2. Will the Minister make a statement on the provision of paediatric services in Pembrokeshire? OAQ(5)0056(HWS)

We discussed aspects of the paediatric service in last week’s urgent question. I reiterate again that I expect service provision to be delivered on the basis of the very best available clinical evidence. And, of course, the Member is familiar with the content of the 2015 review, led by the Royal College of Paediatrics and Child Health.

Cabinet Secretary, as has already been said in this Chamber before, the Royal College of Emergency Medicine have made it clear that a 24-hour paediatric service is needed in order to maintain a full-time accident and emergency service. Given that you continue to tell us that the Welsh Government is listening to experts, can you tell us whether you agree with the Royal College of Emergency Medicine, who are experts, that 24-hour paediatric services are needed to maintain an accident and emergency service? And, if so, will you now look to re-establish full-time paediatric services at Withybush hospital?

Well, there’s an interesting conflation of two separate issues there. In terms of the paediatric service, we know that, in other parts of the UK, the paediatric service is provided by nurses, leading the paediatric service. In fact, the 2015 royal college review indicated that it may be more sensible to move to a nurse-led service around Withybush in any event. That review also told us very clearly that it would not be sensible to try and reinstate a 24-hour paediatric ambulatory care service.

There is a challenge in making sure all these different services match up with each other. A practical thing like moving where the paediatric unit is, so it’s nearer the emergency unit, it’s part of what has already been done. But I do reiterate that the advice that we have had about the model of care being provided in west Wales is one that has serious weight to it, of genuine expertise, where people are responsible for managing, leading and delivering these services around the country, and we’ll continue to be guided by the evidence and advice.

Cabinet Secretary, it is, of course, right that these questions are raised here in the Assembly, and I’m sure that you agree that questions are raised and asked in the Assembly. But I’m a bit concerned about the tone of the question that you had previously, and how that will play out in Pembrokeshire, where I live. I don’t want the message from here to become one of alarm, that, suddenly, Withybush accident and emergency is now at risk, and that is my concern from the previous question. So, what I’m asking of you, Cabinet Secretary, is a clear message that that is not the case, and that the two things that you’ve just said were conflated—paediatric care and A&E services—are separate and that one doesn’t actually depend on the other.

Thank you for the question, Joyce Watson. I recognise that there is real concern about the future of health in almost every part of the country. Given the commentary about healthcare services in west Wales and the extremity of the language, it is no wonder that people are concerned.

I repeat again: the challenge of having a paediatric service is part of what we are being guided by, and its relationship with the A&E service as well. There are no plans to change the A&E service. We are working with the health board, and it’s the health board’s responsibility to work with its stakeholders, to listen to its clinicians and the public, to meet the desire for a service, but to actually meet the need to deliver that service in a genuinely safe manner that delivers the high-quality care that I expect for every citizen right across Wales.

So, I reiterate again that, on the paediatric service, we are listening to the Royal College of Paediatrics and Child Health. They have undertaken another review again, at the end of September, to further inform where we are. I do not believe there is any need to scaremonger or to project fear about the future of A&E services in Withybush or further within west Wales.

Cabinet Secretary, if Withybush was in your constituency, would the constant reliance on locum paediatric consultants meet your demands and expectations of high-quality care?

It’s part of the challenge that we have about ensuring that we have a consistent grade—[Interruption.] You’re getting an honest answer.

[Continues.]—that we have a consistent grade of a medical workforce, and those other professionals who support them, to make sure that we do deliver high-quality care. That does mean that we need to move to a model that will allow us to recruit permanent high-quality staff across all those particular grades. As to the consultant cover is being provided, if you look again at the Royal College of Paediatrics and Child Health’s review, they indicate it’s for an integrated team, based at Glangwili, to provide that cover, but it does not mean that there is no paediatric service within Withybush; it’s one that meets demand and meets need. And if I lived in and around the Withybush area, I would want to know that the service that is being provided is one that is based on the very best clinical evidence and advice. And that is a challenge. Trying to run a service that meets the needs of local politicians and ignores the requirements of evidence and reliable clinical advice is the wrong thing to do for citizens, either in Withybush or in any other part of the country.