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Last Updated: Saturday, 1 January 2005, 12:33 GMT
Check-up for the nation's health
By Sian Lloyd
BBC Wales' health correspondent

Antibiotics (generic)
Will the NHS in Wales need treatment in 2005?
The published waiting lists for hospital treatment provide a visible indicator of performance.

Whether they are the best instrument to judge how the NHS is working is debated but they certainly dominated the headlines in Wales in 2005.

The Welsh assembly government pledged to tackle long waits for Welsh patients with its second offer scheme.

In January, Health and Social Services Minister Jane Hutt allocated 5m pounds to get it off the ground.

Since it began in April, any patient approaching an 18-month wait is offered a second chance of treatment elsewhere. By March 2005 that target will fall to 12 months.

It is for the patient to decide and, so far, a number have opted to wait for treatment in their local hospital.

Then, in the final days of December, Ms Hutt announced a new target, with nobody waiting more than 12 months for an outpatient appointment by March 2006, down from a previous level of 18 months.

But Welsh waiting times still remained longer than in England. The target for an inpatient appointment will stay at 12 months until March 2006, compared with six months across the border.

Jane Hutt lends a hand at the launch of the hygiene strategy
Jane Hutt lends a hand at the launch of the hygiene strategy
In December, the body representing doctors, the British Medical Association (BMA), reacted to the latest waiting list figures stating they made all health professionals "weep in despair."

While they have showed some improvement, it was not good enough for the BMA which had been looking for dramatic changes.

Opponents in the Welsh assembly say it all points to the second offer scheme not working and have called the minister to account.

As with most statistics, different people analyse them in different ways, and the assembly government continues to defend its strategy robustly.

It says the figures show waiting times are coming down but some patients have felt driven to tell their own stories.

According to her hospital, Theresa De Bono from Cardiff, did face an " unacceptable" wait.

The 40-year-old was told she faced a 17-week wait for a mammogram, leaving some members of the public so shocked they offered to pay for her procedure.

On the wards

It was described as one of the biggest challenges facing hospitals - but it was not the waiting lists.

On 1 August, all hospitals had to comply with European rules reducing the hours junior doctors work.

A piece of health and safety legislation, the European Working Time Directive imposed a maximum 58-hour week for all doctors in training, and set minimum rest times.

With some hospital posts unfilled in Wales, the task seemed daunting to planners and doctors alike.

Junior doctors representative Dr Jo Hillbourne said health trusts here had made a lot of effort, but less than six months on their compliance is being strictly monitored.

Contracting an infection whilst in hospital remains a major concern to many patients.

Waiting lists were the hot topic for opposition politicians in 2004

Cases of the so-called hospital "superbug" MRSA across Wales have been highlighted throughout the year.

In September, Health and Social Services Minister Jane Hutt was given a lesson in hand washing when she launched a national strategy to tackle the issue.

But opposition parties called for infection rates for individual hospitals to be published.

In November, the minister announced new ways of producing easy-to-understand information were being looked at.

Doctors on call

Being on call has always been part of a doctor's job -- but not anymore.

Following changes in doctors work contracts, since 1 October the 22 local health boards in Wales have responsibility for making sure patients can access the care they need out of normal surgery hours.

So would patients notice any difference? Some said they did.

In Tywyn in Gwynedd, three thousand people signed a petition protesting at the changes in their area.

In December, Primecare, a company providing out-of-hours health cover in parts of some Wales, announced it was recruiting more doctors and call centre workers.

In October, Welsh Environment Minister Carwyn Jones described the service it was providing as "unacceptable" after he called it when his two-year-old son developed a high temperature.

Changing shape

It is less than two years since dramatic changes in the Welsh NHS, when a multimillion-pound shake-up in the way the service is run saw the creation of 22 local health boards and abolition of Wales' health authorities.

The aim, said the assembly government, was to take decision-making about local health needs closer to the community.

But these changes were not to be the last for the Welsh health service.

In December, First Minister Rhodri Morgan announced further change would be "organic rather than wholesale".

The assembly government invited proposals for hospital trusts and local health boards to integrate.

Political opponents were outraged, believing re-organisation would detract from tackling a waiting list crisis in Wales. It will be a process closely watched in 2005.

The NHS Confederation, which represents the organisations making up the NHS in Wales, believes there are more challenging times to come.


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