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Wednesday, May 25, 2011

Safeguarding the Welsh NHS

The report by the King's Fund published today makes interesting reading in light of the debate that took place during the Welsh Assembly elections on health service funding.

The Welsh Conservatives of course proposed ring fencing the health service budget in real terms, a proposal that they estimated would cost nearly £1 billion. The catch was that this would have led to deep cuts in other budgets including schools, economic development, transport and social services. It was for this reason that none of the other parties signed up to this proposal.

The Kings Fund suggest that financially, things are worse for the health service in Wales that any other part of the United Kingdom. John Appleby, who is the chief economist at the King's Fund, said the NHS in Wales is set for a budget cut of nearly 11% over three years:

According to Mr Appleby, planned health spending is not going up in real terms - it will be cut by around 2.2% by 2014/15 in Northern Ireland.

And in Scotland, NHS spending will be cut in real terms by around 3.3% this year, with no plans yet made for spending in subsequent years.

Wales faces the deepest cuts of all of nearly 11%, claims Mr Appleby, although the figures the King's Fund gives for Wales are over a three year period while the other UK nations projections are for four years.

As for the NHS in England, it looks as if real spending will be around 0.9% lower in 2014/15 than in 2010/11.

For the UK NHS as a whole, funding will be cut in real terms by 2014/15.

Despite the protection of the English NHS budget Mr. Appleby points out that, traditionally, spending per head in England has been lower than in all other parts of the UK:

"On average, over the last seven years, NHS spending per head in Scotland has been around 15% higher than in England - equivalent to a financial gap of over £15bn; or the annual budget of London's entire NHS," he said.

I do not believe that any of this can be put right in Wales in the short term given the financial climate we are in. However, the King's Fund figures underline how important it is to ensure that we eliminate waste in the Welsh health service.

In particular there needs to be immediate action to deal with the misspending of £1 billion identified by Directors of Finance in the NHS a year or two ago. So far the Welsh Government has refused point blank to investigate that issue. Will a new Minister have a new approach?
The swirling winds that are blowing around might make this "Safeguarding the Welsh NHS" a step out of time. Meaning, what we have now might essentially 'go in the blink of an eye'.

Wales looks to London/Westminster, but L/W looks to the USA (i.e., the center of the western economy). America is in a very difficult position with such heavy over spending. Cameron should have focused on that, but apparently was at least equally focused on Libya.

Things are so precarious just now it won't take a lot for the whole US economy to take a massive hit via a sudden drop-off in foreign investor confidence in the US dollar. The Obama Health care plan and now the controversy over Medicare funding are bad omens.

The GOP has put themselves in a stupid box over Medicare - US seniors vote and vote often. The GOP (Republicans) lost a GOP Congressional seat over Medicare fears among US seniors.

Savings can be made without making noises about Medicare by reforming other statutory entitlements. But if some kind of deficit spending reform doesn't come into play soon, the US government may end up defaulting. It is that serious.

Should that happen, the repercussions for Europe/UK/Wales/NHS Wales would be deadly.

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