By stewartb

The release of NHS Wales’ A&E waiting times statistics for the month of June provides yet another example of differences in the BBC’s editorial choices in Wales and Scotland. It also provides yet another opportunity – based on hard evidence – to talk up NHS Scotland, something almost inconceivable it seems to BBC Scotland.

The NHS Wales’ performance – June 2023

The June A&E waiting times performance for NHS Wales has been summarised by the Royal College of Emergency Medicine (RCEM) here https://rcem.ac.uk/ae-delays-persist-in-wales-as-one-in-eight-patients-faced-a-12-hour-wait-in-june/

In a press release headed ‘A&E delays persist in Wales as one in eight patients faced a 12-hour wait in June’, we learn:

• Attendances: there were 68,330 attendances to major Emergency Departments (ED) in June, 3% less than the previous month (70,310)
• Four hour waits: 62.5% of patients in major EDs were admitted, transferred, or discharged within four-hours from arrival. This is a 0.5 percentage-point increase on last month. And a 6.1 percentage-point increase on June 2022.
• Eight hour waits: 20% of major ED attendances waited more than eight-hours (15,269 patients)
• Twelve hour waits: 3% of major ED attendances waited more than 12-hours (8,433 patients).

However, regarding longer waits, the Vice President of RCEM Wales made this statement on the status of the NHS Wales data (with my emphasis): “.. large numbers of patients still faced long-waits in Welsh Emergency Departments in June. Additionally, the data for Wales does not paint a full picture. Some patients continue to be classified as ‘breach exemptions’, experiencing waits of 12-hours or more but excluded from the data due to clinical and operational processes.

“We urge the Welsh government to ensure data are transparent and meaningful so that no patient is hidden. To tackle the delays in Emergency Care, we must see the true scale of dangerously long delays and abolish these 12-hour ‘breach exemptions’.”

Data on long waits in Wales of questionable transparency and meaningfulness? And to think this could be the case with a Labour government in power in Cardiff! What would the party’s leadership and their media allies make of such a thing if happening in Scotland  – ‘shocking’, ‘disgraceful’, ‘a crisis’, ‘resign’?

BBC Wales reporting

The June A&E performance figures were reported in the Wales section of the BBC News website under the headline ‘NHS Wales waiting times: A&Es have record attendances’. The opening sentence  reports (with my emphasis): ‘Hospital waiting lists have risen again in Wales, although A&E waiting times improved despite record numbers turning up at emergency units.’ We learn that: ‘A&E’s four-hour target to get people admitted, transferred or discharged was hit 72.5% of the time in June.’ (See https://www.bbc.co.uk/news/uk-wales-66255935 )

But recall that the RCEM’s assessment of NHS Wales’ data for June was that attendances were ‘3% less than the previous month’ and that the performance against the four-hour target was just 62.5%. A very different picture! Whilst the RCEM focuses almost exclusively on major A&E facilities, the BBC in England and Wales persist in using statistics for all emergency departments. The latter include minor injury units where admissions – and therefore where for example delayed discharges may block admissions and extend waits – are much less likely to occur. Of course, in Scotland the BBC only ever reports on the performance of major A&E departments and then mostly negatively.

The BBC Wales piece acknowledges the significance of what types of A&E department are included in the national statistics: ‘The Grange Hospital near Cwmbran (51.1%) and Glan Clwyd Hospital in Denbighshire (56.4%) had the worst performances against target, although The Grange does not deal with minor injury patients, which may affect its figures.’

BBC in Wales does things differently

However flawed the BBC Wales reporting may be by under-emphasising for the most part the distinction between ‘major’ A&E departments and others (in contrast to the RCEM), its journalist does something rarely, perhaps never, seen in BBC Scotland’s reporting of A&E waits in Scotland – and, candidly, rarely seen in any of its reports on Scotland’s public services. BBC Wales provides perspective by directly comparing A&E performance statistics for NHS Wales with NHS England’s. 

