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Manifesto Check: Plaid Cymru wants more doctors, but do we need them?

Doctors will be asking: am I needed here? from

Plaid Cymru’s plans imply greater expenditure on the NHS in Wales – notably on more doctors, for air ambulances, and for the “New Medicines and Treatments Fund”. The expenditure increase is unlikely to be offset entirely by their pledge to move “towards a paperless NHS that will save money and bureaucracy”. This means additional funding will have to come from elsewhere, if Plaid Cymru’s ambitions are to be realised.

Some standards, and a few novelties

Plaid Cymru opposes privatisation of the NHS and wants to keep prescriptions free. The party promises to increase doctor numbers, and to improve quality of and access to care. The manifesto recites a familiar mantra of wanting care to be provided closer to home, improving integration of health and social care, and investing in eHealth and telemedicine.

But Plaid also offers distinct policies, such as easier access to “wellbeing facilities” to increase physical activity, supporting the All Trials campaign to underpin evidence-based medicine, and a “New Medicines and Treatments Fund for treatments not ordinarily available for patients in the NHS”. One concern is that the latter could prove similar to England’s controversial Cancer Drugs Fund which diverts money from other patient services.

Plaid Cymru also pledges to develop a workforce plan and National Cancer Plan and will propose a Medical Accountability Bill, “so that healthcare professionals are legally bound to tell the truth”, which is likely to prove challenging to enact and enforce.

Improving staffing

Plaid Cymru will develop a national workforce plan, claiming that Wales has fewer doctors than “any other country in the UK”. The number of hospital doctors increased by 5.1% since the last election, to 5,819 in 2014, while the number of general practitioners has remained virtually the same: there were 2,006 in 2014. This amounts to 6.5 per 10,000 population which is slightly lower than the ratio in England (6.6 per 10,000), but slightly higher than that in Northern Ireland (though data for 2014 are unavailable). The UK average is pulled up by Scotland, with a ratio of 8.1 per 10,000.

Plaid Cymru’s ambition is to increase Wales’ ratio to meet the UK average. But a major workforce review published in 2012 claimed that “Wales is likely to have more than enough new GPs to both maintain its current GP workforce, and to continue historical rates of workforce growth” and that “Health Boards and Trusts anticipated maintaining a relatively static medical workforce during 2010- 2016”. So although Plaid Cymru promises to “train and recruit 1,000 additional doctors”, it has yet to demonstrate that so many more doctors are needed.

Quality of care

Having more staff might help arrest recent declines in the performance of the NHS in Wales. Plaid Cymru promise to implement a National Cancer Plan to provide access to specialist cancer nurses and to tackle “unacceptably long waiting times for diagnostic tests”. Despite the target maximum wait for access being eight weeks, over the course of the parliamentary term ever more people have been waiting longer than this, the number (proportion) increasing from 2,588 (5.6%) in May 2010 to 20,945 (29.5%) in January 2015.

The party will also increase resources for ambulance (and air ambulance) services to tackle “undue delays”, the percentage of emergency responses at scene within 8 minutes falling from 64.8% in December 2011 to 51.2% in February 2015

Public health

The party supports plain packaging for cigarettes, though MPs have already voted in favour of this, and the devolved governments of Scotland, Wales, and Northern Ireland have all passed legislative consent motions to apply the changes. Plaid also promises to introduce a 50p minimum price per unit for alcohol, which the coalition Government retreated from enacting.

Legislative progress regarding sugar in food and drinks has stalled but Plaid Cymru “supports a tax on sugary drinks and will work with manufacturers to reduce sugar in food and drink”.

The Conversation’s Manifesto Check deploys academic expertise to scrutinise the parties’ plans.

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