A Labour of Love: Labour’s vision for NHS reform and how it will affect Wales

Yesterday, Keir Starmer set out his vision for the NHS, the third out of five speeches he will make on Labour’s five core “missions” should the party be elected into Government in 2024.

All eyes are keenly focused on what Labour’s offer will be on the NHS, especially in a post-COVID world where health services were essentially paused for months, and people are now feeling the pain of waiting years for vital operations.  It’s no different in Wales – with some saying the situation is more acute. But, how can two Labour governments effectively operate cross border to reduce waiting times, improve public health and reform the social care system?

Turning to Wes Streeting, the Shadow Health Secretary, who has commented that waiting lists would be shared regionally through coalitions of neighbouring NHS trusts, what Labour is offering could be a winning policy in Wales, especially as some of Wales’s Local Health Boards effectively share some health services already with English trusts (for example, Powys Teaching Health Board and Betsi Cadwaladr University Health Board).

Furthermore, clear targets, such as reducing deaths from heart disease and strokes by a quarter over a decade, and reductions of deaths from suicide within five suggest thoughts of a bigger picture on public health.  From banning junk food adverts before 9.00pm, as well as three big “shifts” in the approach for the NHS – digital methods, community care and preventative measures – show an alignment with Welsh Government policies on public health since A Healthier Wales in 2018.

Should a UK Labour Government work hand in hand with devolved Governments, and especially Wales, this would help to take many of those waiting years for treatment off those lengthy waiting lists.  Wales is short of capacity, whether it be through a lack of private hospitals or missing services - Powys has no A&E departments for instance – so any health policy does need thorough thought and partnership between governments.  A Conservative Government, with some enmity towards a socialist Government over the border won’t necessarily offer that.

Reform of a system which is broken will need to be factor, which was recognised by the UK Labour Leader in his speech. Many times, Governments have tinkered around the edges of the NHS without fundamental change because they are too scared to be seen as “damaging” the NHS which is deemed by some to be sacrosanct.  However, we should beyond this argument now, COVID and its resulting fallout has shown that new ways of working are needed.  UK Labour doesn’t have this problem on NHS reform; it can work with a fresh set of ideas and its historic ties to the NHS will get the message of reform through.

Labour is also not afraid to invest in health services – this will be a definitive factor for Wales as well because much of the Welsh Government’s funding is channelled through Westminster.  The NHS Confederation in England has estimated that the health service in England alone faces a £6-7 billion deficit – to which Labour’s response is that it will fund increases in health workers through ending tax breaks such as non-dom status.  This will no doubt be attractive to many floating voters. 

Should a Labour government also provide a significant uplift in the Welsh budget, this will allow for reform and better services within the Welsh NHS as well.  As the NHS workforce has said on a number of occasions, they need uprated pay to stay in the NHS and not be attracted by better offers elsewhere, such as Australia.  What is happening over the border in England is also happening in Wales.

The Welsh First Minister, Mark Drakeford, will also want to leave a legacy behind when he departs in 2024, alongside a smooth transition for the next Welsh Labour leader ahead of the 2026 elections.  Without a sunstantial offer to the Welsh public about fixing waiting lists and gaps in NHS staff, this will potentially create a measure of scepticism to Welsh voters in 2026.  Through working with a Labour Government installed in Westminster, this provides the First Minister and his successor with a golden opportunity to invest heavily in Welsh health services and to work cross border when capacity isn’t there.

The speech by Keir Starmer also comes at a point where the First Minister may not want to continue having the same health minister who, so far, has been unable to significantly cut waiting times and has attracted strong opposition within the Senedd.  Whether he leaves that to the next First Minister to decide, or whether he takes the decision before he leaves, will continue to be a matter for debate.  However, what we can look forward to in 2024 will be a refreshed NHS and the possibility of cross-border working to help treat those on the waiting list.