1. Will the Cabinet Secretary provide an update on progress the Welsh Government is making in reducing waiting times for diagnostic tests? OAQ(5)0170(HWS)

5. What action is the Welsh Government taking to ensure that patients receive diagnostic tests and treatment within target times? OAQ(5)0161(HWS)

Thank you for the question. I understand, Presiding Officer, that you’ve agreed for questions 1 and 5 to be grouped. The number of people waiting over eight weeks for diagnostics at the end of February 2017 was 41 per cent lower than February 2016. This is the lowest figure since June 2011. The latest median waiting time for diagnostic tests across Wales is 2.6 weeks.

Thank you, Cabinet Secretary. Regretfully, far too many people are still waiting far too long for diagnostic tests. We still have nearly 2,000 people waiting more than 24 weeks for diagnostic and therapy services. Diagnostics are the central pillar of our health service, and we must do more to improve access to testing and eliminate waits over 24 weeks. What is your Government doing to ensure that no-one in future has to wait half a year for diagnostic tests?

We’ve made real and significant progress, as I outlined in my earlier answer. I’m clear that the progress is significant and sustainable. In particular, a number of health boards—Hywel Dda, for instance—have no-one waiting over the relevant target time. The challenge will be for the numbers that are left, primarily in south-east Wales, and how they are resolved. I’ve been very clear with both executive officers, but also in particular chairs of health boards, that I expect people to meet to make further progress this year, because whilst I celebrate the progress that is made, I’m never complacent when in fact there is more progress still to be made and some people do wait too long, and I’m determined that NHS Wales will continue to deliver and improve.

Cabinet Secretary, access to diagnostic tests and treatment is particularly important in emergency situations, so I was wondering whether you could comment on the fact that, in a recent coroner’s report following a tragic case of a lady who waited seven hours in an ambulance outside Glan Clwyd Hospital, who passed away shortly afterwards in hospital, he actually said, and I quote his report here:

It is of grave concern to me that my statutory duty requires me to report these concerns by way of regulation 28 reports on a very regular basis.’

So, this isn’t a one-off. This is something that has happened on a regular basis—’a very regular basis’, according to the coroner—outside that particular hospital. This poor woman, this 56-year-old lady, was unable to get access to the tests and treatment quickly enough that she needed to get access to, and that may or may not have resulted in and contributed to her death. Given that this is a health board that is in special measures and that you’re ultimately responsible for that health board as Cabinet Secretary, what are you doing to heed the concerns of the coroner and to make sure that these events don’t happen on ‘a very regular basis’ in the future?

Well, I’ve described the improvements that have been made, but I should just start by recognising that a wait of seven hours outside any hospital department is not acceptable. We need to be clear about not just the level of improvement we’ve made, but equally what we don’t find acceptable within our healthcare system, so we’re clear about the improvement that is necessary. I’m confident that with the improvements that have been made—in fact, in Betsi Cadwaladr, for diagnostic tests, they’ve made significant and sustained improvements for diagnostic waits. The challenge about how our whole system joins up is one that is not complete. I know that in some of the sites across north Wales, the waits outside hospitals are much prompter than others. So, I expect this to be a continued focus of attention—not just the individual case that you highlight, but understanding the broader picture—so we do have a position that is generally acceptable and providing the high-quality healthcare that each citizen in Wales is entitled to expect.

Cabinet Secretary, I welcome the reduction in waiting time waits for the diagnostic tests that you’ve identified. It’s very important that we get people through as quickly as possible. I also welcome the investment in the hub at the Royal Glamorgan Hospital that’s been put into place to ensure that diagnostics work with clinicians on site to improve the service for people. Will you be doing more of these hubs across Wales, and if so, can I put a bid in for Neath Port Talbot Hospital, which is ideally situated for such a hub?

Well, I recognise that he is the local Member for Aberavon. Look, there’s been real progress made in every single health board. Again, Abertawe Bro Morgannwg health board have made real and significant progress in this area. The diagnostic hub to be based at Royal Glamorgan is part of the south Wales programme: the development of a more joined-up service, understanding where those tests could and should take place, as we recognise that whether it’s in unscheduled care or scheduled care, having diagnostic certainty is hugely important to then make proper treatment decisions. I’ll decline from indicating where I’m about to locate, or advance the case for a diagnostic hub to be based in anyone else’s particularly local hospital, but I expect the whole service—the planned for, the demand that we know exists now, that we know will exist in the future—to have a system that is properly geared up to meet those demands that are utterly predictable. We do though know that will require some reform in the way we organise our service. There’ll need to be a properly mature conversation about that in the future. Obviously, I hope that—[Inaudible.]—will help to advance their cause.

Cabinet Secretary, you know that the vast range of new diagnostic equipment is very expensive and very, very effective, leading to more investigations sometimes, and using the new equipment as efficiently as possible is a key to reducing waiting lists—I mean in the evenings, for instance, and over weekends, which often provides more convenient appointment times for people who are in work for instance.

I recognise some of the points that he’s made, as does the service. We invest significant amounts of capital in providing the latest diagnostic equipment. It is important we make best use of it and understand what it’s potentially useful for. For example, I visited equipment that was required for one purpose, but it was actually able to deal with different diagnostic tests. So, it’s well understood in the service, and that’s part of the broader point about what reform does mean. It doesn’t just mean reorganising the physical location of services in primary and secondary care. It also means making the best and most efficient use of the assets that we already have—those are the staff and the equipment that we have. So, your point is well made and well understood by the service.