THE spotlight is shining brighter than ever on the NHS in Wales at the moment, with the issue of heart surgery waiting times continuing to grab the headlines.

WITH all the political to-ing and fro-ing over the issue of heart surgery waiting times in Wales, it is easy to overlook the people who matter the most — the patients.

Since the Royal College of Surgeons expressed its concerns last week about excessive waiting times and a suggestion that more than 150 patients have died in the last five years whilst on the waiting lists for heart surgery in Wales, politicians have gone into overdrive.

It should come as no surprise, given the subsidiary role of the NHS as perpetual political football, but once again the danger is that the collective eye is taken off what needs to be done to put things right where it matters, in the operating theatres of our cardiac centres.

Waiting times for cardiothoracic (heart and lung) surgery in Wales have reached a record high, according to the latest figures available, those for December 2013.

By the end of that month, 950 patients in Wales were waiting to start treatment. More than two-thirds of these (649) had waited less than the target maximum of 26 weeks.

But of the remaining 301, 118 had waited 26-36 weeks, and 183 had been waiting longer than 36 weeks.

That latter figure, again, was a record high and on its way to being a staggering six times the total for 12 months previously, in December 2012, when 32 patients had been waiting longer than 36 weeks.

Of those 183 patients who had been waiting longer than 36 weeks by December 31 last year, 43 were from Gwent. A further 20 from this area fell into the 26-36 weeks bracket.

Quite what happened during 2013 to send the post-36 week waiting list soaring in this most sensitive of specialties has not been explained in any great depth, with official explanations describing capacity issues without going into much detail about the reasons behind them.

But what is clear is that there has been an issue with long waits for heart surgery in Wales for some time, and when the backlog of long waits has been cleared, the Welsh Government should take the time and trouble to explain how it came about, and what steps have been taken to ensure it does not happen again.

The Royal College of Surgeons voiced its concerns formally to the Healthcare Inspectorate Wales (HIW) last July, as the waiting list for those patients waiting more than 36 weeks topped 100 for the first time.

Last week, it voiced more concerns in another letter to the HIW, commenting on the longer than expected gestation of two reports, one on elective surgery death rates in South Wales, and the other on cardiac services for Wales.

In the interim, waiting lists have grown, particularly those involving longer waits for heart surgery, and given the subsequent furore some sort of explanation of what has been going on behind the scenes ought to be forthcoming to try to reassure people that everything that could have been done was being done.

The Welsh Government has spoken of a number of “immediate steps” that are being taken to speed up treatment, including a two-year plan to make cardiac surgery in Wales more sustainable, including a recent £1.3million investment to upgrade cardiac theatres at the University Hospital for Wales in Cardiff.

Meanwhile, to help bring down the waiting list, surgery is being carried out at weekends in Wales, and the Welsh Health Specialised Services Committee is sending 80 patients to England through arrangements with private providers to help bring down the waiting list.

This latter action has kicked up some political dustclouds, with the Conservatives’ shadow health minister Darren Millar AM accusing the Welsh Government of “hypocrisy” and being branded “ridiculous” in return.

Particularly in the last couple of years, the Welsh Government has set much store by trying to ensure as many patients as possible, whatever their requirements and given the services provided here, are treated in Wales.

This has caused some tensions among people living on the Wales-England border, and perhaps it is natural that subsequently having to seek extra capacity in England for heart treatments, particularly in the private sector, should attract a measure of criticism from opponents.

But it all seems more than a little tactless when lives are at stake and, according to what information is out there, people have died whilst on the waiting list.

The RCS correspondence with HIW mentioned a possible 152 deaths in five years. A report on the WHSSC website states that, following an audit of the figures, the number has been reduced to 99.

Which still amounts to an awful lot of pain and grief and, particularly for those whose loved ones had waited longer than the 26-week treatment target, the nagging feeling that if more timely treatment had been available they may have survived.