I was quite impressed by an article on the health service by Jon Osborne in today's Western Mail.
We must make sure NHS in Wales stays healthy
He makes a point that I have made many times before: that the abolition of the NHS internal market in Wales and the commitment not to use PFI as a means of funding new building projects will save us a lot of money in the long term.
So although it's all too easy to focus on free prescriptions or hospital parking charges as targets for saving money when our block grant is squeezed over the next few years, these are actually very small costs in the overall budget of our NHS. We get a better NHS by identifying and fixing the big structural problems, not the trimmings.
Making a political point, I would note that the decision to do away with the internal market in the NHS was a U-turn by Labour in 2007. In the early years of the Assembly Labour went about creating a Welsh copy of the NHS that new Labour was creating - and is still pressing ahead with - in England.
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But later in the article, Jon Osborne makes an even more pertinent point:
What about the cash? Why is Wales so badly off? Although funding on the block grant does not look too bad, the Treasury has a peculiar method of releasing funding for UK special projects that should have a Welsh share, its hypothetical funding.
The trouble is the Treasury mandarins have perfected the art of smoke and mirrors to make it hard for anyone in the Assembly to work out where the money is coming out and whether it has been badged as “England only” to prevent Wales having its share.
At the very least we need an Assembly select committee dedicated to extracting the cash from the Treasury using Freedom of Information requests and other methods of scrutiny.
Of course this doesn't only apply to NHS spending, but to all spending. To be nit-picky, he isn't expressing it in quite the right way. It is actually to our advantage to have spending allocated to England, because it means that we and Scotland then get our proportionate share as a Barnett consequential. The iniquity is for projects in England to be labelled as "UK projects" ... because that means we don't get a Barnett consquential. The Olympics are a perfect example.
But yes, his point is right. We need a way of holding the Treasury to more transparently account for the way it distributes money. In the early years of devolution both here and in Scotland there was very little incentive to do this, because Labour was in power in Westminster as well as in Cardiff Bay and Holyrood. But now we have a different party in power in Scotland, it has highlighted the need for more formal and accountable decision making that is open to public and political scrutiny, rather than have decisions agreed in private by politicians and officials from the same party.
