The current NHS annual budget in Wales is approximately £3.1
billion. The Service employs around 60,000 staff, which equates
to 7% of the workforce in Wales.
In primary care, there are around 1,900 General Practitioners,
which means there is one GP per 1,800 of the population, which
is similar to the figure in England.
In secondary care, there are some 135 Hospitals and over
1,300 Consultants. There are approximately 15,000 hospital
beds, which facilitate around 500,000-hospital stays in any
one-year.
The structure of NHS Cymru Wales has been reorganised in
2003. The Minister for Health and Social Care at the Welsh
Assembly Government is Mrs Jane Hutt, AM. Mrs Hutt is assisted
by the Deputy Minister for Health and Social Care, Mr John
Griffiths. The Health and Social Services Committee advises
the Minister, along with Regional Assembly Offices in South,
Mid and North Wales. She is supported by the NHS Wales Department
within the Welsh Assembly Government.
Prescribing and pharmaceutical issues are decided and advised
upon by the All Wales Medicines Strategy Group (AWMSG). The
AWMSG is advised, in turn, by the NHS Industry Forum, the
Prescribing Group and the Supplementary Prescribing Task and
Finish Group.
The NHS in Wales is split into a number of "Local Partnerships",
each made up of approximately two Local Health Boards, two
Local Authority Councils and one NHS Trusts. Throughout Wales,
there are currently 22 Local Health Boards and 15 NHS Trusts.
In July 2003, the Wanless Report was published on the Health
of Wales. It's findings included statements that the health
of the population is generally poor, primarily due to a series
of underlying socio-economic factors. It also found that waiting
lists were unacceptably long, with expertise in health spread
too thinly. There was an excessive reliance on care in institutions
and an insupportable burden on acute hospital services. Wanless
also found that there was an unacceptable variance in performance
between NHS Trusts and primary care and that there has been
repeated overspends in the NHS in Wales. All these issues
are priorities for the Welsh Assembly Government and will
be tackled in the coming years.
What are the Similarities and
Differences between England and Wales
Similarities
There are many similarities between the way that the NHS
operates in both England and Wales. Perhaps most importantly,
they include the principle of universal access and equality
of care across the Principality, in a patient-centred Health
Service. Just as in England, the NHS in Wales has national
targets that it must achieve and has implemented transparent
corporate and clinical governance throughout the organisation.
The NHS in Wales has enhanced the role of the general public
in an increasingly Primary Care focussed Service. Locally
based decision making has been embraced - particularly in
the restructuring that has taken place over the last few months
- as has the idea of developing greater partnership themes.
Alongside this, there is a move towards greater health promotion
and longer term planning, for both the benefit of patients
and the NHS.
There are also a number of shared organisations between England
and Wales. These include the National Institute of Clinical
Excellence (NICE), The Commission for HealthCare Audit and
Inspection (CHAI) and the NHS Executive. The Minister for
Health and Social Care also sits on the Joint Ministerial
Committee (JMC), alongside the Health Ministers for England,
Scotland and Northern Ireland.
Differences
Despite the similarities, there are also many areas, which
show the differences between England and Wales. Perhaps one
of the most obvious can be seen in the form of the new Local
Health Boards in Wales. These twenty-two organisations are
Care Trusts, which have been set up co-terminously with Local
Authorities, report directly to the Welsh Assembly Government,
providing a real link between the public and government. Community
Health Councils (CHC's) also continue to play an important
role as part of the NHS in Wales. Whilst Wales subscribes
to the work of CHAI, the Wales NHS Inspectorate also exists
to work on audit and related matters in the Principality.
On a policy level, the Welsh Assembly Government does have
authority over the NHS in Wales, and this difference is politically
- and practically - very important, both for the industry
and the public at large. In practice, this means that no Foundation
Hospitals will be established in Wales. There is also continuing
discussion about prescription pricing, and there is a possibility
of "free prescriptions" for the population being
implemented over the next few years.
ABPI
CYMRU WALES