During the General Election hustings in Ceredigion-Preseli, many questions were asked on healthcare and the NHS.  All the candidates replied that “this is a devolved matter…”, which of course is true.  But it’s strange that our UK Government has so little control over what is for many of us a key public service.

Labour claim the NHS as one of their proudest achievements.  Very sadly they lost sight of what the NHS was for, exemplified by Ed Miliband “weaponising” it in 2015.  My party never found the courage to challenge that nonsense.  We just kept on throwing more money at an unreformed NHS with real terms health spending going up 37 per cent between 2010 and now.

What goes around comes around, and Ed’s stupidity may come back to haunt Labour.  Because now, they need to find real word solutions.  And it is going to be fascinating to see how that plays out in Wales.  With Labour Governments in Westminster and Cardiff, there’s nowhere to run and hide!

There are in fairness some good signs (at least to those of us who actually want decent healthcare).  Many of us have had the experience of an old and much loved car coming to the end of its life.  We finally accept that it is beyond economic repair, and change it for a newer model.  It can’t be any great surprise that a 1948 model of healthcare isn’t really working in 2024.  Many of the treatments we take for granted today, weren’t even dreamt of back then.

So when Wes Streeting, the new UK Health Secretary declared that it was now official Department of Health policy that “the NHS is broken”, we should sit up and take note.  Perhaps we should take even greater note of two of the senior advisers he has taken on.

Alan Milburn, started life on the left of the Labour Party.  He was Tony Blair’s Health Secretary from 1999 – 2003.  In my opinion he was the best Health Secretary the UK has ever had.  Paul Corrigan once stood as a Communist Party candidate.  Somewhere along the line he realised the shortcomings of socialism, and became a pragmatist embracing (quite radical) market reforms.  He did much of the thinking behind Milburn’s improvements.

Of course we didn’t hear much about them in Wales, because by 1999, health policy had been devolved to Cardiff.  We didn’t benefit from those reforms, and maybe that’s one reason why the Welsh NHS is struggling more than in England? 

Amongst other ideas, Milburn and Corrigan saw no reason why private healthcare companies couldn’t provide NHS care, so long as the costs were no more and the quality was as good or better.  Hence the Independent Sector Treatment Centres were developed in England, reducing waiting lists and increasing capacity.  These bypassed the “NHS Establishment” to the consternation of many.  Their introduction profoundly altered NHS thinking and behaviour, for the better.

So I hope that Wes Streeting finds the courage, and gets the support to really change the NHS into the new model it needs to be.  He is going to have to take on some massive vested interest groups including the BMA (my old Trade Union) who seem to oppose good ideas, just for the sake of it.

How is this going to play out in Wales and especially here in West Wales where we have unique healthcare delivery issues?  Frankly the signs are less encouraging.  We all know that Welsh Labour have failed to deliver on public service improvements over a quarter of a century.  Will they continue to be different just for the sake of it, or will they adopt pragmatic change and tap into the resources that should be available?

And what role will Plaid Cymru play?  It worried me that in televised election debates, Rhun ap Iorwerth was almost hysterical in asserting that there should be no private provision within the NHS.  Maybe Rhun doesn’t realise that NHS General Practice was always provided by private contractors (GPs), and that largely continues to be the case.  Pob lwc to him in the battle he will have with the BMA if he wants to change that!

The election results suggest that Plaid Cymru may well be increasingly important in determining who governs Wales, and in what direction we travel.  It’s no good just to oppose; time to develop and embrace sensible pragmatic policy.

The winds of change are blowing through the corridors of the NHS.  If a Labour Government with a big majority can’t deliver a fit for purpose NHS, both their days are surely numbered.  Here in Wales we need to set the sails, and ride the wave.  And that’s now a Welsh challenge for Welsh politicians.  Please don’t fail to grasp the opportunity.