Transforming health care in Wales: The time for talking is over

With spring now upon us, it’s easy to forget about the cold and dreary winter months and the challenges these can create.

Alongside the increased risks to people’s health and well-being created by the cold weather, for example, health services often face significant pressures.

This winter was no exception, and reports of long waits for ambulances, overcrowded hospitals and care being provided in unsuitable environments such as corridors, store cupboards and even toilets will probably be familiar to us all.

Many older people have told me it feels to them like the health system is in crisis and that they are worried about the standard of care they or their loved ones would receive if they became ill.

These kinds of issues are unacceptable, a view I am sure would be shared by the government and by health boards, but the fact that they seem to occur so acutely each winter and, increasingly, during other times of the year as well leaves me concerned they have become normalised.

It’s also important to remember that the issues described above represent only the ‘visible’ symptoms of a system that is overwhelmed. Far less focus is given to the impact of a lack of community-based preventative services and support, and the individuals – often older people – who end up in hospital unnecessarily because opportunities for early interventions were missed or are simply not available.

If crisis management continues to be prioritised then the situation faced by many older people will only get worse. Instead, there needs to be a fundamental shift towards prevention, community support and integrated care. People who would benefit from preventative interventions must be sought out proactively; the system shouldn’t wait for individuals to find support themselves.

Furthermore, there needs to be a focus on agile responses within our communities to help keep people well at home, managing conditions and/or frailty and providing place-based care so that hospital admissions can be avoided wherever possible.

Primary care has a crucial role to play in enabling this shift of approach, and I welcome the Cabinet Secretary for Health’s commitment to moving services out of hospitals and into the community, with funding to support this, as well as providing support so that GPs can offer greater continuity of care, something that improves outcomes for vulnerable patients and reduces hospital visits.

These are positive steps forward, but there also needs to be sufficient and sustainable funding for the third sector, which plays a crucial role in preventative care. Short-term, last-minute funding decisions do not allow these essential services to plan effectively or provide consistent support.

In addition, there must be changes in terms of how performance is measured. Performance measures should be broader, including metrics such as population health outcomes and levels of investment in primary and community care.

Engaging with the public to change perceptions about how services should be delivered is also crucial. Too often, we hear people say, “They are in the best place” when a loved one is hospitalised. But hospitals are not always the best places for  older people. We must shift the narrative so that in the appropriate circumstances, home, with the right community-based support, is seen as the best place to be.

For this to succeed, there needs to be genuine partnership with citizens, carers, and communities. Families must be involved in decisions, supported in their caregiving roles and recognised as essential pillars of the health and social care system.

There are opportunities to transform the health system in Wales, but if we fail to act now, the crises we face today will only worsen. Meaningful partnership working between government and healthcare professionals, as well as communities and families can build a system that prioritises prevention, supports people in their own homes and provides the right care at the right time focused on people’s individual needs.

The time for talking is over; the time for action is now. There needs to be genuine commitment and action to deliver these changes, not just for the sake of our healthcare system, but for the health and dignity of every person who depends on it.