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Author Archives: Jim Gralton

The National Assembly’s Finance Committee is undertaking an inquiry into the costs of care for older people. This is timely not least because the UK Government has promised us a green paper on social care finance by the summer 2018  thought there are media reports this could be postponed — it seems that the Brexit policy paralysis is contagious and spreading to other other areas. No doubt in advance of the the anticipated green paper, there has been a flurry of papers and publications in recent weeks. They will add to the dozen or so commissions, green papers etc that […]
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In 2009 the internal market was abolished in the Welsh NHS. Seven unified Health Boards (and three trusts – Ambulance, Public Health and Velindre cancer services) took over the responsibility of the former 22 Local Health Boards and most of functions of the seven Trusts to both plan and deliver health care for the population resident in their geographical areas. In the initial phase following the internal market abolition the acute hospital sector seemed to have “captured” the planning process. But as things have matured the Welsh Government has sought to re-balance matters with the introduction of Integrated Medium Term […]
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Deborah Harrington’s interesting posting on “The Myths and Legends of Hypothecated National Insurance” (March 29 2018) in particularly relevant in the light of media speculation about hypothecated taxes or National Insurance contributions to pay for health or social care. In Wales there is a further variation on this general theme with Professor Gerry Holtham (Dept. of Regional Economics at Cardiff Metropolitan University ) proposing the establishment a social care levy for Wales. (See link below) The levy, based on weekly payments between £1.75 and £7, would differ from a tax in that the receipts would not go into a general […]
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The interim Parliamentary Review, published in July 2017, observed the the Welsh NHS and social care has been subject to many well-considered reviews since devolution. They all shared the common fate of not to achieving transformational change as they never successfully made the transition from the page to the front line. In an attempt to address this it recommended that Welsh health and care services should concentrate on a limited number of significant innovations, evaluate the outcomes and implement the most successful ones with a sense of urgency. Despite this the Final Report (January 2018) itself produces ten “high level”recommendation […]
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The interim report on the Parliamentary Review on the Welsh Health and Social Care Service was published in July 2017 just before the National Assembly’s summer recess. Its main message was that both services needed to innovate and modernise at a much faster rate if they are to continue to provide quality care over the next five to ten years. This is a well rehearsed and often repeated message. However, unlike previously, instead of encouraging “a thousand flowers to bloom”, the Review urges more limited and strategic approaches with a particular emphasis on the needs of the older population. These […]
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Wales was the first health service in the UK to abolish prescription charges in 2007.  The NHS in Scotland and Northern Ireland subsequently adopted the policy. The following article, written by Welsh Cabinet Secretary for Health Vaughan Gething, initally appeared in the Western Mail newspaper:-     This weekend we marked the 10th anniversary of free prescriptions being available in Wales.   When we took the decision to abolish prescription charges back in 2007 it was in light of evidence that some people with serious chronic conditions, such as high blood pressure or heart disease, could not afford their prescriptions […]
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The Welsh Health Cabinet Secretary (Minister) Vaughan Gething AM has identified three major priorities for primary care in Wales * maintaining the sustainability of the sector, * improving access to services and * delivering more care in a community setting. Central to delivering these are objectives are the emerging GP Clusters / Primary Care Networks. There are 64 networks or clusters in Wales with a population base of 30- 60,000 patients. It is based on promoting partnership and collaborative working. The networks allow general practices and a range of other primary and community care practitioners to get together with their […]
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The Welsh Government and the General Practitioners Committee (Wales) have agreed the details of a new contract in Wales… This follows from an earlier agreement between the Welsh Government and GPC Wales to to relax the Quality Outcome Framework requirements until the beginning of April 2017 to ease workload pressures on GPs during the high demand winter months.    

On November 1st 2016 the Welsh Government’s Cabinet Secretary (Minister) for Health, Well-being and Sport, Vaughan Gething, announced the establishment of a Parliamentary Review which will look at the key challenges facing the health and social care services in Wales. He said  “ … (it) will review the best available evidence to identify key issues facing our health and social care services and draw out the challenges that these will present over coming years. For example, there are challenges with NHS finances within a reducing Welsh Government budget, workforce planning, recruitment and retention, and meeting the rising demands of healthcare and […]
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Wales is the only part of the UK where “deemed consent” to organ donation applies. The means that any deceased who is over 18 years, is mentally competent and who had lived in Wales for  12 months is deemed to have given consent to organ donation unless they have formally registered their objection. About a decade ago, the UK had a low organ donation rates (13 / million population) compared to countries such countries as Spain, USA and France. As well it had a much lower rate of next of kin refusal. In Wales around three people per month died […]
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At just over £7 billion, health and social care makes up 46% of the Welsh Government’s expenditure. And over the fourth term of the National Assembly health controversy was never from the headlines. This was, in part, inflamed by the fabricated claims of David Cameron in the run up to the UK general election that Offa’s Dyke had become a line between life and death in the UK. Since then two independent reports, by the Nuffield Trust and the OECD, has exposed Cameron’s scurrilous claims. They showed there was no substantial difference between the various health services across the UK. […]
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David Cameron notoriously claimed at the April 2014  Welsh Tory Spring Conference that Offa’s Dyke had become “the line between life and death” due to the performance of the Welsh NHS. However fortunately for the truth and honest debate, almost to the day the Nuffield Trust published its comparative study “The four health systems of the United Kingdom; how do they compare?”. It reported :- However, this latest study ….. reveals that while there are few indicators on which a devolved country does better than England or its North East region, the performance gap between England and the rest of the UK has […]
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