Let me begin this article by stating that, as a socialist, I strongly believe in accessible, high quality, citizen-centred services for all, not choice for the few.
At the 2011 election, all the political parties in Wales had the opportunity to set out and explain their vision for the NHS in Wales over the coming years.
In the end, it boiled down to choice between two competing set of values.
Either introducing marketisation and competition into the delivery of health services, or maintaining the fundamental founding principles of the NHS – namely, being publicly funded, publicly provided and free at the point of need.
Whilst the Tories in London aim to reduce the role of the state, I believe in a Bevanite NHS with a strong public service ethos that places public interest above private profit. The Tory NHS reforms are an anthema to Wales and its values. The forces of marketisation must be stopped at the Welsh border.
However, whilst the principles that underpin our NHS remain sacrosanct that does not mean that change in whatever guise, cannot happen. Striving for progress and excellence means that change in how services are provided, has to occur in order for improvements to take place.
The principle of needing to modernise services has been understood for many years, but less has been achieved than perhaps might have been. This change now has to happen.
Expert opinion and worldwide experience shows for some specialised services, such as for cancer, stroke or heart attack care- the best option for the future is centres of excellence where the best skilled staff and latest equipment are there to give round-the-clock care. Good local hospital and community services will make sure patients quickly access those services and can continue their recovery closer to home.
We also need to provide better care for patients in their communities, whether at home or in local health facilities, and use our hospitals for care that can only be given in the sophisticated specialised facilities they provide.
The NHS of the future is not, and cannot, be just about hospitals. It has to be about the right care being carried out at the right time and in the right place by the right people. This vision is the right one for Wales, especially as we are seen as the cradle of the NHS –something we can be extremely proud of.
However, having a vision for the future of the NHS and an understanding of its past does not mean we should be uncritical – rather we should all have high expectations that the NHS does well. We have to make sure that NHS services are of a high standard everywhere. We want good GP services across Wales, not an inverse care law where those in greatest need get the poorest services.
The Welsh Labour government has been explicit about the requirements for the local health boards to identify and take responsibility for tackling inequities in health outcomes within their communities and we expect them to take increasingly robust and specific action to tackle them, there is a political and moral imperative to drive this forward – it is an issue of social justice.
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Lesley Griffiths AM is member of the Welsh Assembly for Wrexham, minister for local government and former minister for health and social services. She tweets @lesley4wrexham
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