I thank the Member for the series of questions and the broadly constructive manner in which he has engaged with the statement. I will turn first of all to your finishing point, about setting a target for the number of GPs. We have not set a target for the additional number of GPs, for the simple reason that what we are looking to do is maximise the number of GPs that we can train to meet fill rates. We don’t currently meet all of our fill rates, as is the case, sadly, with every part of the UK. This reinforces the fact that this is a UK and international challenge. I am interested in having more GPs where we don’t currently have enough. If we are going to remodel primary care and we are going to have a genuinely integrated workforce with GPs and other primary care professionals, I don’t think it’s helpful to then set a target for one part of the primary care workforce. We are really clear that we will need more GPs, but we will also need GPs to work differently, and that’s a point that I will come back to.

Your point about incentives: we have been working with the Wales Deanery. Also, part of the point about the taskforce is to have discussions with partners about what incentives could and should look like. So, we are looking in particular at bonding schemes—we know that this is something that your party has been interested in as well—about potentially looking at bonding schemes to bring people into areas where there are challenges and, equally, to look at the potential for new GPs and how you can potentially help people with some of the costs of their training, if people agree to undertake a certain period of service here within NHS Wales. So, there’s something there about having something for something, and that is something that we are actively exploring with partners. I will, of course, keep not just him but the rest of the Chamber updated as we properly and actively consider that and bring it to a conclusion.

I didn’t mention it in my statement, but I have mentioned before in this Chamber, the point about Wales-domiciled students. I met the deans of both Cardiff and Swansea medical schools, and I met them together, rather than having separate conversations where they could tell me what the other people weren’t doing. I had a joint conversation and it was actually very constructive. Again, that’s been something that I’ve been really struck by and gives me some cause for optimism: there hasn’t been points-scoring. There has been an acceptance of the fact that we need to do better. Part of that conversation was about how we encourage more Wales-domiciled students to undertake careers in medicine, and how we can make it available to a wider range of people as well. So, it’s about widening access as well as widening numbers too. That’s very definitely part of the conversation that we are having, because we want to see more Welsh students choose to undertake their GP training here. A range of Welsh students are ready to go to other parts of the UK and abroad to undertake their medical training. There’s a range of reasons why people do that. If you look at new undergraduates going to a career in medicine, they may well want to have a different experience, away from home. There’s no reason why there shouldn’t be excellent opportunities for them here in Wales. But, for example, a direct comparison is the nurse training workforce. The average age of nurse trainees at the start is 29. They are in a very different position to, if you like, your typical undergraduates, in terms of their roots in a particular area and responsibilities. So, we need to recognise the different groups of people that we are dealing with, and how we make that attractive and remove barriers to having more Welsh students studying medicine here in Wales.

This also feeds into the point about work experience. That is something we are actively considering, not just within the GP and doctor part of the workforce here, but the wide range of careers that exist within the NHS, and making sure the NHS is more proactively engaging with the local population that it serves, works with and for, in highlighting the whole range of careers that are available in the national health service at a younger age as well. I expect to be able to tell you more about what the NHS is doing, but there’s a very clear expectation from Government to the NHS that there will be a much broader work experience offer, about making sure that people have the opportunity to come in at a younger age, as well as for people as they get older and are thinking about different options later in their academic life too. In fact, in terms of experience and making opportunities in medicine, I haven’t yet watched it, but the S4C series has just started, looking at doctor training. Actually, Cardiff University and the medical school were both really positive about the way that that was going to present the opportunity to be a doctor, what it really means and actually what it can give to someone—not just the financial returns, but a really rewarding career within all parts of medicine, including primary care as well.

Now, if I can come back to your final point there about where you start and about the shape of primary care, well, you said that where we are isn’t sustainable. The current way of working isn't sustainable, and so, large parts of healthcare will need to look different in five years’ time—we should want them to. The point is that we should plan for them to look different in a way that best serves the needs of our population. The challenge here is how we ensure that change isn’t the inevitable that happens to us—that we’re taking control and ownership of it. And that’s what I’m looking to do with our partners. I have to say that, so far, in the engagement this term, there’s been a positive approach with other parties in this Chamber and we’re all looking in the same direction at this point in time. Now, that will mean, in primary care, though, we expect there will be a smaller number of practices. We are likely to have fewer of them. We’re likely to see more amalgamations. We're likely to see more federations as well. There's a federation starting in Bridgend, which I think is a positive example. That could mean that, over a broader area, you're going to provide different services for the population, as well as having more robust services. So, I have no particular plan to bring in to local health board control a certain number of practices; our aim is to ensure we have a genuinely sustainable primary care workforce on a footprint that makes sense and is generally sustainable, and that will mean change. And given the number of single and double-handed practices we have in Wales, there is understandably going to be some change, and that is uncertain both for individuals who work for those practices and the local population. Our challenge is how we approach that in a genuinely mature and constructive manner without trying to exploit fear and opportunities for immediate point scoring, but actually saying, ‘How do we make sure that, in five years' time, primary care is in a better place, more sustainable, and people have real confidence about the quality of services that they receive and take part in’.