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A NHS prescription

08 June 2011

Professor Sir Mansel AylwardProfessor Sir Mansel Aylward

NHS Wales can survive the difficult economic, demographic and social factors ahead if all sectors of healthcare, government and society pull together and agree the transformation needed in culture, practice and quality and delivery needed, according to a major new report.

Professor Sir Mansel Aylward, School of Medicine, as Chair of the influential advisory NHS Wales body, The Bevan Commission, has published NHS Wales: Forging a better future.

The report, commissioned by the previous Minister for Health and Social Services, Edwina Hart AM, makes a series of key recommendations designed to maintain and enhance a values-based service in NHS Wales during a time of social and economic challenge.

"The strength of the NHS Wales model is that it follows Bevan’s idea that only collective strength is ‘scientific’ and ‘principled’. However, if NHS Wales is to continue reliably meeting people’s needs, some things must change," according to Sir Mansel.

"Fundamental changes and considerable progress have already been realised by NHS Wales since the abandonment of the internal market and the inception of NHS reforms however, there are challenging times for NHS Wales – but change is necessary and inevitable."

The report warns of the challenging times ahead with spending cuts disproportionately affecting communities in Wales which have a greater dependency on welfare benefits and public services.

To meet this challenge, the report makes a series of recommendations and urges all NHS stakeholders from the public, politicians to senior NHS managers to play their part in ensuring a successful future.

Among the key recommendations:

  • The people of Wales need to take more responsibility for their own and their family and community’s health, aided by information and public health support;
  • Healthcare professionals need to sustain and spread the current efforts to make quality the pressing priority for all those working in the health service, with continuing and intensifying action eliminate poor practice, wasteful practice, and avoidable variation in patient outcome;
  • Politicians need to do much more to help people be responsible for their own health through addressing the barriers that make this difficult;
  • Healthcare leaders do much more to help people be responsible for their own health giving practical support and advice.

Sir Mansel adds: "The principles that inspired Aneurin Bevan and many others to bring the dream of a National Health Service to reality, still stand.

"NHS Wales can triumph over the economic, demographic and social factors that are marshalled against it, but it will require commitment, tenacity, leadership and partnership throughout healthcare, government and society.

"If change is driven by NHS Wales, government and society, in line with the recommendations in this report, the people of Wales have an unparalleled opportunity to achieve a health service that will meet their health needs comprehensively, universally, and free at the point of delivery."

Born in Merthyr Tydfil, Sir Mansel’s research has informed practical public health interventions in Wales and elsewhere. He has examined the psychosocial, social, economic and cultural factors that shape health and wellbeing, as well as identifying the factors which pose obstacles to recovery, public beliefs about illness and disability and the relations between work and health.

Sir Mansel received a Knighthood in 2010 for services to healthcare. It was the second such honour Sir Mansel received having also been appointed a Companion of the Bath in 2002.

As chair of Public Health Wales, a new NHS Trust aiming to protect and improve the health and wellbeing of the population of Wales, Sir Mansel is contributing to a new primary and community care strategy for Wales, reducing patients’ time in hospital and delivering healthcare support as close to where they live as possible.

Since 2005 he has been the Director of the University’s Centre for Psychosocial and Disability Research which extends knowledge and understanding of the factors that influence health, illness, recovery, rehabilitation, and reintegration into rewarding work.

A full copy of the report is available at:

The report and recommendations will be discussed in a Plenary debate of the National Assembly for Wales on Tuesday 14th June, 2011.