3. Will the Minister make a statement on services provided at Ysbyty Ystrad Fawr? OAQ(5)0069(HWS)

Thank you for the question. Ysbyty Ystrad Fawr provides a wide range of services, including 24-hour emergency services, emergency admission and assessment, short stay observation facilities, minor injuries service and a co-located out-of-hours service. In fact, between the areas of day care, of emergency admissions and of maternity and elective in-patients, it sees, on average, more than 10,000 people within each year, in addition to those other services it provides.

That is the correct answer, Cabinet Secretary. [Laughter.] I’d say, amongst residents in Caerphilly, the role of Ysbyty Ystrad Fawr, though, is not fully understood. The specialist critical care centre that’s designated for Cwmbran, or near Cwmbran—Ysbyty Ystrad Fawr was designed to serve it. And, by the way, you won’t ever hear me call it ‘the SCCC’ ever again after this mention, because I don’t think that sells it to the people of the area.

Bearing in mind this issue, I recently met with the chief executive and chairman of the Aneurin Bevan health board. Following those discussions, I’d like to see a further centre of excellence at Ysbyty Ystrad Fawr, particularly in the form of a centre of excellence for breast care services. I think that would further enhance the activities that are going on in Ysbyty Ystrad Fawr, particularly in relation to the critical care centre that will open in association with it. Will the Cabinet Secretary add his support to that campaign, and add any further support that he’s willing to give?

I thank the local Member for inviting me to join a local campaign that I know he is taking very seriously. However, I’m sure you will understand that it’s for the health board to take the decision on whether they do have a specialist centre for breast care and on where that is as well. They need to engage the local public, and particular the community health council. It is possible, where I could be called upon to make a decision, you understand that I wouldn’t express a view on it. But what I will say is to reiterate points that I’ve made previously—that the decisions around the capital programme, in particular the specialist and critical care centre, are part of a whole healthcare system that includes Ysbyty Ystrad Fawr. The services that are provided there need to be based on what is the evidence of patient benefits in the patient experience, the patient outcomes in a genuinely sustainable service. I’m aware that there are proposals and discussions about a specialist breast care service, and I look forward to receiving the outcome of those, and understand that they really are founded on those really important points about how we deliver a better service, not just for your constituents, but constituents across Gwent and wider south Wales as well.

Cabinet Secretary, following the same question that my predecessor asked, Ysbyty Ystrad Fawr is one of the sites being considered by Aneurin Bevan board for a specialist centre of excellence for breast cancer services—

That’s what I just said.

Yes, I know. I’m just mentioning it and agreeing with you. [Interruption.] In March this year, it was reported, Presiding Officer, that patients in Gwent are waiting longer for breast cancer referrals than anywhere else in Wales. Will the Cabinet Secretary advise when a decision is likely to be taken, and will he commit to exploring all options available to him to deliver excellent breast cancer services in South Wales East?

I thank the Member for the question. In trying to discern what’s different about the points made by the Member for Caerphilly—I’ve said what I said about not being able to comment on an individual decision, but the evidence about the current service drives the need to think about how the service is delivered in the future. And that’s the point—I’m not thinking you can deliver the same service in the same pattern and expect improvement. So, I look forward to seeing the proposals that the health board are running, and have a discussion with the local population and the community health councils. If it comes across my desk, I will look at, as I’ve said to the local Member for Caerphilly, the evidence of patient benefit, experience and outcome, and a genuinely sustainable high-quality service.

Some people were clearly disappointed by the scope of services available, and particularly the nature of the emergency service, compared to their prior expectations. I just wonder if there are any lessons to be learned by the Welsh Government or the health board as plans are made and communicated for the future of the Royal Gwent Hospital in Newport and Nevill Hall Hospital in Abergavenny, in light of the very welcome specialist and critical care centre.

Well, some of the challenges about the nurse-led service are about understanding what is and isn’t there, and, actually, some of that relates to a lack of understanding about the high-quality care that advanced nurse practitioners do provide, and the high numbers of people who go to Ysbyty Ystrad Fawr and are seen very quickly and very professionally. You don’t hear an awful lot of complaints, actually, about the quality of care that’s provided in Ysbyty Ystrad Fawr, and I think more people could make more use of that, rather than defaulting to a larger centre, where their care needs could be met closer to where they are.

There are always lessons to be learned about how health boards communicate plans for changing the way that health services are delivered, and it’s important that we don’t shut off and say we’ve reached a point of perfection. There will always be more that we could and should learn, so that’s why we expect health boards to constantly engage with their local populations to explain the rationale behind any decisions and proposals for the future. I think the most important point is to constantly reiterate: what is the benefit for the citizen, what is driving the service change agenda, how will it actually impact on those patients, and can we expect to see an improvement in the quality of the service that they receive? I think, actually, Aneurin Bevan is one of the better health boards in this area. For example, despite some difficulties with the way that the stroke care reconfiguration has been delivered, it’s now in a much better place and they’re recruiting stroke clinicians in a way that other parts of the country aren’t always able to, because they’ve got a better service and they’ve engaged their local population about that. So, I look forward to seeing other health boards learning from each other and improve the way we talk to and listen to our public in redesigning healthcare for the future.