10. 6. Debate: The Chief Medical Officer's Annual Report 2015-16

Part of the debate – in the Senedd at 5:44 pm on 29 November 2016.

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Photo of Vaughan Gething Vaughan Gething Labour 5:44, 29 November 2016

It’s exactly the reason why we’re investing in our community pharmacy network, and it’s why we’re rolling out extra investment in that IT platform and expecting them to do more. Now, that’s an open conversation we’re having and I’m generally pleased that there’s not just a pharmaceutical committee, but the role of Community Pharmacy Wales being genuinely open-minded about the future. It’s a real positive, and it’s a helpful contrast between Wales and England. I think everyone in every part can take some real pride that we’re taking that approach here in Wales.

A number of people mentioned education and the importance, not just of the new curriculum and the health and well-being aspects of that, including relationships, but this whole point about childcare and early years education. I know Jenny Rathbone mentioned this as well. It’s definitely part of the agenda of this Government not just to improve our childcare offer, but to think about how we add a real quality element to this, so it’s not just volume but the quality of that intervention too. Because we do recognise that talent is not the reason why wealthier communities outperform poorer ones, both in terms of educational outcomes and indeed economic ones at the end of it as well. There is much more to it than that. I’m happy to recognise the points that both Julie Morgan and Angela Burns made about adverse child experiences and their impact on people’s outcomes later in life, but in particular the really important ones are the first 1,000 days, and the priority that we pay to that as well.

It isn’t explicitly mentioned in the report, but as part of the Healthy Child Wales programme and the focus on the first 1,000 days, there is no letting up on the importance of breastfeeding as well. There’s something about: is the message still ‘breast is best’ or ‘breast is normal’? Because actually we need to renormalise breastfeeding because, you’re right, there are still far too many examples of the way that people react poorly or offensively when someone is breastfeeding. It’s an entirely natural process and it’s good for the child and the mother too, as you’ll recognise there’s a lot of research for that as well.

I’m glad to hear that John Griffiths didn’t miss the opportunity to tell us about the Newport update as well, but I want to address perhaps one of the points that Caroline Jones made. In the report, we recognise the differential rate of smoking and its real impact on health outcomes. I don’t quite share your enthusiasm for e-cigarettes as the way forward as almost a panacea for smoking. There is evidence that is contrary at present. Some of the proponents of e-cigarettes as an alternative, there’s alternative evidence both from the British Medical Association and also the World Health Organization as well. I think we’re doing the right thing keeping an open mind, but a precautionary view on e-cigarettes as a potential tool to help people to give up smoking, but they are not a harm-free substitute for smoking. There is still harm associated with e-cigarettes. We want to monitor and understand that evidence before we reach a definitive conclusion.

On the point that Jenny Rathbone made about obesity and diabetes in particular in children and young people, and the importance of food and nutrition in schools and in wider communities, there’s a real challenge here not just about what goes on in schools, because I’m proud of the work we’re doing across schools right across the country, in having a really clear healthy-eating message and the food that people are provided with in a school setting. There’s more that we can always do, but it has to be working with that whole-school community so that parents and carers understand the choices they make outside the school gates and the impact they have, because actually that message is more important than the one that children get in school.

Llywydd, I’m really pleased with the debate we’ve had here today and the recognition that health inequalities arise because of inequalities in society, both in the conditions in which people are born, grow, live, work and age and in the structural drivers of those conditions—the unfair distribution of power, money, resource and opportunity. Professor Sir Michael Marmot, a recognised expert in the determinants of health and health inequalities made recommendations for action to reduce health inequalities in his report, ‘Fair Society Healthy Lives’. He’s highlighted the majority of steps required to address health inequality and a social gradient to take place outside of the health service.

I’m delighted to have taken part in a helpful and constructive debate and I look forward to working with Members across the Chamber over the next few years as we look to take forward not just the message in this report, but how all of us have a contribution to make.