3. Will the Cabinet Secretary make a statement on out of hours GP services in South Wales Central? OAQ(5)0099(HWS)

I expect health boards in South Wales Central to provide safe and effective out-of-hours services. This includes ensuring that all patients are dealt with within a clinically appropriate time.

Okay. The problem is—and this comes from people in the service—that there have been times over the last 12 months in Cardiff when there has been no doctor available at all in the out-of-hours general practice service. What can be done to make sure that that doesn’t happen in future?

Thank you for the question. I’m aware that there were in two occasions, one in August and one in December, when there was no GP available for a limited period of time for part of the night. What actually happened to make sure that the health board could provide a proper service was that there were other health professionals, and there was call-on support from neighbouring health boards, too. The challenge is across the country, in varying degrees. For example, Cwm Taf health board have been much more stable and secure, and they’ve got greater GP numbers going into their service. Cardiff and Vale held another recruitment day in the middle of this month, and they’re hoping that there will be more GPs coming into the service. It is something about how we make the whole model more sustainable as well. It isn’t just a GP out-of-hours service. It is about how we understand all of the needs. For example, 7 per cent of the calls over the last month have been on dental issues—and that’s something I’ve got particular sympathy for right now—but we do need to see the whole range of professionals covering and doing that. That should make it more attractive for GPs to undertake their part of the service.

In many ways, it’s a similar issue to the earlier questions and discussions we had on the wider primary care team. We need a wider team within out-of-hours to make sure the GP’s part of the role is both interesting and attractive for GPs to undertake it, so that they provide the right care and make the right decisions that only they can make as part of the out-of-hours service. But it’s definitely something that is on my radar, and I expect to see further improvements over the rest of the year.

Cabinet Secretary, you talked about making the service more sustainable, the GP service and, indeed, the out-of-hours service. Obviously, the backbone of that is having doctors on the ground who can perform the service when it’s required. I heard, in a previous answer that you gave to Nathan Gill, about the insurance, and indemnity insurance in particular, for doctors who are coming to the end of their career who might wish to practise part time and could offer this service back into the NHS, thus alleviating some of the staff pressures. Are you going to bring forward a national indemnity insurance scheme, such as is available in other parts of the UK that is paid out of the NHS risk pool? This would go a long way towards actually tapping into that huge resource of retired doctors who would wish to continue to practise but, because of the cost they face in insuring themselves, it is just not financially viable for them to do that.

I indicated earlier, as you will have heard in my response to Nathan Gill, that we’re having active conversations with the BMA about trying to resolve the issue of indemnity. It’s a particular area of concern for them and the whole GP community. It isn’t just an issue about the end of a career, either—it is something running through the lifetime of a GP’s career, as indemnity costs are rising. I’m not going to spike those conversations by trying to talk halfway through about the range of options there are. But, we’re considering a range of options with the BMA, and, as I said, over the coming months, I’m hopeful we’ll be able to bring forward a proper proposal that we will have worked through in partnership with the BMA. Again, that’s the point—we want to work in partnership with our GPs and the rest of the healthcare community.