Part of the debate – in the Senedd at 3:49 pm on 27 September 2016.
Minister, thank you for this statement. I’m very pleased to welcome both elements of it on behalf of the Welsh Conservatives. I do have a couple of questions to ask, though, and I’d like to turn in the first instance to the new treatment fund that you speak of here. You have said previously that the new treatment fund has been developed from Welsh Government experiences of managing high-cost treatments. Last year, for example, Welsh Government funded four new treatments for hepatitis C and a rare genetic disease, atypical hemolytic uremic syndrome. I’m so glad I got that out. Those were just going to be funded by Welsh Government. Can you confirm, in light of your treatment fund, that those particular four new treatments—all high-cost and innovative—have now all been absorbed by the health boards? The reason I ask this is that all my questions do revolve around the funding issue, because I have a bit of concern, given the £75.5 million deficit that we have throughout the joint health boards, as to whether they’re going to be able to absorb the cost of these without Welsh Government funding.
Now, you answered Rhun’s question by saying that you would be seeking for them to do that, but what I wasn’t clear on is: once you’ve withdrawn the funding for a drug, you will expect the health board to pick up that cost. You mention in other evidence that you’ve given on this subject that you would expect the health board to follow the Welsh Government priorities. What would happen if a health board said, ‘Yes, that is a good drug, yes, we’ve had it for a year, yes, it has been effective in some areas, but we can’t afford to prioritise that in the way that you would wish it to be prioritised’? You were funding it when you were funding it, and it was fine, but you’re now no longer funding it. Therefore, it’s become a financial cost to the health board. Will you either be giving them additional funding—and that’s what I couldn’t quite work out from your answer to Rhun—or will you be issuing a very strict set of guidelines that say, ‘Now that this new drug has been trialled by us, has been accepted by us, has been part of the new treatment fund, and is now going to go into mainstream’—although, obviously, rare use, because otherwise it wouldn’t be in this fund—‘you have simply got to find the money for it yourself and prioritise it’. Some clarity there would be really helpful. I’ve used the previous treatments that you funded last year for the hepatitis C and aHUS to understand where they’ve gone. Have they been absorbed by the health boards? Will they still be in the new treatment fund? Will some drugs always be in the new treatment fund for funding, because they are so rare and/or so expensive, even though they do have a good outcome? Will Welsh Government always be putting forward some money, or do you actually see that £80 million being redeployed every year, year after year, on completely different drugs?
Finally, my final question on the new treatment fund is that, when you are looking at using that £80 million, will you be looking at any weighting between the health boards? So again, I’m not quite clear whether the funding will go to the health boards for the new drugs, or whether you will only give the money to the health boards once they’ve used the drugs. Because I would suspect that some health boards, particularly those such as Cardiff and Vale, where they hold more of the rare and specialised clinics, will end up dishing out those drugs and authorising those drugs far more than, perhaps, Withybush hospital in my patch, because they don’t have the very rare and unusual clinics. I’m just trying to understand where the responsibility for that money will lie. Will there be any weighting amongst the health boards on the use of that?
Turning to the independent patient funding programme, I’m really delighted about this. Do you know, First Minister—Cabinet Secretary—