4. Will the Minister outline his priorities for health services in Pembrokeshire? OAQ(5)0019(HWS)

My priorities are to provide the people of Pembrokeshire with health services that deliver the best possible outcomes for patients. I will, of course, be guided by the best and most up-to-date clinical evidence and advice to deliver the high-quality healthcare that the people of Pembrokeshire deserve.

Cabinet Secretary, you won’t be surprised to hear me say that my constituents’ priorities are to reintroduce the special care baby unit and full-time paediatric services at Withybush hospital. However, you’ve made it quite clear that the Welsh Government’s changes to services at Withybush hospital have come about as a result of the Royal College of Paediatrics and Child Health review, which concluded that there was no harm facing patients in Pembrokeshire. But I put it to you that, in order to be meaningful, the review should have collated and collected a large pool of data over a significant period of time before concluding that there is no harm facing patients. Therefore, in the circumstances, what plans does the Welsh Government have to conduct more research into this matter so that the statistical evidence is fully reliable, because I believe that the changes that have been made are unsafe for the people that I represent?

There is absolutely no evidence to say the changes are unsafe, and I really do regret the manner in which this debate is approached, because people are unnecessarily worried and concerned when elected representatives say that services are unsafe or are dangerous. That is deeply unhelpful. There is simply no evidence to support the assertion that the Member has made in this Chamber and in press comments locally. In fact, what we do have as an evidential base is the fact that there has been no clinical harm to any baby or mother who has delivered their child under the new arrangements. In fact, 210 women have presented to Withybush midwifery-led unit since it has been opened. Three quarters of them have delivered safely within the midwifery-led unit. A quarter have been transferred for safe delivery to Glangwili, and, in fact, the same proportion have delivered home births as well.

This is a successful system delivering quality care to women and their children, and that is what we want. We need to invest in and respect the professionalism of midwives and the job that they do. We need to make sure that specific, specialist services are provided on a model that is sustainable and delivers the quality of care that people need. Now, that is my commitment to the people of Pembrokeshire, and right across Wales. If the evidence changes, then we’ll look again at the system that we are delivering and at the quality of care being provided, but, at this point in time, there is zero evidence of clinical harm as a result of the changes that we have made, and I’m proud that we have made changes based on evidence and that people are receiving a better service as a result.

I’d like to follow up the question that was asked by Rhun earlier, and that is: in the light of the decision in England to reject the contract by junior doctors, there could be a real impact in terms of morale in the NHS in England. I just wondered if you could tell us what you could do in addition to really attract, possibly, some of those people who are disillusioned with the system as it is being conducted in England.

Thank you for the question. As I said earlier, we do not intend to go down the route that England is going down by imposing a contract. A big reason why that contract was rejected was because doctors don’t trust the UK Government, and that’s such a damaging state of affairs. I’m pleased that we do have a relationship of trust with the British Medical Association here in Wales, and they recognise that after the vote on rejecting the junior doctors contract. So, I will be meeting them, and we will of course be making clear to junior doctors in England and any other part of the UK that they will be respected and valued if they want to live and work here in Wales. It’s not just about making the offer to people in England, but to positively say there are good reasons to come here to Wales to live and work in a system where they will be trusted and respected. We are actively listening to and engaging with doctors to understand what we need to do to improve the quality of training available. I’m actually really optimistic about this because the Royal College of General Practitioners and the BMA themselves are actively engaged in the work that we’re doing. They think that we’re on the right path and we’re doing the right things. The challenge for us is to do it at scale and at pace and deliver the sort of healthcare that we want here in Wales, and the number of doctors that we recognise we need as well.

In light of the fact that there is a shortage of GPs and primary care services in south Pembrokeshire, I would like a statement from the Cabinet Secretary that he is confident that the service is safe for the constituents in Pembrokeshire. Secondly, would he like to explain why he hasn’t supported making the experiment of the minor injuries unit in Tenby, which was opened over Easter, into something that is available throughout the tourist period at least?

I thank the Member for his question. I have regular contact with people in south Pembrokeshire about the quality and nature of primary care services. It is absolutely an issue that crosses my desk on a regular basis and I do take an interest in it. I have not had people present to me with concerns about the safety of the service; rather more worries about the quality of care and how people access that care is the primary concern that is brought to me. There are a range of interventions that the health board has provided, including providing extra nurse practitioners, extra therapists and, indeed, paramedics to help support primary care in that particular part of Wales. So, the health board are being genuinely proactive in addressing the issue.

When it comes to minor injuries, and in particular the seasonal nature of the additional minor injuries work that goes in, following the pilot over Easter there’s been an evaluation and the health board is actually working through a more regular and sustainable service for doing that, and understanding what they need to commission for the seasonal additional level of interest and service they’ll need to provide. They’ve already agreed, in fact, to make sure that there is an additional service through the summer months by commissioning a service through St John Ambulance as well. So, this isn’t an issue where people are being ignored, or where recommendations and evaluation reports are being rejected; it is simply about working through how that is delivered in a sensible manner so people do get the quality of care that they need at the particular times of the year when there are additional pressures on that service in that particular part of Wales.