It’s good to hear from a GP who is reflective on their behaviour, because far too often, I’m afraid, some GPs have reached for the script, rather than other solutions to people’s mental distress.

Last night, I spent quite a lot of time running around trying to contact people who were yet to register to vote in order to beat the midnight deadline. Many were delighted to be reminded that they needed to get registered and I was successful in that regard. But I also met other people who disturbed me quite a lot. I’ve met them before. These are people who say, ‘No, I’m not interested in registering to vote; I’m absolutely not interested in voting because they’re all the same, whatever happens, there’ll be no difference to my life’.

These are people who are so far away from engaging with society and making any sort of positive contribution that it’s really quite disturbing. That is potentially quite dangerous as well. These are not people who are busy working hard to make ends meet for their family; they’re generally people who have completely fallen out of the workforce and, in some cases, will have no more than a cursory acquaintance with the workforce throughout their lifetime. I’m not a liberal on this matter. I do not think we should tolerate people living off the state and not being required to contribute anything back. It’s bad for them and it’s bad for the whole of society.

We, of course, have to support people who fall out of the workplace because of some personal crisis. One in four of us will undergo a significant mental illness in our lifetime and employers are not always adept or, indeed, sympathetic to the situation. Losing your job or having a baby can mean you’re out of the workforce for a considerable time and, not surprisingly, people lose their self-confidence, in some cases become agoraphobic, unable to tolerate being outside in open spaces or in unpredictable situations.

In other scenarios, as the Cabinet Secretary has described, people end up using out-of-hours services as a prop for their pain, which is neither appropriate for actually helping them feel better about themselves—but is also clogging up emergency services for those who do need them. So, I was very interested to attend the frequent attenders multidisciplinary team that’s operating across Cardiff and the Vale. They look at the top 20 attenders in accident and emergency, out-of-hours and the GP surgeries for that month, and they get prescribed tailored services to meet their particular needs. It is really very, very impressive what the outcomes are: 80 per cent of these people get back on their feet and resume their normal existence and are no longer an inappropriate burden on emergency services.

It’s Communities First that often takes the lead on getting people referred to them. They lay on well-being courses, confidence building, living life to the full, social support networks—whether it’s gardening or cookery clubs. Generally, under the King’s Fund definition, there’s often a link worker involved, and I suppose one of the key questions for the Government is really: what will happen once Communities First fades away, and who are going to be the link workers who need to be there to guide the individual through social situations that they find difficult, and to support the rest of the people involved in that social group to know that there will be support available if things become difficult? I think Angela Burns has made some interesting comments about the role of the third sector in this regard, but there does need to, clearly, be statutory services having some oversight over this as well.

I just wanted, lastly, to state my concern about the challenges facing young people at the moment. The statistics I received yesterday from some of the employment link workers working in Communities First areas are really quite frightening. In Cardiff north and east there are 166 year 11 young people who are 16 and are about to do whatever exams they’re going to do—they have no destination next year. They do not yet know where they’re going to be next year, and we need to ensure that they’re not NEETs. And a further word of warning is that there are 86 people from the last cohort who would be year 12s if they were still in education who are completely unaccounted for. We do not know what is happening to these people. Hopefully, some of them are gainfully employment, but others are completely missing. So, we need to roll out social prescribing to ensure that everybody is given the opportunity to make a contribution and is gradually being moved towards enabling them to stand on their own two feet.