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Opinion

Blaming Westminster for the state of the NHS in Wales won’t wash any longer

07 Jan 2023 6 minute read
An NHS hospital ward. Picture by Peter Byrne / PA Wire

Dr Andrew Potts

The NHS has more resources now than ever before but is struggling to treat as many people as it did before the pandemic.

And while Wales’ health minister Eluned Morgan said she was “hopeful”[1] ambulances would reach the most serious calls during the paramedics’ strike, hope isn’t really a strategy for running the NHS.

Speaking about the recent strikes, Mark Drakeford has observed that increasing [nurses’ and paramedics’] pay “would have meant fewer treatments, fewer nurses, less money for the health service itself.”

He also acknowledged that the Welsh Labour administration “chose not to [increase pay]. “We’re accountable for that decision”.

But he still found his usual wiggle room when he added that: “we don’t have the money to be able to increase our pay offer, while the UK Government refuses to put more money into the pay bill in England.”

So what started as a statement of Welsh Labour taking responsibility turned into, well, a hospital pass.

It’s not a state secret that our population is increasing[2], with the number of people in Wales aged 65 and over projected to rise by about 16% over the next decade, while those aged 75 and over is expected to rise by a quarter over the same time period.

Logically we need more hospital beds to meet the needs of that population since, while we may be living longer we aren’t necessarily getting healthier.

As a nation Wales is getting sicker, with the number of people receiving Personal Independence Payments increasing from 186,000 to more than 218,000 in the last three years alone. This is partly a result of the pandemic but it is likely that those people affected will have long term conditions, making it inevitable that they will sooner or later need medical intervention.

So you’d expect that a devolved administration which is set to spend half its £20 billion budget next year on health and social care would be presiding over a health system with more beds than it inherited in 1999.

Unfortunately not. Chart 1 shows[3] the average number of staffed beds available in which inpatients are being or could be treated without any changes in facilities or staff.

The number of hospital beds in Wales has halved over the last three decades, including a 30% fall since devolution.

At the same time a quarter of the Welsh population are on a waiting list, with over 95,000 waiting more than a year for their first outpatient appointment.

It’s true that ‘bed blocking’ due to a lack of social care packages is having an effect, but so too has reducing the number of hospital beds available in the first place. Fewer beds, fewer patients able to be treated.

Funding

Of course, funding obviously determines both the quantity and quality of resources the NHS can use to provide healthcare.

Roughly half of the budget goes on staffing costs. Chart 2 below shows that the total number of staff increased by 2,505 (2.8%) last year to almost 91,000 (and a headcount of 105,000), with the largest increase (2,100) seen in Administration and estates staff.

The above illustrates that there are more staff across all staff groups in 2022 than the previous year. Indeed, the chart below shows that the number of staff has increased to record highs across almost all staff groups (the number of Healthcare assistants fell by ten per cent) since 2009.

Worryingly, although the number of nurses, midwives and health visitors has gone up by 16%, the number of administrators has risen by 41% over the same period). It means that for every three nurses there are two people employed in administration roles.

But record staff numbers don’t necessarily mean that there are enough staff. Post-pandemic fatigue may mean that more staff are needed to provide the same level of care. And we can’t estimate how much is ‘enough’ particularly as this can be dependent on national and regional political decisions over what care is provided where (a merry-go-round of centralisation/localisation of services).

So despite record staff numbers NHS Wales spent over £130 million last year on agency nurses to cover gaps in rotas, with around 3,000 current vacancies.

And sickness[4] absence rates have increased over a similar period from 6.3% to 7.2% of all staff (see Chart 3), meaning additional staff doesn’t automatically translate to more staff being available.

The number of ambulance staff went up by 113 (4.2%) over the last three years, but sickness rates went from 10.7% to 13.6%. This means the ‘effective’ ambulance staffing levels fell by more than 9%. In other words taking on more staff has not had the desired effect. Sometimes more is less.

We have an ageing population and an increasing number of people who are long-term sick or disabled.

Staff numbers, spend, waiting lists and waiting times are all at record highs. In a Yes, Minister world where a department’s success is measured by the size of its staff and budget then the health service is ticking all the right boxes.

So successful that if you live in Wales there’s a good chance that you’re either working for the NHS or waiting to be treated by it. Indeed, Wales is fast becoming a giant waiting room for a health service, which is just not sustainable.

Accountability

Welsh Government cannot simply expect more money to funnel into the NHS without any accountability. Betsi Cadwaladr[5] health board demonstrates what happens when you do.

