By stewartb

The waiting times performance figures for major emergency departments in NHS Wales during the month of October 2023 have been released. We’re now in a position to make comparison with similar performance metrics in Scotland and England.

Summary table  – October 2023

Metric	NHS England	NHS Scotland (‘main sites’)	NHS Wales (‘major’ departments)
% attendances meeting 4-hour standard	55.6% (‘Type 1’ departments)	64.2%	58.2%
% spending over 8 hours in A&E	Not reported	12.7%	23.4%
% spending over 12 hours in A&E	10.7% (‘Type 1 and Type 2’ departments	5.4%	14.6%

The basis of these tabulated statistics is set out below. In this context, it is timely to reflect on the reactions to NHS performance from the leadership of the Labour Party – in government in Wales and in opposition in England and Scotland.

The performance of NHS Wales

The statistics for major emergency departments in Wales for October, 2023 reveal the following:

• Total attendances in month = 134,802

• Attendances where patients spend less than the target 4-hours = 78,394
  • therefore percentage meeting the 4-hour target = 58.2%

• Attendances where patients spend less than 8-hours = 103,216
• Percentage meeting the 8-hour target = 76.6%
  • therefore 23.4% are spending 8 hours or more in A&E

• Attendances where patients spend less than 12-hours = 115,160
• Percentage meeting the 12-hour target = 85.4%
  • therefore 14.6% are spending 12 hours or more in A&E.

Source – https://statswales.gov.wales/Catalogue/Health-and-Social-Care/NHS-Hospital-Waiting-Times/emergency-department/performanceagainst4hourwaitingtimestarget-by-hospital The BBC Wales article – ‘NHS Wales: Hospital waiting times hit record high again’ – referred to in an earlier TuS blog post provides this perspective for readers: ‘when major A&E units are compared to England, the performance in Wales was slightly better for a second month in succession’.  Now that’s a comparison that BBC Scotland could have been making about NHS Scotland relative to its peers in England and Wales on the occasion of each release of A&E waiting times data for months if not years -but rarely if never does! See graph from the Royal College of Emergency Medicine (RCEM) below:

Performance of NHS England

Here are the performance statistics for A&E in NHS England for October 2023:

• 55.9% of patients were seen within 4 hours in major (Type 1) departments
• 10.7% of attendances ((152,000 patients) waited more than 12 hours from arrival at A&E in Type 1 and Type 2 departments (Type 2 are single specialty A&E services e.g. ophthalmology, dental).
  • this is a provisional figure: for September 2023 the confirmed 12-hour figure is 9.3%.

(NHS England does not report on a 8-hour period target.)

Sources: https://www.england.nhs.uk/statistics/wp-content/uploads/sites/2/2023/11/Statistical-commentary-October-2023-abcdr.pdf and https://www.england.nhs.uk/statistics/wp-content/uploads/sites/2/2023/11/ECDS-Supplementary-Analysis-Statistical-commentary-October-2023.pdf

Performance of NHS Scotland

Analysing the data for broadly equivalent A&E departments in NHS Scotland (the so called ‘main sites’) reveals the following for the period from week ending 8 October to week ending 5 November, 2023 (Note: it is comparison of percentages not absolute numbers that is pertinent here):

• Number of attendances = 124,577

• Number of attendances spending less than the 4-hour target = 80,044
• Percentage of attendances meeting the 4-hour target = 64.2%
  • Recall less than 4-hours in NHS Wales = 58.2%

• Number of attendances spending over  8 hours = 15,832
• Percentage of attendances spending over 8-hours in A&E = 12.7%
  • Recall 8 hours or more in NHS Wales = 23.4%

• Number of attendances spending over 12 hours = 6,727
• Percentage of attendances spending over 12-hours in A&E = 5.4%
  • Recall 12 hours or more in NHS Wales = 14.6%.

