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Last Updated: Friday, 6 October 2006, 06:13 GMT 07:13 UK
A fair deal for Welsh patients?
Hywel Griffith
Health correspondent

Doctor and patient (generic)
Are patients better off on the Welsh or English sides of the border?
In 1999 politicians were prepared to abseil down hospital buildings to prove their commitment to the NHS.

After descending a 130ft wall in Cardiff, Alun Michael promised Labour would invest and reform if they won the first Welsh assembly elections.

Once elected, Mr Michael lasted less than a year as leader of the assembly government, but what about his promises to improve the Welsh health service?

So seven years on, who got the best deal from devolution: England or Wales?

There are the same sort of problems here working in an environment near major cities with the same social problems as when I worked in the valleys of south Wales
Dr Sioned Williams, Derbyshire

It all comes down to how you judge the performance of the NHS. A quick look at hospital waiting times would at first suggest England is streets ahead.

The current target time for a first outpatient appointment for an English patient is 13 weeks. In Wales, the same target is eight months.

Access to care is high on the list of priorities for Catrin MacDonnell, who is originally from Aberystwyth, and now lives in Bristol with her husband Simon and two young children.

"We have a new NHS walk-in centre," Catrin explains. "On a Sunday, for example, if your child has a rash you can just go down there. You don't see a GP but you do see a nurse."

"That's been a really, really good thing in Bristol."

NHS walk-in centres have not been introduced in Wales, with the money spent on other projects, such as the introduction of free prescriptions by April 2007.

Living beyond budget

Alun Michael at polling station
Feet on the ground: Alun Michael promised to support the NHS

How money is spent is a key point in the comparison. Despite historic levels of investment, the NHS in both nations is living beyond its budget.

Last year NHS deficits in England reached 512m, while in Wales there was a 24m overspend.

But the strain has shown more in English hospitals, with 9,000 job cuts being announced this year. Redundancies have not followed in Wales.

Dr Sioned Williams has experience of the NHS on both sides of the border, and is currently based in Kegworth, Derbyshire.

"There are the same sort of problems here," explained Dr Williams, "working in an environment near major cities with the same social problems as when I worked in the valleys of south Wales."

She felt the experience for patients within England was also variable. "You hear about the postcode lottery and that's not going to change overnight."

Different solutions

Whatever the problems, there are clear differences of approach. In England, the use of private finance is far more widespread to build new hospitals, but it has led to some disquiet.

"Unfortunately people are finding if you bring in a company whose main aim in life is to make money," said Dr Dominique Thompson from Bristol, "then secondary to that is going to be healthcare and we're seeing that with these new property developments."

The new health centre at which she works opened last year, having been built using private finance. It has meant a state of the art facility, but there are concerns.

"The interest rates on loans are going to be much more than people expected," said Dr Thompson. "That's going to cause long term problems for the trust."

The jury, then, is still out on who had the better deal with devolution.

But as Wales' politicians prepare for next year's assembly election you can expect plenty more pledges or investment and reform... and even the occasional abseil.

Me and My Health - A Debate, a BBC One Wales programme examining the challenges facing the NHS will be recorded in Caerleon, near Newport, this month, for broadcast on 25 October.

If you would like to take part in the programme or have any questions for the debate, please e-mail debatewales@bbc.co.uk or call the BBC Wales information line on 08703 500 700.


SEE ALSO
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29 Sep 06 |  South East Wales

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