Part of the debate – in the Senedd at 3:41 pm on 7 February 2017.
Thank you for the comments and questions, and in particular for the welcome for the plan and again, the recognition of progress that we have made and intend to make here in Wales. I’ll deal with the last point first about research and screening. Of course, there’s a range of research that takes place across our university and health board sectors. Whenever people mention screening, I just—. We need to take a step back and actually understand what we mean by that and what the value of all of this is. The easiest thing is to call for a national screening programme to understand and to identify early a range of conditions, but actually, we need to have reliable tests that actually tell us something useful and not undertake harm to people. That is our challenge. Is there a reliable test that we can screen the population with? Do we really see health gain in trying to undertake a national screening programme in this area, or are we going to have a greater return in terms of the value for individuals, as well as the NHS, with other measures? At this point in time, I’m not aware that there is a sensible approach to population screening in this area. We need to undertake procedures where we understand there is risk and to understand the risk that people have in their own family histories.
On the point about waiting times, we’re seeing waiting times reducing. As you’ve seen, in my statement, I indicated that we’ve invested £6.6 million in the Swansea centre, as well, to give us more capacity to allow those waiting times to fall even further, as well as the work I’ve already described in answer to other questions about the work we’re doing in primary care to make sure that we have alternative services to make sure that the people who really do need to be referred to secondary or tertiary care have the opportunity to do so quickly.
On your point about smoking falling, again, it was remiss of me not to recognise what Rhun ap Iorwerth said. Measures taken by this place on avoiding smoking in certain parts of the public estate in particular have had a real impact on changing the nature of the conversation around smoking. It’s part of the armoury that we have in actually reducing rates of smoking. It was a difficult choice to make. People may think now that of course you shouldn’t be allowed to smoke in a variety of public places, but there was very real and significant opposition at the time that this place made a choice to prohibit that. We were the first part of the UK to do so. On your point about e-cigarettes, well, e-cigarettes are not unharmful; it’s not as if there’s no harm at all. The challenge is that we don’t understand the exact nature of the harm in these products. That’s why regulation is being taken forward on what could and should go into an e-cigarette. But I recognise that some people use them in trying to give up, but we’ve continued to say, as a Government, that we’ll be led by the evidence and what exists, both about the harm caused by e-cigarettes, and then as an alternative to tobacco. So, I’m not about to go off on a flyer today and announce an entirely different or new approach. We’ll continue to take a precautionary approach, but we’ll be led by the evidence on the right way forward.
Finally, your point about diet and exercise. Again, it’s come up in other questions, but there is a consistent healthy schools message, and any Member who visits one of their local primary schools in particular will be hard pressed not to see a healthy living and healthy eating messages within their schools. So, actually, I think our schools are delivering their part of the bargain in delivering that healthy eating, healthy living message. The work that we’re doing, for example, in rolling out the daily mile in schools is part of that message. The challenge always is how we engage with the parent and the carer group around that school, because they are bigger influences than our schools are themselves on the health behaviours that people acquire and then take with them into adulthood. So, it’s about the whole picture; not just saying it’s the responsibility of schools, because actually, each of us in our roles—as individuals, parents and carers and in our roles in communities—we have some responsibility too, but the challenge always is how we help people to make choices, rather than be seen to be lecturing people or telling them that they’re doing the wrong thing. Actually, that hasn’t proven to be a very effective way to deliver change. Most people understand healthy living and healthy eating messages; our challenge is how we help them to do that more successfully and more effectively.