Part of the debate – in the Senedd at 4:32 pm on 23 May 2017.
Thank you, Deputy Presiding Officer. I’d like to start by thanking all Members who have contributed for their considered and constructive contributions. This isn’t an area where the Government has a hard-and-fast view on what work and must work. As I indicated, we’re looking at developing an evidence base based on examples of what already takes place in Wales, and the evidence of what works best.
I think we’re really talking about appropriate prescribing. Sometimes, it may be that social prescribing is something to replace poor prescribing decisions by clinicians and, of course, we should always constructively review what clinicians do, but there are, of course, entirely appropriate reasons why people’s health will be treated by a form of medication prescription. This is about how we add to and potentially replace some of that in a way that is appropriate for the individual. If you like, picking up on what Eluned Morgan said, ‘What matters to you, not what is the matter with you’, and see how we empower people to take more ownership of their own choices, and then to give them those choice and how easy those choices often are, if only they’re pointed in the right direction and helped in that way. There was much in Eluned Morgan and Angela Burns’s contribution, even without the intervention that Angela made, where there was actually a lot of commonality: book prescriptions, art, music and sport, and the role that they have. There are a number of things we’re already doing with young people, both myself and the Cabinet Secretary for Education, where we have a number of things we’re doing in schools to help to try and support people and their resilience in the most general terms, and understanding what we can do to promote that general well-being for the child and their whole family, and to think about how that works. But I would not pretend that we have perfect answers. As you know in Government, there is rarely a day when there is a perfect answer, and if there is one I have yet to come across it myself. But we are thinking seriously about what we’re doing and, as I said, the pilot that we’re going to develop to start this year will be about building their own space. To go back to Eluned’s point about where the budget is, that very much depends on what the evidence tells us about both the cost of providing the service, but then of the impact of that service, and our broader challenge, if we’re speaking honestly and in a mature way, about how we shift the way in which we provide services with citizens, not to citizens, and actually how we make those choices different ones as well. So, the challenge is about how we gear this up to make that system-wide shift and change.
Just going back to Angela Burns’s contribution, I’m happy to recognise your point about how you refer people into a service, and what that service is, because there will, of course, be occasions when that service comes from a medical professional. There may also be times when what we call social prescribing doesn’t necessarily get routed through a GP or a healthcare professional. But if it is about how you provide someone with a route to actually access support, resilience and advice to improve their general health and well-being—that’s why I don’t want to get too tied up on a definition, but I do recognise the King’s Fund definition is a useful place to start from—.
Again, thinking about Dai Lloyd’s challenge about walking—those of us who have iPhones—other smartphones are available, of course—if we walk around with them, they have this handy thing on them that tells you how many steps they think you’re doing, how many flights of stairs you’ve had. I don’t always think it’s entirely reliable and I tell myself there are occasions where I’ve done more walking when my phone’s been sat on a desk—but this job is difficult and politicians are often very poor examples of doing what we say others should do. At election time, we almost all get our 10,000 steps in, but in a normal day otherwise, it’s actually really quite difficult—but it’s something for us about how we take time to do things for ourselves as well.
Then we had Jenny’s contribution and, in particular, I’m pleased to hear you mention the frequent attenders work that’s often there about not saying that frequent attenders don’t have health and well-being needs, but their needs are being met or dealt with inappropriately in going to the wrong place for the wrong care at the wrong time. That point is about how you provide people with a route to understand what their needs are and how they’re then met appropriately. Often, that is about directing them to other services or towards what they can do for themselves.
I’m particularly pleased that you highlighted the cross-Government challenge that we have. Good health and well-being is not just an issue for the health service, it is absolutely an issue that goes into education, that goes into housing, it goes into the economy—virtually every area covered in ministerial portfolios. Also, thinking back to my previous life, when I was an employment lawyer, and about the links between health, well-being and work—.
Finally, in terms of some of the other points made by Mark Isherwood and Caroline, we recognise, as I said earlier, the broader benefits of this approach and in particular the importance of the third and independent sectors in helping us to get this right. So, I’m really pleased about the constructive debate that we’ve had. I look forward to developing our approach to social prescribing in Wales and to further raise awareness of the health and social benefits that it can bring. I ask Members to support the motion and the amendments and I look forward to reporting back to Members in due course on the work that we will undertake in the pilot and developing the approach here in Wales.