Part of the debate – in the Senedd at 4:46 pm on 4 October 2016.
Minister, thank you for your statement today. I’ve got four areas of questioning I’d like to raise with you. The first thing I’d like to talk about is co-production—this has become a watchword for many organisations, including the Welsh Government and the NHS. I would like to understand better what you’re going to be able to do with all these disparate plans to ensure that co-production and real integration happen, particularly in the areas that sit more comfortably side by side, for example, stroke services with neurological services.
You and I were both at an event only last week when the neurologists were talking about the fact that there’s still an awfully long way to go to ensure that they are able to be effective influencers in some of these implementation plans, and that they were calling for better integration of services. So, it’s not just there, it’s in other areas. What kind of read-across are you getting? How are you ensuring that the people who are carrying out these plans are doing a read-across of all the other plans in existence to ensure that we get the maximum integration and the maximum amount of co-production we possibly can?
My second area is on best practice. I was really pleased to read some of these examples of best practice that you cite here. You talk about Cardiff and Vale University Local Health Board with their pilot seven-day patient-centred integrated rehabilitation service for stroke, and I think you talk about—there’s another one somewhere—Cardiff University with their post-anaesthetic care unit. I’d be interested to know how long it is taking these areas of pilots (a) to be run, (b) to be evaluated, and (c) to then have that best practice shared across other health boards to ensure that we can make these gains throughout the entire NHS and not in just one or two areas.
My third area is about recruitment and I’d like to just say that, whilst I take on board the optimism with which you’ve delivered this statement, I have to say that we still have worse outcomes on some areas—stroke, cardiac care and cancer. We are moving in the right direction, but I would like to understand, in the ambition to reach the successful goals and to catch up with other countries, what part is played by the lack of specialist consultants, specialist nurses and other health professionals in those particular areas of these plans. What is that doing to impact upon the success? I spoke earlier—I think you were here—to the First Minister about the lack, for example, of epilepsy nurses. Because we don’t have epilepsy nurses, how about running epilepsy clinics? We don’t have either. Initiatives like that that would actually, in that case, promote better neurological service delivery for patients, and of course, ultimately, improve that patient’s life and save the NHS money. Because having 70 per cent of people able to control their seizures is much better than having only 50 per cent of people. For epilepsy, you can read across the piece. You and I both know that recruitment is a real issue. So, I’d like to understand what impact it is having on these plans.
My final area is just that I’d like to understand the monetary element of it. I believe that you said that it was £10 million per plan. [Interruption.] Ten million pounds over all of the plans? Yes, thank you, because I thought it was £10 million over all of the plans and I was thinking, ‘Good grief, I haven’t noticed you give out £100 million recently, very generous man that you are.’ So, can you actually tell me, that £10 million, how is it divided up across all of those different implementation plans? Who says who is going to get what money, how much money? And who is actually then following that money through the whole process to ensure that we have proper value for that money and that it is delivering an outcome that we deem to be satisfactory in connection with the value for that money?