Thursday, 8 May 2014

Wales - cradle and grave of the welfare state?

Local government is under stress. Over the next few years funding will fall way. Less money will come from the Welsh Government whose decision to ring fence health and education spending will have consequences on funding other areas. and is itself, clearly not sustainable.
But why are we afflicted with poor public service management, desperately bad leadership and no "joined up thinking"?

How can Iceland, with roughly the same population as Swansea, provide an excellent health care service over larger distances and have one of the longest population life expectancy figure in the world?.

When I came back to wales from Scotland in December 1994 the hospital sector was obviously underfunded and under resourced. The Conservative government was generous at the time with NHS funding, money followed the patients and services improved. But then Tony Blair appeared, decided that public spending should be cut equally everywhere,and soon started the year on year "efficiency savings" which eventually reversed many of the gains of the previous decade. In order to make the cuts my local hospital lost its children's ward, a planned midwifery unit and eventually acute surgery and recently the A&E service was downgraded.

 Local community and political activity was focused on fighting the cuts rather than looking at a stable solution. Fair play, it was not realized that the cuts were a permanent feature and small hospitals were fair game for easy cuts.

Welsh Government may have made things worse by its policies.

I doubt if the new Assembly, made up of people with predominantly Council and Westminster backgrounds and outlooks realized how dire the situation was likely to be. No scent of recession, a limited pool of talent to take up ministers' posts and even possibly a lack of "decent help". One of the first class of AM's told me that Cardiff was a dumping ground for civil servants who couldn't "cut it" in London Ministry's and had been to sent to the Welsh Office, seen as a place where they could do little harm!

Targets in a health service already poorly funded lead to a culture of creative accounting of waiting lists, fantasy business cases and random cuts and new services, and poor cooperation between areas. The basic problems were denied and made worse by cutting back on services, many already barely adequate and some not even that. All through empty reassurance that all was well ,and in fact better for us. A basic survey of what we had in 1999 and measures to share the resources across Wales and use English services where needed, might have saved much misery, duplication and creative propaganda. Reorganizations never saved money, management bloomed , some front line services declined,  psychiatry withered and every department was said to be a "centre of excellence."

 I lost my NHS career in 2005 by whistle blowing on a private practice fraud in which consultants used their NHS time, drugs, diagnostics and equipment  for private patients without paying for it.

I was not thanked for my revelations [except by the Audit Commission who confirmed my suspicions of fraud] and treated appallingly by both management and my greedy colleagues. I've not been able to work for the NHS since.  However, I have much sympathy and respect for those who still try to give a good service in the NHS despite the uncertainties and lack of direction for the future.

Frankly I've found local government much the same, although on a different time loop. Years of plenty led to waste and dreadful planning as no-one saw the depression coming and assumed that public money was always increasing and close scrutiny unlikely. As cuts fell, the same culture of spin and defensive rebuttal and harsh treatment of whistle blowers. How do we deal with declining resources and prospects as lying our way out of it clearly isn't working.

There is one big thing that must change soon. Forget the spin, stop re-writing history and throw out the rhetoric of blame. Our problems are ours to solve. We are where we are and trying to gloss over the situation is wasted effort. Our Government must take responsibility, be truthful, and sit down and talk with all concerned because this is the biggest crisis we will ever see and the lives and likelihoods of the people who live here in Wales are more important than egos, politics and recriminations .

Sian Caiach
People First County Councillor for Hengoed Ward,
Llanelli, Carmarthenshire. 

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