The Christmas season is now well and truly upon us. It’s a time for celebration, a time to perhaps eat (and drink) a little too much and a time to spend with your loved ones. Most of all it is a time to forget work and relax. For some though Christmas is another day at work.
Whilst Christmas brings with it many reasons for celebration it also poses its fair share of problems. Among other things, it marks the beginning of flu season, the usual over indulgence and not forgetting the cold weather.
We are currently in the grips of an especially harsh British winter – over the past few weeks it’s been impossible not to notice the chaos the weather has caused across the country – and with it come increases in traffic accidents, broken limbs and other problems linked to cold weather such as hypothermia.
All this puts a huge strain on all of our public services, but none more than the Welsh Health Service, and with the extremely cold weather potentially running well into the New Year the increased pressure on the Health Service looks set to continue.
At a time when most of us are preparing for an enjoyable Christmas and New Year with family and friends, the Health Service is preparing to tackle everything from falls (caused by slippery conditions) to flu (Seasonal flu, and more recently the increase in swine flu cases in Wales will add to the workload as patients have their jabs and seek treatment).
The fact is that people’s healthcare needs do not end at Christmas. Where there is someone who needs caring for weather it is in a hospital, an A&E department or in a residential care home then there will need to be someone to provide that care.
At Christmas it is all too easy to get wrapped up in everything, the shopping, the cooking and the gifts, but we need to spare a thought for those who have to work on a day which many of us are lucky enough to have off work. Healthcare professionals work so hard every day of the year to provide us with the best healthcare they can and Christmas day is no exception.
The reality today is that the Welsh NHS should be a 24 hour, seven days a week service, Christmas or not. The least the Labour-Plaid Government can do is provide healthcare professionals with the best possible conditions to work in and make it possible for them to do their jobs to the best of their ability, uninhibited by restrictive and overly bureaucratic targets.
According to BMA Wales, “Recent figures reveal that Wales is short of almost 400 hospital doctors. We have seen hospitals being downgraded, wards closed, and inappropriate workloads being forced upon employees – which inevitably hamper the quality and safety of care patients are receiving. Many are working in excess of their contracted hours to fill the gaps caused by recruitment failures”.
Despite this, health care professionals have shown and continue to show amazing resilience in the face of enormous difficulties and that is something to be commended. Whatever your point of view, we can all agree on this point.
It is for these reasons that in the New Year I will continue to campaign for a more efficient, effective health service which delivers for the patient and staff alike.
In the days running up to Christmas I would like to convey my thanks to all those who have worked so hard and who will be working throughout the Christmas period to provide us with the security and the care which we have come to expect.
Veronica German, Welsh Liberal Democrats Shadow Health Minister, has called on the Labour-Plaid Government to publish all Welsh Government expenditure in the NHS over £25,000 in the interest of transparency and accountability.
Last week, the UK Coalition Government published detailed spending of all expenditure over £25,000 allowing the public to see for the first time how money is spent and hold politicians to account.
However the in Plenary, the Health Minister refused to commit to publishing all detailed spending for the people of Wales to easily access on the government’s webpages, raising questions over the Labour-Plaid government’s commitment to openness and transparency.
Veronica German, Assembly Member for South Wales East said:
“We have a right to see what the government is spending our money on, especially during times when the Welsh pound has to have the biggest impact possible.
“The Liberal Democrat – Conservative Government has recently published detailed spending of all expenditure over £25,000 allowing the public to see for the first time how money is spent and hold politicians to account. When I asked the Health Minister if she would do the same in Wales, she refused.
“The people of Wales shouldn’t have to request information on spending through complicated and often bureaucratic freedom of information requests; they should be able to easily access information so that they can judge for themselves if the Labour-Plaid government is spending money wisely.
“Many people were astonished that the work of McKinsey cost half a million pounds and this only came to light after intense pressure from the Welsh Lib Dems. Given that the Health Minister has the largest departmental budget, I’m surprised she doesn’t believe the people of Wales have a right to know how their taxes are spent.
“The Labour-Plaid must be held to account for the spending decisions they are making however today just goes to proved that they have much to hide.”
In advance of a Welsh Liberal Democrat-led debate on the NHS in Wales, the Welsh Liberal Democrats have today published a new report, In Need of Care, exposing the failures of the Labour-Plaid Government’s stewardship of the NHS.
In Need of Care highlights a catalogue of failure:
• Failure to bring NHS buildings up to operationally safe levels.
• Failure to ensure that NHS buildings are fire safety and DDA-compliant.
• Failure to investigate the billion pounds of inefficiency in the NHS.
• Failure to meet the Government’s own waiting times target as set out in the ‘One Wales’ programme.