We learn: ’When we compare major A&E units in Wales with those of similar grade in England, then for the last 10 months, Welsh emergency departments have been performing better than those in England against the four-hour target.’

Is the BBC really permitted to make such a direct comparison – a user of BBC output in Scotland would be forgiven for assuming not!  On the point of comparison, one could say the same about the comparable A&E departments in Scotland except the period of ‘performing better’ would extend to years! Of course BBC Scotland could never – would never – tell its readers, listeners and viewers such a thing, even when it’s factually correct. Gaslighting and ‘bias by omission’ are much preferred when reporting Scotland!

(Did a BBC Scotland radio presenter not deride the use of comparisons between Scotland and England as ‘whataboutery’?)

NHS Wales goes even further: on NHS waiting times more generally, it asks ‘How does this compare with parts of England?’. It goes on to argue that ‘The north east of England has been described as more comparable to Wales than looking at the whole of England. It has similar characteristics in terms of industrial heritage, its population make-up and sickness and poverty levels.’

The BBC making a comparison that excludes the favoured areas of London and the South-East – that’s a revolutionary concept! It is one unlikely to be adopted by BBC Scotland!

The NHS England’s performance – June 2023

The RCEM has also commented upon the A&E waiting times in June for NHS England. (See https://rcem.ac.uk/15254-2/ ). In summary, it reports the following:

• Attendances: there were 1,389,009 attendances at major (Type 1) EDs in June. This represents a 0.1% increase compared with June 2022
• Four hour waits: the four-hour performance at major EDs was 60.2%. This represents a 0.2 percentage point decrease from the previous month
• Twelve hour waits: 108,225 patients waited 12-hours or more from their time of arrival. This accounts for 8% of Type 1 ED attendances. This figure is 4.3% lower than the previous month. (The numbers waiting over 12 hours from time or arrival is more than four times larger than the number of 12-hour waits measured from ‘decision to admit’ – the ‘dishonest’ metric NHS England relied upon in monthly reporting until pressure from the RCEM led to a change in reporting practice as recently as April, 2023.)

Talking up NHS Scotland

With NHS England and NHS Wales having now reported on their Type 1/major A&E departments’ performance for June, we can compare and contrast these directly with the main A&E departments in NHS Scotland. (The percentage figures for Scotland in the table include ones by calculation based on weekly reports in ‘NHS Performs’.)

Much too favourable a story revealed here regarding NHS Scotland and the Scottish Government to be of any interest to BBC Scotland! There would be no opportunity in such a favourable report for a context and perspective free political rant from leading figures in the Tory, labour and Lib Dem parties in Scotland. So of no benefit to the Union!

End note

A blog post majoring on the NHS in Wales is relevant here on TuS for two reasons, neither of which is to have a pop at NHS Wales or the Welsh Labour government!

The problems facing the health service in Wales are similar to those in England, NI and Scotland. And the pressures on NHS Wales – as elsewhere in the UK – are due for the most part to Westminster governments’ inability or unwillingness over c. 13 years to address root causes by providing appropriate resources, specifically to NHS England. Moreover, Westminster governments have been responsible for public services in England lacking resilience to cope with and recover from the impacts of the Covid pandemic. Whatever a Westminster government decides on resource levels for devolved public services in England, the governing administrations in NI, Scotland and Wales have to cope as best they can with the fall-out.

No, the two reasons for writing this relate to: (i) the hypocrisy of the Labour Party leadership in Scotland in the content and tone of its comments on the performance of NHS Scotland and of the Scottish Government over health; (ii) the contrasting editorial choices concerning the NHS made by the BBC in Scotland and Wales. These are issues all too familiar to regular readers of TuS. 

As we approach another electoral test, these matters assume even greater importance as the Labour Party seeks to hoodwink voters in Scotland and the BBC continues with mis-reporting Scotland.  Alerting more voters in Scotland to the nature of both organisations becomes an even higher priority.