Future Hospital update from Wales

Abstract

In Wales, where we have a large rural population, a growing public health crisis, and real terms cuts to the health budget, recent attempts to redesign NHS services have been met with a media storm, angry patient group protests and bitter political squabbling. Recently, the row has spilled over the border, and with a general election only months away, the Welsh NHS is, for the first time ever, a regular reference point during Westminster debates. In the past year, stories of poor patient care and higher than expected mortality rates at some hospitals have led to claims of a ‘national scandal’ from prime minister David Cameron. The health secretary in England has suggested that the Welsh Government is ‘sleepwalking into a Welsh Mid Staffs tragedy’. The Welsh Government have called these accusations ‘utterly unfounded’, pointing to a recent Nuffield Trust report which suggests outcomes in the NHS in Wales are broadly in line with the rest of the UK, or have improved to a ‘similar level to England’. Since devolution, the health service in Wales has followed a different path to England, abandoning the plurality of competitive providers, and rejecting the internal market. Instead, seven local health boards (see Fig 1) plan, secure and deliver primary, community and secondary care services for around three million people, with a focus on integrated care and collaborative working. …