Wales has many problems, not the least of which is a lack of political competition. This affects aspiration in both health and education. Rationing occurs more overtly, by limiting choice, and gagging is just as frequent. A recent article in The Economist makes the situation plain. Wales gets 15% more than England for health spending, but the outcomes are worse….:
Wales – Full steam ahead from the Feb 20th Edition
“…..many of the policy areas under Welsh control have fared rather badly. Health care is one. A report from the Nuffield Trust, a research group, found that in 2012-13 patients in Wales waited about 170 days for a hip or knee replacement, compared with 70 days in England and Scotland. One reason is that spending on health was not protected, as it had been in England. Indeed, it fell in real (inflation-adjusted) terms by 4.3% between 2009-10 and 2012-13. Wales has also done less than England to increase competition between health providers. People in Ebbw Vale complain of a “postcode lottery”; some cross the border to England in order to get a better service.
Education is similarly mediocre. Welsh schools’ poor results are partly explained by the country’s relative poverty, but not entirely: looking only at those children who qualify for free school meals (a measure of poverty), 26% of those in Wales get five good GCSE qualifications at age 16, compared with 38% in England. Some believe that Wales’s opting out of the “academies” programme, under which most English schools have been made independent of local authorities, has held them back. And although many hoped that subsidising university for all would encourage more youngsters to apply, that does not seem to have happened: Welsh entry rates this year were 32%, compared with 37% in England, where rich students pay steep fees in order to subsidise the poor ones.
Part of the problem is a lack of political competition……”