
In a couple of months time the NHS will celebrate its 60th anniversary. The memory of Nye Bevan will evoked again and again as as the crowning achievement of the 1945 Government is celebrated.
But as I've found out over the last few months, the Health Service is in turmoil.
Like most people who consider themselves to be on the centre left I strongly believe in the founding principles of the NHS. When presented with anecdotal evidence of failings by the Health Service and its staff I have been amongst the first to make an excuse.
But my grim experience of the NHS maternity service in the last few months has left me pondering some very uncomfortable questions.
Perhaps I have been naive in not realising the depth of the difficulties facing the NHS (after all there have been no shortage of warnings), but I was deeply shocked by the resignation of the staff towards the sub-standard nature of the care that is all too often administered.
When I was a journalist I was wary of over using the word crisis, but I can think of no better way of describing the state of the NHS. Not simply in operational terms, but strategically.
In the face of an ever demanding consumer mindset, can the NHS adapt quickly enough to rising expectations to prevent middle class flight? That I think is one of the biggest challenges.
Those who can afford it (at a push) are routinely going elsewhere for care when they can.
For example, to avoid the prospect of an amniocentesis test for Down Syndrome, couples are increasingly prepared to pay £180 for the less invasive and more accurate nuchal scan at private health care centres. Once introduced to the world of private medicine many return to it in times of uncertainty when the NHS is found wanting. Meanwhile those who cannot afford it are effectively left with no choice.
It is not simply a matter of a gap in provision. I won't self-indulgently list my own gripes but I doubt very much the problems I encountered are restricted to Cardiff and Vale (clearly they are not), or indeed to maternity services. Some of the problems I encoutered were localised, others suggest there a deeper systemic malaise. In fact, a senior nurse in Wales' leading hospital told me recently that patients routinely 'slip through the net'.
The flow to private providers may only be a trickle now, but there's a danger that it will become a hemorrhage if the support of middle income groups for the NHS is eroded.
Let us not fall back into the familiar narrative here, it is not simply a matter of the rich having choice and the poor having none, many of the people turning the private sector have to borrow money but in desperation feel they have no choice.
It will become increasingly difficult to protect the services relied upon by the poorest if the allure of the Private Sector and the opportunism of the Right undermine the broad consensus which sustains the NHS.
As the NHS reaches its 60th birthday some unpalatable questions need addressing.
It is not just a matter of funding:
Doctors, nurses and midwives must ask themselves if they always give the best care that they can;
professional bodies and trade unions must examine whether their stranglehold on the
NHS is in the long-term interests of their members or the public;
politicians who enjoyed the easy kill of the internal market must show how in its absence the NHS can respond to patient demand;
and voters must confront the uncomfortable reality that if we want public services to meet our demands as modern consumers we cannot rely on solidarity alone to be sustain them.
I don't pretend to have the answers. But if the NHS is to be more than a fall back service for those who cannot afford to go private, the Welsh political elite must acknowledge the problem and engage with the search for solutions.
Sunday, 11 May 2008
Will there be life after 60 for the NHS?
Monday, 5 May 2008
What do the local election results mean?
Anyone who spent a few minutes glancing at the local government election results in Saturday's papers couldn't help being struck by the remarkable divergence in results across Wales. There is no doubt that the results were awful for Labour, but even for Labour there were chinks of light in Neath Port Talbot and Bridgend. For every other party there were significant opportunities to celebrate but also the odd downside or two.
The question now is what kind of pattern of political control will we see emerge from the mish mash of results that was May 1st? I'd say the jury is very much out at the moment, and it is very much a case of watch and wait.
BUT, and I think this is a crucial point for the whole future of Welsh politics - political pluralism is here to stay. If these results prove anything they show that the once dominant force of Welsh politics, the Labour Party can lose anywhere. [Labour has also shown over the past 15 years in Wales that it can win anywhere]. For those who still think that coalition government in Cardiff Bay is an aberration, some rethinking is very much in order. Because, at a local level while Labour could reasonably aspire to play a leading role in a dozen or so authorities, if it adopts old ways of thinking in its approach to negotiations, it could end up in opposition in all but a few authorities.
These elections are not only a challenge to Labour, but will challenge all parties to think anew about patterns of political competition and cooperation; and that can only be healthy thing for the future of politics in Wales.
Friday, 2 May 2008
Women and Drink and Arrests
According to the research by Channel Four News Online, Gwent showed the second biggest increase in the UK for women arrested for being drunk and disorderly. It was second only to the West Midlands, which reported a 12-fold hike from 59 arrests five years ago to 731 last year.
The statistics for 2007/08 only covered 11 months of the year, so the full picture is likely to show even higher increases.
