Thank you, Deputy Presiding Officer. I’m happy to move the motion on the order paper and at the outset confirm that the Government is also happy to support the amendment tabled.

Now, each year, as Members will know, the Chief Medical Officer for Wales sets out an independent overview of health and well-being issues facing the nation. I’m pleased to lead this debate to mark the publication of the very first annual report from our new chief medical officer, Dr Frank Atherton. It’s been written jointly this year with Professor Chris Jones, the deputy chief medical officer.

This annual report traditionally sets out an assessment of where Wales stands with regard to health and well-being and I hope that Members have noted that, in this report, the chief medical officer has actually given us a different feel to those previous reports. Now, it builds, of course, on many of the messages of his predecessors, particularly in relation to prevention and timely intervention. But the new chief medical officer has chosen to view things in a slightly less traditional manner. He’s not simply added a section on the social gradient, he’s focused the whole report specifically on the social gradient and how people from disadvantaged groups experience higher levels of ill health and poorer life chances.

I welcome the direction of this report. It challenges all of us here in this Chamber, as decision makers and scrutineers, and it should drive our choices in the future and I hope it will inform the future debate of health and well-being in Wales. It provides recommendations on how we make our services more effective, accessible and sustainable for all.

The social gradient affects everyone and all our public sector organisations must think and act differently if we are to tackle the inequalities that exist within communities in a meaningful way. These are inequalities within each community and between different communities. Whilst these inequalities are not unique to Wales and they are seen in other countries across the world, they do, of course, have a uniquely Welsh dimension, in terms of history, culture and geographic location. It’s the understanding of people and the communities that they live in, in which their everyday life takes place, that will help us to work together to ensure the most appropriate response for those circumstances. Because all of us know that the national health service faces a continual struggle to meet the demands caused by ill health—demands that we recognise as rising, year on year.

An overreliance on services and outdated clinical custom and practice can cause huge amounts of activity in the system, but do not always meet the needs of those who are worst off. I’m pleased to highlight here the work we’re already doing in trying to reform the out-patient system. We know it drives huge inefficiency into our services. It does not make the best use of clinicians’ time, or, indeed, make the best use of patients’ time, all the time; it is really a point of activity that can have huge savings for our health service and much greater value in terms of what we deliver afterwards.

The chief medical officer’s report quite rightly asks what the NHS can do to address this situation, by, amongst other things, unlocking the power of the individual and community involvement in creating a shift away from ill health to well-being. Now, ultimately, this should reduce demand on services and make them more sustainable. By looking at health outcomes through the lens of the social gradient, we can observe a higher prevalence of lifestyle-related and social harms, illness, and early death in the more economically disadvantaged groups. So, the report seeks to set out what we understand by the social gradient in health and it shows that it is as unambiguous here in Wales as it is elsewhere. Health gets progressively better as the socioeconomic position of people and communities improve. The report also examines how the social determinants of ill health, from a difficult early-life experience during foetal life or in the early years, poor education, housing, unemployment, or the impact of poverty, each one, can impact on our health and well-being in the longer term, and how the national health service and other public bodies can intervene to influence or mitigate some of those negative factors. The report reinforces what we’ve learnt and know about how best to tackle the social gradient: that is, through universal services that respond to the level of need, which differs in different parts of our country.

Now, our free-at-the-point-of-use NHS, with its worldwide reputation for excellence, has done much to prevent health inequalities, but this report asks questions about how we use the NHS resource here in Wales to its best effect, how the NHS must be organised to further reduce, not increase, the social gradient, and about how best to embrace our prudent healthcare principles here in Wales and provide more equitable services to be genuinely co-produced with the individuals and communities that they serve. I think here is the point that the amendment is seeking to focus on as well. We recognise that there is a leadership responsibility for people like us, politicians, and for people in health boards and other organisations leading and running organisations. But, as well as that leadership, we won’t be truly successful unless we’re able to work with different communities and individuals, not simply to tell them what they must do. At each interaction with health and care professionals, and with peer support and peer challenge as well, we recognise that we can help to inform people to make genuinely informed choices. We do know that the more informed patient tends to make better choices.

The messages in the report regarding a more sustainable healthcare system and the need to manage demand are challenging, but essential. NHS Wales is a busy system. It’s our largest public service. It consumes 48 per cent of our resource, and, indeed, our spending on health and social care is now 7 per cent higher per population than that in England. The most recent OECD report, which reviewed the quality systems operating in the four United Kingdom health departments, was complimentary about much of what we are already doing in Wales, but felt we could do more to achieve our ambitions. That means moving away from treating ill health and towards ways of supporting people to make the best of their life chances, when, in many cases, good health will follow.

The messages in this chief medical officer’s report about new models of care, such as social prescribing, for example, and the need to better understand the challenges faced by communities in order to find solutions, are timely and welcome. The pivotal role of health professionals is also important and chimes with similar best practice for all of our public services in terms of culture, leadership and behaviours. Generally trusted and highly valued, with access to our population at key junctures in their lives, we need to maximise the ability of our workforce to intervene with individuals within their communities and employ shared decision making in order to improve those outcomes for individuals and families. Of course, that also supports the aspirations set out in our Well-being of Future Generations (Wales) Act 2015.