Health Minister talks health
A FEW weeks ago we reported on what the Labour leadership candidates were saying about NHS Wales. We wrore then “As Health Minister, Edwina of course recommits to the content of the One Wales agreement as the core plan for health in Wales until 2011.”
We can now update this following a press release put out by her team last night, which emphasises key points on her immediate agenda as both Health Minister and prospective First Minister. She says: “The restructuring of the Trusts means that we now have single local health organisations that are responsible for delivering all healthcare services within a geographical area, rather than the Trust and Local Health Board system previously operating” ,she said. ” By ending the internal market in the NHS and having single organisations delivering all healthcare services in seven regions, we will now have a more joined-up approach to healthcare delivery, benefiting patients and staff.”
Other reforms are emphasised which will look to ensure that:
Looking to the future, Edwina Hart plans to build on these successes by pushing ahead with capital programmes throughout Wales including new hospitals in Ebbw Vale, Ystrad Mynach, Mountain Ash, the Merthyr Health Park and other primary care developments. She argues that apart from providing well overdue modern medical facilities, these programmes will provide a major boost to employment in Wales at time when construction jobs are badly needed.
She elaborates: “My aim for the future doesn’t just involve new buildings. I want to see an expansion of services which are community focused, working with local populations in response to local needs. We must harness the long term affection for the NHS which undoubtedly exists, so that it becomes an asset in the process of change rather than a barrier and source of discontent.”
It is also interesting to note a clear commitment to the underlying principle of Designed for Life. Edwina reiterates: “We need to see a fundamental shift from hospital-based treatment to community based services. I have been saying for some time that we want to see more directly employed GPs for example and the extension of surgery hours wherever possible – breaking down the barriers between ‘in hours’ and ‘out of hours’ services. I am encouraged that my fellow leadership contenders are now following my lead.”
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One is tempted to suggest that the removal of the internal market in Wales as an achievement is a little like climbing Snowdon and claiming it for Wales. LHBs were never really permitted to operate an internal market in Wales with the ability to control what services should, could or would be provided or where. They may have created some challenge to the old hospital Trust hegemony but in the end this was a poor substitute for some real debate about what our health services should be doing. I would like to know where or when this debate will take place. Probably in the too difficult box.
Nice to see the commitment to community based care although this is no cheap option. The NHS has been discussing the balance between hospital and community in Wales since the current Director General’s strategic document (now largely forgotten) called “A Question of Balance” written in the late 1990s. How much progress since then? Well it has been painfully slow. Again the hospital waiting times targets have sucked in the investment. Interesting to see the headlines today about the ongoing debt problem in the NHS and the Minister’s response to the Lib Dem request for further investigation. The need for the NHS to balance it books set against the political imperative for it to continue to be all things to all people means that a potentially nasty car crash may await in the future. Meantime, the managerial led dash to find cash (savings) inside these institutions is not likely to assist the very real need to develop the clinically led efficient and effective services that could provide a quality service and the best price, never mind the investment back into community services. Still the parking will be free so that’s OK.