NHS waits and robust debate at assembly

The Health Secretary Vaughan Gething has repeated his claim that the market-driven focus of the English NHS produces perverse incentives.

He was responding to the latest report from the Board of Community Health Councils on the impact of waiting times on people's lives.

If that is the case, why is it that waiting times for most of the main treatments and diagnoses are shorter in England, than in Wales?

This is a debate that will continue to run although our latest analysis showing a strong relative performance on Welsh cancer waits will provide welcome news for a system that all too often has to respond to negative headlines on this issue.

There was an interesting development at Betsi Cadwaladr recently when the health secretary clawed back £3m after it failed to hit targets on those waiting longer than nine months.

Hit targets

Mr Gething insists he has done this before with other health boards and that he is not following the English model where trusts are routinely fined for failing to hit targets.

Be that as it may, it is difficult to imagine his predecessor and candidate to be the next first minister, Mark Drakeford, imposing a financial penalty like this.

Despite the sanction, there was actually huge progress made in Betsi Cadwaladr on its nine month waiting times.

In September 2017, there were 8,982 people waiting longer than 36 weeks, by comparison the corresponding figure at Cardiff and Vale was just 1,053.

The number at Betsi rose to 10,365 in December before coming down to 5,714 in March.

Jacob Rees-Mogg

So the health board nearly halved the numbers waiting the longest but did not manage to get them down as much as had been expected after Betsi received its share of the £50m extra the Welsh NHS received last summer to bring down waits.

The good news for ministers is that reductions can be achieved, the bad news is it would appear it can only be done by throwing money at the problem, and with half of everything the Welsh Government already spends going on the NHS, that is not an easy message to sell to other departments.

On a separate note, what are we to make of the letter written by the Plaid Cymru leader Leanne Wood to Carwyn Jones complaining about the way he compared her with Jacob Rees-Mogg during First Minister's Questions this week?

The comparison could be described as a bit of light-hearted knockabout but Ms Wood believes there is a pattern of personal and patronising attitudes to women in the chamber from Labour ministers.

These accusations are virtually impossible to gauge; one person's dismissive sleight is another person's legitimate defence.

Robust

And it is worth saying that Leanne Wood had just accused the first minister of betraying the nation by capitulating during the talks on Brexit legislation.

There's also likely to be plenty of raised eye-brows from Labour AMs at the letter, considering that some of the most vocal and robust performers in the assembly are currently to be found on the Plaid benches.

It will be interesting to see whether the tone changes within Plaid ranks in light of the letter.

All of this taps into the debate on what kind of politics people want to see played out in the assembly.

Those who have been monitoring events in Cardiff Bay longer than I have will tell you there is a combustible mix of characters there at the moment who have made it far more like Westminster than ever before.

This may be down to the fact that a number of the AMs are former MPs themselves.

The question in a way is not whether it is acceptable to AMs or journalists, but whether the public like a bit of theatre, which inevitably includes the possibility of some going over the top, or whether they want a more polite, and many would say, a more mature way of debating politics.