NHS in Wales – Gazette July 2012

Carwyn Jones AM at the Princess of Wales eye clinic
Carwyn Jones AM at the Princess of Wales eye clinic
Lots of people have been concerned about proposed changes to the NHS across Wales so I thought this week I’d explain some of the challenges that we face in the future.

It goes without saying that money is tough. The UK government is cutting our budget by 7.5 % over three years. Given that health makes up something like 45% of our spending all we’ve been able to do in Wales is keep spending steady rather than increase it as we would have liked. To do that would have seen education spending down by 20% coupled with huge increases in council tax.

There are other issues though. It’s becoming increasingly difficult to recruit doctors in particular specialisms, particularly in A&E where there is a huge shortage across the UK. Increasingly, doctors want to train and work in large hospitals, which makes it difficult to recruit in smaller hospitals. Added to this, the UK government’s tightening of immigration rules has meant that fewer doctors are coming here from abroad and we have traditionally depended on them. The problem isn’t easily solved by training more doctors because medicine is a portable qualification and some British doctors have always travelled abroad to work.

We are also seeing a situation develop where doctors are being told by their training bodies that they must see a sufficient number of cases every year to get proper training. At the moment for example, people with severe burns get transferred to Morriston for treatment. People who have severe head injuries go to Cardiff, for the simple reason that the expertise and experience to treat them exits in those hospitals. There are some illnesses and injuries that are so difficult and unusual that they have to be treated in one place for doctors to get enough experience to deal with them. At the end of the day, people need to be treated by doctors who see an illness or injury on a regular basis.

We are running a recruitment campaign to persuade doctors to come to Wales to work and we must remain committed to delivering safe services as close to people’s homes as possible while recognising that some services have to be centralised in a few places in order for people to get better and more specialised treatment.

The trick for Local Health Boards in the coming months is to get that balance right.