Posted: Sun 10th Dec 2023

Updated: Sun 10th Dec

Health minister challenged over plans to address NHS backlogs in Wales

Health minister challenged over plans to address NHS backlogs in Wales
This article is old - Published: Sunday, Dec 10th, 2023

Plans to ensure patients are “waiting well” have been described as an admission that long NHS backlogs are here to stay. ‌​‌‌​​​‌‍‌​‌​‌‌‌​‍‌​​​‌​‌‌‍‌​​​‌‌​‌‍‌​​‌‌‌‌​‍‌​​‌‌‌​​‍‌​​‌​‌​​‍‌​‌‌‌​‌‌‍‌​​‌‌​‌​‍‌​​‌‌‌​​‍‌‌​​‌‌​‌‍‌‌​​‌‌​​

Eluned Morgan told the Senedd that the Welsh Government’s focus cannot solely be on increasing the capacity of health services to meet ever-increasing demand. ‌​‌‌​​​‌‍‌​‌​‌‌‌​‍‌​​​‌​‌‌‍‌​​​‌‌​‌‍‌​​‌‌‌‌​‍‌​​‌‌‌​​‍‌​​‌​‌​​‍‌​‌‌‌​‌‌‍‌​​‌‌​‌​‍‌​​‌‌‌​​‍‌‌​​‌‌​‌‍‌‌​​‌‌​​

The health minister said Wales must also seek to address demand through preventative approaches and supporting people to take control of their own health. ‌​‌‌​​​‌‍‌​‌​‌‌‌​‍‌​​​‌​‌‌‍‌​​​‌‌​‌‍‌​​‌‌‌‌​‍‌​​‌‌‌​​‍‌​​‌​‌​​‍‌​‌‌‌​‌‌‍‌​​‌‌​‌​‍‌​​‌‌‌​​‍‌‌​​‌‌​‌‍‌‌​​‌‌​​

Baroness Morgan told the chamber: “There’s a real opportunity especially to encourage them to do this while they wait for NHS treatment”. ‌​‌‌​​​‌‍‌​‌​‌‌‌​‍‌​​​‌​‌‌‍‌​​​‌‌​‌‍‌​​‌‌‌‌​‍‌​​‌‌‌​​‍‌​​‌​‌​​‍‌​‌‌‌​‌‌‍‌​​‌‌​‌​‍‌​​‌‌‌​​‍‌‌​​‌‌​‌‍‌‌​​‌‌​​

Highlighting the Welsh Government’s “promote, prevent and prepare” strategy, she said everyone waiting for elective care will have a single point of contact by spring. ‌​‌‌​​​‌‍‌​‌​‌‌‌​‍‌​​​‌​‌‌‍‌​​​‌‌​‌‍‌​​‌‌‌‌​‍‌​​‌‌‌​​‍‌​​‌​‌​​‍‌​‌‌‌​‌‌‍‌​​‌‌​‌​‍‌​​‌‌‌​​‍‌‌​​‌‌​‌‍‌‌​​‌‌​​

Baroness Morgan added that a digital self-assessment tool has been developed to provide tailored health advice and signpost to additional support. ‌​‌‌​​​‌‍‌​‌​‌‌‌​‍‌​​​‌​‌‌‍‌​​​‌‌​‌‍‌​​‌‌‌‌​‍‌​​‌‌‌​​‍‌​​‌​‌​​‍‌​‌‌‌​‌‌‍‌​​‌‌​‌​‍‌​​‌‌‌​​‍‌‌​​‌‌​‌‍‌‌​​‌‌​​

The Welsh Government has claimed the “waiting well” policy will help prevent 6,000 last-minute cancellations of NHS treatments. ‌​‌‌​​​‌‍‌​‌​‌‌‌​‍‌​​​‌​‌‌‍‌​​​‌‌​‌‍‌​​‌‌‌‌​‍‌​​‌‌‌​​‍‌​​‌​‌​​‍‌​‌‌‌​‌‌‍‌​​‌‌​‌​‍‌​​‌‌‌​​‍‌‌​​‌‌​‌‍‌‌​​‌‌​​

