Jeremy Hunt delivers a speech during his visit with David Cameron to the Evelina London Children's Hospital on July 5, 2013 in London. Photograph: Getty Images.
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The Tories' attacks on the Welsh NHS have been exposed as baseless

A new report calmly and authoritatively shows that there is no significant difference in the performance of the four UK health systems.

When David Cameron was first elected Prime Minister he came to Wales and pledged "a new respect" agenda, promising collaboration and partnership between the devolved Welsh Government and his own. Yesterday, he returned to Wales to address the dwindling band of Welsh Tory faithful at their annual conference and spectacularly broke that promise.

In a vitriolic speech that demeans the office of Prime Minister, Cameron described Offa's Dyke, the divide between England and Wales, as "a border between life and death".  Even the Western Mail (the Welsh daily once described by Nye Bevan as a Tory rag and the Coalowner's Gazette) marvels at language from the Prime Minister that would be more suitable "to describe a criminal atrocity or a natural disaster".  They concluded that "politically motivated scaremongering is intolerable...the battle for votes in England can never justify terrifying a grandmother in Wales on the eve of a hip operation."

Sadly, this sordid intervention by Cameron is a new low in a long campaign the Conservative Party have been orchestrating to smear the NHS in Wales. Jeremy Hunt did exactly the same in his conference speech yesterday and even the Secretary of State for Wales, David Jones, has been using any opportunity to whip up fear by criticising key Welsh public services. The Conservative chairman Grant Shapps even went as far as openly stating that his party were going to target Wales as part of their general election strategy.

But what is most galling and insulting about this grubby strategy of targeting the Welsh NHS is that it is unquestionably based on a lie. On the very day this speech was being made, leading health academics at the Nuffield Trust, published a report based on over a decade’s worth of data, which made it crystal clear that "no one country is emerging as a consistent front-runner on health system performance". 

In the face of Cameron’s claims of a crumbling NHS in Wales, the weighty report 'The four health systems of the UK: How do they compare?' calmly and authoritatively showed beyond question that while each of the four nations have particular strengths and weaknesses, none of them is consistently ahead. In doing so, the report dealt a significant blow to the Tory election strategy. Perhaps most importantly, it also points to the fact that "there have been significant improvements in the performance of the four UK health systems over the past two decades". Showing the Conservative claims of a health service in meltdown are groundless. The Tories’ fox has not only been shot, but stuffed and mounted as well.

The report does say – as with everywhere in the UK – that there are challenges to be addressed. Over the period it looked at, waiting times for certain procedures, such as knee operations, rose as austerity set in. But the latest information shows that the standard waiting time for an orthopaedic procedure in Wales is 15 weeks – this is less than the Welsh Government’s target of 26 weeks. This is despite Wales managing budget cuts from UK government of £1.7bn and the fact we have the oldest population of the four home nations.

Nevertheless, extra investments have been made since the period covered by the report to tackle waiting times, including an extra £63m for orthopaedic surgery, and overall health spending per head still remains higher in Wales than England – showing the Welsh Government’s commitment to the NHS. All Welsh Labour politicians realise that we are custodians for the NHS, the most treasured institution in Wales. Ours is the country and party of its founder Nye Bevan - no one is more proud of our NHS than the Welsh people. That is why it has been so galling to see the Prime Minister and others make attacks on the NHS in Wales, which have been proven beyond doubt to be groundless.

Yet for all their negativity, the Conservatives have had little positive breakthrough with the public.  A recent YouGov poll showed just 14 per cent of Welsh people trust the Tories with the NHS, perhaps too many of us remember when they were last in charge in Wales, with crumbling hospitals and people being forced to wait two years for operations. Far from genuine concern for the health of ordinary people, this smear campaign is a smokescreen to distract from David Cameron’s handling of the NHS in England where he has caused an A&E crisis and wasted £3bn on a pointless reorganisation.

So my message to the Tory high command is as clear as the Nuffield Trust’s report - if you want to fight the next election on the health service, be our guest.  Nationally, Labour saved a crumbling health service in 1997 and in Wales we continue to run an excellent and improving service, true to the NHS’s core values of putting people before profit.

Owen Smith is Labour MP for Pontypridd and Shadow Secretary of State for Work & Pensions.

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Donald Trump is the Republican nominee. What now?

So a Clinton-Trump general election is assured – a historically unpopular match-up based on their current favourability ratings.

That’s it. Ted Cruz bowed out of the Republican presidential race last night, effectively handing the nomination to Donald Trump. “From the beginning I’ve said that I would continue on as long as there was a viable path to victory,” Cruz said. “Tonight, I’m sorry to say it appears that path has been foreclosed.”

What foreclosed his path was his sizeable loss to Trump in Indiana. Cruz had bet it all on the Hoosier State, hoping to repeat his previous Midwest victories in Iowa and Wisconsin. He formed a pact with John Kasich, whereby Kasich left the anti-Trump field clear for Cruz in Indiana in return for Cruz not campaigning in Oregon and New Mexico. He announced Carly Fiorina as his vice-presidential nominee last week, hoping the news would give him a late boost.

It didn’t work. Donald Trump won Indiana handily, with 53% of the vote to Cruz’s 37%. Trump won all of the state’s nine congressional districts, and so collected all 57 of the convention delegates on offer. He now has 1,014 delegates bound to him on the convention’s first ballot, plus 34 unbound delegates who’ve said they’ll vote for him (according to Daniel Nichanian’s count).

That leaves Trump needing just 189 more to hit the 1,237 required for the nomination – a number he was very likely to hit in the remaining contests before Cruz dropped out (it’s just 42% of the 445 available), and that he is now certain to achieve. No need to woo more unbound delegates. No contested convention. No scrambling for votes on the second ballot. 

Though Bernie Sanders narrowly won the Democratic primary in Indiana, he’s still 286 pledged delegates short of Hillary Clinton. He isn’t going to win the 65% of remaining delegates he’d need to catch up. Clinton now needs just 183 more delegates to reach the required 2,383. Like Trump, she is certain to reach that target on 7th June when a number of states vote, including the largest: California.

So a Clinton-Trump general election is assured – a historically unpopular match-up based on their current favourability ratings. But while Clinton is viewed favourably by 42% of voters and unfavourably by 55%, Trump is viewed favourably by just 35% and unfavourably by a whopping 61%. In head-to-head polling (which isn’t particularly predictive this far from election day), Clinton leads with 47% to Trump’s 40%. Betting markets make Clinton the heavy favourite, with a 70% chance of winning the presidency in November.

Still, a few questions that remain as we head into the final primaries and towards the party conventions in July: how many Republican officeholders will reluctantly endorse Trump, how many will actively distance themselves from him, and how many will try to remain silent? Will a conservative run as an independent candidate against Trump in the general election? Can Trump really “do presidential” for the next six months, as he boasted recently, and improve on his deep unpopularity?

And on the Democratic side: will Sanders concede gracefully and offer as full-throated an endorsement of Clinton as she did of Barack Obama eight years ago? It was on 7th June 2008 that she told her supporters: “The way to continue our fight now, to accomplish the goals for which we stand is to take our energy, our passion, our strength, and do all we can to help elect Barack Obama, the next president of the United States.” Will we hear something similar from Sanders next month? 

Jonathan Jones writes for the New Statesman on American politics.