ALTHOUGH the latest batch of NHS performance data contained some good news for the Welsh government, chronic problems with meeting targets remain the headline.

The Welsh Government announced further funding to reduce waiting lists earlier this week. Following that announcement, the Health Minister, Jeremy Miles, led a Welsh Parliament debate on waiting times on Tuesday, November 19.

HARD FIGURES

The number of patient pathways increased from 800,163 in August to 801,307 in September, the highest figure on record, equivalent to one-quarter of the Welsh population.

There were still around 618,200 individual patients waiting for treatment in September.

Two-year waits remain at 23,701 in Wales. Eluned Morgan promised to eliminate these waits by March 2023 and again by March this year. The dial is moving slowly in the right direction, but progress is painfully small.

At the end of September, the average (median) time patient pathways had been waiting for treatment was 22.7 weeks.

In October, only 50.4% of red calls (the most serious) received an emergency/ambulance response within eight minutes. This is a tiny improvement but a long way short of the Welsh Government’s performance target for the Welsh Ambulance Service. The Ambulance Service has never hit any of its performance targets since the Welsh Government first set them.

Performance worsened against the 62-day target for patients starting cancer treatment; it is now 55% as of September.

MINISTER FINDS THE POSITIVES

Wales’s Health Minister, Jeremy Miles, responded to the data: “I’m pleased to see the number of patient pathways waiting more than a year and two years for treatment have fallen in the last month.

“This shows positive progress is being made across Wales to reduce the longest waiting times. I hope to see this continue.

“While there has been a small rise in the overall number of patient pathways waiting to start treatment, more than half are waiting less than 26 weeks, and there was a fall in the number waiting more than 36 weeks in September.

“We recognise the impact long waits for treatment can have on someone’s life, both mentally and physically, so we have a laser-like focus on reducing the longest waits and improving access to patient care.

“More than 1,800 people started cancer treatment in September, and nearly 14,000 people received the good news they didn’t have cancer.

“There were also reductions in the long waits for both diagnostics and therapies services and some reductions in the numbers of pathway of care delays.

“Urgent and emergency care services continue to be under great pressure – in October, the Welsh Ambulance Service received the second highest number and proportion of immediately life-threatening calls per day on record, but more than half of these calls received a response within eight minutes.”

NHS “AT CRISIS POINT”

Sam Rowlands MS, Welsh Conservative Shadow Health Minister, said: “I fear that we are at a crisis point as waiting list figures continue to head in the wrong direction in Labour-run Wales.

“The Labour Health Minister’s latest initiatives, even if his expectations are met, will barely scratch the surface in terms of tackling these excessive, record-breaking waits for treatment. Something needs to change fast.

“The Welsh Conservatives will stand up for the Welsh people’s priorities by eliminating restrictive guidance blocking cross-border and cross-sector working and by enacting a substantial workforce plan to boost staffing numbers, with a tuition fee refund for healthcare workers at its heart.”

LOCAL TRENDS

The month-to-month performance data provide a limited snapshot of the details. Their nature encourages politicians to exchange barbs and engage in self-praise. Specious comparisons between Welsh NHS performance and English NHS performance crumble under the gentlest scrutiny, not least as the English NHS counts waiting times and collates patient data differently from the Welsh.

Long-term trends are more revealing.

Immediately before the Covid pandemic (data released in March 2020), 1.6% of patients in the Hywel Dda UHB area waited over 36 weeks from referral to treatment. 85.7% of patients went from referral to treatment within 26 weeks.

By March 2022, 35.2% of patients in the local health board area were waiting for more than 36 weeks, and the percentage seen within 26 weeks had fallen to 56.7%. By the following March, just over 60% were seen within 26 weeks, and the proportion of patients waiting more than 36 weeks had fallen to 28.2%.

If you move forward to September 2024, Hywel Dda UHB’s performance figures have marginally slipped. There are no peaks and troughs in the performance data; they remain steadily bumping along at the same level and are far worse than they were in March 2020.

The Health Minister’s honest acknowledgement that the £50m funding injection to address waiting times is a short-term measure to boost performance and not a long-term solution highlights the scale of the problem. The question of waiting lists is not how much money it will take to tackle them but how much money will be spent before radical reform tackles systemic problems with healthcare delivery.

Placing Hywel Dda’s difficulties in a national perspective, the Welsh Government’s planned care recovery plan established a target to eliminate two-year waits in most specialities by March 2023. ‘Most’ refers to all specialities, excluding seven recognised as exceptionally challenging even prior to the pandemic.

