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The latest A&E waiting time statistics for NHS Scotland are getting the usual coverage on the BBC News website. Yes the data are disappointing but this is probably not surprising: there is no quick fix available to NHS Scotland or the Scottish Government. In a UK context, the NHS in Scotland is NOT exceptional in the length of waits and it is NOT exceptional in its inability to fix its problems quickly.
However, it is worthwhile reflecting on the comments from opposition politicians in Scotland quoted in today’s (8 November) BBC article. Let’s get Tory spokesperson, Dr Sandesh Gulhane out of the way first. He is quoted saying: “Patients at A&E are terrified ..”.
Personally, I find this language unacceptable from any politician in this context. I find it even more reprehensible because (a) it’s coming from a medical professional who should know better than play with such alarmist phrases, and especially when offering zero evidence, and (b) he and we know that his own party in government in Westminster is presiding over similar and in many cases worse performance statistics in England. And ONLY his party colleagues in Westminster have had unfettered access to resources for the NHS for over a decade if they had wished to increase them further!
And then we have the comments of Labour’s Ms Baillie. Here are some extracts (with my emphasis):
“The SNP’s RACE TO THE BOTTOM must be stopped before things get any worse for our A&E departments.’
“For months Scottish Labour has been calling on the Scottish government to get a handle on this crisis, and yet we are CONTINUALLY LEFT WITH RECORD-BREAKING FAILURES and nothing but EMPTY WORDS AND ENDLESS EXCUSES from this hopeless health secretary.”
“It is time for the first minister to SACK her failing health secretary and put patients’ needs first.”
Labour’s tactic is clear: a sustained focus on Mr Yousaf personally, wanting him sacked. Might this be justified because Labour in Scotland is benchmarking its expectations of the Scottish Government and its health minister against what is being achieved by a Labour government and Labour health minister in Wales? Well maybe not!
Published on 20 October 2022 on the BBC News website’s Wales page there was this headline: ‘NHS Wales waiting times: What the figures show’. Interestingly – and something we don’t see from BBC Scotland – the article includes direct comparisons between the performance of NHS Wales and NHS England on a number of waiting time metrics.
Here are a few extracts from the BBC Wales article (with my emphasis). They should be read whilst keeping the comments of Ms Baillie (above) in mind:
‘Waiting times for hospital treatment in Wales have again REACHED RECORD LEVELS, latest monthly figures show. People waiting more than a year has REACHED RECORD LEVELS and accounts for nearly a quarter of the list.’
And: ‘CANCER WAITING TIMES ARE THE WORST ON RECORD and AMBULANCE PERFORMANCE TIMES HAVE EQUALLED THE WORST ON RECORD. Waits – from referral to hospital to when a patient is treated – PASSED 750,000 FOR THE FIRST TIME as the latest NHS performance figures were published on Thursday, showing a 28TH SUCCESSIVE MONTH OF RISING WAITING LISTS.’
‘Only 52.5% of newly-diagnosed cancer patients started their treatment within the target of 62 days – the LOWEST PROPORTION SINCE THIS DATA SERIES BEGAN in July last year.’
And when compared to NHS England: ‘Waiting lists are also rising in England and hit 7 million in August, but we can see by looking at the proportions waiting in different time periods that 60% OF WAITS IN ENGLAND ARE LESS THAN 18 WEEKS COMPARED TO 45% IN WALES. The biggest difference is in those longest waits.’
‘IN ENGLAND, ABOUT ONE IN 20 PATIENTS on the list have been waiting more than a year, in WALES IT IS NEARLY ONE IN FOUR. We can see IN WALES, 7.9% OF WAITS ARE MORE THAN TWO YEARS – IN ENGLAND, IT’S JUST 0.04%.’
And we also learn this: ‘The Welsh health minister said NHS WALES WAS USING PRIVATE PROVIDERS AND ENCOURAGING PEOPLE TO GO ELSEWHERE “but the problem was there aren’t many gaps elsewhere” and they were looking at “every option” as the demand keeps on coming.’
Yet another record: ‘There is a new target for Wales to have no-one waiting for an outpatient appointment for more than a year by the end of 2022. But AUGUST SAW THE NUMBER HIT A RECORD HIGH of more than 102,000 waiting that long.’
