Doing things differently in Wales
Thursday 5 June 2008
'A big country can ignore what happens in a small country but a small country can't ignore a big country, because it colours your decisions – expectations are set by what's happening in England.'
Rhodri Morgan, First Minister for Wales
Wales has a unique set of health issues and since devolution the country has tried to find a Welsh way of addressing them, First Minister Rhodri Morgan told delegates in Wednesday afternoon's Welsh Assembly Government session.
The consequences of the 'glory era' of the Welsh coal and steel industries – and what happened when they collapsed in the 1920s and 30s - are still being felt, he said, and much of the NHS and welfare state hascome about through the consequences of that growth and decline.
'If you compare the social, economic and health problems of the industrialised parts of North and South Wales with the North East of England, they are very similar,' he said. 'But Wales is also a popular retirement area, like the South West of England, so we have the problems associated with that combined with the public health and socio-economic problems associated with our industrial heritage.' No other part of the UK has this combination, he said.
'When you look at the league table of local authorities in terms of people with long term conditions, or people claiming sickness benefit, more than half of those in the top ten will be in Wales - despite Wales accounting for only five per cent of the population,' he said. 'That is an astonishing figure.' However, life expectancy is very good compared to Scotland and England, and quality of life is high. 'People leave for economic reasons but they want to come back. We lose populations in their 20s, but we gain in every other age group. This is what you would expect in a country without a metropolis.'
All of this is reflected in the health service, he said. Since devolution in 1999 the country has tried to find a way of addressing uniquely Welsh issues like the socio-economic split and high dependency rates associated with an older population. 'This is why we decided not to follow as obsessively as the English NHS the primacy of the crushing of long waiting lists.
'We took the view that the missing element in Nye Bevan's health service when it started was prevention,' he continued. Wales has decided to concentrate on that but has been 'crushed in the millstone' between a media looking for problems and English success in cutting waiting times. 'In the end we couldn't hold the fort by saying "waiting lists are important but they're not as important as prevention",' he said.
Even though devolution means four health services in the UK it is always easier for England to do things differently, he said. 'A big country can ignore what happens in a small country but a small country can't ignore a big country, because it colours your decisions – expectations are set by what's happening in England. We find it quite difficult to do things differently, even though we know it's the right thing to concentrate on prevention. But we will continue to try to do things differently, not for its own sake but for the sake of the people of Wales,' he said.
Watch First Minister Rhodri Morgan's speech as part of the Welsh Assembly Government plenary session