Thursday 17 July 2008

That's better

The proposed reconfiguration of the management of the NHS announced yesterday by Edwina Hart goes a lot further than her original proposals. The merger of LHBs and Trusts is a much more radical move than the previous suggestion, and marks a more decisive break with the 'internal market' philosophy introduced by the Tories. No wonder that the Tories' leader is unhappy as one of the most ideological and unnecessary changes ever made to our NHS is swept away in Wales, following the examples of Scotland and Northern Ireland. Only in England will this crazy system remain in place. And it's no coincidence that only in England do Labour rule alone.

Nick Bourne is right, of course, in saying that it is "a total reversal" of the previous stance of the Labour Party and the Labour Government in Wales; but I for one think that is to be welcomed, not condemned. Since when has recognising past mistakes and correcting them been something for which people should be criticised?

The new proposal also deals directly with one of the three concerns that I expressed in my previous post. The split between primary and secondary care providers didn't make sense to me – or to many of those working in the NHS - and I'm glad that the Minister has now come to the same conclusion. I think it is also one of the few occasions on which a government consultation exercise has actually been meaningful, with the proposals being changed in response to comments received, another welcome departure from past practice.

I remain unconvinced that the final number and boundaries of the proposed bodies is based on a careful consideration of what is needed, rather than on what is easily achievable from the starting point. Obviously, I would have preferred to see Plaid's election manifesto proposal implemented, and a commission established to study the whole question. I suspect though that what is now proposed is considerably closer to what the outcome of such a commission would have been.

The Minister is also allowing more time for consultation following the publication of the revised proposals. I very much hope that adequate time will be allowed as well for implementing the proposals, and that lessons will have been learned from previous rushed changes.

The main thing which I and other people locally do still want to see, however, is clarity over what services are to be provided where. Campaigners supporting Withybush Hospital, in particular, remain unclear on the long term plans for services to be delivered from that hospital, and in the absence of such a statement, concerns will remain.

No comments: