Mark Drakeford is not having a good war. After a relatively strong start to his pandemic response last year, Wales’ favourite cheese enthusiast has stumbled into pitfall after pitfall in recent months, from the ludicrous sight of “non-essential” aisles including female sanitary products being roped off in supermarkets, to the downright dangerous idea that vaccinations should be slowed down in case supply runs out and vaccinators have nothing to do.
Welsh politics flies criminally under the national radar. It is poorly understood in Whitehall outside of the Wales Office, it is ignored by the national headquarters of all the major parties, and it is rarely if ever covered by the national press unless there is some big scandal in the offing. Thinktanks tasked with creating national policy rarely if ever devo-proof their drafting, and to add insult to injury the bulk of SW1 persists in viewing Wales through the prism of Scotland.
While the recent national exposure of the Welsh Government’s pandemic response has brought some long overdue attention to some of the issues in Cardiff Bay, the long-term result of this negligent oversight is a litany of failures of governance going back decades. Because the die was cast long ago for the strain the Welsh health system now faces.
Above my desk for many years there was a cartoon I had cut out of The Sun, of a Welsh dragon with his arm in a sling, limping across the border to an English hospital. It had run alongside an editorial on a catalogue of failures in the Welsh NHS, from patients having to wait three months longer than their English counterparts for hip and knee replacements, to astronomical delays in start times for cancer treatments, and a failure to adopt the recommendations of the Keogh Review which followed the Mid-Staffs care crisis. And the politician in charge of the Welsh health system at the time? Mark Drakeford.
The symptoms of failure may have been diverse, but the cause was always the same, a Welsh Government who refused to countenance solutions created anywhere other than Cardiff Bay, who hid behind a shocking lack of voter understanding of where power and responsibility for healthcare lay. This culminated at one point in the “One Wales” healthcare policy, where patients should at first pass be treated at their nearest Welsh centre of excellence. In reality, this would have meant transporting a neurosurgery patient from North Wales to Cardiff, instead of the nearest centre of excellence in Liverpool, which had a long traditional connection with Wales, to the extent of employing Welsh-speaking nurses.
The Sun editorial was one of only about six national editorials on Welsh Government failures while I was SpAd in the Wales Office, despite my very best efforts I couldn’t get anyone to bite at the issue more often. I was always mystified as to why over £15 billion is handed to the Welsh Government every year in the Block Grant, and yet there is absolutely no inclination to follow the money from the national political press corps. If any other democratic institution in London had that much money there would be weekly FOIs and regular investigations into how it’s spent.
This failure to hold Cardiff Bay adequately to account has never been more apparent than this past year, when politicians and pundits alike have sharply woken up to how much power they have continued to give away, and how little they understand the institutions to which it has been given. While the ultimate beneficiary of this ignorance has been an underperforming legislature, the ultimate victims have been the citizens of Wales, for whom the realisation of who runs what has been as much of an epiphany as it has for Whitehall.
Understanding of who runs what in Wales has never polled particularly highly. When I was in the Wales Office it fluctuated between about 36% and 42% of respondents knowing that healthcare was a devolved competence. I confess, it was politically expedient for us to alert voters in Wales to the fact that the crumbling health system was Labour’s doing, and that the Tory-led coalition in Westminster was running a better performing health system in England. But there was another overriding consideration: citizens in Wales were getting a raw deal from their devolved government, who were in turn hoping they could shift the blame to someone else by virtue of how poorly understood their competences were.
If there is one upside to this sorry legacy coming to a head this year, it is that no one is under any illusions any more that there is any such thing as a National Health Service. There are four National Health Services, and the true postcode lottery of care outcomes is not whether you live in Kent or in Gloucestershire, but whether you live in England or in Wales.
No longer will politicians at either end of the M4 be able to wallow in ignorance of the devolution settlements; voters will demand better after the pandemic shone a spotlight on the gulf between the nations. No longer will thinktanks be able to use England and UK interchangeably in their drafting. No longer will the political press at Westminster be able to ignore the legislatures at the other ends of the motorways; their readers and viewers will demand that as much national attention be paid to their democratic institutions as to England’s.
And that is exactly as it should be. For if our nations are to remain in union, if we are to still be one country in a decade, then we deserve better from both our legislators and those whose job is to hold them to account.
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