25/10/2015

Elin Jones's radical proposals for the Welsh NHS

This post contains the main part of the speech made at the Plaid Cymru conference on Saturday by Elin Jones, Assembly Member for Ceredigion and Plaid's Shadow Health Minister. I'm publishing so much of it here because, apart from being typically waffle-free, it proposes the kind of radical changes  to the Welsh NHS that deserve a deeper read than that allowed by the usual online news articles:


"...My style is not to obsess over Labour’s failures. Not to dwell or rant about what’s wrong. My style is to offer solutions, to offer a vision of how a Plaid Cymru-run NHS would protect and improve services

"In the next Welsh Government Plaid Cymru will safeguard and strengthen our NHS with a 6 point plan.

"Our 6 point plan will:
     Cut waiting times for diagnosis and treatment
     Improve access to mental health
     Create a paperless NHS
     Tackle the public health threats of today
     Train a next generation of NHS workers
    Fully integrate health and social care & deliver equal care for equal need

Point 1
"We will cut waiting times for diagnosis and treatment.   Currently, 31.4% of Welsh patients are waiting over 6 weeks for a mri scan in Wales. In Scotland it’s 9.1%  and in England it’s  1.3%  Unacceptable.  Since 2011, there are 21000 more people waiting longer than 36 weeks for hospital treatment. 

·   "We’ll set up 3 Full Diagnostic Centres to provide a comprehensive range of tests and diagnosis, to enable cancer diagnosis to be confirmed within 28 days.

·   "We’ll set up dedicated Treatment Centres to undertake a very large proportion of elective, planned treatments and surgery. We’ve seen the success of the Golden  Jubilee Hospital in Scotland and how the SNP Government now intend to invest in more centres to further drive down waiting times and provide state-of-the-art effective surgical services. I want to replicate this is Wales.

·   "We would have one National Hospital Board to plan and deliver all acute and specialist hospital services. A Plaid Cymru Government next May would scrap all 8 Health Boards, and replace with 1 Hospital Board. 3 million people, fewer than 20 hospitals – we do not need 16 Chairs and Chief Execs for that job. 2 will be more than enough. We wouldn’t keep Betsi Cadwalader in Special Measures – we’d scrap it. National planning, but guaranteeing local delivery. And no community in Wales would be further than the magic hour from emergency, life-saving hospital services.

Point 2
"We would dramatically improve access to mental health services. 
Mental Health services deserve parity of esteem with Physical Health, and will not be an afterthought in a Plaid Cymru government.
  
"In the last 2 years, the number of children waiting longer than 4 months for their first appointment with a mental health professional has increased almost 5-fold. 50% of our most vulnerable children have to wait 4 months before they start treatment. That’s 4 months of disruption to their education, 4 months of anxiety and 4 months of waiting that can have lifelong effects. That is not acceptable.
So our priority would be to ensure no child waits longer than 4 months for mental health treatment. Our children and young people can not be allowed to be the victims of a poorly-run Labour Government.

Point 3
"We would create a modern, paperless NHS – fit for the 21st century. It cannot be right that you can go into a District General Hospital and see porters still wheeling large trolleys of patient files and notes. It can’t be right that I can book a hotel room in Buenos Aires on my smart phone from this stage right now, but I can’t use my smartphone to book an appointment or repeat prescription from my surgery just down the road.
·      We need universal electronic patient records that are accessible to every part of the NHS, wherever the patient presents at any point in time.
·      We need Skype clinics to reduce the number of patient visits and miles.

"But a modern 21st century NHS is not just about more imaginative use of IT. It is also about cutting-edge research and treatments.  I want to see more university-led medical research in Wales, also more pharmaceutical and private sector research in Wales. Our senior medics and researchers need to lead more clinical trials – for the benefit of Welsh patients. And we will bring to an end the postcode lottery of access to new treatments and drugs.  We want a NHS that is be fair and transparent in decisions that affect whether a person lives or dies.

Point 4
"Plaid Cymru will tackle the big public health challenges that face our nation.  Whilst the current Welsh Health Minister fixates on banning e-cigarettes in public places, Plaid Cymru will address the major causes of harm.  We will use new taxation powers to introduce a sugary-drinks tax. When Plaid Cymru first announced this policy 2 years ago in Aberystwyth, we were ridiculed by Carwyn Jones and Welsh Labour. David Cameron is equally set against a sugary drinks tax.