• Failure to tackle the problem of variable ambulance response times.
• Lack of transparency.
• Failure to listen to experts.
Commenting on the report, Veronica German AM, Shadow Health Minister, said:
“Since becoming an Assembly member just six months ago, I have been shocked at the level of wasteful spending and inefficiency that is going unchecked within the NHS. NHS staff work tirelessly on our behalves and we all owe them a debt of gratitude. But in talking to frontline staff working in the NHS, it is clear to me that the NHS in Wales is being let down by the Labour-Plaid Government.
“For all their talk about investment, the Labour-Plaid government has presided over escalating costs and declining standards. It is simply unacceptable that in Wales we have an NHS that costs more per head than England but delivers worse outcomes.”
Kirsty Williams AM, Leader of the Welsh Liberal Democrats, said:
“The failures highlighted in this report go far beyond issues of funding. The Welsh Liberal Democrats are lifting the lid on an NHS in Wales that is rife with waste and inefficiency.
“Up and down the country, families and businesses are learning to do more with less. It is the job of Government to ensure that the NHS does likewise. So now is not the time to make foolish and insubstantial promises that the NHS funding should be ring-fenced. The NHS needs an approach that is more mature and thinking that is more joined up than that. The priority for Welsh Liberal Democrats is to make the efficiency savings in the NHS that allow us to protect and improve frontline services.”
Notes to editors:
Attached is Welsh Lib Dem In Need of Care: Labour and Plaid’s NHS failure
Item 6: Welsh Liberal Democrats Debate (60 mins)
NDM4582 Peter Black (South Wales West)
The National Assembly for Wales:
1. Believes the NHS is of crucial importance in promoting and maintaining the health of people in Wales.
2. Notes that:
(a) evidence given to the finance committee suggests that that there is up to £1bn of the NHS budget “that we are not utilising appropriately”;
(b) the work undertaken by McKinsey and Co. concluded that Government strategies are ‘financially unaffordable’, ‘lack accountability’ and that there is ‘a lack of capacity to deliver them’; and
(c) evidence from the Nuffield Trust suggests that healthcare is poorer in Wales than many parts of England, despite higher levels of funding.
3. Believes it is essential that the Welsh Assembly Government should continually seek to deliver improved value for money, stronger leadership and year on year improvements in health services for patients.
4. Calls for the Welsh Assembly Government to:
(a) take urgent measures to ensure more effective NHS spending, stronger strategic leadership and improved patient outcomes, and
(b) urgently investigate how much of the £1 billion ‘that we are not using appropriately’ could be redirected towards frontline services and to report back to the Assembly on progress in achieving this goal.
Liberal Democrat Health Spokesperson, Veronica German, has today asked the First Minister to make a statement on the promotion of new technology in the Health service and whether successful schemes would be continued.
In plenary, Ms German stated:
“The CHAP pilot scheme, introduced into Powys Teaching Health Board early last year, involved giving hand held electrical devices to its 140 district nurses and then later its 40 health visitors as well. Such a device allows nurses to track the progress of a patient in numerous ways, such as allowing nurses to record data about patients quickly.
“Similar schemes elsewhere have seen a major decrease in wasted medicines so they are beneficial to patients and they save money”
Ms German asked the Minister whether his government plans to continue schemes that have clearly benefited Wales, as so far she has only heard anecdotal evidence that they would. The First Minister replied that the health minister would make an announcement regarding next week.
Ms German, Assembly Member for South Wales East, later commented:
“Given that the Welsh NHS currently wastes £50 million on recycling and destroying medicines, these schemes are of significant importance. Following discussions I have had with various people it seems that that these schemes have ground to a halt.
“These are exactly the kind of schemes that should be rolled out across Wales in the future. The Labour-Plaid government seem unprepared to suggest an alternative scheme that would deliver similar results, so why has this scheme come to a standstill? I look forward to hear their announcement next week and hope that they make the right decision for Wales.”
The first week back of term at the Welsh Assembly has been an eventful one especially for health. It’s been difficult to avoid discussion of the McKinsey ‘report’.
Last year the Health Minister commissioned management company McKinsey and Company to examine the Welsh NHS and make recommendations based on their findings. The main remit of the report was to look ahead to the next five years and suggests ways to improve the finances of the Welsh NHS.
Unlike the English report, the Welsh Assembly Government commissioned McKinsey in such a way that its findings would not have to be published and made available to the public. The Government have referred to it as a commission and called it a ‘process’ serving to inform the Welsh Assembly Government’s decision making, rather than culminating in a final report.
This meant that the general public, as well as professionals working in the health sector, were unable to view and scrutinise the documents that these decisions were based upon.
