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There are no major differences in the performance of the NHS between healthcare systems in Wales, Scotland, England and Northern Ireland, a new report has revealed.

A two-year analysis by the highly-respected Organisation for Economic Co-operation and Development (OECD) concluded that “no consistent picture emerges of one of the United Kingdom’s four health systems performing better than another”.

The conclusion comes despite a long-running bitter political row in which Prime Minister David Cameron has condemned the Welsh Government's handling of the NHS.

He has described Offa's Dyke as "the line between life and death".

Report's conclusions

The report made a number of conclusions about the state of the NHS in the four nations of the UK - some positive, others negative.

The positive conclusions focused on the "clear and consistent commitment to quality of care in all of the UK's health systems".

However the negative focused on "average or disappointing performance" in some areas - particularly survival rates for breast, cervical and colorectal cancer.

It said all of those areas were below the OECD average.

In conclusion, it said: "From the limited country-specific data available, however, no consistent picture emerges of the United Kingdom's four health systems performing better than another".

'Apologise - demands Carwyn'

First Minister Carwyn Jones has called on Prime Minister David Cameron and Health Secretary Jeremy Hunt to apologise to 84,000 NHS staff in Wales following their criticisms of the health service in Wales.

Mr Jones said: “With a growing social care crisis in England, and the continuing doctors’ strike, it is time the Tories focused on getting their own house in order.

“We accept that the NHS in Wales has challenges ahead – just like every healthcare system in Europe – and we are up for meeting that challenge.

“That is why we spend more on the NHS and on social care than in England, why access to cancer drugs is faster and why we are investing more than ever in training nurses and other NHS staff.”

Wales has 'unique challenges'

The OECD authors highlight similar issues facing all the home nations, such as an ageing population and the growth of chronic and complex conditions.

But it also acknowledges the “unique challenges” faced by Wales, which includes providing healthcare in isolated areas and the commitment to provide services in both Welsh and English.

Some of the Welsh NHS major campaigns and initiatives were also praised, such as its “prudent healthcare initiative” which seeks to address over-diagnosis and over-treatment and improve the relationship between individuals and the health service.

Read more: How prudent healthcare aims to give patients ownership over their own health

Health boards criticised

(Image: Rob Browne)

One particular area of concern was how the nation's seven health boards operate.

They were set up by the Welsh government in 2009 when the previous system of 22 local health boards was scrapped - and they run almost all aspects of local healthcare from GPs to hospitals.

The report says: "There is scope for a greater degree of steering and oversight to provide consistency, direction and a strong accountability framework."

Mark Pearson, head of the OECD's health division, told BBC Wales : "We're worried about the health boards.

"This was an idea that wasn't wrong in principle, it just hasn't worked well in Wales - the idea that the centre has a general view about what's happening but leaves it to the health boards to decide in each little authority."

"If you look at GP practices in Wales - they don't look much different to what they would have looked 20 years ago."

He said the Welsh Government needs to use a "stronger central guiding hand" and "make more prescriptive demands" of health boards to drive meaningful improvement.

But it cautions against too much control, as shown in a "congested" system in England with too much central direction.

Mark Drakeford: 'This report is the line between fact and fiction'

Health and Social Services Minister Mark Drakeford said the OECD report “finally puts to rest” claims that a particular heath service in one part of the UK is better than the others.

Prof Drakeford said: “This report is the line between fact and fiction. Any claims of one nation having a second-rate NHS compared to others simply do not reflect the facts.

“The time has come for a real, mature debate about the future of our health services.

“There are difficult decisions to be made and areas where I expect performance to improve.

“However, the Welsh Government will continue to protect funding for our NHS which is free at the point of need.

“As a government we will continue to support our health service to provide the most effective modern and compassionate care possible.”

'A robust tool'

The OECD report found that the commitment by staff and the public to the values of NHS Wales seems strong.

It described the Welsh Government’s Escalation and Integration Framework for health boards and Trusts, which was introduced in 2014 as a way of monitoring performance, as “a robust tool for quality assurance and intervention.”

Read more:Two Welsh health boards 'likely to overspend' this financial year

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And it praised the introduction of a three-year planning and funding cycles for Welsh NHS organisations, even though two health boards are still told to produce annual plans.

In addition, the creation of primary care clusters – a grouping of GPs and practices locally – has the potential to be “an important resource in Wales”.

Welsh Government funding for the health and social services is the highest it has ever been, with a record £6.7bn invested this financial year, rising to £7bn in 2016-17.

(Image: Peter Byrne/PA Wire)

Leader of the Welsh Conservatives, Andrew RT Davies, claims Labour are in denial over the systemic issues faced by patients in Wales.

Report does not take into account waiting times

He said: “The First Minister is calling for an apology, but the only people who deserve an apology are the people of Wales and hardworking Welsh NHS staff.

“First of all, how about an apology for the one-in-seven people in Wales on a waiting list; more than 26,000 of whom have been waiting more than nine months to start treatment?

“How about an apology for the Welsh cancer patients forced to move to England because they cannot access life-prolonging treatments here in Wales?

“And how about an apology to the hardworking staff whose attempts to deliver a first class health service have been sabotaged by Labour’s £1 billion budget cuts since 2011?

“Let’s be clear this report is not a comparison study and it fails to take into consideration one of the most important aspects of the patient experience – waiting times.

“Previous reports by the House of Commons Library, the Wales Audit Office and the Nuffield Trust have showed that spending has been slashed by Labour since 2011 and that waiting times are much longer here in Wales.”