Both Wales and Scotland are viewed by some on Labour’s left as beacons of social democratic hope in a sea of New Labour heresy. ‘In Scotland and Wales,’ wrote Roy Hattersley just before the elections there last year, ‘Labour – free from the shackles of the London party – is offering programmes that amount to a rejection of much of the Westminster cabinet’s domestic policy.’
And, indeed, there is much in the two countries to set leftwing hearts aflutter. Scotland has introduced free home care for the elderly, abolished university tuition fees, and guaranteed jobs to all new nurses and midwives. Wales has ruled out specialist schools, radically scaled back school testing, brought back free school milk, and introduced free local bus travel for the elderly and people with disabilities. Welsh Labour also made a bold pledge: no one would wait more than six months for outpatient treatment or more than eighteen months for inpatient treatment.
As in England, Wales has certainly received significant enough increases in funding – health and social services spending in the principality has risen from £2.68 billion in 1999/2000 to £4.55 billion in 2004/5 – to start making strides towards meeting its promises.
But how to spend that cash? Since it took charge of health policy in 1999, Welsh Labour – or ‘classical Labour’ as First Minister Rhodri Morgan prefers to put it – has decided to put some ‘clear red water’ between itself and New Labour in London.
In England, Labour has used private sector cash – through the Private Finance Initiative – to boost capacity and has attempted to push decision-making down to the frontline. Welsh Labour, on the other hand, has rejected PFI and foundation hospitals and, while attempting to build a localist approach, has actually created a highly centralised one.
The differences between the results of these approaches could not be starker. According to Department of Health figures, in March 1999, the number of people waiting over a year for inpatient treatment in England was over 46,000. By December 2003, that figure had dropped to just 25. By contrast, during the same period in Wales the number of people waiting for more than a year soared from over 7,000 to nearly 12,000.
At the end of 2003, the number of patients waiting more than eighteen months for inpatient care was just six in England. In Wales, it was just short of 5,000. That figure has risen by over 500 percent since May 1999.
Of course, Wales does face some very particular health problems (the higher incidence of poverty, the legacy of heavy industry and poor diet), but Derek Wanless, who looked into this very question for the Welsh assembly government, concluded that the underlying conditions in Wales were similar to those in the North East of England. However, while Wales has received higher funding than the North East, its health service has not, he argues, got as much as might have been expected for its extra expenditure.
It’s easy to see why many Welsh Labour MPs are close to apoplectic, believing, as Gareth Thomas puts it, that ‘for the sake of political correctness, we are losing out.’ In other words, are some on the left, in their quest for ideological purity, allowing sick people to suffer for longer than they need to?
For a long time, New Labour has had to suffer the brickbats of those who see ‘the project’ as somehow immoral, or, at least, amoral: slavishly following the focus groups and polls and elevating ‘what works’ above principles. At best, New Labour is seen as a primarily political undertaking – even many of its adherents seem, at times, to have accepted the critique of our detractors.
Perhaps it’s time, then, for progressives to stop ceding the moral high ground: if ‘what works’ allows a sick elderly person to get a hospital bed quicker, a school child to leave school with better qualifications, and helps an unemployed former steel worker back into work, is that really so wrong?
Of course, not everyone sees it that way. Hattersley concluded his paean to Welsh Labour with the words: ‘I wish I had a vote in… Llangollen rather than London.’ Well, yes; but where would you rather be on a waiting list?