Adapting services for an increasingly ageing population, particularly in deprived communities, is one of the key challenges for our public services. Our population is steadily growing, but is also steadily ageing. Recent statistics from the NHS Confederation show that, across the UK, the population of over-65s will rise to nearly 18 million in 20 years’ time, with the population of over-85s doubling during the same period to nearly 4 million. And, as has already been highlighted by the spokesperson for health for Plaid Cymru, in Wales, we estimate that figure to be over 1 million over-65s. It’s going to be a major element of our figures.

Now, these wider population changes will undoubtedly have a significant effect on our health and social care services, with more and more people needing extra help at a time when our public spending resources are being reduced by the UK Government on a continual basis. For secondary care in Wales, the average age of a hospital patient is 80 years old, with 10 per cent of hospital patients aged over 90. Now, added to this, the average hospital stay in Wales is seven days. We can see the impact this is having on our secondary care services. These figures give us a clear measure of the potential impact on our services. Increased demand inevitably means longer waiting times for appointments and potential delays of transfer of care, while an ageing population invariably means an increase in the number of patients with long-term conditions requiring continual attention, alongside multimorbidities. Two thirds of our population aged 65 and over have at least one chronic condition, while one third have multiple chronic conditions, all of which inevitably require more and more complex treatments and longer consultation processes. This increased pressure on our increasingly limited resources requires us to make strategic, sustainable and innovative decisions around workforce planning.

The flow of patients through the secondary care setting is crucial in order to provide high-quality care packages as fast as possible, but the role of community-based care must not be underestimated. We have often spoken in this Chamber of the need to get back to our communities and provide services that are as local to people as possible, enabling them to remain in familiar environments with social support from family and friends and making full use of the community services provided.

In discussing transfers to community-based care, we cannot neglect the warnings of the British Medical Association and the Royal College of General Practitioners around GP recruitment. We know that, in Wales, we have a challenge to recruit GPs, not just in rural areas, but also in many deprived urban areas, and these challenges are widely documented and must be tackled if we are to effect a whole-system change. We must recruit new GPs, not only to fill the vacant spaces, but also to take over from older colleagues, 23 per cent of whom are over 50, as has been highlighted already. They are ageing faster than we are training new replacements, with only 107 out of the 125 GP training places filled last year. We must do more to incentivise our young trainee medical professionals to follow a GP pathway and provide them with the training and skills that they need to address these issues. We must increase the number of places available from the current 136. That must be dealt with with the deanery and we must look for training places in GP practices to accommodate them as well.

We must also avoid focusing solely on GP provision, as we seek to provide a holistic model of community care such as we’ve seen recently in Prestatyn. We must look to our community dentists and pharmacists and our district nurses and physiotherapists to provide excellent care where GPs are not needed. In this, we must follow the principles of prudent healthcare to make full use of all their colleagues and ensure that they do what only they can do. We therefore also need to address the training of these professions practically: in-practice and district nurses and advanced practice nurses and other practice nurses. We can perhaps link and encourage alternative pathways of training for these professions.

I welcome the Welsh Government’s primary care workforce plan, which will support creating greater service delivery in practices across the sector and I look forward to its successful delivery. These are clearly targeted at addressing some of these concerns. But we must also look at our public health services, as the older population must be supported in their communities to live full and happy lives. We know that loneliness and isolation pose serious health risks, as do tobacco and excessive alcohol consumption. We must support campaigns that tackle social isolation and promote befriending groups across our communities. We must further encourage our population to make healthy life choices, providing the social, cultural and sporting environments that they need to lead active and sustainable lives, thereby reducing the likelihood of developing medical conditions and ending up in our hospital services.

Finally, we must remember that the challenges of an ageing population are not unique to health and social care services. We must take a more rounded approach to our decision making, encompassing housing and education and particularly lifelong learning and improved literacy and numeracy skills, encouraging collaborative working across our public services. We must further look to the future, ensuring that the principles that are enshrined in our Well-being of Future Generations (Wales) Act 2015 underpin our actions in all portfolio areas to help our ageing population.