Thank you, Llywydd. I’m very pleased to open this debate today on the Health, Social Care and Sport Committee’s report on winter preparedness 2016-17, which we’re in the middle of now. Of course, winter is a hugely challenging period for our health and social care services. It’s a time when the year-round pressures of an ageing population, increasing demand for services, and workforce challenges, are thrown into sharp relief. Just two weeks ago the chief executive of the Welsh NHS remarked that the NHS has already faced exceptional challenges this winter, experiencing some of the busiest days ever faced by hospital emergency units and the Welsh ambulance service.

That’s the week the Cabinet Secretary for Health, Well-being and Sport announced that certain targets for GPs are to be suspended temporarily to help free up appointments in their practices, such is the pressure on primary care over this winter. Assembly Members will almost certainly be aware also of the coverage relating to similar pressure on health and social care services elsewhere in the UK and in England in particular.

We as a committee felt it was important to examine how prepared the Welsh NHS and social care services are to deal with pressures on unscheduled care services during what is now the current winter period. As part of this work, we wanted to look at the progress that has been made in this area over the past few years, particularly since the work done by our predecessor committee in 2013-14. Our terms of reference also included a focus on patient flow, including primary care out of hours, emergency ambulance services, emergency departments, and delayed transfers of care.

We spent the 2016 summer period asking stakeholders to tell us their views on whether the Welsh NHS was equipped to deal with pressures on unscheduled care services during the coming winter. We had a really good response to this and we’re grateful to everyone who took the time to write to us and present evidence to us in our formal meetings.

That’s the evidence that’s helped us to come to some very clear conclusions and has enabled us to make what we believe are robust recommendations to the Cabinet Secretary and Minister. Although many of our recommendations are important in terms of managing additional winter pressures, they need to be considered as part of a much wider review of health and social care services in Wales. Indeed, our overriding conclusion is that a more resilient NHS and social care service would be better equipped to cope with the considerable spikes in demand over the winter period. Without that greater resilience all year round, efforts to manage winter-specific pressures will be more about trying to limit their effects than achieving the whole-system change that is so greatly needed. Regular readers of our report will know that paragraphs 71 to 75 tell us this.

I note that the Cabinet Secretary has partially accepted our first recommendation. We are all aware that statutory regional partnership boards were established under the Social Services and Well-Being (Wales) Act 2014 as a way of taking forward the agenda to deliver integrated health and social care. However, I’m glad the Cabinet Secretary recognises there is more to do and that his Government will be supporting further improvements.

Overall, we concluded there is a need for greater integration between the health and social care sectors, both in the planning and delivery of services, and there is a need to include the independent sector, both care home and domiciliary services, in this work. In light of this, I am disappointed the Cabinet Secretary has rejected our recommendation that he should commission or possibly review any available research into the effectiveness of the co-location of primary care services in A&E departments, especially as he acknowledged the evidence from across the United Kingdom outlining the effectiveness of co-location. The information he has provided relating to out-of-hours services working alongside emergency departments is welcome, despite that.