The borrow-and-spend of Trussonomics failed miserably (and thankfully quickly). Both Drakeford and Keir Starmer have ruled out the tax and spend of old. In an interview for The Spectator Rishi Sunak said as chancellor he was dismayed that little of the extra money he announced for the NHS seemed to help patients.

Nigel Lawson said that the National Health Service was the closest thing we have to a religion. Thirty years on and the problems facing the NHS – rising waiting lists, ambulances queueing outside A&E departments, difficulty getting a GP appointment, and seemingly unresolvable strikes over pay and conditions – are well known, and our health service (whichever side of the border you live) remains a system crying out for reform.

The Welsh Labour Government simply spending more money clearly isn’t working. And continuing to claim it’s Westminster’s fault just won’t wash any longer.

The time has come that with so many of us waiting for treatment by the NHS, perhaps we should be a bit more agnostic in our treatment of the NHS.

Dr Andrew Potts is a Conservative Party activist from Neath


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Fi yn unig
Fi yn unig
1 month ago

I want to thank Nation Cymru for inserting the crucial information at the end that this is written by a ‘Conservative party activist’ which entirely invalidates the content of the article.

SundanceKid
SundanceKid
1 month ago
Reply to  Fi yn unig

Not entirely. Welsh Labour continually blames Westminster yet does not seek a solution to the crisis! Part of that solution should be being in charge of our own borrowing, spending and expenditure. Time to wake up and face the reality that the current arrangement is not working, has not worked, and never will work. Blaming and complaining about Westminster – the very institution which is part of the problem – and expecting them to resolve the problem when there is no indication they ever will (because blaming Welsh Government in turn, is in their interests), is surely the definition of… Read more »

Last edited 1 month ago by SundanceKid
BigPooba
BigPooba
1 month ago
Reply to  Fi yn unig

This comment just highlights the problem with a large section of the voting demographic in Wales and their ignorance of reality.

Tim
Tim
1 month ago

The Conservative party activist completely ignores the same problems are occurring throughout the UK. Is this Welsh Governments fault too? Real wages in the UK are today lower than they were 18 years ago, and, according to the Financial Times, workers have seen a collapse in real wages since austerity started under the Tories in 2010. Perhaps collapse isn’t the right word. More properly, it’s a planned demolition. Nurses real pay fell by £1,800 (-£5,000 since 2010) Paramedics real pay fell by £2,400 (-£6,000 since 2010) Midwives real pay fell by £2,400 (-£6,000 since 2010) All alternatives to the NHS… Read more »

Fi yn unig
Fi yn unig
1 month ago
Reply to  Tim

Nicely done and a perfect counter to the tripe in the activists article.

Tim
Tim
1 month ago
Reply to  Fi yn unig

The USA spends more money on healthcare than any other nation yet has lower life expectancy than any European country. Profiteering is the norm in the USA which makes health outcomes inefficient. I believe the Tories are the enablers of American health and insurance companies looking to make vast profits from the UK once the NHS has collapsed. I would like to see Labour bring in a punitive tax on private health insurance to fund the NHS. Here is a link to a graph showing health expenditure v life expectancy by country. It shows just how terrible the healthcare system… Read more »

Wedibleni
Wedibleni
1 month ago
Reply to  Tim

He says “our health service (whichever side of the border you live) remains a system crying out for reform”

Tim
Tim
1 month ago
Reply to  Wedibleni

Reform is Tory code for scrapping universal healthcare and replacing with an inferior and costly insurance based system that only benefits the wealthy.

Tom Bennett
Tom Bennett
1 month ago

Wastemonster!

Owen williams
Owen williams
1 month ago

The 25 year underperformance of welsh nhs and education has nothing to do with the welsh govt and everything to do with Westminster. Don’t dare say diffferently

I.Humphrys
I.Humphrys
1 month ago

This looks very much like reports I have had from a man in Southern England, who also cannot blame Westminster?
He had to drive his cousin to A and E, due to NO ambulance, then holding a bowl under his cousin’s chin, while waiting for hours.
The whole system obviously needs looking at, but first Wales requires independence. Why? Because one cannot move if a giant imbecile is sitting on one’s head!

