1. Will the Cabinet Secretary make a statement on the number of patients referred for orthopaedic treatment in north Wales? OAQ(5)0201(HWS)[W]

Thank you for the question. There has been a significant increase in orthopaedic referrals in Betsi Cadwaladr over the last four years and capacity has not met demand. The local health board is taking a range of measures to deal with the increase, including the use of various triage services such as physiotherapists in general practitioner practices and lifestyle and weight management clinics, in line with recommendations of the planned care programme.

More than 1,200 patients are waiting longer than a year for treatment in north Wales and that is unacceptable. I hope that you would agree with that. A recent paper from the board on developing orthopaedic services emphasises the need for more training places in order to provide the necessary workforce to create a sustainable service that can meet reasonable targets. Isn’t the statement that you made yesterday that there is no case for establishing a medical school in north Wales entirely contrary to the spirit of that paper and runs contrary to what was said in the recent health committee report? Of course a medical school cannot be established overnight, but your pledge to have more students spending more time in the north, as if it were some far-flung country, clearly isn’t enough. So, when are you going to show some ambition on this issue and set a target so that we can start to move towards it?

Thank you for the follow-up questions. I do agree that long waits are unacceptable. There’s a real challenge for Betsi Cadwaladr in actually delivering property capacity and demand within its services. We know that there’s likely to be more demand as we move forward and that’s why they have to take a range of measures. The initial orthopaedic plan they had at board wasn’t endorsed because there’s still further work to do on it.

There’s a challenge here about a range of our services, not just specialist services but elective services as well, in understanding how we use properly the capacity we have and in reconfiguring that capacity to make better use of it. I think the link that you attempt to draw between a decision over a medical school and the ability to recruit enough staff to work within a different model—I don’t accept that there is a direct link in the way in which you try to present it.

The decision that I announced yesterday was meeting the commitment that I gave to the Assembly to give that indication before recess, and it was deliberately done before questions today to make sure there are opportunities to have this debate within the Chamber. But the health committee report did not say that there should be a medical school in north Wales. It made a number of points that I do take seriously about the case being made to make sure that training across the country takes place, and where those medical education places are actually provided. That includes a proper conversation with the two medical schools about where their students are housed and where they undertake their medical education, and, as I indicated in my statement yesterday, I do think there is a proper case to take forward to ensure that more people undertake medical education within north Wales.

So, there has to be a proper partnership carried forward between Bangor, Cardiff and Swansea universities and the national health service to make sure we do deliver more places for medical education to take place. That must take place regardless of any expansion in numbers, because if I were to try and tell you and other people this will only take place if there is an expansion in numbers in medical education, it would be the wrong signal to give. I think it’s important with our current cohort we think about how we provide the opportunity for more of those people to undertake their education in different settings. That does tie in with work already in place, and I’m committed to doing that and to having and open and a sensible conversation with stakeholders, not just across the national health service but in this Chamber and beyond to deliver on that ambition, because I do think there will then be a greater prospect of people either staying in north Wales or returning to north Wales to undertake further periods of medical education and actually staying to work within the national health service thereafter.

Thank you to the Member from Ynys Môn for raising this once again in this Chamber. Now, according to the latest Welsh Government figures, the number of patients left waiting over 36 weeks, which is twice as long as long as in England, for trauma and orthopaedic treatment in north Wales now stands at 3,336. This is the highest it has ever been. Anecdotally, an 84-year-old female constituent of mine waited 103 weeks—84 years old—that’s over 720 days, almost two years, for their surgery. And a male constituent waited three years for hip operations. In response to my correspondence, you state that you expect all patients to be seen at the earliest opportunity. That is a laugh. What are you going to do about your failure to deliver for these 3,500 patients in north Wales? It’s your Government—you hold the brief and portfolio for health. And I have raised this question time and time again, and we get very, very waffly answers. Tell the people in north Wales—the 3,336 who have been waiting over 36 weeks, twice as long as in England—tell them when are they going to have their operations.

I can assure the Member this is not a laughing matter and it’s certainly not something that I find amusing at all. The challenge always is, whether in relation to an issue where we understand there is more than one reason for a rise in demand, and the inability of the health service to meet that demand—. The demand for a simple answer, to flick a switch and deal with it—that’s unlikely to be the case. And I would much rather be honest and deal with Janet Finch-Saunders saying that I’m waffling by explaining honestly and clearly the challenges we face and what is being done about them, rather than pretend that there is a magic lever within Government to make all of this go away. I think that is absolutely the wrong thing to do.

But I am clear—I do expect people to be seen at the earliest opportunity. And that is why I’m very clear, not just to her, but to other Members in the Chamber, across other parties too, that I do think that waiting times within north Wales are unacceptable. That’s why I expect the health board to improve. That’s why I expect to see a real plan for orthopaedic services in north Wales to make a real difference, not just at a long point within the future, but progressively over the rest of this term as well.