7. Will the First Minister make a statement on rheumatology services in Wales? OAQ(5)0338(FM)

Yes, through the development directive for arthritis and chronic musculoskeletal conditions, we continue to raise awareness and support people to reduce their risk of these conditions and, where they do occur, to assess, diagnose and provide ongoing care as locally and as quickly as possible.

Thank you. First Minister, the ‘Rheumatology in Wales: The State of Play’ report has found that referrals for diagnosis to rheumatology departments have now increased by 66 per cent since 2012, yet just 22 per cent of patients diagnosed with rheumatoid arthritis were seen by a specialist within three weeks. Thirty-five per cent found it difficult to get any appointment, and 20 per cent had waited over two years to begin treatment. A significant number have now resorted to paying for a private consultant for diagnosis as a result of NHS waiting times in Wales. What immediate action will you now be taking to ensure that your health service complies with National Institute for Health and Care Excellence guidance and that arthritis sufferers in Wales are no longer let down by this Welsh Labour Government?

Well, I have to say, in 2015-16, where there is the latest available data, there were just under 94,000 rheumatology outpatient attendances across Wales; 24,000 were new attendances and the remainder were follow-ups; and 2,300 outpatients didn’t attend their appointment, which is never, obviously, helpful in terms of being able to organise the service.

At the end of October there were 14 people waiting over 36 weeks for an appointment, and of these, two were waiting for a first outpatient appointment, both in Cardiff and the Vale. So, yes, some people, it’s true to say from those figures, have waited longer than we would want, but the vast majority of people get seen as quickly as possible.

Bear in mind, of course, that rheumatoid arthritis is not that easy to diagnose. There are many other conditions that GPs will tend to look at first before looking at rheumatoid arthritis, before the blood tests are then conducted looking at the—I think it’s called the rheumatoid factor, as far as rheumatoid arthritis is concerned. So, it’s not that easy to diagnose as a condition, but we want to make sure that general practitioners are more aware, of course, of the need to refer and ultimately, of course, that people get treatment—well, first of all, diagnosis, because the earlier the diagnosis, the better for rheumatoid arthritis, and ultimately, of course, the right level of treatment for them.

Very often, people link arthritis with older people, but it is something that can affect people of all ages. Wales is the only nation in the UK that doesn’t have a paediatric rheumatology service, although patients from north Wales can be treated in Alder Hey hospital in Liverpool. Does the First Minister believe that Wales should be able to offer paediatric rheumatology services?

It is true that rheumatoid arthritis can strike anyone at any age. It’s not something to do with things wearing down but the body attacking itself—it is an autoimmune disease, therefore. We have to be careful here. I don’t want to see people having to come from Anglesey to Cardiff, for instance, to a national centre. So, the geography of Wales indicates to me that it’s important that people can have treatment as close as possible to their homes.

I apologise for a similar question, but, First Minister, with around 400,000 children living in south Wales, the fact that the region is still without a dedicated multidisciplinary paediatric rheumatology service is shocking. Currently, services are being provided part time by an adult rheumatologist, but there is no formal clinical network or adequate multidisciplinary input. What plans does the Government have to establish a tertiary paediatric rheumatology service in south Wales?

Much depends, of course, on the throughput of patients as to whether the unit could be specialised enough. It’s the old question we always face to be effective. But what I’ll do, both as far as the Member for Ynys Môn’s concerned and the regional Member, is to write with further details about paediatric rheumatology to explain why the situation is as it is.