This is our simple demand for the 2005 general election. We believe the appalling deficiencies in the Welsh health service have made patients and staff suffer for far too long. We urge you to tell politicians you won't vote for them unless they agree to meet the three demands listed here. Health Editor Madeleine Brindley reports
THE waiting times targets for Wales state that by 2006 no patient will be waiting more than 12 months for inpatient treatment, or 12 months for a first outpatient appointment. By comparison the English targets set a maximum waiting time of six months for inpatient treatment by December 2005. The "standard" waiting time for outpatient appointments is 13 weeks in England.
Under current Welsh Assembly Government plans, patients in Wales must wait until 2009 for a guarantee of waiting times similar to those in England.
But for waiting times to be almost halved in the space of the next year requires significant work to address and eradicate delayed transfers of care, and the high numbers of emergency admissions, both of which result in patients' operations being cancelled at short notice because of a lack of free beds.
Tina Donnelly, director of the Royal College of Nursing in Wales, said, "Patients in Wales pay the same taxes and National Insurance contributions as elsewhere in the UK and they are entitled to the same level of provision in a timely fashion.
"There also shouldn't be a postcode lottery - it shouldn't matter whether you live in North, South or Mid Wales - patients are entitled to the same level of service as elsewhere in the UK.
"It's diabolical that we don't have that."
Peter Johns, director of the Board of Community Health Councils in Wales, added, "We would support any initiative that reduces waiting times for patients but it is important that it happens without jeopardising other services.
"The intended direction of providing more services in the community would need to be developed to provide the capacity in hospitals to deal with outpatients and inpatients."
NHS walk-in centres were developed in England as an additional frontline service alongside the nurse-led NHS Direct helpline.
The centres cater for patients with minor health problems - offering treatment for injuries and illnesses as well as health advice - and have been used to reduce pressure on accident and emergency departments and GP surgeries.
The distressing scenes of patients being kept on trolleys for hours in the corridors of Welsh hospital casualty departments, and the large number of people who turn up at A&E because their GP surgery is shut, have seen calls for NHS walk-in centres to be created in Wales.
Richard Jones, deputy director of the Royal College of Nursing in Wales, has been at the forefront of the campaign.
He said, "NHS walk-in centres could be invaluable to Wales - although they are not the answer to everything, as part of a package of services, I believe health services in Wales can be delivered more effectively.
"Patients would be seen by experienced registered nurses and the statistics from England suggest that 84% patients do not require to be referred on to another health professional after being seen at one of these centres.
"Walk-in centres have been successful because there has been close collaboration between them, GPs and A&E departments."
Peter Johns, director of the Board of Community Health Councils in Wales, added, "The idea of walk-in centres needs to be looked at as an alternative to GP out-of-hours services and as a way of taking some of the load off busy A&E departments.
"It's a bit like reinventing minor injuries units, which can be nurse-led and distributed around the country to ensure equity of access."
NHS dentistry is in crisis in large parts of Wales. Patients are experiencing increasing difficulties registering with an NHS dentist in North, Mid and West Wales, as dentists leave the health service and the NHS treadmill, preferring to run private practices which give them more opportunity to care for their patients.
The departure of an NHS dentist last month in Flintshire left thousands of patients facing the prospect of a 100-mile trip to the only other NHS dentist in North Wales still taking on new patients.
But the decision by Pembrokeshire Local Health Board last month to directly employ the first dentist in Wales could provide an answer to the crisis. Dr Devendra Rajcoomar, who is based in Milford Haven, provides an emergency service to patients who are not registered with an NHS dentist.
Peter Johns, director of the Board of Community Health Councils in Wales, said, "Given that the Assembly has developed a successful second offer scheme for patients waiting for operations, why not have a second offer scheme for patients wanting an NHS dentist?
"If there is no NHS dentist in the area, why not buy in services from dentists operating in the private sector?"
Stuart Geddes, director of the British Dental Association in Wales, added, "Reform of NHS dentistry is long overdue. The BDA supports many of the guiding principles behind the current reforms to be introduced in April 2006, including the commissioning of dental services by primary care trusts in England and local health boards in Wales.
"To meet patient demand and need, reform to NHS dentistry must be properly planned, funded and communicated to patients and dentists.
"Any changes must simplify the existing complicated system and must not penalise those who have the greatest need but least money to pay for care."