In Wales, McKinsey’s findings were set out in a document named Delivering a Five-Year Service, Workforce and Financial Strategic Framework for NHS Wales. This document sets out the Government’s strategy for the Welsh NHS for the next 5 years.
The Welsh Liberal Democrats along with other bodies have been asking to see the McKinsey document for some time and now that it has been revealed, I can see why the government was so keen to keep it under wraps.
It lists numerous shortcomings in the Welsh NHS. It states that ‘strategic objectives are too numerous and not prioritised, so none or the wrong ones are implemented’. It points out a ‘gap between policy leads and operational delivery’. Possibly most damming of all the document states that initiatives, set out by the Government, are ‘financially unaffordable’. With a copy of the report now placed in the public domain, questions to the Health Minister were dominated by ‘McKinsey’.
Assembly debates this week have pushed into harsh light the lack of transparency in our government. Documents of this nature need to be in the public domain so that they may be publically scrutinised. Only then can the recommendations be discussed by those who are affected by them and those who have to implement them.
These views are shared by Andrew Dearden of BMA Wales. He has contributed to the document but hasn’t even seen it himself. He told BBC Radio Wales: ‘In our view, as the BMA Wales, we have asked for copies of the document, we have asked to review it because we were actually asked to give evidence, so if it was full of positive comments, I suspect it would have been made public.’
Of course, this isn’t just about a document. This is about people and a service that we all rely on every day. It seems to me that frontline staff have been completely ignored. The document even says that frontline staff ‘do not own’ strategies set out by the government. It is essential that they have a say in a service that they have to implement.
I intend to press the government on this issue. By asking questions and continuing to talk to frontline staff I will attempt to get to the root of the substantial problems the NHS in Wales is facing.
The McKinsey document has unveiled the need for serious change in the Welsh NHS. This document will have come at a substantial cost to the government. Its criticisms were substantial and worthy of public debate. Equally they are worthy of a substantive government response. So far the Health Minister is refusing to answer detailed questions about the McKinsey report. It is incumbent on her to do so.
Sadly though, I fear that ultimately it is not the Government who will pay the price, it is the people of Wales who will bear the real cost of the government’s ineptitude.
Veronica German, Welsh Liberal Democrat Shadow Minister for Health and Wellbeing and AM for South Wales East is ‘encouraged’ to see that there has been an improvement in ambulance waiting times across South East Wales but in certain areas this is not reflected.
Veronica German said: “After the disappointing drop in May I was encouraged to see that the response time figures for South Wales East improved for the month of June, if only marginally.
“I’m glad to see improvements in response times almost across the board in Monmouthshire, Blaenau Gwent and Newport and I welcome the work that has been done in these regions to solve this problem.
“However, despite the continued hard work of the Welsh Ambulance Service, whole areas of South Wales East have suffered a decline in response times.
“The ambulance service in Wales has established new systems to work more efficiently but they are facing a constant battle against hand over times. Ambulances queuing outside hospitals mean they are not available to take calls.”
Torfaen has seen nearly a 3% drop in the number of calls responded to within eight minutes and Merthyr Tydfil has suffered a decline of nearly 4% in the number of calls responded to within ten minutes.
“The Welsh Assembly Government needs to address this issue. In Caerphilly alone the number of calls being answered within 14, 18 or 21 minutes dropped by nearly 5% in June to 58.7%.
“This falls far below the Government’s own target of 65%, which is not good enough.
“It shouldn’t be a post code Lottery. No matter where a person lives, when someone dials 999 there should be a fast efficient service that is focused on the patient.
“It is time that the Labour-Plaid Government looked at the wider issue and addressed the system as a whole so that the ambulance service can work more effectively with the hospitals.
“I will continue to apply pressure to the Government to make sure that ambulance response times remain a priority and the people of South Wales East get the ambulance service they deserve” Veronica commented.
Veronica German AM for South Wales East and Shadow Minister for Health and Wellbeing, has today expressed her deep disappointment on hearing the possibility that a number of Minor Injury Units in the South Wales East region are having their opening hours heavily reduced.
Chepstow, Monmouth and Tredegar’s Minor Injury Units are all allegedly having their opening hours shortened.
Veronica German said:
“Myself and local residents are extremely concerned about the possibility of losing this vital service. Having the service reduced would mean residents will now have to travel to the Royal Gwent in Newport or Nevill Hall in Abergavenny, which is often not practical. “
“This will only add to the burden of the already massively overstretched A & E departments which in turn may effect ambulance handover times putting more pressure on our Ambulance service.”
