NHS marks 70th anniversary: What does the future hold in Wales?

Credit: PA

The day when the UK marks its big NHS birthday is an opportunity to celebrate and to consider the challenges facing the service.

A (very) brief history

Credit: PA

In 1948, the NHS was created under Tredegar-born Aneurin Bevan.

From 1969 the Wales office had responsibility for health, and then from 1999, with devolution, the NHS in Wales has very much gone in its own direction.

Aneurin Bevan

Some numbers

Approximately half of the Welsh Government's budget is spent on health - around £7bn. Per-head spending for Wales's population of 3million is just over £2,000 - higher than England's.

From its creation by Welshman Aneurin Bevan, the NHS has become an institution that's envied around the world. Here's a look at the NHS through the ages:

What Wales spends on its NHS comes from the lump of cash it gets from Westminster. This is calculated through the Barnett Formula. It's complicated and many don't think it's fair - particularly when you consider Wales has a generally older and sicker, population than England, for example.

Since it's creation, the Welsh NHS has seen 2,600,000 births.

How it's doing now

There is undoubtedly a great deal of fantastic work going on in the Welsh NHS.

Our NHS 70 coverage so far is testament to that.

The NHS is in many ways a victim of its own success.

Despite being devolved, the NHS in Wales shares many of the challenges of the NHS around the rest of the UK (something politicians here will always tell you).

Like it's counterparts in England, Scotland and Northern Ireland the NHS is trying to keep pace with increasing demand from an ageing population. The difficulty with an ageing population is that patients tend to have more than one thing wrong with them.

You could look at this as a positive - it's a sign that the NHS has been doing a good job. People are living longer. The flip side is that whereas someone may have died because they couldn't get treatment or surgery, they're now able to access that care and are living long enough to develop multiple chronic conditions.

This heaps pressure on the system. Add to that the increase costs of advanced medical treatments and it's not hard to see the challenge.

When it comes to measuring performance, the Welsh NHS is a mixed bag. Recently, referral to treatment, diagnostic and therapy waiting times have been shortening.

See the stats for yourself

The Welsh Ambulance Service is also continuing to hit its response time target of getting to 65% of life threatening 'red' calls in eight minutes or less. It's done this ever since it changed its response model.

How's the ambulance service doing where you are?

But elsewhere the cracks show.

There are staff recruitment and retention difficulties across the country - in hospitals, GP surgeries and beyond. A&E waiting times are better only than Northern Ireland and some distance behind Scotland and England.

See how your nearest A&E is performing here.

Wales's largest health board, Betsi Cadwaladr is in special measures and has been now for three years. Other health boards are one step away from direct Welsh Government control - what's called 'targeted intervention'.

Where is it going?

The difficulty for any government (in whatever nation) is how to pay for the NHS. It's big, complex and very expensive.

The biggest possible solution being talked about is tax rises. More details of the prime minister's plan for the NHS (and it's knock-on to Wales) are expected in the Autumn. At the time of writing, £1.2bn could be heading Wales's way - but whether it will go towards the NHS, or even make it across the Prince of Wales bridge is far from clear.

The Welsh Government recently responded to a parliamentary review into healthcare in Wales. It laid out a plan for more joined up health and social care. If you think you've heard that before, then you probably have - it's not exactly a new idea. While there are examples of joined up working already in Wales, the challenge for the government will be to scale these projects up to a national level.

There are also significant plans to restructure services in west Wales and in Cwm Taf health board area as well as a new hospital being built near Cwmbran. Change is undoubtedly happening.

You can't talk about the future without talking about Brexit.

This is, again, an unknown commodity. The deal (if there is one) that is struck between the UK and EU has the potential to impact the supply of drugs, technology and staff.

The Health Secretary, Vaughan Gething AM, laid out his views in this recently by saying: "Many people simply aren’t aware of the number and scale of threats to the NHS and social care from a no deal Brexit".

Over the last 70 years it's clear that vast majority of staff and patients have come to love the NHS. How to make it fit for the future will be the challenge for years to come.