Source of NHS Scotland data – spreadsheets linked from https://www.nhsperforms.scot/hospital-data?hospitalid=42

Labour’s reactions

The above comparative analysis begs a question: how do the endless, vitriolic attacks by the Labour leadership in Scotland on the government responsible for NHS Scotland square with an NHS in Labour-run Wales performing much less well?  Puzzling?

Well, not really! The fact is, what we get from the Labour leadership in Scotland is arch hypocrisy, given what party colleagues in government are struggling with in Wales. The holding of government to account is legitimate and necessary for a well-functioning democracy. However, the tactics and tone adopted – the unrelenting negativity, the raw politicisation, the placing of ALL blame for everything on the Scottish Government alone – by the likes of Dame Jackie Baillie are IMHO beyond the pale. And should continue to be called out at every opportunity!

And of course such utterances of Labour in Scotland get picked up and amplified – without critical analysis, without context, without perspective – by BBC Scotland and most other parts of the mainstream media that supposedly ‘serve’ Scotland.

Candidly, the ferocity of Labour’s attacks on the Scottish Government over the NHS exceeds by a long way Labour’s responses to the Tory government in Westminster on NHS matters.

Earlier this month BBC Wales had an article on the BBC News website entitled: ‘Winter pressure may hit NHS Wales wait targets – minister’. On waiting lists, it reports this from Labour’s health minister in Wales, Eluned Morgan (with my emphasis): ‘she is hopeful winter pressures will not hit targets to bring down waiting lists. However, Eluned Morgan said she would not guarantee that this year’s winter pressures would not further jeopardise the targets.’

And later in the piece: ‘Asked whether she would take political responsibility for the state of the NHS, she said she was “constantly taking responsibility”. She added that she took her fair share, but insisted that it was for others, including health boards and the public, to do the same.

• “I do think that health boards have got to take the responsibility, because I delegate a lot of power and responsibility to health boards, and they need to step up and they need to make sure they deliver.” She added that it was up to individuals to take responsibility for their own health and for their families. “I think the public need to take more responsibility, because it is not sustainable unless we all take a personal responsibility.’

Recall this for contrast. Back in 15 September 2021, BBC News published this article: ‘Health secretary says only call ambulance if ‘absolutely critical’. The piece included this contribution: ‘Scottish Labour health spokeswoman Jackie Baillie said: “Ambulance services are in crisis due to the SNP’s failure to support frontline workers and paramedics. “Humza Yousaf should focus on fixing the problem rather than shaming Scots who are fearing for their health.”

On 17 October, 2023 BBC Wales published an article with this heading: ‘Mark Drakeford makes ‘crisis’ cuts to prop-up NHS and trains. The piece includes this:

• ‘In an unusual exercise mid-way through the year, ministers have spent months trying to find extra money to protect frontline services. The outcome was announced by Finance Minister Rebecca Evans in a statement to the Welsh Parliament on Tuesday. Inflation has reduced the government’s spending power and it is facing higher wage deals in the public sector. That has heaped pressure on Wales’ £20bn budget, which pays for devolved services such as the NHS, schools and social care.’

• ‘Mr Drakeford used the word “argyfwng” which translates as crisis or emergency. He said there would be extra beds made available in the health service over the winter, but there will be fewer than last year.’

• ‘In her statement Ms Evans said health boards will still need to make “some extremely difficult decisions both this year and in the next financial year to balance their budgets”.

• ‘Ms Evans said the “NHS in Wales is facing the toughest financial pressures in recent history“, citing high inflation, and a “decade of underfunding of public services by a succession of UK Conservative governments”.’

• In her statement Ms Evans warned that the next financial year’s budget, which starts next April, will be “even more difficult”. “We will simply not be able to do all the things we will wish to do,” she said.’

Source https://www.bbc.co.uk/news/uk-wales-politics-67089977

The purpose here is not to have a pop at the Welsh Labour government: I have a lot of time for Mark Drakeford. No, the motivation is to point up how the leadership of the Labour Party in Scotland conducts its politics. The BBC and most of the mainstream media supposedly ‘serving’ Scotland fail to challenge it on this.