Thursday, 1 May 2008
Rethinking Regeneration in the valleys
Sunday, 27 April 2008
Wales and Community
Tuesday, 22 April 2008
Low paid on £18K?
Monday, 21 April 2008
what is causing social breakdown -thoughts from JRF
A century has passed since Joseph Rowntree set up the three trusts which bear his name to “search out the underlying causes of weakness or evil in the community”. In 1904, he identified
poverty, war, slavery, intemperance, the opium trade, impurity and gambling as the “great scourges of humanity”. Joseph Rowntree recognised, that times would change and he wanted the trusts to be “free to adapt themselves to the ever-changing necessities of the nation”. This consultation revisits the concept of ‘social evil’ and explores the underlying problems that cause the most damage to British society or the most misery to its people.
The public consultation asked ‘What are today’s social evils?’
The following concerns about how we seem to live our lives were highlighted:
• A decline of community: communities are weak and people are increasingly isolated from
their neighbours, at considerable cost to well-being and happiness.
• Individualism: people tend to see themselves as individuals and not as part of wider society,
leading to selfishness and insularity.
• Consumerism and greed: an excessive desire for money and consumer goods has eclipsed
values and aspirations rooted in relationships and communities.
• A decline of values: there is no longer a set of shared values to guide behaviour.
Participants emphasised a lack of tolerance, compassion and respect shown to others.
Against this backdrop, people identified the following, more concrete, social evils:
• The decline of the family: family breakdown and poor parenting were felt to cause many
other social problems and leave young people particularly vulnerable.
• Young people as victims or perpetrators: Young people were seen as perpetrators of social
evils like anti-social behaviour, or the victims of stereotypes and limited opportunities.
• Drugs and alcohol: misuse of drugs and alcohol was viewed as the consequence and
cause of many other social problems, like family breakdown and poverty.
• Poverty and inequality: poverty was viewed as a corrosive social evil in an affluent society,
underpinning other social problems, such as homelessness and family breakdown.
• Immigration and responses to immigration: participants felt that local residents lose out to
immigrants in competition for scarce resources. Others criticised negative attitudes to and
lack of support for immigrants and thought society should be more tolerant and inclusive.
• Crime and violence: people felt that Britain is more dangerous and violent than in the past.
Child abuse and exploitation were highlighted as particularly damaging evils.
Government, media, big business and religion were believed to be responsible for these social
evils. People also emphasised personal responsibility for social evils, but thought bad choices and
damaging behaviour could be symptoms of underlying social problems, such as poverty.
What is the point of the All-Wales convention?

I heard Sir Emyr Jones Parry sketch out his ideas about the role of the Convention he’s been asked to Chair last week.
There’s no doubting he’s a distinguished man and he’s been given a difficult task, but I found the plan he mapped out a little disingenuous.
In essence he said he intends to take his committee around Wales to take the pulse of the nation, hear the arguments, take evidence, and then form a view about the way ahead.
But isn’t that exactly what the Richard Commission did?
He plans to fill his committee (not quite sure what makes his model a Convention?) with representatives from all the parties and some independent people. Again, I’m sure I’ve seen that approach adopted somewhere before?
Of course, we can’t expect people to support more powers for the Assembly until it has been proved that the existing powers have been fully used, he said.
And – he added – in the timeframe available it isn’t realistic to expect the Convention to recommend anything that is not already on the statute books courtesy of the 2006 Government of Wales Act. In other words, extra members and further powers are off the agenda.
I sat there scratching my head. I’m sure I remember the Richard Commission spending a Million pounds in an exhaustive evidence taking exercise, reaching a unanimous view (including the Tory representative) for more powers, more members and a new voting system.
So what’s point of this new Constitutional Convention? To fill time until conditions become favorable for a successful referendum campaign – which most likely means a Tory Government at Westminster.
Politics will decide the fate of devolution, not some pseudo scientific consultation exercise presided over by the great and the good. That’s stating the obvious, but let’s be honest about it.
Saturday, 19 April 2008
Credit Crunch Cymru
Thursday, 17 April 2008
Welfare to where?
I see Rhodri Morgan is saying (in today's Western Mail) that helping people into jobs is 'a key objective' of his and Ieuan Wyn Jones' government. I agree - getting people into work is the best route out of poverty.
Strange that this priority is an area of government that is not devolved and over which Morgan and Jones Ltd have no control.
