Where does the truth lie?

Another day, and another tit for tat between the Daily Mail and the Welsh government.

In my earlier blog I didn't go into the heart of some of the claims, but the most sensitive revolve around cancer treatment and cross-border services.

The figure which has attracted most attention so far is one quoted in the Daily Mail saying that 15,000 cancer sufferers from Wales are being treated in England every year, a big rise over the past decade.

In its response, the Welsh government points out that is clearly wrong because only 16,000 patients are treated for cancer in Wales every year anyway.

The answer is that the 15,000 figure relates to repeat appointments, rather than the number of patients, which it says is around 1,500.

That said the 15,000 appointments of Welsh patients in England has risen hugely over the past decade.

General movements

But the Welsh government says that the number of people being treated for cancer across Wales over the past ten years has risen hugely as more people are diagnosed earlier.

So while more people in cross-border areas like Powys are being treated for cancer in hospitals in England, more people are treated for cancer in the Welsh NHS as well.

In other words, it says there has been no proportionate increase in Welsh cancer sufferers getting treatment in England, which is the central thrust of the Daily Mail.

And what about the general movement of patients from Wales to England?

The paper says nearly four times as many Welsh patients are treated in England as the other way round.

The Health Secretary, Jeremy Hunt, has also told the Commons that for every one English patient being treated in Wales there are five going in the other direction.

People in Wales go for treatment in England for geographical and medical reasons.

Damaging claims

They may live in an area like Powys which does not have any district general hospitals or they may require a specialist service you can only get in one of the major English hospitals.

Historically this has always been the case. The key question is what does the trend show?

The Welsh government says the numbers going to England have been getting smaller since 2011, while there has been a marginal rise in the numbers coming into Wales.

Another highly damaging and central claim in the paper is that people with cancer have to wait far longer for scans in Wales then they do in England.

The Daily Mail says: "...around half of Welsh cancer sufferers must wait six weeks or more for many scans and tests yet across the border in England.. The comparable figure is less than 6 per cent."

Ministers say the performance on hitting cancer treatment targets in Wales stands up well and in some cases is better than in England.

Scans and tests

But the Daily Mail quotes these statistics: "House of Commons library figures show that, at the end of July 2014, the proportion of patients waiting over six weeks for a cystoscopy was 56.5 per cent in Wales and 5.4 per cent in England. For a colonoscopy the figures were 46.3 per cent in Wales and 3.5 per cent in England, for a gastroscopy 47.1 per cent in Wales and 3 per cent in England and for a flexi sigmoidoscopy 43.9 per cent in Wales and 2.5 per cent in England."

You may not understand the medical terminology but the differences in the figures are stark.

The Welsh government responds by saying these are misleading because they do not relate to cancer but instead relate to general treatment.

That said it does not dispute these figures.

Instead it says there is an eight week target in Wales, rather than a six week target in England, to deal with diagnostic tests like these and that it manages to meet that target in seven out of ten times.

Nevertheless it admits, and as these figures show, that the Welsh NHS is well behind England when it comes to a number of diagnostic tests.

The Welsh government has in the past admitted that there are problems in the length of time it takes to get many scans and tests, and points to investment in this field.

There are many more disagreements but none touch raw nerves in the way that cancer and cross-border services do.