The Welsh Government policy on community health services and health budget cuts described by the Wales Audit Office as ‘unprecedented in UK history’ increased pressure on our general hospitals. The 2016 Welsh Conservative manifesto included proposals to drive greater integration between health, social services and communities. We also said we’d create a community hospital development fund and re-establish minor injury units to repair the damage caused by Labour’s community bed cuts and minor injury unit closures. In March 2010, the Labour health Minister then said, ‘I’m not aware of any threats to community hospitals across Wales.’ In reality, I’d established CHANT Cymru—Community Hospitals Acting Nationally Together—which successfully campaigned for suspension of Labour’s plans to close community hospitals in 2007. However, when Labour returned to single-party power in Cardiff in 2011, they again pushed ahead with their community hospital and bed closure programme.

North Wales Community Health Council wrote to the then health Minister expressing concerns about the robustness of the information provided by Betsi Cadwaladr university health board, which they had used to inform their closure decisions for community hospitals in Flint, Llangollen, Blaenau Ffestiniog and Prestatyn. Dozens of community beds were lost, despite bed occupancy levels of 95 per cent and above. The GP who set up the north Wales pilot enhanced care at home scheme with the health board said that this will bring a service that is currently frequently gridlocked further to its knees, and that a central part of the proposed shake up of health services—providing more care in people’s homes—won’t fill the gap left by shutting community hospitals.

The Labour Government ignored the Flint referendum in which 99.3 per cent voted in favour of returning in-patient beds to Flint and then ignored the Blaenau Ffestiniog referendum when an overwhelming majority voted in favour of returning beds there. When I had visited Holywell hospital, staff told me that extra investment in our local community hospitals such as Holywell and NHS community beds in Flint would take pressure off our general hospitals, help tackle the A&E crisis and enable the health board to use its resources more efficiently.

As the head of the NHS in England said not so long ago, smaller community hospitals should play a bigger role, particularly in the care of older patients. At a British Medical Association Cymru briefing in the Assembly in June 2014, the chair of the North Wales Local Medical Committee warned that general practice in north Wales is in crisis, that several practices had been unable to fill vacancies and that many GPs were seriously considering retirement. Early this year, GPs in north Wales wrote to this First Minister accusing him of being out of touch with the reality of the challenges facing them.

The Royal College of GPs states that general practice in Wales provides, as we’ve heard, 90 per cent of NHS consultations, but only 7.8 per cent of the budget. They say prolonged underinvestment means that funding for general practice has been decreasing compared to the overall Welsh NHS, yet we face the significant challenges of an ageing and growing population. As they say, consultations are becoming longer and more complicated as we deal with an increasing number of patients with multiple chronic conditions. As they stated in an Assembly meeting yesterday, nearly four in 10 patients in Wales find it difficult to make a convenient GP appointment—up 4 per cent in two years; 84 per cent of GPs in Wales worry that they miss something serious with a patient due to pressures; and more than 52 per cent of GPs face significant recruitment issues, with Wales needing to employ more than 400 more GPs.

Given the GP shortage, we heard that models such as the multi-disciplinary practice introduced in Prestatyn are needed. However, we also heard that this was based on an overseas model, which had a higher ratio of GPs to other disciplines; that we will lose the holistic view and continuity provided by GPs, damaging the well-being of patients; and that the health board is not stepping in until crisis or disaster. We heard that, in Manchester, 100 per cent of junior doctors will spend time in general practice, compared with just 13 per cent in Wales, and that every junior doctor in Wales should be exposed to general practice. We heard that north Wales needs to focus, once again, on recruiting GPs from Manchester and Liverpool universities; that support is needed for struggling practices and individual GPs suffering burnout; and that NHS community beds add to the breadth of things GPs can do, assisting both primary and secondary sectors.

So, let us hope that this reshuffled Labour Government starts listening, at last, and delivering the solutions that the professionals know that we need.