Part of the debate – in the Senedd at 5:15 pm on 6 December 2016.
I don’t share your view. What I would say is that if you put that cap on, you end up with wards running short of nurses, and you end up with hospitals short of doctors. The problem is we need agency staff. The challenge to the Welsh Government and the health service is to get to a situation where we don’t need agency staff because we’re fully staffed.
Why are you, as stated by a former health Minister, twice as likely to have your tonsils removed in Ynys Môn than you are in Wrexham, which are both part of the same health board? Why does the cost of an operation such as cataracts vary so much between different hospitals? We recently heard reported that the cost of locum doctors in Wales exceeds £137 million—an increase from £64 million in the previous year. The highest paid locum, according to the newspapers, received £183,000 last year. We need a system where we get more doctors in, and I put my cards on the table that I believe in salaried GPs.
Why are medical interventions that do no good for the patient still taking place? The auditor general reported on this practice, as have NICE. How many patients overnight does a minor injuries unit need to see for it to be kept open overnight? Currently, the answer to that is three.
We as a committee of the Assembly scrutinised the Cabinet Secretary for health and the Cabinet Secretary for finance as to who engages in the in-depth scrutiny of health board expenditure, not over accuracy and legality, but over efficiency and effectiveness.
Whilst people generally have their major health needs during the last 12 to 24 months of their lives, they can need social care for up to 40 years, with the level and complexity of care increasing as people age, often ending up with a residential care package having to be paid for by the local council. It is also of no surprise that those living in inadequate housing tend to have greater health needs. Health is also a lifestyle. Exercising facilities run by local authorities, and fitness, diet and smoking cessation schemes run by Communities First all help to improve the health of people in Wales.
While the autumn statement has added additional capital expenditure to the Welsh Government’s budget, according to my calculation it still has not even taken us back to 2008 expenditure in real terms. Additional capital expenditure would benefit the Welsh economy. Remember that the capital expenditure that Ed Balls called for and that George Osborne described as wrecking the recovery has now been brought forward by Philip Hammond. It’s very pleasing that they’ve almost learned.
Can I just say something relating to this idea that you have to keep on cutting to make austerity for things to work? No, you grow your economy. You increase your tax take by growing the economy. You get more people working; not as we have at the moment, working limited hours and zero hours and short-term contract hours, but you actually get them working full time and you get their salaries up. When that happens, the tax take goes up and people end up better off. Can I just say that, finally, capital expenditure is desperately needed for things as diverse as new schools and flood defences, even though the global warming deniers do not believe that we need the additional flood defences?