Some of it is, and as you listen to the rest of the debate, I think you may be slightly cheered. Granted, the headcount for GPs remains fairly stable. However, there is little recognition that many of those heads are not full time. Not only has the GP’s role changed, but the way patients wish to access their GP has also changed. Patients still wish to see a named GP, and to be able to see him or her within a short space of time. To quote one doctor, who encapsulates neatly the views of many: ‘Patients want immediacy, but immediacy with the doctor of their choice at the time of their choice, and that is a gold standard. We’d all like that, but there seems to be little understanding among patients that that isn’t actually possible.’

There is also a recognition that recent years have seen a decrease in self-care, with patients no longer seeing the GP as the final call when they are showing signs of illness, but the first. Figures also show that, although appointment times have been increasing, the UK still has one of the shortest appointment times, and a total of 73 per cent of all UK GPs said they were dissatisfied with the time they were able to spend with each patient. A recent Welsh BMA survey, in February this year, clearly demonstrates that: 57 per cent of GP practices reported the quality of service had dropped in the last 12 months; and, 64 per cent said their workload was either unmanageable a lot of the time or all of the time. Many of these issues could be tackled with better workforce planning, greater education and signposting. We really need to understand the picture we have before us. Cabinet Secretary, will you undertake to review the collation and sharing of data within the primary care sector, so that we can form a clear picture and share that knowledge base with all decision makers?

I have noted that in your document, ‘A Planned Primary Care Workforce for Wales’, there is a desire to encourage primary care clusters to assess local need and match resources. However, comprehensive workforce planning needs to take into account the availability and training requirements for all the other primary care workforce, such as physiotherapists, nurses, optometrists, pharmacists, occupational therapists, speech and language therapists, healthcare support workers and clinical psychologists. We already know from committee inquiries, such as those into looked-after children, adoption, and child and adolescent mental health services, that we are facing a Wales-wide shortfall in speech and language therapists, eating disorder clinics, behavioural and social care support workers, and that timely access to mental health services is very difficult to receive.

Today’s GP is less a general doctor and more a complex care practitioner. She or he is being asked to front-line an extraordinarily diverse range of illnesses. They are being encouraged to manage as much as they can in order to take the pressure off the secondary care sector. However, in order to achieve that objective, they must be secure in the knowledge that there are a plethora of trained professionals that they can refer to. Unfortunately, there are not, which is why, Cabinet Secretary, I would ask that workforce planning is comprehensively undertaken throughout all areas of the primary sector, and that it looks at hours rather than heads, and future needs and training requirements rather than the status quo.

Training and encouraging people into primary care is absolutely key to strengthening and planning for workforce management in front-line services. The BMA has highlighted that, despite commitments from successive Labour-led Welsh Governments, the overall training places for GPs in Wales remain static. They also state that investment not only needs to be made into high-quality undergraduate and postgraduate training in Wales, but also continuing professional development. We need to look for a national medical workforce. We need to have a compulsion for junior doctors training in Wales to undertake GP rotation as part of their training. I've had this message reinforced to me by local GPs who also raise concerns over whether the medical schools really grasp the importance of rotations as a means of ensuring that general practice is not perceived as the cinderella division of the medical profession. Add to this the view that trainees don't see becoming a GP as a desirable career due to increased costs surrounding indemnities, the ageing state of the buildings, you know, increased work pressures—people are just not wanting to enter into a very necessary and valuable part of the NHS workforce.

Finally, I'd like to quickly turn to the Plaid amendment, which we will be abstaining on. Now, I totally accept that there’s empirical evidence that clearly suggests that medical students often stay in the area where they are trained, and I recognise that this amendment mirrors the call by the Royal College of Physicians. However, such is the shortage of doctors, I would suggest that if a Scot, an Italian or a Welsh-domiciled person were to train in our medical schools, then we should embrace them with open arms and seek to retain them in the country where they have trained. I would also like to understand better how many Welsh-domiciled students are refused training or choose to train away because they cannot get the place locally. Hence an abstention, because I can be persuaded if you can show us the evidence. I think that a stronger argument, which my colleague will develop, is that we should increase the number of training places available and broaden the geographical research.

Cabinet Secretary, this is a crisis that is enveloping general practice. So, in summation, we would like to see a recruitment programme that encapsulates the needs of partners and families, comprehensive workforce planning undertaken that includes all the strata of primary health care in order to ensure that general practice has the ability to refer patients across the piece in a timely manner, that there are changes made to the training of junior doctors in order to ensure that rotations into general practice are as routine and valued as rotations into cardiology or acute medicine, that a review is undertaken into the financial pressures in general practice from capital expenditure to indemnity insurance, that a comprehensive package is worked out with health boards and the ambulance trust to better understand the causes of the high levels of stress-related illnesses the services experience and that an accessible programme of intervention for individuals to access is put in place, and that the voice of general practice is strengthened and put front and centre in health board and Government planning. If you achieve this, Cabinet Secretary, you will avert the storm building in front-line services, and we, the Welsh Conservatives, will support you in this endeavour. Thank you.