What you think of reshaping the NHS

 

The NHS was thought up by a Welshman, brought to life by a Welshman and at some point between then and now it's become sacrosanct. Knock it - or be seen to knock it - at your peril.

A few weeks ago we covered the row that flared up when the Welsh government decided it wouldn't, after all, be offering all over 50s a health check with a doctor. Labour accused by the other parties of a blatant U-turn. It was quite clear that what they'd said they'd do and what they were now doing was not one and the same. We said so and that was the story.

What, asked one viewer, did we have against the NHS and its wonderful staff? Why were we attacking the NHS on BBC Wales? I wrote back telling him that we weren't. We were reflecting a political row about the NHS, not attacking it. I'm not sure he was having any of it.

No politician will be surprised by any of that. They know that politically, the NHS is well nigh untouchable - and that if you are going to dare suggest it needs a prod and a poke if not a good makeover, you'd better be ready to prepare the ground with a liberal dose of praise for NHS staff first. When Carwyn Jones says the NHS will "collapse" unless it changes, he goes out of his way to make sure he's not seen to be questioning the commitment of those who keep it afloat now.

All of which means the health minister has the sort of job that leaves others shaking their heads, partly because they think she's got it very wrong, but also, partly, because they know, in their heart of hearts, neither she nor they could possibly get it right.

The problem for Lesley Griffiths is that she has got to persuade you that she doesn't have it in for the NHS in its current form, but rather what she does have is a model that we can afford and that will work.

She's got to convince those who make up the NHS in Wales that she knows what she's doing, is leading them in the right direction. And she's got to persuade you that she's changing the NHS in Wales because if she doesn't, it could collapse but that if she does, in the end, it will be better.

Our poll, published a few days ahead of 1 March this year, suggests she's failing - failing to convince you that centralising services in fewer, larger hospitals is the way to go.

Given a straight choice between district hospitals continuing to offer the same range of services as they do now, or patients travelling outside their local patch to find an improved quality of service, a shade under three quarters opt to keep services local. 23% opt for better services further from home.

Back in November the Welsh NHS Confederation asked a similar question - not the same question - but similar enough to look at it with interest today. They found that 58% were opposed to the policy of concentrating services in fewer, larger hospitals. 27% supported it. 14% didn't know.

The confederation asked a number of questions - you can read them all here - and concluded that overall, "while concerns remain over the centralisation of specialist services, people still overwhelmingly prioritise the quality of hospital care over the time it takes to get there".

That is not what our poll suggests. It doesn't suggest the effort to centralise services is wrong. It does suggest the argument that it's right is being lost.

By the way it's also the lowest 'don't know' category in the whole opinion poll. Over 40% don't know whether three of the four leaders in Wales are doing a good job, or a bad job but only 2% don't know where they stand on the reconfiguration of the health service in Wales.

There's plenty in the poll - from confirmation that those who raise taxes are rarely as popular as those who spend the money raised, that Carwyn Jones is nearly as popular as Boris Johnson (more popular than Alex Salmond in Scotland comes one suggestion?) and that more people agree with, than disagree with him that policing and criminal justice should be devolved to the Assembly.

What do you make of the snapshot, one that suggests our appetite for giving the Assembly more powers is there and growing, but that when it comes to using the powers the government already has to shape some of our public services, you seem to find their plans pretty unpalatable.

 
Betsan Powys Article written by Betsan Powys Betsan Powys Former political editor, Wales

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  • rate this
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    Comment number 32.

    Topcat (26)

    While making allowances for your obvious North Walian habitation...

    May I suggest that if you are paying £11 a gallon for your fuel, a visit to any large fuel-selling supermarkets such as Tescos, Sainsburys, Asdas etc. might prove profitable.

    Here in Cardiff we pay around £1.40 a ltr., which equates to aprox £6.35 a gallon.

    I know the north is prone to exaggeration but......!

  • rate this
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    Comment number 31.

    "What do you think about reshaping the NHS"

    Well ending the compulsory teaching of the Welsh Language to every pupil in Wales, would help.

    Why? Because our schoolchildren would then be taught much more biology, maths, and sciences. This would probably lead to the creation of more 'home grown' medical jobs in Wales.

    Thus ending the need to "import" so many expensive non-Welsh medical staff .

  • rate this
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    Comment number 30.

    #28 I think that the Beveridge Report was initially commissioned by the WW2 gov coalition. With Churchill and Atlee, they were likely to differ when they saw the report.
    Agreed it was Bevan who let the consultants have their half-in / half-out status. A necessary compromise to get the NHS off the ground: 'stuffed their mouths with gold' as I remember.

  • rate this
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    Comment number 29.

    In post 18 I gave an example of a question that would have created a different response to the biased questions within the BBC poll. The point I was making was that the BBC commissioned a flawed poll
    The lack of clarity on this issue is entirely the fault of Griffiths. It is clear is that we cannot afford a major hospital in every town and the sooner people are honest about that the better

  • rate this
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    Comment number 28.

    20 Boxer - I am not sure you are correct - at first Labour rejected the Beveridge report.
    It was in fact, Bevan who agreed that consultants could work both within and outside of the NHS. A problem that persists today.