However, Plaid Cymru’s Mabon ap Gwynfor raised concerns that “waiting well” is simply a tacit admission that long waiting lists will be here for the foreseeable future. ‌​‌‌​​​‌‍‌​‌​‌‌‌​‍‌​​​‌​‌‌‍‌​​​‌‌​‌‍‌​​‌‌‌‌​‍‌​​‌‌‌​​‍‌​​‌​‌​​‍‌​‌‌‌​‌‌‍‌​​‌‌​‌​‍‌​​‌‌‌​​‍‌‌​​‌‌​‌‍‌‌​​‌‌​​

‘Status quo’ ‌​‌‌​​​‌‍‌​‌​‌‌‌​‍‌​​​‌​‌‌‍‌​​​‌‌​‌‍‌​​‌‌‌‌​‍‌​​‌‌‌​​‍‌​​‌​‌​​‍‌​‌‌‌​‌‌‍‌​​‌‌​‌​‍‌​​‌‌‌​​‍‌‌​​‌‌​‌‍‌‌​​‌‌​​

The shadow minister pointed out that 19% of the Welsh population is on a waiting list. ‌​‌‌​​​‌‍‌​‌​‌‌‌​‍‌​​​‌​‌‌‍‌​​​‌‌​‌‍‌​​‌‌‌‌​‍‌​​‌‌‌​​‍‌​​‌​‌​​‍‌​‌‌‌​‌‌‍‌​​‌‌​‌​‍‌​​‌‌‌​​‍‌‌​​‌‌​‌‍‌‌​​‌‌​​

He said: “Waiting well cannot mean simply managing the status quo. It must be one part of an overarching and integrated strategy for clearing the backlog.” ‌​‌‌​​​‌‍‌​‌​‌‌‌​‍‌​​​‌​‌‌‍‌​​​‌‌​‌‍‌​​‌‌‌‌​‍‌​​‌‌‌​​‍‌​​‌​‌​​‍‌​‌‌‌​‌‌‍‌​​‌‌​‌​‍‌​​‌‌‌​​‍‌‌​​‌‌​‌‍‌‌​​‌‌​​

Mr Gwynfor also raised concerns about more patients seeking private treatment, creating a two-tier system of health care and entrenching class-based inequalities. ‌​‌‌​​​‌‍‌​‌​‌‌‌​‍‌​​​‌​‌‌‍‌​​​‌‌​‌‍‌​​‌‌‌‌​‍‌​​‌‌‌​​‍‌​​‌​‌​​‍‌​‌‌‌​‌‌‍‌​​‌‌​‌​‍‌​​‌‌‌​​‍‌‌​​‌‌​‌‍‌‌​​‌‌​​

The Dwyfor Meirionnydd MS called for assurances that the approach to dealing with waiting lists is more than simply leaving it to the private sector. ‌​‌‌​​​‌‍‌​‌​‌‌‌​‍‌​​​‌​‌‌‍‌​​​‌‌​‌‍‌​​‌‌‌‌​‍‌​​‌‌‌​​‍‌​​‌​‌​​‍‌​‌‌‌​‌‌‍‌​​‌‌​‌​‍‌​​‌‌‌​​‍‌‌​​‌‌​‌‍‌‌​​‌‌​​

Baroness Morgan said waiting well is not only about clearing the backlog: “It’s also about optimising the chance of that patient getting a better outcome.” ‌​‌‌​​​‌‍‌​‌​‌‌‌​‍‌​​​‌​‌‌‍‌​​​‌‌​‌‍‌​​‌‌‌‌​‍‌​​‌‌‌​​‍‌​​‌​‌​​‍‌​‌‌‌​‌‌‍‌​​‌‌​‌​‍‌​​‌‌‌​​‍‌‌​​‌‌​‌‍‌‌​​‌‌​​

She added that the Welsh Government wants to improve facilities in A&E departments to give people a better experience. ‌​‌‌​​​‌‍‌​‌​‌‌‌​‍‌​​​‌​‌‌‍‌​​​‌‌​‌‍‌​​‌‌‌‌​‍‌​​‌‌‌​​‍‌​​‌​‌​​‍‌​‌‌‌​‌‌‍‌​​‌‌​‌​‍‌​​‌‌‌​​‍‌‌​​‌‌​‌‍‌‌​​‌‌​​

“Ideally, you don’t want them to wait there at all,” she said. ‌​‌‌​​​‌‍‌​‌​‌‌‌​‍‌​​​‌​‌‌‍‌​​​‌‌​‌‍‌​​‌‌‌‌​‍‌​​‌‌‌​​‍‌​​‌​‌​​‍‌​‌‌‌​‌‌‍‌​​‌‌​‌​‍‌​​‌‌‌​​‍‌‌​​‌‌​‌‍‌‌​​‌‌​​

