(Title Image: fullfact.org)
Before starting full coverage of the 2021 Senedd election at State of Wales, over the next fortnight there’ll be a few primers examining whether the Welsh Government actually delivered on their 2016 manifesto promises during the Fifth Senedd as well as the key challenges and committee inquiries in each area.
I start with health. Later on there’ll be education, the environment, the economy and our communities (housing, local government, culture etc.).
Key Events & Issues of the Fifth Senedd in Health
Covid-19 Pandemic – It goes without saying, doesn’t it? While decisions made by both the UK and Welsh government during the pandemic will influence the election, I have to consider the whole five-year term. The pandemic response is best dealt with in more detail once it’s clear the worst is behind us.
Future of Social Care Funding – An independent report (pdf) has suggested some form of social care insurance/tax. While there have been moves to try and cap or limit the financial impact of social care costs, with an ageing population it’s a struggle to see how long this discussion can be put off for.
Impact of Brexit – There have been concerns about how new post-Brexit immigration rules will affect NHS and social care staff from the EU. Short-term, there’s unlikely to be much impact but longer-term it’s going to be an increasing struggle to fill certain vacancies. That would normally lead to pay increases under the principle of supply and demand, but we don’t value social care work in the same way. Other associated issued include a long-term replacement for the European Health Insurance Card system and the import and export of time-sensitive medical supplies.
Cwm Taf Maternity Scandal – An investigation into poor standards of care on maternity wards in Llantrisant and Merthyr Tydfil suggested this was possibly linked to baby deaths and placed mothers at risk, resulting in the health board’s maternity services being placed into special measures. The situation has seemingly been addressed, but it prompted an unsuccessful no-confidence motion in the Health Minister. It should never have been allowed to get as bad as it did, suggesting a culture of cover-ups and groupthink amongst NHS managers, reigniting the debate over whether administrators should face the prospect of being “struck off” in the same way as clinical and nursing staff.
Autism Services – There has been an on-off debate on whether service standards for people on the autistic spectrum and their carers/families should be put on a legal footing. A backbench Autism Bill was unsuccessful with the Welsh Government promising to introduce a new statutory Autism Code instead, but this may not be seen to go far enough.
Child & Adolescent Mental Health – Probably the biggest hidden disgrace in modern Wales is the poor management of CAMHS. Even before the pandemic, waiting lists for treatment were excessively long and there was a hidden epidemic of poor mental health amongst young people fueled by multiple factors. There have been demands from the Senedd’s Children & Young People Committee for children’s mental health to become a top national priority, but nobody seems to know how to deal with it.
NHS IT Systems – A damning report from the Senedd’s Public Accounts Committee prompted a long-overdue overhaul of NHS informatics systems given the increasing importance of digital technology in healthcare. There were suggestions that IT outages had resulted in disruption to some aspects of healthcare and could have put some patients at risk. Although a new Digital Health & Care Wales service is currently being established, it’s unclear whether the pace of change or the budgets put towards fixing the problems are sufficient.
Key Committee Inquiries
- Use of Antipsychotics in Care Homes (Health & Social Care)
- Suicide Prevention (Health & Social Care)
- Loneliness & Isolation (Health & Social Care)
- Policing & Mental Health (Health & Social Care)
- Physical Activity by Children & Young People (Health & Social Care)
- NHS Informatics Systems (Public Accounts)
- Hospital Catering (Public Accounts)
- Mental Health Support for Young People (Education & Young People)
- Perinatal Mental Health (Education & Young People)
- The cost of caring for an ageing population (Finance)
Key Health Legislation
- Coronavirus Act 2020 – An emergency law introduced at the UK level to address the impact of the Covid-19 pandemic, which includes extensive regulation-making powers for the Senedd.
- Minimum Alcohol Pricing Act 2018 – Introduced a minimum per-unit price for alcohol in Wales, which came into force in March 2020.
- Health & Care Quality Act 2020 – Introduced a “duty of candour” to health and social care services and also replaced Community Health Councils with a new citizens’ voice organisation.
- Public Health Act 2017 – Having initially been rejected (in controversial circumstances) at the end of the Fourth Senedd, the Bill was re-introduced and included new regulatory regimes for the body art industry, new restrictions on smoking and duties relating to the provision of public toilets.
- NHS Indemnities Act 2020 – Established a new public indemnity scheme for GPs.
Some key health statistics stopped being collected and published during the Covid-19 pandemic. Even if they were, they would arguably make for an unfair comparison. As a result, most of these have been counted under “normal” working conditions (up to and including the 2019-20 financial year).
