Apr 2011, Lyn David Thomas wrote:

    “Any elections are bound to be political, choices and priorities are political. The institutions exist but are either nominated, part nominated or appointed by council leaders. Id rather not expand the patronage of council leaders or ministers and have an elected body make the decisions.”

    What if the reps are elected by and from present Councillors, at the beginning of the Council term, in relation to the size of each group on the Council. This would remove the patronage of both Leaders and Ministers. The winners would serve on the commission for the remainder of their term, not the Council, though they could still do ward work. This would save an expensive election and not constitute an extra layer of politicians.

  • Comment number 39.

    Lyn I respect your view and perhaps I disagree only with your conclusion. My business is in a rural area. Our life is hugely influenced by Assembly derived policy... Planning and education for example.. Much of Wales is in my situation of course. So perhaps we get a powerful perspective on what WAG driven policy and its civil service can or wishes to do for us already.

  • Comment number 40.

    LDT; "We don't need another 4/5 years of manigerialism, we need some change."

    You have this the wrong way round, We do NOT need change we need competent manigerialism. Plaid is an untrustworthy party, their end game is always to make Welsh speakers predominant in political and social life in Wales and to push the seperatist agenda by increments. Their "Vision" is a mirage; they are not and never will be a leading party of government and that gives them the leeway to exercise the duplicity for which they are famous.

  • Comment number 41.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • Comment number 42.

    Glyndo I'd rather avoid double jobbing myself, and yes having some form of STV election by the council may be a way of putting their reps on the regional commissions, but I think that blurs responsibility and also I would like people to get direct mandates for policies publicly debated. We got rid of 8 county councils and 37 district councils, we have consistently reduced the number of councillors (remember the 13 counties and more than 100 district councils we once had?) - I know there is a lot of anti politics feeling and anti politician feeling but in this case I think there is a case for direct election and people with a dedicated responsibility rather than splitting their responsibility between two bodies.

    Sedwat - where is your ambition? Wales has an economy that has been declining almost continually for 100 years. And once again you persist with this strange conspiracy theory. Yet I - like most Plaid members are not Welsh speakers.

  • Comment number 43.

    My view of political Wales is similar to SEDWAT and Ben Andone ....

    Plaid has been a distraction for Wales politics for too long, a tiresome distraction that has added little value to our culture, even less to the economy.

    Labour can add much to both culture and economy if it can leave the 20th century firmly in the past.

    The Conservatives can also add to culture and economy if it can abandon the theorists as historic anomalies that have little to offer a society with compassion.

    The Liberal Democrats would do well to look to the "liberals" amongst the electorate, the people who see less as more.

    And the Assembly, well I believe it has the tools to do the job, education to build skills, and funds to bridge the gap between personal guarantee and commercial bank risk. Our politicians need to court the real business creators, they are not the international corporate scroungers, they are the men and women with business ideas who fail not because the idea is poor, but because no one is prepared to take a chance.

    Returning to Plaid, it will be everything to everybody as long as it can further its aim to break up the Union, there is only one way to combat its insidious political indulgence ................. prosperity, and there is a sufficiency of hard working people just waiting for a leg-up in Wales today, there is no room for plaid-politics.

  • Comment number 44.

    LDT; We've been here before;

    "Yet I - like most Plaid members are not Welsh speakers."

    I asked you then where the proof of this is.....I'm quite willing to believe you by the way but just saying it repeatedly is not enough. Tell me how many Plaid members there are and how many are Welsh speakers and where this information comes from.

    I can make this point however; the majority of fluent Welsh speakers vote Plaid.

  • Comment number 45.

    LDT if you look at the breakdown of the recent Clarity poll you will see this voting intention for "No skills in Welsh";
    Lab. 34%
    Con 13%
    lib/dem 5%
    Plaid 5.6%
    green .6%

    Don't know 34.6%

    There is no poll that I have seen that doesn't show Plaid heavily dependent on Welsh speakers and attracting a minor percentage of non-Welsh speakers. Of course even a minor percentage of the 80% of the non Welsh speaking adults in Wales may be more than a majority of Fluent Welsh speakers.

  • Comment number 46.

    The only figures I have was something from some time ago which said that 55% of Plaid members were not Welsh speakers. As to adding to the culture and economy, interesting that all parties are saying that Barnett is not fit for purpose, something Plaid have been saying for a few decades... I am all for moving into the 21st century - a time when we all accept that Wales is bilingual, indeed multi lingual and the anti Welsh language campaigners just get over it.

  • Comment number 47.

    Its no use LDT, Ive googled your statement on non-Welsh speaking members of Plaid and the only thing Iv'e come up with is this;

    "I don't have the figures, but remember the figure quoted of around 55% - 60% being non Welsh speaking."

    And that was you on Betsan's in June 2010.

    I think you are making it up.

  • Comment number 48.

    Barnett is another distraction, neither Barnett nor the proposed "needs based" replacement provides an incentive to become an economic powerhouse, I would recommend "full" tax raising powers to replace Barnett, incentivise politics to take responsibility for its actions.

    The language issue is little more than a political diversion that generates "Much Ado About Nothing",

  • Comment number 49.

    Such a pity John Tyler, and you were doing so well.

    Your final sentence...."The language issue is little more than a political diversion that generates "much ado about nothing". is so wrong it makes normal folk weep.

    It is now established that Plaid Cymru's apparently casual fondness for the widespread promotion of the Welsh language is a divisive and vital tool in their now admitted aim of an independent Wales.

    Our placid Assembly really are like a flock of 60 sheep. And with a tiny number of voters, and third place in elections, Plaid Cymru are mysteriously punching way above their weight. Whether this is down to Labour being too soft on them in the coalition I don't know, but I do know that many now suspect that the entire Assembly would not be averse to a steady drift into an Independent Wales.

    Everybody seems to be telling us what would be the best thing for Wales......

    May I add my fourpennorth and suggest that more Gwyn Thomas and less (much less) Alun Ffred Jones, would do for a start.

    "Now lead us home" has never been so needed....or relevant.


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