“But I’m just accepting the fact that the chances are that we’re not going to be able to fix this immediately, so I do think it’s important for us to engage in this.” ‌​‌‌​​​‌‍‌​‌​‌‌‌​‍‌​​​‌​‌‌‍‌​​​‌‌​‌‍‌​​‌‌‌‌​‍‌​​‌‌‌​​‍‌​​‌​‌​​‍‌​‌‌‌​‌‌‍‌​​‌‌​‌​‍‌​​‌‌‌​​‍‌‌​​‌‌​‌‍‌‌​​‌‌​​

The health minister told MSs that services are curtailed in how much they can commission from the private sector because they do not have the money. ‌​‌‌​​​‌‍‌​‌​‌‌‌​‍‌​​​‌​‌‌‍‌​​​‌‌​‌‍‌​​‌‌‌‌​‍‌​​‌‌‌​​‍‌​​‌​‌​​‍‌​‌‌‌​‌‌‍‌​​‌‌​‌​‍‌​​‌‌‌​​‍‌‌​​‌‌​‌‍‌‌​​‌‌​​

‘Distraction’ ‌​‌‌​​​‌‍‌​‌​‌‌‌​‍‌​​​‌​‌‌‍‌​​​‌‌​‌‍‌​​‌‌‌‌​‍‌​​‌‌‌​​‍‌​​‌​‌​​‍‌​‌‌‌​‌‌‍‌​​‌‌​‌​‍‌​​‌‌‌​​‍‌‌​​‌‌​‌‍‌‌​​‌‌​​

Russell George, the Conservatives’ shadow minister, said many of the targets set out in the 2022 planned care recovery plan have been missed. ‌​‌‌​​​‌‍‌​‌​‌‌‌​‍‌​​​‌​‌‌‍‌​​​‌‌​‌‍‌​​‌‌‌‌​‍‌​​‌‌‌​​‍‌​​‌​‌​​‍‌​‌‌‌​‌‌‍‌​​‌‌​‌​‍‌​​‌‌‌​​‍‌‌​​‌‌​‌‍‌‌​​‌‌​​

He broadly welcomed the proactive, tailored approach and single point of contact, but raised concerns about the capacity of the workforce. ‌​‌‌​​​‌‍‌​‌​‌‌‌​‍‌​​​‌​‌‌‍‌​​​‌‌​‌‍‌​​‌‌‌‌​‍‌​​‌‌‌​​‍‌​​‌​‌​​‍‌​‌‌‌​‌‌‍‌​​‌‌​‌​‍‌​​‌‌‌​​‍‌‌​​‌‌​‌‍‌‌​​‌‌​​

His Conservative colleague Altaf Hussain was less flattering, describing plans for a single contact as a distraction. ‌​‌‌​​​‌‍‌​‌​‌‌‌​‍‌​​​‌​‌‌‍‌​​​‌‌​‌‍‌​​‌‌‌‌​‍‌​​‌‌‌​​‍‌​​‌​‌​​‍‌​‌‌‌​‌‌‍‌​​‌‌​‌​‍‌​​‌‌‌​​‍‌‌​​‌‌​‌‍‌‌​​‌‌​​

The former consultant orthopaedic surgeon told the Senedd: “We already have a contact: the GP and the treating consultant in the hospital. ‌​‌‌​​​‌‍‌​‌​‌‌‌​‍‌​​​‌​‌‌‍‌​​​‌‌​‌‍‌​​‌‌‌‌​‍‌​​‌‌‌​​‍‌​​‌​‌​​‍‌​‌‌‌​‌‌‍‌​​‌‌​‌​‍‌​​‌‌‌​​‍‌‌​​‌‌​‌‍‌‌​​‌‌​​

“It is that contact that we should be maintaining and patients should have access to. ‌​‌‌​​​‌‍‌​‌​‌‌‌​‍‌​​​‌​‌‌‍‌​​​‌‌​‌‍‌​​‌‌‌‌​‍‌​​‌‌‌​​‍‌​​‌​‌​​‍‌​‌‌‌​‌‌‍‌​​‌‌​‌​‍‌​​‌‌‌​​‍‌‌​​‌‌​‌‍‌‌​​‌‌​​

