Comments on: Health Minister talks health http://waleshome.org/2009/11/health-minister-talks-health/ Independent analysis from and about Wales Sat, 11 Feb 2012 08:00:56 +0000 hourly 1 http://wordpress.org/?v=3.1 By: Jackson http://waleshome.org/2009/11/health-minister-talks-health/comment-page-1/#comment-2143 Jackson Thu, 12 Nov 2009 19:07:30 +0000 http://waleshome.org/?p=4551#comment-2143 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. 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.

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