What is more urgent is making sure that the people of Wales are not penalised when the draconian reforms come into effect in the autumn - by providing childcare, better occupational health, public transport so people can get to jobs, not to mention creating jobs themselves. Otherwise it won't be welfare to work it iwll be welfare to .... nowhere.
http://icwales.icnetwork.co.uk/news/wales-news/2008/04/17/welfare-to-work-key-says-rhodri-as-he-defends-political-leadership-91466-20776211/
Monday, 14 April 2008
Eight, twelve or twenty two - here we go again
Sunday, 13 April 2008
…Go on, say something!
Within 18 months, at the most, Wales will get a new First Minister; and Labour a new leader.
At the risk of repeating myself, there should be no assumption that the person who fills these offices will be the same.
But for the Party that assumes they will remain in control, shouldn’t it be a cause of concern that there is no debate about what the future holds?
Of course there is lots of speculation and gossip within the Cardiff Bay bubble about personalities: Will Leighton get enough nominations to take on Carwyn; Has Andrew lost his appetite; Will Edwina take the advice of those around her and stand etc.
But on the question of what any of these (potential) candidates will do with power there is silence.
“Too early to start campaigning yet”, I am told by those who have the ear of one of the contenders. But with Labour facing certain losses in the next month’s Council elections, am I the only one who thinks we should be hearing more about what those who wish to lead their Party plan to do to bring about a revival?
Ideas Wales has done nothing since its interesting, but ultimately pointless, seminar in Feburary. Wales 2020 has published three interesting pamphlets but has generated little debate.
And the source of debate and ideas outside the Labour Party is little better. The Bevan Society deserves credit for staring this blog, but the IWA has become a prisoner of caution.
Tempting as it is to blame others, culpability rests of the door of those who wish to lead.
Rhodri Morgan has given his party the courtesy of a leaving date. The job has been advertised, so let’s see the CVs – and more importantly lets here the presentations.
It seems at times that no one wishes to offend the First Minister by taking him at his word and planning for his departure. What is everyone waiting for? I’m sure they’re all busy Governing Wales and keeping a coalition together, but they won’t have to worry about it for much longer unless they start thinking, and talking, about the future.
In a brilliant speech to the Labour Party conference in Manchester 18 months ago Bill Clinton told Labour that unless they presented themselves as the agents of change somebody else would fill the gap. “Make no mistake about it”, he said, the question for voters “is not whether you will change. It's how you will change and in what direction.
But at this rate the only change Labour is heading towards is opposition.
Friday, 11 April 2008
A Welsh art gallery - whose culture?
The culture vultures are at it again, this time about whether a national art gallery should be housed at the National Museum in Cathays Park, Cardiff. Well yes I am sure we need at some point to have a National Art Gallery (but given the number of excellent art works already there why can't we just call it that and have done with it) but we also need lots of other things too, like a good childcare, better facilities for cycling and walking, better education for children etc etc. And even within the culture brief, is it really right that yet more investment goes into high art in Cardiff? What about other aspects of Wales' culture - its political heritage, its music - and other parts of Wales?
And as for moving artifacts currently in the museum to St Fagans, most of those that were moved from the old Industrial and Maritime Museum to Swansea's Waterfront museum - like the beam engine pictured - have never been seen again. 'Resting in a warehouse' I've been told.
Let's hope this one withers on the vine.
Wales - a sick nation?
Hardly surprisingly with this lifestyle, more than half of us are overweight or obese.
Just when we are going to get some government action and joined up thinking to promote public health in Wales? I fear that we need more than allotments and free bicyles.
http://new.wales.gov.uk/topics/statistics/publications/hsw2008/?lang=en has the details
Tuesday, 8 April 2008
Passive driving
We all understand what is meant by passive smoking. Well, just as non-smokers suffer the effects of other people's actions, so pedestrians and non-drivers suffer the consequences of other people’s travel behaviour.
People who make relatively little use of a car (and therefore cause less pollution, noise and congestion within communities as a result of their travel) are still exposed to the pollution, noise and damage to communities caused by other people’s car use.
As a report out today by Sustrans shows, a quarter of all households are car-less, in Merthyr and Blaenau Gwent the figure is as high as 36%. And yet the availability of jobs, goods and services are planned on the assumption that we can all hop in the car.
Many families on low incomes feel forced to 'invest' in a car to prevent social exclusion. The poorest spend a quarter of their incomes on the cost of motoring and Citizen's Advice report that buying and running a car is a major cause of getting into dept.
If you spend more than 10% of your income heating your home you are considered to be suffering from fuel poverty. Although there is no similar official definition of ‘transport poverty’, that is what these families are experiencing.
As oil prices rise this will only get worse. And with 95% of all transport reliant on oil our economy is deeply vulerable.
So long as we continue to place road building at the centre of our transport policy we will reinforce car dependecy and deepen transport poverty.







