Opposition MSs called for greater transparency on A&E performance data amid claims statistics have been inaccurately reported for more than a decade.
Russell George said the Royal College of Emergency Medicine (RCEM) found that emergency department data does not reflect how long people are waiting in reality. The Conservatives’ shadow health minister raised concerns that exemptions to waiting time targets misrepresent the true picture.
However, the Welsh Government has refuted the claims – with the health minister describing any accusations of gaming the system as fundamentally untrue. A clinical exemption can be applied when a patient stays in A&E longer than waiting time targets if, for example, they require extended monitoring before being discharged.
Mr George claimed data for 673,000 patients has been misrepresented since 2012. He said 80% of clinicians surveyed by the RCEM have a negative view of the exemptions policy as he urged ministers to listen to professionals.
‘Not fit for purpose’
The Montgomeryshire MS said: “The Welsh Government should rescind the breach exemptions policy in line with the wishes of the royal college, or at least publish the two figures so we can see the true position.”
Mabon ap Gwynfor, Plaid Cymru’s shadow health minister, said A&E waiting times have deteriorated over the past decade even with the exclusion of exemption figures.
In August 2023, 31% of patients waited more than four hours, 17% waited more than eight hours and 10% waited longer than 12 hours in A&E.
Calling for the policy to be scrapped, he told the chamber: “The Welsh Government has fixated on the semantics of how A&E data is presented, yet the reality is the breach exemptions policy is not fit for purpose.”
Jane Dodds raised concerns about health being politicised during the Conservative debate on Wednesday October 26. The Lib Dem leader called for cross-party collaboration to address the A&E crisis.
Response
Responding to opposition MSs, Eluned Morgan refuted any suggestion that the Welsh Government has gamed the system by excluding certain patients from statistics.
Arguing that a freedom of information request submitted by the RCEM was flawed, she told the Senedd: “Health boards have confirmed they are compliant with the guidance issued in 2011, and I’m pleased to note the independent Office for Statistics Regulation has welcomed steps we’ve taken to provide assurance on the quality of statistics.”
Baroness Morgan recalled how she took her 89-year-old aunt to A&E two years ago due to concerns about her heart.
“They did the initial tests, they determined what medicines she needed, and her treatment was effectively finished in a couple of hours,” she said. “But they wanted to keep her in for observation for a longer period. The treatment was complete, the job was done, but they wanted a belt-and-braces approach, so they stopped the clock.
“The exemption to the target meant that there was no incentive to admit her unnecessarily, which could have resulted in a long and debilitating hospital stay, and they didn’t need to push her out of the door before they had complete confidence she would be okay without breaching the target.”
The health minister said the Welsh Government would be willing to have a conversation about changing guidance. However, she warned that a fundamental shift in the way statistics are gathered would hamper comparisons with the rest of the UK.
The Tory motion as well as Plaid Cymru and Welsh Government amendments were defeated. Speaker Elin Jones used her casting vote against in line with convention.