Part of the debate – in the Senedd at 4:44 pm on 1 November 2016.
Minister, I’d like to welcome your statement today, and I do appreciate the consultation exercise that you have run with all the parties here. I do agree that it is time for a mature debate on the national health service and the social care model that we currently have in Wales. However, I think that, as a matter of record, I need to put on the record that I have expressed concerns about the size of the remit. I thought it was interesting that Rhun ap Iorwerth, who I know has constructed much of this with you, has brought that up as one of his concerns. I would have thought you’d have discussed that previously, but I would also like to see a very clear and tight set of remits going forward from the new chair of this panel, because it is such a big brief to look at the entire health and social care model that we have here in Wales. You’ve given this inquiry, you were talking in your statement, about a year. I’m concerned that if the remit is too large we will see too much drift. You said a little bit earlier, in response to Rhun ap Iorwerth, that you could see that it might drift a bit but you wouldn’t like to see it going on for several or more years. To be frank, I think that even two years might be too long. So, will you be able to give us an indication of how much time and effort the members of the panel are able to dedicate to this inquiry, and how much work you will expect to be undertaken in terms of investigative and analysis work by their respective support staff?
I would also like, Cabinet Secretary, if you could give us a clear and unequivocal direction, which can be listened to today by health boards, that this inquiry is not a stopping point to other tactical measures that we need to get on with, whether it is the workforce sustainability, whether it is winter pressures, new hospital builds, which I know you’re going to discuss later, because I know, from my experience in education, that when the Government announced various large scoping inquiries, it was used by some, in some quarters, to stop all other work and I would not like to see that happening in the NHS because we have tactical issues that we need to address on a constant basis.
You will know that I was very keen for the panel not to be the usual suspects, and I have discussed with you personally in great detail my view on those who are not on the panel. I don’t think it would be entirely appropriate to air those concerns and observations in public, but I do want to say that I’m extremely pleased to see the sector representatives from organisations such as the Nuffield Trust, the King’s Fund and the Health Foundation, who I believe will bring impartiality, hopefully best practice, and evidence of benchmarking experience to you. As you know, I’ve raised with you my concerns that the panel was being too health-focused and the whole review would become through the prism of the health service, so I was very, very keen to welcome Keith Moultrie—and I thank you for that appointment; I think that he will add to us—and to hear the voice of a practitioner such as Professor Rafferty. And, of course, you are very aware of my very strong desire to see somebody on that panel from a business experience who’s got large corporate understanding of enormous personnel challenges and issues and logistics and management of logistics. I, too, welcome Dr Ruth Hussey to the chair. And I would like to ask you, Cabinet Secretary, will the chair, Dr Hussey, be the person who will put into place the structure that will enable this panel to interface with Assembly Members, particularly members of the health and social care committee, or do you see yourself putting in place that kind of structure? Because I believe that when we’ve discussed this, we’ve talked about how we can get a measure of cross-party political engagement feeding into the panel on a day-to-day, or week-to-week or month-to-month basis as the panel develops its thoughts.
My final point: I would just want to raise again, and I know that Rhun ap Iorwerth has also raised this, was his comment that slid into the statement about the review team drawing on the work that’s already been carried out in Wales by various large research organisations. This is fresh thinking. One of the big guarantees was that the review panel would look from scratch, not to reinvent the wheel, but that they would reference—and I use that word very clearly—the work already done by organisations such as the Nuffield Trust, the King’s Fund, the Health Foundation et cetera. I would just like your absolute reassurance that they are going to look at this with clear sight, because, as you and I both know, there’s already much research in the public domain that one can argue has come from a particular point of view that might already predicate outcomes that none of us are wildly comfortable with. To just recycle those and put them forward as a set of recommendations would put this and me in a deeply uncomfortable position, because I would like to think that this august panel of highly intelligent individuals with a vast amount of experience will look with real clarity and focus to come up with a picture that would really suit a canvas that would really suit Wales going forward, so that we can put up on that canvas the structure for our health and our social care in the years to come.