3. 2. Questions to the Cabinet Secretary for Health, Well-being and Sport – in the Senedd on 1 March 2017.
4. Will the Cabinet Secretary provide an update on waiting times for treatment in north Wales? OAQ(5)0117(HWS)
I expect all patients, whether in planned or unscheduled care, to be seen and treated in a timely manner based on clinical need. Some orthopaedic waits in particular are not acceptable, as I have already made clear. I expect to see improvement in this year’s March figures, with further improvement in the year ahead.
Thank you for that answer, Cabinet Secretary. You’ll be aware that I raised the orthopaedic waiting times for hip operations in particular with the First Minister during a recent First Minister’s question time, and made reference to the fact that the routine waiting time at the moment at Glan Clwyd Hospital is 112 weeks for such operations, in spite of the Welsh Government’s 26-week target. At that time, the First Minister laughably responded that a hand surgeon had been appointed at Glan Clwyd—a locum hand surgeon—in order to reduce waits in this area. I’m pleased that you recognise that that is not going to deal with the problem of waiting times for my constituents. Can I ask you, given that the health board is currently in special measures, what responsibility do you, as a Welsh Government, recognise is your responsibility for the lengthening of these waiting times over the past two years?
To be fair, the follow-up question that you asked the First Minister wasn’t specifically about hip waiting times, so you got a response about general orthopaedic action. There is a challenge here about hips within the orthopaedic waiting times that the health board are experiencing. On the Ysbyty Glan Clwyd site, it’s where they see the most complex patients, and, actually, they are the long-waiters—they are more likely to be long-waiters. Unfortunately, there isn’t the capacity available to deal with all of those people at present. There’s a medium-term plan that’s being constructed by the health board, together with their clinicians, to actually tackle that, because we recognise that they do need to do that.
Overall waiting times are much more reasonable. The challenge is this particular group and other particular groups of longer-term waiters. Part of the challenge for the health board is the capacity that they do have and the capacity that they’ve previously been able to make use of within the English system, of which there is less, but it’s also, actually, about the fact that there has been a significant increase in demand in the health board area. In fact, the number of people who have been referred for orthopaedic treatment in secondary care has gone up over 83 per cent in the last four years. Actually, the number of people seen and treated within time has gone up by a third in that time.
So, you see that there’s a mismatch in the ability to see and treat more people, which the health board has done, and to actually meet the demand itself. That’s why actually delivering against the planned care programme is really important—those measures have to go forward. It’s why the support that we provide to the health board matters. It’s not just money, but some of the expertise and the scrutiny of their plans. Of course, I expect to see further improvement over this year and the next year as well. It will be part of the scrutiny and accountability exercise that takes place—whether this health board or any other is in special measures—because, as I’ve said before, I recognise that these long waiting times are not acceptable, and it’s a challenge for this part of the health service and every other.
I’ve stood in this Chamber a number of times in the past criticising the health board and drawing the Cabinet Secretary and others’ attention to a number of problems and frustrations, so it’s only fair that I congratulate when there is room to do that. In this context, I want to congratulate the health board on the use of the app on waiting times that has been produced—well, not produced, but, certainly, it is being used in north Wales now. As a parent, it is something that I’ve had cause to use, and I know of other parents who’ve used it. I was looking now—three hours in Glan Clwyd, a little over two hours in Wrexham Maelor, and no waiting time in the minor injuries unit in Denbigh. And so, I’m sure that you would join with me in congratulating the board—as you’ve recognised in the past—on this development.
But what I want to ask you, of course, is: what is being done to ensure that this best practice is adopted across Wales? But also, what investment is your Government making to enable Welsh health boards to make similar investments in this technology, which each and every one of us has, which, in turn, will help to tackle some of the very practical problems that the service is facing?
I thank you for recognising the success of the app, both in terms of how user-friendly it is but also its usefulness to people seeking to access unscheduled care in particular. This isn’t a particular issue about the cost in developing the app from now, and actually spreading it out; it’s actually about understanding enough time and enough evidence about the value of it. And, actually, it’s been really helpful to have one health board leading in its application.
It’s fair to say there was some anxiety within the service about whether this would prove to be an innovation that would be helpful, or whether it would provide more questions than answers. And, in fact, when I was in Ysbyty Gwynedd on Monday, making a positive announcement on investment in a new accident and emergency department, staff themselves commented they’d actually found the app helpful, and people attending had found it helpful as well. So, it’s been a positive start, but I think, once we have more data on its use and its usefulness, then we will of course look at how we can take that learning forward for the rest of our system—not just in north Wales, but across the rest of NHS Wales as well.