the last three years, against total invoicing of £315m by English NHS trusts. Performance In 2014 the Nuffield Trust and the Health Foundation produced a report comparing the performance of the NHS in the four countries of the UK since devolution in 1999. They included data for the North East of England as an area more similar to the devolved areas than the rest of England. They found that there was little evidence that any one country was moving ahead of the others consistently across the available indicators of performance. There had been improvements in all four countries in life expectancy and in rates of mortality amenable to health care. Despite the hotly contested policy differences between the four countries there was little evidence, where there was comparable data, of any significant differences in outcomes. The authors also complained about the increasingly limited set of comparable data on the four health systems of the UK. Rising social costs have led to a significant increase in the time between patients being declared "medically fit" and finding social care placements in many cases. NHS Wales has not met targets for A&E. Figures for December show the worst A&E performance since March 2016 but attendance was 5.4% higher than in 2017. 78.9% of patients were admitted transferred or discharged after spending less than four hours in emergency care facilities, the target is 95%. This is 1.5% lower than in December 2016. 70% of "red" ambulance calls came within eight minutes (there is a 65% target). Ambulance services are under resourced, staff miss breaks and have to work beyond their shift. Due to pressure sickness absences for ambulance staff reached the highest level since records began in the first three months of 2018. Political criticism A survey of attitudes to the NHS in 2014 concluded that the Welsh held the NHS dear to their hearts, though almost two-thirds of respondents felt the performance of the Welsh NHS had declined in recent years. The survey found a wide range of problems caused by a lack of resources. Staff complained that Whistleblowers risked professional suicide and some patients said complaints or concerns were not taken seriously by NHS managers Defenders of the NHS in Wales point out that it operates on £1,900 per person compared with the North East of England, which is similar to Wales in terms of "need" and gets £2,100 per person. While