Those specialisms, which include Orthopaedics, ENT, and Gynaecology, are large areas of surgical practice. They are excluded from targeted improvements because tackling them is too difficult. Proposals to establish surgical hubs made by the Welsh Conservatives have not attracted Welsh Government support as resources and staffing remain highly problematic. However, a quick win for the Welsh Government on the longest waiting times is potentially available.

LABOUR’S conference in Llandudno last weekend was an opportunity for the Party’s great and good to come together and tell each other how wonderfully things are going.

The key message was that, while the Labour Government in Cardiff Bay was nothing less than a roaring success, things could only get better with Labour governments at either end of the M4. Labour in Wales must hope that this last phrase sticks in the electorate’s consciousness and glosses over Welsh Labour’s problems.

There are plenty of those problems, although you’d be hard-pressed to identify any of them from the keynote speeches delivered to the faithful.

Speakers hit all the important notes:

• Labour was delivering more money to the Welsh Government to spend (big cheer).
• There would be money to spend on the NHS (bigger cheer).
• There were no more Conservative MPs from Wales in Westminster (ecstatic rapture).

And so on and so forth in all the key speeches.

PREACHING TO THE CHOIR

It’s only fair to begin with the big cheese himself, Sir Keir Starmer. Cheese is the right word. The Prime Minister recapped his October speech at Labour’s national conference, and he laid on added Welsh schtick with a trowel. Nye Bevan, the NHS, the Industrial Revolution, the sense of community. All his speech lacked was the Morriston Orpheus Choir humming “A Hyd a Nos” in the background.

Thankfully, as is the way things are nowadays, there were no big announcements in Keir Starmer’s speech. Its content had been well-trailed. Bashing the Tories while taking credit for their policies and adding the odd million here and there is enough for a Labour leader in Wales to get a rapturous reception. And he got one.

Eluned Morgan was more old school: “There’s a new Wales on the horizon, and I intend to lead us there,” the First Minister began.

She continued to explain that: “The people’s priorities are my priorities.

Improved health and social care, delivering future-proofed jobs and growth, higher standards in our schools and more social housing because your postcode should never determine your prospects, improving transport and keeping people in touch. New trains, a new bus bill, better roads.”

Nobody could disagree with those objectives. Nobody casting a more critical eye over them could help but wonder why it’s taken 25 years for the penny to drop.

The First Minister’s attempt to create some pithy soundbites was undermined by how she introduced them: “They offer soundbites – and we deliver sound policies. They sow division – we build unity. They promise walls – we build bridges. They complain – while we campaign.

And while they look backwards – we move forwards.”

It was a bit like Tony Blair. “Now is not the time for soundbites, but the hand of history is on out shoulders.”

STEVENS STANDS OUT

Jo Stevens, the Secretary of State for Wales, hit an altogether stronger note.

She announced £13 million to provide support for workers, families and businesses affected by the closure of the Tata Steel blast furnaces in her first address to the Welsh Labour Conference since Labour won a landslide General Election result in July.

The investment from the Transition Board, which will provide non-repayable grants of up to £10,000 to help workers and their families set up their own businesses, is part of a wider £26.5 million package committed by the UK Labour Government since taking office, and part of an £80 million commitment to fully fund the Transition Board and to support workers that came out of Labour’s Autumn Budget.

Jo Stevens developed her theme by attacking the Conservatives’ failure to bankroll a scheme they’d announced: “In October last year, the Tories had promised £80m to support workers and businesses in Port Talbot. Nine months later, they hadn’t delivered a single penny.

 “Now we know why – the £80 million was never there. It was one of a long list of unfunded spending commitments.

 “Today, I am announcing a £13 million fund to support existing and new businesses in Port Talbot and across our steel communities. And Labour’s first Budget confirmed that £80 million in full.”

The conference loved it all. But apart from Jo Stevens repeating an attack line that Labour had already developed in the preceding weeks, it was rather thin gruel, albeit enthusiastically delivered.

THE PARTY OF GOVERNMENT

Wales’s Transport Minister, Ken Skates, announced a “new” Bus Bill to re-regulate bus services and integrate train and bus timetables, tickets and routes. The inverted commas around the word “new” are advisable as this is a Bill that’s long been out for consultation. Councils have already outlined their responses to it, and it was one of his predecessor’s major pieces of legislation. When the Bill is finally published next March, it will be only four years since the commitment appeared in the 2021 Manifesto and seven years since the Welsh Government announced its intention to legislate.

