Diolch, Llywydd. It seems remarkable, in a debate such as this, that we’re going to have to go over some of the basics of how the Welsh Government receives its funding and why the decisions of how England chooses to run its national health service are relevant to both the financial and workforce decisions that are possible in Wales. So, for the benefit of people who perhaps don’t recognise or realise the relevance, in simple terms, it is this: the available budget for the NHS in Wales is highly influenced by overall public spending in England. So, if a UK Government cuts the NHS budget there, then the Welsh Government would either have to cut the budget of the NHS here or cut another budget to break even. If the UK Government decides to increase the budget of the NHS in England, and doesn’t cut other relevant departments, then the Welsh Government can also make that decision. But the key factor is always the decisions made about spending levels in England. It would be effectively impossible for England to have an NHS with a substantially smaller budget and for Wales then to maintain a higher budget. This is why spending decisions for NHS England, and the nature of that spending and the structure it falls into, matter to us. If the NHS in England is likely to be spending substantially less money, then Wales has less money to make a different decision.

There are other implications too: if the NHS in England cuts services used by Welsh patients, for example; if the standards of training for the workforce drop because companies providing services start de-skilling in order to maximise profit, and, conversely, hyperinflation for senior management salaries—a predictable consequence of private sector growth—would inevitably lead to an effect here.