Nuffield Trust report exposes Tory lies on Welsh NHS

David Cameron claimed last week that the Welsh border was "the dividing line between life and death". A new Nuffield Trust report shows such rhetoric is dishonest. 

Tony Beddow
16 April 2014

Image: NHS Wales

The Welsh NHS is “sleepwalking to a mid-Staffs tragedy, claimed Jeremy Hunt on Friday. David Cameron went further that day, telling Welsh Conservatives the Welsh NHS was a “national scandal” and Offa’s Dyke “has become the line between life and death”.

In fact a thorough comparison of the UK health systems - published earlier that day by the independent Nuffield Trust - showed that overall, NHS Wales compares well.

Challenged on the discrepancy BBC Radio Wales on Friday, Welsh Tory MP Alun Cairns was keen to bluster about longer waiting times for hip and knee operations.

He didn't want to hear that cancer care was better. That acute admissions for chronic conditions were falling. That the Nuffield Trust report found that there was no evidence Wales was “lagging behind”. That it was "broadly in line" with the rest of the country on "avoidable deaths".

That in fact Nuffield's study showed Wales' (far less privatised) NHS was improving faster than England's - on less money.

Wales gets less funding per person than areas of England with similar levels of ‘need’ like the North East of England. There, the NHS gets allocated £2,100 per person - 10% more than Wales, which gets £1,900 per person.

The Barnett formula which works out how much money Wales gets was established as a temporary fix - in 1978. 35 years later its inadequacies are clear to all - except the Tories and the Welsh Lib Dems.

Plugging the gap with funds from education or social care are unattractive options. The devolved Welsh NHS uses about 40% of the total Welsh Government block grant, so the impact of the unfair allocation on its NHS is huge.

And what of that orthopaedic waiting time figure?

Reported figures show an average hip and knee operation waiting time in Wales of 170 days as opposed to 70 days in England.

However, they do not necessarily indicate much poorer treatment.

The English figures are not collected and reported on the same basis as the Welsh. The English rules allow the English waiting times "clock" to be stopped in different ways.

Some of the difference in reported waiting times is almost certainly down to England being better at gaming the data rather than being better at treating patients. Rob Findlay, an expert on waiting times, has observed that it is “striking” how often the clock is stopped in England just before the 18 week target and suggested some English NHS trusts are “systematically” misusing the system of “clock-stopping”.

Average waiting times are in any case a crude indicator. Patients should be treated at the best time. For some patients discussing with their doctors the optimum time for such surgery, it may make sense to wait a while so that revision surgery some years hence is less likely.


Cameron and his fellow pro-marketeers are keen to disparage NHS Wales because it has not followed England's path of dramatically expanding the amount of private involvement in health provision.

But as Welsh Health Minister Mark Drakeford said on Friday, the Nuffield report “has shot Cameron’s fox good and proper”.

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