INVESTING IN OUR NHS

Plaid Cymru wants to press ahead with an achievable training and recruitment plan that brings the number of doctors per head in Wales initially to the UK average then beyond. This is the 1000 doctors policy. 1000 extra doctors would take us to the level of the North East of England, which has similar health needs. Wales would still be substantially below the EU average or Scotland – but it would be a step forward.

One thousand extra doctors would add between £70 to £100 million to the payroll at current rates depending on which specialisms the doctors ended up working in (and includes calculations for additional financial incentives). However, because this cost would be a gradual rise of the wage bill over the next 10 years as the doctors were recruited and trained, the financial hit wouldn’t be experienced immediately. The current health and social care budget is £6.5 billion – so our proposal involves increasing spending by less than 1% of the current budget within 10 years.

The adoption of this policy would lead to substantial savings from the agency and locum bills – which amount to over £100 million a year. Furthermore a pop tax would raise £45 million, plus reduce NHS expenditure on diabetes – which currently represents 10% of the NHS budget.

However, people who are familiar with the NHS know that finance is not the obstacle to recruitment of doctors. Making the NHS in Wales more attractive for doctors to work in is the main challenge we would face. That’s why we proposed many policies such as a paperless NHS, making the NHS research friendly, and developing more home grown doctors through investments in training

The need is obvious; wards are closing and services being moved from local hospitals because of a shortage of doctors, almost a quarter of GPs are close to retirement and will need to be replaced (in the valleys this figure approaches 50%), and the demands on the health service are rising daily. We simply won’t have an NHS without doctors – solving the GP shortage by asking people in the Valleys to travel to Cardiff or in our rural areas to travel long distances to see a GP is just not an option.

ENDING THE POSTCODE LOTTERY ON NHS DRUGS

At present, there are real concerns that the usual way of approving treatments for general use takes far too long, and doesn’t take into account that some patients may be more responsive than others to some types of treatment. There is a process where patients may apply for funding if their doctor thinks they should have the treatment, but far too often these decisions come down to the area a patient lives, and the criteria of ‘exceptionality’ – which basically means patients have to prove they are more worthy than others.

Plaid plans to establish a national panel to approve/reject requests for treatment not ordinarily available for patients provided by our NHS. Its decisions would apply nationally so that the postcode lottery can be brought to an end. Plaid would also get rid of the criteria that patients demonstrate ‘exceptionality’ in order to be successful, which will lead to more patients benefiting from this. This would obviously lead to an increase in spending on drugs and other treatments. To cover these costs Plaid would fund this by establishing a ring fenced budget funded by the Pharmaceutical Price Regulation Scheme rebate payments that Wales receives every year. In 2015/16 this fund would be £56 million.

National panels would be established for each speciality where these issues tend to arise e.g. a national panel for cancer.  When a doctor found they could not access treatment for a patient in the usual manner, they could apply to the National Panel by making an individual patient funding request, getting two other doctors to support the application. The doctor would have to demonstrate that the treatment proposed would be effective in treating the patient or significantly prolonging their life. Doctors would also have to keep a record of the patient’s progress to ensure we weren’t wasting money on treatments that didn’t work.