  • rate this
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    Comment number 27.

    #26 Buy a keyboard that does capital letters ! And full stops. Have some respect for your readers.

  • rate this
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    Comment number 26.

    50 miles at 11 pound a gallon,oil poverty on the cards soon we will not be able to aford transport cost to run ambulance,we need to power ourselves,sharps make solar panels in wrecsam wales ,liberate wales by solaring roofs green up to get the oil monster of our backs and create jobs in manufacture and installation,raising taxes to fund wales needs
    small is beautiful cariad bach cymru am byth

  • rate this
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    Comment number 25.

    we used to have one in mancot flintshire,

  • rate this
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    Comment number 24.

    #22 'A&E 50 miles away. ' If you are a woman and you get a bad facial cut, you can go to Abercynon and have a general houseman put in five stitches, or go to Swansea and have a plastic surgeon put in 50. With a headwound, you would want good X-rays, MRI and an experienced neurosurgeon. With a stroke, you need clot-busters, but what about bleeding? You need an expert: you need a big hospital.

  • rate this
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    Comment number 23.

    #22 'you can die in a Hospital 50 miles away and you can be saved in a local Hospital.' Both are possible but not equally probable. The more specific operations a surgeon does, the better his results for that operation. If you break your hip, an orthopaedic surgeon is better than a general surgeon, but a super-specialist who just does hips and has done a lot is better still. The figures don't lie.

  • rate this
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    Comment number 22.

    Djohn you can die in a Hospital 50 miles away and you can be saved in a local Hospital. Now we are getting silly again. Where do you get them from. But it is not just about inpatients. Many more go to OutPatients or A&E or visiting and travelling 50miles each way is rather awkward especially if you have to use Public Transport. Or travelling in noisy Ambulances and the wait hours to get seen.

  • rate this
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    Comment number 21.

    #18 '"do you want to die in a local hospital - or be saved in a hospital 50 miles away"?'
    This is one of the best classifiers of class that there is. Better than 'Do you have a son called Marcus ?' .
    If you would travel to the Royal Brisbane for your prostate op, because it has the best results put #10.
    If you regret the closure of the Miner's maternity unit (friendly staff, good tea) put #1

  • rate this
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    Comment number 20.

    #18 'Betsan on a point of fact it was the Beveridge Report that led to the NHS'
    It was. But it was the politicians who comissioned the Report. And politicians like Nye B were influenced by their experience of the Medical Aid schemes in the Welsh Valleys, where miners contributed weekly and got free care for themselves and family: a sort of proto- NHS / NI

  • rate this
    +1

    Comment number 19.

    ... I understand capitalism tellingme ... (#15), and although I'm not sure as to the real benefits of the likes' of Ford in Bridgend, I do agree that it was "Paradise lost" with Morgan's reign in Cardiff Bay.

    I tend to believe a "Final NHS Solution" has been developed, no matter what the YouGov survey tells us, It only remains for Carwyn's government to stop dithering and give us the plan ...

  • rate this
    +1

    Comment number 18.

    Polls achieve the results that the commissioning body wants.
    Had the BBC asked "do you want to die in a local hospital - or be saved in a hospital 50 miles away"? the result would have been different. Griffiths' weak leadership has resulted in the lack of proper debate on reform
    Betsan on a point of fact it was the Beveridge Report that led to the NHS and the modern Welfare State.

  • rate this
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    Comment number 17.

    It would be interested to see the projected funding for WAG in next 10 years,and compare with the demographic time-bomb in terms of ill-health/poverty that going to hit us over that time scale. I personally know an 'expert' on these matters,and he feels that everyone in power knows whats coming,but afraid for political reasons to fully explain implications to welsh people.(13) AGREED entirely!!

  • rate this
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    Comment number 16.

    Betsan, I'm surprised at you! You must know by now that it is completely pointless getting into a spat with a 'troll'. Now, as to the NHS, and not just in Wales, I share the opinions of 'Private Eye's MD columnist, a lifelong clinician, who from his vast experience makes it clear: it is better to go 50 miles to a hospital with a lot of expertise and live than get treated locally and die.

  • rate this
    +1

    Comment number 15.

    John. The capitalist world means that money flows where it can make greatest profit after efficiency gains. In the past we have benefited,ie. FORD/SONY in Bridgend,now the foots in the other dap!!. When King Rhodri had all that money he should have invested it in making major structural changes to NHS,however to prove DEVO works it was spent on 'pet projects' to keep the welsh NATS on-board.

  • rate this
    -1

    Comment number 14.

    #12 cont ...

    What's the difference between the carpenter and tax avoider at the top end of the earnings scale.

    Consider the need for cheap goods, we export jobs to the Far East, and forget that the workers dumped on the altar of price cutting have not disappeared from this green and pleasant land.

    We are responsible tellingme... and needs must we look after all parts of society !

  • rate this
    +1

    Comment number 13.

    There are to many non contributers -immigrants and health tourists and sick people coming here specifically for health treatments .many with long term requirement of costly drugs not available in their own country.

 

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