Are you Welsh? British? Or Both?

Plus Vaughan Gething appears before the Covid Inquiry and Plaid Cymru say how they will fix the Welsh NHS

Hello!

Welcome to those who joined after my Guardian column on 20mph.

Today’s newsletter is going to be a whistle stop tour around several topics. This will start with how your “Welshness” impacts how you vote, what we saw at the Labour conference, Vaughan Gething at the Covid inquiry, the latest NHS waiting lists and Plaid’s plan to fix the health service.

There was a request in the comments last week for some analysis of how the new inheritance tax rules will impact farmers in Wales. I think this is a really worthwhile topic to cover but the Welsh Government will be announcing details of how they will revise their sustainable farming scheme tomorrow so it makes sense to cover it all in one go next week.

Two other bits of housekeeping:

• Next week I will be interviewing the First Minister Eluned Morgan. The contents of that interview will be shared first in next week's newsletter.

• Tomorrow you will get a short “bonus” newsletter looking at the Welsh Government plans to introduce a visitor levy for anyone staying in Welsh hotels. It will include the price of the charge and who it will apply to. This might sound a bit technical but it is likely to prove controversial in some quarters. Don’t say I never give you a treat…

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What your Welshness says about you

I want to build on some of the analysis by Dr Jac Larner and Professor Richard Wyn Jones from Cardiff Uni’s Wales Governance Centre we discussed last week because the stuff around identity is particularly insightful.

Below are three graphs. They can take some getting your head around initially but they are really interesting. 

• The circles in the middle show how people in Wales identify. People were asked how they feel in terms of identity.

• When people answer just “British” they were also asked if they were originally born in England or Wales. These were defined as British (E)” and “British (W)”. So if I defined myself as British and was from Kent I would be British (E).

• The size of the circles is how much of the Welsh electorate they make up. The bigger the circle, the more people define themselves as that.

• The X axis (along the bottom) shows how right or left wing a group is. The more to the right they are politically, the further to the right of the graph they will be.

• The Y axis (along the side) shows how liberal or authoritarian people are. The higher a circle is, the more authoritarian they will be in political outlook. 

• The three graphs show the Welsh electorate in 2016, 2021 and 2024. 

Take a look at them and then we will explore what they tell us:

There is so much going on here but there are several conclusions the researchers have drawn from this that are well worth your attention:

• We are far more divided. Look at how close the circles were together in 2016. By 2024 they are spread out with the largest gap seemingly between those who define themselves as “Welsh” and those who describe themselves as “British and English”.

• The growth of the “other” identity. The size of the “other” circle has increased significantly in the last eight years. While this is in part down to immigration, according to the authors, this is primarily because people are changing how they identify with the rise of labels such as “European”.

• The difference between the “British” born in England and Wales. Look at where “British (E)” and “British (W)” sit compared to each other in 2016 compared to now. Back at the time of the Brexit vote they were almost identical in terms of where they sat on the left/right scale. But now the people born in Wales who define themselves as British and not Welsh are incredibly right wing. Whereas people from England who have moved to Wales and think of themselves as British are far closer to the centre and more liberal.

• The “Welsh only” identity is growing and becoming more left wing and liberal. It is clear from the data that the “Welsh only” identity is on the rise. There is probably a lot at play here, not least that younger people are more likely to identify as Welsh. 

• “British and Welsh” remain firmly in the centre. Though there has been some drift to the right, the significant part of the electorate that sees themselves as “Welsh and British” have remained fairly central compared to most of the other “British” identities.

I share all this because, as well as being interesting, it demonstrates that Wales as a polity doesn’t really have a large part of the electorate on the right of politics. Many have authoritarian instincts but the big political cleavages within the country are not right wing but rather moderate or left. 

I therefore think that while political parties in Wales are right to take the threat from Reform seriously, the route towards electoral success doesn't need to appeal to the extremes.

That said, if the election in the US shows us anything it is that you can’t just appeal to identity alone when campaigning. The perceived ability of a candidate to make change and a focus on issues that matter to people also play a massive role. 

Vaughan Gething before the Covid Inquiry

Last Wednesday both Vaughan Gething and Eluned Morgan appeared before the UK Covid Inquiry. I watched the many hours of testimony that both gave and, while there wasn’t anything particularly new, there are some areas that I think are noteworthy. 

It can be easy to forget the specifics of the Covid response - not least because it is a time most of us don’t care to remember. Listening to the testimony from Vaughan Gething I was struck by his evasiveness and inability to take responsibility for his and the wider Welsh Government's shortcomings.

This is how it played out again in his latest appearance. It was relentless dodge, weave and word-soup that has become Mr Gething’s trademark. I almost don’t blame him for wanting to avoid answering questions. The first time before the committee he made the admission he didn’t read a key report into pandemic preparedness. You can watch the video of that here:

There are several points from Vaughan Gething’s testimony today that I want to draw your attention to.

“The NHS was not overwhelmed”

This is a Welsh Government mistruth that needs to end. I have lost count of the number of times that Welsh Gov ministers, both old and new, have said something to the effect of: 

“Due to our decisive action the Welsh NHS was not overwhelmed.”

Both Mr Gething and Ms Morgan were asked repeatedly if they believe the Welsh NHS had been overwhelmed at any point during his time as health minister. To this Mr Gething said: 

“No, but that is only because we took extraordinary measures. If we had tried to run the system as normal, then it would have been overwhelmed. That’s why we had to turn on a measured process to turn off parts of the NHS to ensure it would still function.”