Chepstow’s Minor Injury Unit has always offered a 24 hour service, but residents are now facing the likeliness of having their service completely closed on Sundays and closing at 1pm on Saturdays. The service will also be closing at 6pm on week days.
“Whilst I understand that the night times are relatively quiet, it makes very little sense to have the service unavailable for the majority of weekends.” Veronica remarked
A Chepstow resident stated:
“When my mother was still alive I don’t know how we would have managed without the Minor Injury Unit. She had frequent falls at all hours of the day and night. It was marvellous to be able to just take her up the road and have minor wounds taken care of. I don’t know what we would have done if we’d had to take Mum to the Royal Gwent every time she had a fall.”
Veronica German AM Welsh Liberal Democrat Shadow Minister for Health and Wellbeing has today criticised the Plaid Chief Whip for his comments over the protection of senior Welsh NHS executives salary.
Veronica German said: “I am amazed to hear the Plaid Chief Whip’s admissions that the Labour-Plaid Government’s decision to allow the protection of payments for 10 years after jobs are axed is unjustifiable.
“The issue of protected salaries of senior executives in the Welsh NHS is something that the Welsh Liberal Democrats have expressed serious concerns about since the reorganisation.
“In these tough economic times payments such as these are difficult to defend.
“It seems incredible that Plaid have suddenly come around to this way of thinking. It is the Labour-Plaid government who have approved these changes.
“It is nothing short of hypocrisy for one of their senior politicians to now declare that he disagrees with these decisions.
“This is a blatant exit strategy from Plaid. They are trying to distance themselves from the decisions made by the government ready for the Welsh Assembly Elections next year.
“This just shows that Plaid Cymru is not a party of principle. They are more than willing to take credit for the good decisions but they are quick to disassociate themselves from the bad ones.
“The people of Wales won’t be taken in by crocodile tears from Plaid. This was allowed to happen by a Government that Plaid is part of, they should take responsibility for it.”
In my first month as the Assembly Member for South Wales East I have been getting to grips with my other new post, as Liberal Democrat Shadow Minister for Health and Wellbeing.
I want to do everything I possibly can to make sure the NHS in Wales remains a great service; a service, free at the point of demand that puts patients first and provides quality healthcare when it’s needed.
The NHS in Wales impacts on each one of us at some point in our lives. There is no argument over the need to deliver a cost effective, safe, patient-centred service in an efficient and timely manner. The question is how?
The present economic climate gives us an opportunity to think smarter and look at systems as a whole. We know, from a recent Assembly Government report, that NHS organisations in Wales “enter this more challenging period from a less financially secure platform” than England. And yet NHS Finance directors have already indicated that about a fifth of the NHS budget or £1 billion is spent ineffectively here in Wales. So there is no time to lose.
People’s expectations are rising and there is a growing demand for healthcare, but this cannot be solved by increasing capacity. In commerce and industry, a greater understanding of demand and capacity has led to increased productivity. By focussing on what customers want and looking at the service as a whole, the quality of the service can be significantly improved.
There is much talk of changing the way the health service works but is it happening quickly enough?
Take the ambulance service. New systems are in place which use past data to predict where the likelihood of the next call will come from, so staff can be deployed to appropriate locations, leading to improvements in performance.
However, the ambulance service relies on an efficient handover of their patients when they reach the hospital. On a regular basis over 100 ambulance hours can be ‘lost’ in one region as ambulance crews remain stacked up outside hospitals or in corridors with their patients on trolleys. In fact in Wales as a whole around 120 ‘lost’ hours a day is not uncommon.
This not only has a detrimental effect on the patient waiting on the trolley and the patient waiting for that ambulance, but on the resources available throughout the NHS.
Unless a person has first hand experience of this situation they find it difficult to fully appreciate what happens. Many people are under the illusion that after an ambulance crew has made the patient safe and transported them to hospital that they are then ready for the next patient. Is this an unrealistic expectation then? After all, when do you ever see patients being treated in the corridor or ambulances queuing up outside the Emergency Department on well known TV hospital dramas?
There are many reasons for these delays ranging from a shortage of beds due to delayed transfers of care to lack of capacity in Emergency departments. The Minister has admitted that the Local Health Boards need to address these delays. What is clear is that none of these issues can be looked at in isolation. The operation of the ambulance service impacts on A & E departments and vice versa.
This is just one example of where the system in place works against the best interest of the patient. Making efficiencies is not just about doing the same for less, but examining and re-examining what is done and if necessary changing the way we operate.
The NHS needs to be approached in an efficient and creative way. Even in these challenging times there is still room for a fresh and innovative approach. After all, a healthy NHS that works for the patients is something that we all deserve.