Last edited 1 month ago by I.Humphrys
Kerry Davies
Kerry Davies
1 month ago

I just had to wheel my partner down from her cancer ward 45 minutes late for her radiotherapy keeping two highly qualified radiographers waiting around because there were no porters available. Two salient points to note are; 1; This was in Cheltenham General and 2. She had to walk out of the ward into which I was not allowed because the senior nurse had been trying for three hours to lift Covid restrictions and the office involved was closed. When we returned from treatment the junior doctor on duty had taken it upon himself to lift restrictions because, in his… Read more »

Mab Meirion
Mab Meirion
1 month ago
Reply to  Kerry Davies

Ah! I read earlier that there has been a 40% increase in admin/managerial staff, way above nurses, as for the truth of this who knows?…They should organise a manhunt…clue; he’s hiding behind a stupid smirk in No 11…

Last edited 1 month ago by Mab Meirion
Mawkernewek
1 month ago

The NHS has more resources now than ever before

How does that square with real terms pay cuts for NHS staff? And no doubt if you apply the same inflation factor to non-wage NHS expenditure, there will be less resources per £ of expenditure and potentially less overall.

dai ponty
dai ponty
1 month ago

It is what it is Propaganda by the English Nationalist Party TORIES or just downright lies by the tories they do what they always do blame somebody else i read all the newspapers on line and the lies the blame that comes out one headline lately was about in the Daily Depression Express Scotland First minister runs N H S Scotland into the ground all the right wing Tory rags are on about the Royals nothing else deflecting real news the state of the N H S through the whole of the U K another Headline was the Odious Tory… Read more »

Notttabottt
Notttabottt
1 month ago

Is the c**t that wrote this in here voting down comments? Delete this article its terrible. The final line alone discredits all points, Wales is not funded fairly, that underlines EVERYTHING

Owain Morgan
Owain Morgan
1 month ago

The Conservative Party has defunded the front line of the NHS and starved that incredible organisation of tens of thousands of employees and potential employees. However, that pales in comparison to the tens of thousands of available deaths that Tory actions and inactions have caused. The Tories have blood on their hands!! Whether you’re a Nationalist or a Unionist it’s time to get the Tories out of power and keep them out!

Windy
Windy
1 month ago

The bottom line is the tories want the our NHS to fail so that a system allied to the USA nonhealthcare can be implemented.
By keeping wages within our NHS down the staff will go to work for agencies where they can earn more without the stress and responsibilities they have within our nhs therefore leaving our nhs short staffed by people who have to carry the responsibility of patient care whilst agency staff move freely from hospital to hospital as it them

The Original Mark
The Original Mark
1 month ago

This is what I’ve always had issues with, the realisation that all the time you’re fighting for something, there are people on the inside fighting against you. The worst betrayal of course, came from the UDM, (anyone else remember those scabs)
Tories as usual, putting the N in cut’s

dai ponty
dai ponty
1 month ago

Being a Former Miner U D M Scabs UNION OF DEMOCRATIC MINERS but after the strike along with the pits that where on strike the Scum party tories rewarded the SCABS by shutting their pits at the same time so the tories rewarded them well NOTTS MINERS HAVE ALWAYS BEEN SCABS

Dr Wales
Dr Wales
1 month ago

It is worth clarifying that Andrew Potts is not a medically trained doctor.

Sikejsudjek
Sikejsudjek
1 month ago

Worse under the Tories in England too. Can’t blame Labour for that can you!

James
James
1 month ago

I blame the public at large. Unhealthy eating, lack of exercise and drinking. If we all just took half an hour of exercise a day then there would be more services for the people who need it. It’s disgusting watching fat people waddling around.

Richard
Richard
1 month ago

And his solution is? Hopefully he is not clinging on to the debunked dogma of a privatised service being cheaper and better.

Tourmaline
Tourmaline
1 month ago

Massive fraud uncovered by auditors of £122 million at Betsi Cadwaladr University Health Board under Drakeford’s watch. Disgusting and shameful. Inefficiency and corruption of this magnitude are scandalous and an embarrassment for Drakeford’s Welsh Assembly, who are hell bent on ruining the Welsh economy and talking dribble with woke promoting policies, diversity, ineffective mask wearing, inclusion and wasting tax payers money installing tampon and sanitary wear in male toilets. Welsh people deserve better and desperate need of a major political shake up, as do the whole of the UK. Conservatives no longer deserve to be in power and Starmer, who… Read more »

Sir Montague Flange
Sir Montague Flange
29 days ago
Reply to  Tourmaline

Ha ha ha, yep let’s give all money and support to a bunch of racist poshboys like tice and his bunch of idiots, you’ll certainly get a banana republic with those parasites anywhere near power

Andy Williams
30 days ago

First week of the new year, Welsh NHS, on it’s knees, patients despair in trying to access the proper care. It would have been nice, if our Health Minster could have come on TV, to give an explanation or the very least, a way forward. Because, at the moment, it is a bit scary to get ill.

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