Whether or not the Welsh NHS was overwhelmed very much depends on your definition. The Welsh Government’s position seems to be that if there was a spare bed anywhere in the health services, it couldn’t be classed as overwhelmed.

However I would suggest that if you cancel every single elective surgery in Wales and don’t restart them to pre-pandemic levels for over a year then you have already been overwhelmed. 

The inquiry barristers pushed Mr Gething on the issue of intensive care beds. They included testimony from healthcare leaders who said that during the pandemic people were not given an ICU bed when they normally would have been due to the pressure the service was under. That is the definition of overwhelmed. 

Surely the definition of overwhelmed is when a health service becomes unable to deliver the bare minimum of what you would expect a health service to do. By this definition I think you can make the argument that the NHS is overwhelmed right now. People are literally dying on waiting lists and living for years with debilitating conditions. If that isn’t the definition of overwhelmed I don’t know what is. 

NOTE. I am not blaming individual members of the health service for these issues. I have many friends and family in the Welsh NHS. They are giving everything and deserve better than the current governance and funding models that are in place. 

“Wales never ran out of PPE”

An email sent to Vaughan Gething from a consultant working at the Prince Charles Hospital at the start of the pandemic

Another narrative from the pandemic in Wales that I despise is the idea that Wales never ran out of PPE. 

A report by the Auditor General for Wales back in 2021 made this claim and was full of praise for the Welsh Government’s efforts to procure PPE. 

But the fact there was a gown/glove/mask in a warehouse somewhere in Wales is pretty slim comfort to the NHS staff I spoke to throughout that period who were working with homemade masks and bin bags for gowns. These are people that became ill and sometimes died because we failed to equip them, 

A great demonstration of how unprepared we were for the pandemic was how quickly PPE stocks declined once the pandemic started. The inquiry shared this image of how long different stockpiles lasted: 

As you can see one of our “stockpiles” lasted less than two weeks with others little over a month. Perhaps our then health minister should have read that report which found there were serious shortcomings in how ready we were to deal with this kind of scenario…

“What did you do about it?”

I have interviewed Vaughan Gething many times. He is always very fluent and polished in his replies to the point you are always sure he must have said something relevant and insightful. However, when you break down what he actually said there is often nothing of substance that relates to the question you asked. 

This was clearly a problem that the inquiry has come up against. Several occasions the inquiry barristers and the chair have said to him, both this time and in previous sessions, “yeah but what did you actually do?”. They have probed for specifics and time and again he, very neatly deflects to vague contextual points about the pandemic response. 

Here is one example of what he said when asked what specific actions he took to reduce transmission to staff:

This is just one example. Below is another where they asked him why inter-staff transmission had increased in early 2021 compared to late 2020. 

He blamed the fact that the virus was more transmissible but the inquiry wouldn’t let him simply use that excuse. They asked again for specifics and they received the usual word soup while deflecting the responsibility to other staff (this time lead nurses):

The point of an inquiry is primarily to learn lessons about what has happened in order to be better prepared in the future. It is also to hold people to account for their decisions and provide answers for those affected and their families as well as a greater understanding of their experiences.

If politicians continue to pass the buck and evade scrutiny, it makes it hard for the inquiry to achieve any of these functions. Vaughan Gething is by no means the only politician to be doing this either in Wales or the wider UK. But his seeming inability to say “yeah I made a mistake there” or “I could have done this better” is precisely what contributed to his short tenure as First Minister in my opinion. 

Where the Welsh NHS is now and how do we fix it?

At the Welsh Labour conference last week health minister Jeremy Miles announced an additional £22m to tackle the longest waiting times, increase outpatient appointments and speed up diagnostic testing on top of the £28m that they have announced already.

Of this, £3m will be dedicated to reducing the longest waiting times for children’s neurodevelopmental assessments across Wales.

But what will this money actually be spent on? Well according to Mr Miles: 

“It will pay for more evening and weekend working. And where necessary, we will use private hospital capacity to reduce the longest waits.”

Now using the private sector is the go-to response for anyone discussing how to reduce NHS waiting lists. But the challenge of this was actually outlined by Eluned Morgan during her evidence to the Covid Inquiry about whether the Welsh Gov used private capacity. She said: 

“There’s got to be an understanding of the number of beds in the private sector in Wales. We have 172 beds in the entire private sector in Wales. In England I think they cleared about 18% of their waiting lists by private sector, we had 172 beds. And if we did use the private sector, there’s not much to use there. We did use some private capacity in England as well. It is not as if we didn’t do it, it's that the provision is a long way off in Wales.”

So this is not a silver bullet for tackling NHS waits.

How long are the NHS waiting lists at the moment?

Last Thursday the latest waiting list data for Wales was released which showed:

- Two year waits down were 2.03%

- Waits of over one year for a 1st appointment were up 0.4%

- Waits of over one year for any procedure were down 0.25%

- The total waiting lists were up very slightly by 0.14%

There is a very long way to go on the longest waits and the overall list is still increasing…

Labour sources are still telling me they they are hopeful of a 10% fall in two year waits by the next election. At this rate they may manage that. But if this means that the overall lists have gone up this will hardly be a vote winner.

What is Plaid Cymru’s plan?