o how exactly are things different in Wales? What has the different philosophy of the successive Labour and Labour-led governments in the Welsh Assembly, that may be broadly described more socialist, famously characterised as 'clear red water' between Welsh Labour and England's New Labour by First Minister Rhodri Morgan back in 2002, delivered for the people of Wales? Were there particular circumstances which allowed this approach, and could it or elements of it be replicated elsewhere?
Without going into the myriad of areas from agriculture to economic development for which the Welsh Government is now wholly or partially responsible, health and education are the two most obvious examples in which decisions in Wales differed considerably from what was going on in England, even under a Labour Government, not to mention since 2010.
There were undoubtedly advantages to the Welsh Assembly being a new body. In the run-up to the first Welsh Assembly elections in 1999, in spite of objections from some in what is still, in Welsh Labour heartlands, a very male dominated party, Labour used the twinning system to select its candidates, and to field equal numbers of men and women in winnable as well as unwinnable seats. With Labour as either the majority or the biggest party, this has made a significant difference to the make-up of the Assembly.
The successive Labour and Labour-led administrations have had a firm commitment to equality, and there has been an opportunity with this new body to tackle deep-seated problems in a more radical way, to place an emphasis on equality of outcome, not just equality of opportunity, to examine the great inequalities in health and educational outcomes, both within Wales and between Wales and England and to tackle this inequality at its roots. Hence in health the emphasis on healthy living and prevention of disease, with the ban on smoking in public places and measures to prevent coronary disease. In education the significant importance and funding directed to the Foundation phase (the 3 – 7 year olds). These are undoubtedly the right solutions long-term, but politically they do not produce instant gains. Money spent on three-year-olds does not translate into GCSE results for 13 years, and changes in diet and lifestyle may take years to translate into greater life expectancy and fewer premature deaths.
As far as the NHS in Wales is concerned, in addition to the emphasis on the prevention of disease and a determination to tackle health inequalities, early steps by the Welsh Assembly government in its first term included a rejection of foundation hospitals, and a rejection of private treatment centres being paid to take work from the NHS. There was also a determination to avoid using Private Finance Initiatives where possible. Steps were taken to prevent the transfer of hospital staff such as porters and cleaners to private firms, later cleaning contracts that had already been outsourced were brought back in house.
The much-publicised free prescriptions policy cost less than one might think. So many people who made significant use of medicines were already entitled to free prescriptions. This policy is of particular importance in helping to get back into work those who have long-term conditions which require medication – as they can otherwise be caught in the benefits trap – with free prescriptions if they remain on benefits, but significant costs if they work, which may make it not worth their while to do so.
The free parking at hospitals may again seem minor but it was significant to those on low income who had to make frequent visits to hospital. Both of these measures are very visible signs of the principle of an NHS free at the point of access. Behind the scenes, the Welsh Government has abolished the purchaser/provider divide by replacing the Trusts (providers) and Local Health Boards (purchasers) with a single tier of Local Health Boards, and encouraging collaboration between boards. Wales has also retained Community Health Councils with their patient advocates. CHCs were abolished in England in 2003.
One of Wales's greatest challenges is its geography. Because on a map Wales looks relatively large, it is easy to forget just how small it is in terms of people – with its population scarcely reaching three million, it is smaller than some of the larger conurbations in England. This has the disadvantage of the additional cost of providing services over a wide geographical area, because, apart from the few main towns in the south, the rest of Wales is either rural – or, in the case of the ribbon-like development in the valleys (where no-one would have built rows of terraced housing were it not for the mines), the communities are industrial, the geography is rural, with long distances and high costs to access services or find work. Even if people wanted to shop around for hospitals (which surveys show they neither want nor feel qualified to do), all they want is a good hospital, and their real concern is keeping services local.
This geography also means that when the last Tory government introduced the elusive concept of 'parental choice' in education, which of course always means choice for some, but not for many, whilst in cities like Swansea and Cardiff, we saw a drift of pupils towards the schools in the more affluent areas of town, for most pupils across Wales, it is neither practical nor affordable to go anywhere other than your local school. So 'every school a good school' assumes greater importance, and has buy-in from the middle classes who in urban England might look elsewhere.
Furthermore, the uptake of private education in Wales is tiny, and when the last Tory government tried to bribe schools to leave Local Authority control and become Grant Maintained, very few in Wales did, and there was significant rejection in the parental ballot of the Grant Maintained concept in some schools in affluent areas where in England you might have expected a yes vote. One explanation for the success of the No campaign in these schools is that many of the pupils had parents who were working in the public sector, and who had greater loyalty to the local authority than to the Tory government in England. Indeed, in many cases, the issue never went to parental ballot because it had already been scotched by Governors.
Is there general support for the Welsh Government's approach? Is there a certain mentality which is unique to Wales? Probably to a certain degree yes, but that mentality is probably shared by other areas of the UK, such as the North of England.
It is easy to trot out the clichés of a strong chapel and trade union culture in Wales, and certainly the support by many in Wales both in and out of the Labour Party for a collectivist and socialist approach does owe something to these origins. No doubt the early strength of the Chartist movement in Wales in the nineteenth century, the tales of the legendary 'Fed' as the South Wales Miners' Federation was known, and the prevalence of highly unionised heavy industry right up until the 1980s, has played its part. Unionisation of 73% of the workforce in Tescos in Llanelli (with 61% in Wales and a UK average of 52%) suggests that workers in this traditional coal and steel community may be influenced by the importance that family and friends have attached to union membership in the past.
The dominance of the chapel culture in Wales, has long helped to strengthen a democratic consciousness, with its flatline rather than hierarchical structure. So, for example, the Welsh Congregationalist chapels (called Independent chapels in Wales for good reason) made their own decisions and selected their own new ministers, in contrast to the very centralised Anglican and Catholic traditions.
I suspect that in recent times, support for a fully publically run health service under Welsh Government control and education under Local Authority control, and rejection of the outsourcing and privatising of services has more to do with the current high proportion of public sector workers in the Welsh workforce, together with associating privatisation with the hated Tory governments of the 80s and 90s. People have seen the results of privatisation – worse terms and conditions for workers, no guarantee of a better service for users and some scandalous ripping off of the public purse for the sake of private profit.
This fear has been reinforced in recent days with what is happening to the NHS in England, giving the lie to Cameron's treacherous 2010 election posters, claiming the NHS is safe in his hands. Whether this will provoke the rejection of the privatisation of the NHS by Middle England, and what a future Labour Government could realistically pledge to do about it, remains to be seen.