Having announced £22m to cut waiting times just over a fortnight before the Labour conference, Health Minister Jeremy Miles announced a further £28m, which included £3m to shorten waiting lists for children awaiting neurodevelopmental assessments.

Remarkably, the entirely nonpartisan Welsh Government press office was on hand to announce these initiatives in almost identical terms to the Labour Party’s press releases on the same subjects and as they were made to the Party faithful. There is a separation between the party political activities of Welsh Government ministers on the one hand and Welsh Government actions on the other. While the lines have blurred over recent years, it is not the business of Welsh Government employees to assist Ministers with campaigning activities, such as a conference speech.

Labour is the Party of government in Wales, but it is not the Party of the Welsh Government.

LABOUR’S WELSH PROBLEM

In Westminster opposition, Labour made many of the right noises about doing right by Wales. Chief among those noises was sending Wales “£4bn” as a consequential payment for the HS2 project that the Conservatives (boo!) had denied Wales. There were other promises, too:

• Rejigging the basis upon which Westminster allocated money to the devolved governments.
• Making sure the Welsh Government regained control over the funding that had replaced the European Union’s money.
• Devolving more powers to the Welsh Government.

Big promises, all of them.

In the thrill of victory and delivering and taking the credit for projects launched by the Conservatives (boo!), those promises have vanished into talking shops and the language of “hard choices”.

And so, to make up for the fact that the Westminster Labour Government has left its Cardiff comrades in the same position as the Emperor wearing his new clothes, Labour’s conference speeches were long on triumphalism and mood without any sign of much that was new. 

Turnout in Wales on July 4 was down over 10.5%, and Labour’s share of the vote fell by 3.9%. Labour’s share of the General Election vote in Wales has only twice slipped below July’s level (in 2010 and 2015). Even in 2019, Labour polled better. In 1997, when Tony Blair’s New Labour swept the Conservatives from power almost as dramatically as in July, Labour won almost 55% of the vote in Wales.

Labour’s polling for the next Senedd election is even more dire than July’s outcome, with some polls showing support hovering around 30%. In 2026, the low turnout and divided vote that skewed General Election outcomes in Welsh constituencies could cause a very different outcome. Turnout in Welsh elections is often pitiful, and the new voting system could erode Labour’s dependable “red rosette on a donkey” vote.

Between now and May 2026, Labour must not only say what it wants to deliver but also get on with it. The lack of urgency about its previous Manifesto commitments and the ongoing omnishambles that is the Welsh NHS leave Eluned Morgan little room for manoeuvre.

In opposition, parties abuse the government of the day. In government, parties abuse the preceding government. In Wales, where Labour’s been in power for twenty-five years, the problem goes without saying.

PEMBROKESHIRE businessman Darren Briggs, founder of petrol station operator Ascona, has been named a winner of the prestigious Allica Bank Great British Entrepreneur Awards in the ‘Scale-Up Entrepreneur of the Year – Wales’ and the inaugural ‘Randal Foundation Entrepreneur of the Year – Wales’ categories.

Now in its 12th year, the Great British Entrepreneur Awards shine a spotlight on the individuals and businesses driving innovation, creating jobs, and shaping the future of the UK economy.

This year, the brand new ‘Randal Foundation Entrepreneur of the Year’ award celebrated entrepreneurs whose business embodied The Randal Foundation’s core mission – to save lives, improve life chances, and contribute positively to local communities.  

Ascona has been committed to supporting local communities since its inception, having established The Ascona Foundation in 2020. The success of the Group over the years has enabled Darren and the team to support many charities in the areas in which it operates, with the Company donating over £400,000 to local, national and community organisations since 2017.

Darren Briggs, Founder and Chief Executive Officer of Ascona Group, commented: “It is a great honour to be recognised for such prestigious awards at this year’s Great British Entrepreneur Awards.

“I am incredibly proud of Ascona and everything we have achieved over the years. This is another milestone for our business and the recognition is a testament to everyone’s hard work, commitment, and ‘Team Ascona’s’ ethos over the years.

“However, I am most proud of our charitable endeavors and the team’s commitment to giving back. It is something that is very close to my heart. We’re committed to supporting our various charity partnerships, including the Wales Air Ambulance this year, as we continue our extensive fundraising initiatives across the Group.”