Published: 05/09/2002, Volume II2, No. 5812 Page 13
When I spotted the splash headline 'McConnell's recipe for a healthier Scotland' in the Glasgow Herald the other day my thoughts went not to Scotland's first minister but to his Welsh counterpart, Rhodri Morgan.
Why so? Because many of Scotland's problems also exist in Wales. And because I remember a health policy-maker in Whitehall telling me that, while Scotland still has poor health outcomes, it has more staff and better waiting times.
'The bad one is Wales, ' he said. 'It is poorly run, a lot of heart operations have to be done in London and the Welsh Assembly goes its own way. When we put up a new policy it says, 'We will not be doing that here'.'
In fact, it is doing some things here. Just as Jack McConnell is trying to change people's bad eating habits - too much booze, cigs, drugs as well as deep-fried Mars bars - so are Mr Morgan and his health minister, Jane Hutt.
I always associate Wales with friendliness and cardiac-inducing cream cake shops, and recall a chum explaining how Welsh heart op jobs in west London are sometimes put up at the Kensington Hilton.Argh - the cost of cake!
This matters because Wales is underfunded. 'If we were funded on health needs, Wales would get an extra£800m a year, ' explains one Welsh politician. That is on top of its current£3.2bn health budget, so It is a lot.
Like the Scots since devolution, Mr Morgan and Ms Hutt have diverged quite a lot from the Alan Milburn-Gordon Brown line, giving free prescription charges and dental checks to the under-25s for instance, free bus passes for the disabled, free eye tests, grants to poor students.
It is easy to see why such divergence matters more in poor Powys than in rich Richmond.
But English taxpayers are stumping up for much of this while not getting it themselves, so there is a looming problem here. But Mr Morgan faces more urgent problems as they try to assert greater autonomy from my disapproving Whitehall friend.
His declared priorities are greater control over animal welfare so that Wales can act faster next time foot and mouth strikes; also local control over wind farms, which are big in every sense in Wales.
The genial Mr Morgan (despised by his brooding predecessor, Ron Davies) also wants legislation at Westminster -remember, Wales has no such power of its own, not yet - that would end the health-monitoring role of the Audit Commission in Wales, replacing it with a local version.
Is this good? In July, the commission was harsh about the Welsh NHS's poor progress compared with deprived parts of England.
Separation will only make Wales more insular and backward, suggest some, including Jon Owen Jones, Labour MP for Cardiff Central, and health minister before devolution.
There is logic to a devolved audit, and supporters point to diverging health strategies:
local health groups are developing differently from England. Yet Plaid Cymru says they are inferior, and Dr David Lloyd, Plaid Cymru's Assembly health spokesman, is forcefully articulate in attacking the MorganHutt record.
As a GP in the heart disease blackspot of Swansea since 1984, he recalls the time when there were five consultant cardiologists in the whole principality, compared with 31 in just half of London. Now there are 31, but there should be 62 by average English standards, up to 90 on a needs basis.
Among the grim statistics he rattles off is that 6,000 Welsh people were waiting six months to see a consultant for the first time in 1997, the number is now 76,349. Such figures used to be counted by county.
Now they are all-Wales, says Dai Lloyd with glee.
'That makes Plaid's job a lot easier. Devolution has uncovered what we long suspected.Wales is getting a raw deal, ' he insists.
Politically, Plaid has not done so well since Dafydd Wigley stood down as leader (heart problems, actually). Next May's assembly elections are a chance to fight back .
If Rhodri does not get his audit legislation in the Queen's Speech (Mr Milburn will surely not be keen) he will be clobbered as weak. If he succeeds he will be clobbered as unwise. Nor does Plaid intend to let his preventative health drive detract from the waiting lists. 'The NHS is in permanent crisis here, ' says Swansea's Dr Dai.