Speech to the Welsh Assembly
"The Government has given a predictable response, stating that the direction of travel is correct—that is the correct response as far as the Government is concerned.
I wonder what would have happened had Jane Hutt been in charge of the inquiry into the sinking of The Titanic.
She probably would have concluded that the ship was on the right course and was bound to arrive in New York, but that there was an unfortunate accident on the way and that we should not dwell on such occasional failures.
The Government's line is not credible. To quote the auditor's letter, there is 'an inefficient configuration of services … the current situation is a manifestation of deep-seated system problems—national, local, political, managerial and clinical'.
Yet the Minister concludes that she is going in the right direction. Let us not forget that the Audit Commission's report was published on the same day as the report on the NHS in England, which was largely positive.
I do not want to belabour the point, but comparisons with England are quite legitimate, because we should be seeking an NHS that performs better than the NHS in Britain as a whole.
Reference has been made to the last tranche of waiting list figures. In fairness, waiting lists have fallen. However, there is much debate about the significance of that. The Minister trumpets this as a great success, while ignoring the past five years of poor performance.
The BMA's consultant committee in Wales has said that our waiting lists are among the worst in western Europe.
We have a poor record of using private finance initiatives. I hope that the Minister will read Jon Owen Jones's letter in today's edition of The Western Mail, which urges the use of PFI. Compared with England, we are doing badly and, compared with Scotland, we are doing much worse.
Jon Owen Jones quotes a change of view within Plaid Cymru, and I hope that this is sustained.
The Government has said that the new primary-care-led NHS will somehow transform the situation through the work of local health boards.
Part of the propaganda is to tell us that almost nine out of 10 treatments are carried out in the primary sector. Are we to believe that this is something new? Has this not always been the pattern of NHS care?
However, this is now presented as a factor that will mitigate poor acute services. The Audit Commission's findings in this area are deeply disturbing for the Government.
The report says that LHBs are 'new organisations, have limited resources and an extremely challenging agenda which … they are not always tackling on a health community … basis'.
The report goes on to say that: 'Planning on a regional basis as proposed in the implementation process will be difficult to manage. The number of sub-groups centrally and 22 LHB solutions locally is potentially complex and both the regional office and the LHBs will need considerable support.'
The auditor is not saying that LHBs in their present form are what we need to deliver a strategically coherent NHS.
The auditor's findings are disturbing for all parties in the National Assembly and for all involved in the NHS, which effectively means everyone, because we are all either patients or potential patients.
I will again quote the report: 'In the past 10 years there has been significant change to healthcare in Wales (eg mergers, the abolition of the health authorities, etc) but little of the reconfiguration necessary to drive improvement and change…. This reflects the reality of local public and political opinion…. The history of local consultations and change in the NHS suggests that public fear about losing access to local emergency services overrides the reality of poor access to elective services and carries greater political weight.'
We are all guilty. I found Mike German's earlier admission refreshing, and I would like to admit that, four years ago, I concentrated too much on the aspect of preventing change and reconfiguring services.
To conclude, Jane Hutt has been to NHS performance in Wales what General Haig was to the preservation of life on the western front. We are being forced over the top to defend a weak strategy.
It is no longer good enough to say 'one more heave'. We need to rethink the fundamentals."