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
"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 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."