Many speakers today have talked about the remarkable work carried out by health workers in Wales, and who hasn’t heard about the extreme sensitivity used by some of our palliative care nurses with people in their dying moments? Who hasn’t heard about those incredible stories of how surgeons have saved the lives of a dying child and how that’s transformed and given meaning back to the life of those parents? Who hasn’t marvelled at the ability of GPs to see a patient every 10 minutes without being totally frazzled, and I know, because I live with one?

I’m not sure where Caroline Jones got her figures from in terms of the 10 A*s. I was going to have to go back and whip my son into gear, because we are so desperate for GPs, I think we all need to make a contribution here. He’s never going to get 10 As the way he’s going now. But, fortunately, you need a B in maths, a B in English and three As and a B in a science, so we may be lucky there.

But the key thing, I think, we have to understand is that, as Hannah has pointed out, it’s not just the people who are working on the front line we must remember. We must remember those people, the unsung heroes, who are just as important—those cleaners who are making sure that we don’t have C. difficile and we have attacked the issue of MRSA in our hospitals.

We know that almost all NHS workers are under extreme pressure, and that’s partly because we now have an ageing population. Our NHS is also under extreme pressure because we have to finance these new expensive technological developments and new medicines that are demanded by patients. Angela Burns is absolutely right to point out that the expectations of patients today are things that are very difficult to meet.

Proportionately, the fact is that we spend less in percentage terms in this country on health than Portugal, France and the Netherlands. Of course, whilst there’s room for improved efficiency, I think there will come a point where we have to have an honest conversation with the public—that they will have to understand that if they want more, they will have to pay more, or we will have to cut back in other services in order to pay for that help. We all seem terrified to have that honest debate with the public, and at some point we will have to do that.

The NHS in Wales is coping remarkably well under the circumstances. We have got an older and a sicker population, and yet our NHS is no worse, according to the Organisation for Economic Co-operation and Development than any other part of the UK. With that ageing population, we are likely to see more complex care needs develop—care that doesn’t necessarily need a hospital stay but will require that extensive nursing. A 44 per cent rise in the over-65-year-olds has been predicted by the Office for National Statistics over the next 25 years. A 44 per cent rise. If you think about the over-80s, by 2040 we will have over 30,000 people who are over 80 living in Wales. That’s the whole of Llanelli—every single person in Llanelli over 80. Are we ready for that? Are we prepared for it? No way. We don’t have the kind of plan or strategy that will be required. We need to think about that, and we need to understand that that pressure on the health service is not just about health, it’s about our care services—that cinderella service that we always forget about. It’s important that we understand that it’s financed in a different way and that we need to understand the relationship. The Government has understood that relationship. We have the intermediate care plan. It’s beginning to kick in. We will need more of that, without question. If we want to avoid treating patients on trolleys in the hospitals of the future, we need to know that we can release people back to their homes and to their communities.

That cinderella service, I think, we have to change. We have to change our attitudes, we have to appreciate this vital service that we’re all going to need in some way or another, and we have to have a serious conversation about how on earth we’re going to pay for it. Care workers are poorly paid, they’re poorly qualified and they need increased support. We need to work out how we incentivise people to attract them to that important service, and we need to keep people in that sector for the demands of the future.

I think it’s also worth asking how we can look at different models. If you look at the Solva Care model, which is a very interesting model, we have volunteers from the community doing some of the care work that obviously doesn’t require nurse training but that can relieve some of that pressure on our care services as well. Until we address that care service issue we will see more delayed transfers of care, we will see an increase in emergency admissions, putting further pressure on the NHS workforce. At some point, we will need that honest debate with the public about how we fund this.