And another record equalled: ‘In September, only 50% of red (life-threatening) calls to the ambulance service were reached within the eight minute target time. This EQUALS THE WORST ON RECORD SINCE COMPARABLE DATA BEGAN IN 2019, with only half reached too in October 2021.’
‘The NHS Confederation in Wales, which represents health boards, said it was hearing that IN SOME AREAS NEARLY HALF OF BEDS WERE TAKEN UP BY THOSE CLINICALLY FIT TO BE DISCHARGED. “This means fewer operations can take place, fewer beds for patients coming into emergency departments and less capacity for ambulances, impacting individual patient’s experience and outcomes,” said director Darren Hughes. He said the system was under “considerable and sustained strain”.’
Now whilst keeping in mind the comments of Dr Gulhane – “patients in A&E are terrified”- and from Ms Baillie – ‘sack the health minister’ – let’s look at the reporting in the BBC Wales article of opposition politicians’ comments:
‘Conservative health spokesman Russell George said: “For over two years we have called for surgical hubs to reduce the backlog, something backed by the Royal College of Surgeons. The Conservatives did in England but Labour did not in Wales.”
‘Welsh Liberal Democrat leader Jane Dodds said: “WALES ROUTINELY HAS THE WORSE HEALTH FIGURES IN BRITAIN despite all nations facing similar challenges. This cannot go on.”’
And the Labour health minister’s response: ‘Health Minister Eluned Morgan said NHS Wales energy bills had shot up and the government had to find money from existing budgets, apart from a little additional money from the UK government. But Ms Morgan said the financial outlook she was facing next year was a “hell on earth” and inflationary pressures were leaving them in “dire trouble”. The Welsh government added: “We will continue to work with health boards on how we can best support them to meet our planned care targets.”
And the minister adds: “We acknowledge ambulance performance is NOT WHERE WE, NHS WALES NOR THE PUBLIC EXPECT IT TO BE and we are driving a whole system response to support improvement.” And notably: “WE EXPECT HEALTH BOARDS TO TAKE OWNERSHIP AND IMMEDIATELY REDUCE AMBULANCE PATIENT HANDOVER DELAYS while working with social care services to improve timeliness of patient transfers home from hospital.”
(In today’s BBC article on A&E waiting times in Scotland we have this: ‘.. Yousaf said the waiting times performance of emergency departments was “not where I want it to be”. “Covid continues to impact the delivery and performance of services and pandemic backlogs, Brexit-driven staff shortages, and inflation costs have all contributed to make this the most challenging winter the NHS has ever faced,” he said. …. “Despite this, I am clear that A&E performance is not where I want it to be.”’ Much different from the Labour health minister in Wales? Not really!)
On 22 September, 2022 the BBC News website had this headline: ‘NHS waiting list in Wales: Patients turn to surgery abroad’.
We’re told: ‘Several patients awaiting treatment on the Welsh NHS have TURNED TO SURGERY ABROAD AS WAITING LISTS HIT RECORD LEVELS AGAIN.’
And this: ‘Prof Jon Barry, Wales director of the Royal College of Surgeons said: “A NEW APPROACH IS NEEDED TO TACKLE THE ENORMOUS NHS WAITING LIST THAT HAS BUILT UP IN WALES”. The professional body urged the Welsh government to establish regional surgical hubs operating across health board boundaries. “This will help to ensure planned operations continue all year round,” Prof Barry said, “by separating planned care from urgent and emergency care.”
‘… THE CONSERVATIVES ACCUSED LABOUR MINISTERS OF HAVING “LITTLE STRATEGY” TO TACKLE “EXTRAORDINARY WAITS”, while Plaid Cymru called for action “to increase capacity and improve patient flow”.
(‘Surgical hubs’? Like the Golden Jubilee National Hospital in Clydebank perhaps: ‘.. the flagship hospital for reducing waiting times in key elective specialties, particularly ophthalmology, orthopaedics and diagnostic imaging.’)
As I’ve said before in similar posts btl for TuS, I take no pleasure in highlighting public services in Wales in this way. Wales suffers from Westminster government just as Scotland does. My objective is to call out and make plain the hypocrisy of Labour – to be specific, its leadership in Scotland – which professes outrage at NHS Scotland’s performance that is no worse, often better, than the equivalent in Wales where Labour has long been the governing party.