“Otherwise this new introduction of a point of contact is going to fail and create more problems and red tape, and there’ll be no accountability and there will be more litigation.” ‌​‌‌​​​‌‍‌​‌​‌‌‌​‍‌​​​‌​‌‌‍‌​​​‌‌​‌‍‌​​‌‌‌‌​‍‌​​‌‌‌​​‍‌​​‌​‌​​‍‌​‌‌‌​‌‌‍‌​​‌‌​‌​‍‌​​‌‌‌​​‍‌‌​​‌‌​‌‍‌‌​​‌‌​​

Feedback ‌​‌‌​​​‌‍‌​‌​‌‌‌​‍‌​​​‌​‌‌‍‌​​​‌‌​‌‍‌​​‌‌‌‌​‍‌​​‌‌‌​​‍‌​​‌​‌​​‍‌​‌‌‌​‌‌‍‌​​‌‌​‌​‍‌​​‌‌‌​​‍‌‌​​‌‌​‌‍‌‌​​‌‌​​

Baroness Morgan highlighted positive feedback from users of the service which attempts to take the pressure off GPs and consultants. ‌​‌‌​​​‌‍‌​‌​‌‌‌​‍‌​​​‌​‌‌‍‌​​​‌‌​‌‍‌​​‌‌‌‌​‍‌​​‌‌‌​​‍‌​​‌​‌​​‍‌​‌‌‌​‌‌‍‌​​‌‌​‌​‍‌​​‌‌‌​​‍‌‌​​‌‌​‌‍‌‌​​‌‌​​

She raised Hywel Dda health board’s waiting list support service as an example of good practice, saying a review found it increased patient satisfaction and reduced complaints. ‌​‌‌​​​‌‍‌​‌​‌‌‌​‍‌​​​‌​‌‌‍‌​​​‌‌​‌‍‌​​‌‌‌‌​‍‌​​‌‌‌​​‍‌​​‌​‌​​‍‌​‌‌‌​‌‌‍‌​​‌‌​‌​‍‌​​‌‌‌​​‍‌‌​​‌‌​‌‍‌‌​​‌‌​​

The minister also pointed to the example set by Cardiff and Vale health board, which sent out digital “nudging” messages to 3,000 patients waiting for treatment during the pandemic. ‌​‌‌​​​‌‍‌​‌​‌‌‌​‍‌​​​‌​‌‌‍‌​​​‌‌​‌‍‌​​‌‌‌‌​‍‌​​‌‌‌​​‍‌​​‌​‌​​‍‌​‌‌‌​‌‌‍‌​​‌‌​‌​‍‌​​‌‌‌​​‍‌‌​​‌‌​‌‍‌‌​​‌‌​​

Baroness Morgan said the health board’s “prepare well” service which concentrated on improving patients’ physical health through a supported exercise programme. ‌​‌‌​​​‌‍‌​‌​‌‌‌​‍‌​​​‌​‌‌‍‌​​​‌‌​‌‍‌​​‌‌‌‌​‍‌​​‌‌‌​​‍‌​​‌​‌​​‍‌​‌‌‌​‌‌‍‌​​‌‌​‌​‍‌​​‌‌‌​​‍‌‌​​‌‌​‌‍‌‌​​‌‌​​

She told MSs: “This had additional benefits such as helping with confidence, reducing anxiety and improving motivation. An independent evaluation found a cost value of just under £3 for every £1 spent on the service.” ‌​‌‌​​​‌‍‌​‌​‌‌‌​‍‌​​​‌​‌‌‍‌​​​‌‌​‌‍‌​​‌‌‌‌​‍‌​​‌‌‌​​‍‌​​‌​‌​​‍‌​‌‌‌​‌‌‍‌​​‌‌​‌​‍‌​​‌‌‌​​‍‌‌​​‌‌​‌‍‌‌​​‌‌​​

By Chris Haines, ICNN Senedd reporter ‌​‌‌​​​‌‍‌​‌​‌‌‌​‍‌​​​‌​‌‌‍‌​​​‌‌​‌‍‌​​‌‌‌‌​‍‌​​‌‌‌​​‍‌​​‌​‌​​‍‌​‌‌‌​‌‌‍‌​​‌‌​‌​‍‌​​‌‌‌​​‍‌‌​​‌‌​‌‍‌‌​​‌‌​​

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