"But public health experts and medical organisations all now support a pop tax. And Jamie Oliver endorsed our policy and Plaid Cymru backs his campaign. But, a Plaid Cymru government will not introduce a poptax in Wales just because it’s backed by a certain celebrity chef. We’ll do it because the harm that is done to our children’s health by over-consumption of unnecessary sugar cannot go unchallenged.

Point 5
"Our NHS is the sum of its parts. And its parts are its staff. Without a motivated and well-rewarded staff, then the NHS crumbles. We all owe a huge debt of gratitude to all the staff working in our NHS and wider health and social services. They do sterling work day in, day out. And yes, Jeremy Hunt, they already work weekends and nights.  A Plaid Cymru Government would not seek to undermine the work of NHS staff in the same way as Jeremy Hunt is England – targetting the junior doctors today, and someone else tomorrow.

"We would protect today’s staff and plan for tomorrow’s staff.  It is scandal that the Welsh Labour Health Minister is shying away from any action to properly plan for the workforce. Plaid Cymru would create a National NHS Workforce Plan.  We’d start by prioritising doctors – and we’d train and recruit an additional 1000 doctors over 10 years.

 "To do so we would create financial incentives to attract doctors to hard-to-recruit areas and specialisms, but we’d also ensure more capacity in medical schools – in Cardiff, Swansea and Bangor. They would be medical and nursing schools to serve and supply the Welsh NHS and we would place a percentage quota of student places for Welsh students in our medical schools.

"Our workforce plan will start with doctors, but it will become a plan for all health and social care professionals.

Point 6
"And finally, our most ambitious plan of all. Where others talk about fully integrating our health and social care systems – we will do it.

"Two systems set up by great pieces of 1940s legislation. Two systems – health and social care – separated at birth. Health care free at the point of need and social care means-tested and assessed at the point of need.  Health care provided by the NHS, social care by Local Authorities.    
        
"They were systems of their time, but they are no longer in synch with the needs of today.

"Before I became Shadow Health Minister, I was the Minister for Rural Affairs, dealing with animal health matters, rather than human health. Looking back, I think I can say that there is better integration of health and social care in agriculture, than in human health and social care!  Farmers do the social care bit, and vets do the health care – and they do it in an integrated, effective way – even in times of crisis.

"Plaid Cymru will create a Community NHS – to combine GP surgeries, community nursing teams, other community health professionals and community hospitals, out-of-hours GP services and community mental health services and adult social care. 

"Local authorities would be given the lead responsibility of managing and delivering Community NHS. Services would be planned coherently and delivered seamlessly.

"However, will organisational change on its own deliver the seamless care that our elderly and vulnerable need? In the current system, the diagnosis you have in large measure determines the financial support you get to cope with its effects.

"In the 21st century, it is simply not acceptable that people with conditions that can involve very similar burdens, such as cancer and advanced dementia, can end up making very different contributions to the cost of their care.

"In Government, Plaid Cymru will end the historical divide and current inequalities between health and social care, we will ensure “equal support for equal need”

"The final barrier between full health and social care integration is the answer to the question who pays? For health care, it is the state, and for social care, it depends. For a cardiac patient it is the state, for a dementia patient, it depends. It depends on the assessment of need and on a means-assessment.

"Plaid Cymru is committing to provide free social care for all over 65s within 10 years, with clear milestones along the way.

1  "Firstly, we will introduce free personal care for the elderly within the first 2 years of Government. This would abolish all fees for non-residential care.

  "Secondly, we would abolish charges for those with a dementia diagnosis within 5years – including for nursing and residential care.

    "Thirdly, we would completely abolish all social care charges for the elderly within a second term of Welsh Government

"This a fully-costed plan and it will provide equal care for equal need. That is our pledge – equal care for equal need, so that in 21st century Wales - those people that care and those that are cared for will be guaranteed quality care and dignity of care, without financial fear or financial burden.

"For May next year, Plaid Cymru has the policies and priorities to strengthen our NHS. Labour’s poor, poor record on health can not be allowed to continue.  Labour Ministers have been unwilling to take the big decisions on the NHS and unable to get the small decisions right. 

"They have spent too much time over the past 4 and a half years blaming a Westminster Government for a lack of funds.  There should be no more excuses.  Labour should be judged on what it has failed to achieve with the powers and budget available to it, and we will be judged on what we promise to achieve within the powers and budget available to us.

"The people of Wales deserve better than to hear Labour politicians blame others for what can and can’t be achieved.  There is a change that our NHS needs. There is a change that Wales needs. Plaid Cymru is that change."

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