7. What is the Welsh Government’s response to the O’Neill report on the threat to human health from the overuse of antibiotics? OAQ(5)0007(FM)

It is a threat, as we know. Overprescribing of, and resistance to, antibiotics is a global problem that requires global solutions. Nevertheless, we do have a delivery plan in Wales—a blueprint for specific actions that will have the biggest impact in slowing the spread of resistance. There are 12 specific actions in that plan. They’re all designed, of course, to make sure that we contribute to slowing down resistance, in terms of bacteria and viruses, to drugs that have been in use for many, many years. Some of the stories that I’ve seen in the news are quite chilling, in terms of what might happen unless investment is made now into research.

It’s good to hear, First Minister, that you recognise that this really is a global threat to human health and survival rates from common causes. We have always assumed that we would easily survive the common diseases that now could cause death. Professor O’Neill is calling for worldwide action on this, both in relation to the overuse of antibiotics in animals as well as the overuse of prescribing to human beings. I wonder how this delivery plan that was published just before we went into recess is going to deal with the variations in practice, both in our hospitals and in our GP practices. I particularly note that in the Cardiff east GP cluster, there is a significant overprescribing for respiratory diseases compared with other clusters, and it would be useful to explore why these differences exist and how we’re going to deal with them.

The Member’s right to point out a significant issue in the Cardiff east cluster. I can say that the All Wales Medicines Strategy Group has published further detailed information in relation to the prescribing of medicines for respiratory illnesses to support clusters in identifying and addressing variation in prescribing behaviours. We are a long way away from the days when antibiotics were prescribed as a matter of course, because we know it doesn’t harm the individual but it harms herd immunity, if I can put it that way. There are some illnesses—. Tuberculosis in my grandparents’ generation was a real killer. It was believed that with Streptomycin, TB would no longer be an issue for us, yet we know that it appears that there are now strains of TB that are becoming resistant to the drugs that we have. That’s a natural process in the world of microbiology, and it’s hugely important that we make sure that research is still carried out across the world to combat that resistance before it becomes so bad that it claims the lives of many people.

First Minister, you may agree with me, perhaps, as I say that the use, or indeed the overuse, of antibiotics is a responsibility for us all. As we know, the use of antibiotics happens in agriculture as well as being prescribed by GPs and used in our hospitals. Of course, in some European nations, you can now just buy antibiotics—you don’t even need a prescription in the first place. Of course, there are increased pressures on GPs, particularly in our practices, to be prescribing when, given that the common sore throat is going to be caused by a virus, an antibiotic isn’t the best treatment. It’s important that the public should be aware of that in addition to the GP. So, would you agree with me that raising awareness is important, but the use of antibiotics, or the misuse or overuse of antibiotics, is a responsibility for us all?

I’m not going to argue with a doctor; he is right in saying, of course, that there is a duty on us all to ensure that we don’t over-request. There is a tendency for people to think, if you’re ill, there’s a pill to cure all ills. That’s not the case, of course, and it’s important that people realise that in some cases they don’t need an antibiotic. Certainly, antibiotics wouldn’t make a difference with a virus. So, I accept your point that this isn’t simply a duty for doctors, it’s a duty for the public as a whole.

First Minister, one of the problems, we are told, is that people aren’t getting a diagnosis early enough and therefore, unfortunately, infections are ravishing them before the antibiotics can be prescribed. Given the difficulties that people in Wales are facing in accessing GP appointments, and the difficulties in securing responses and outcomes from diagnostic tests—many people wait many weeks sometimes for simple diagnostic tests not only to be undertaken but to get the results back from those tests—don’t you also agree that we need determined action to address those problems if we’re ever going to defeat this problem of antibiotic resistance?

Indeed, and the Member will know that waiting times for diagnostic tests have plummeted. It was not acceptable that they were so long, and there’s been a significant decrease of 20 per cent in a very short space of time, and that is something that we intend to continue with, in terms of that trend continuing in the future. But it’s important as well that, for many people who go and see GPs, quite often they don’t need to—they could go and see a pharmacist, they could go and see a GP practice nurse. We need to make sure that the message of Choose Well continues to be reinforced in the future and that people don’t automatically assume that, if you go to the doctor, you must come out with a prescription. So, yes, there’s a duty, of course, on all of us to ensure that that message is understood.