2. What efforts are being made by the Welsh Government to retain existing staff in the health service in Wales? OAQ(5)0196(HWS)

There are a range of measures in place. The Welsh Government remains committed to supporting and retaining the existing NHS workforce. We have an open and constructive dialogue with trade unions and other staff representatives and we’re determined to create a supportive learning environment for our staff to work in and deliver high-quality care with and for the people of Wales.

There’s a link between waiting times and the number of staff that you’ve got working in the service. Recent figures have shown that the number of nurses and midwives in the UK leaving the profession has risen by 51 per cent in four years. Within these figures, released by the Nursing and Midwifery Council, home-grown nurses have been found to be leaving in the largest numbers. Now, the Royal College of Nursing and the Royal College of Midwives have both called for the pay cap to be scrapped to prevent this situation from getting worse. Do you not agree that it is time for you to fulfil the Welsh Labour manifesto pledge to scrap the cap, to ensure that nurses remain in post in Wales? Secondly, by ensuring that you stick to your manifesto commitment, you will help to prevent further damage to people’s trust in politics.

There is a real issue about staff within the service, and the pay cap is not just about people’s financial means—there are real issues about value. And that was set out very clearly in the last NHS pay review body report. It was set out again, not just within the health service but across the public sector, in a report from the senior salaries review body, issued this week and in the armed forces’ pay review body as well. There is a real issue about the continuing pay cap, and the effective approximately 14 per cent drop in real-terms income.

This Government wants to see the pay cap removed. We’ve been very clear about that. I’ve discussed that with both the RCN and other trade unions as well. And trade unions themselves understand very well that this requires the UK Government to shift its position. The remit that is given to pay review bodies essentially comes in the financial envelope from the resources available. And that means that if the UK Government do not shift their position and provide resources to deliver a real-terms pay increase, what we could do is give them a remit to give a bigger increase to staff, and we’d then have to fund that increase for national health service workers on the back of redundancies in other parts of the public service.

That is the reality of where we are. And it’s no use the leader of Plaid Cymru saying that isn’t true—we need to deal in reality, because people in our public services are facing the reality of a pay cap. They face the reality of the Tories continuing that pay cap. You may think the right way to approach this is to give the Tories a free pass on the issue. I think all of us who want to see a real-terms pay rise for public service workers need to identify the real cause of the problem, and make sure the Tories do not get away scot-free—that we do make sure that the UK Government deliver on the signals they give and actually make sure that the pay cap is ended. That is what trade unions want; that is what our staff want; that is what this Government wants.

The concern raised with me in mid Wales is not so much about retention, but about the recruitment of health professionals in the first place. There are concerns raised with me on a regular basis about the severe shortage of the recruitment of dentists in mid Wales. So, can I ask: what is the Welsh Government doing to incentivise the recruitment of dentists, GPs and other medical professionals to take up positions in mid Wales in particular?

In terms of reviewing and understanding the recruitment across mid Wales and, in fact, every other part of Wales, health boards themselves, within their integrated medium-term plans, are supposed to be able to plan for the workforce. We are taking forward measures to more properly understand the needs of the workforce and our training and education requirements. That’ll get taken forward with the introduction of Health Education and Improvement Wales—that’s part of the picture.

But the general picture of recruitment is also affected by the issue that we’ve just discussed with the leader of Plaid Cymru, about the continuing pay cap—that is a real issue about how people are valued. The way in which our services work is also a particular challenge for us. To try to pretend that there is one single issue to resolve all of these just means that a politician may have an easy answer to give, but will not deal with the issues that public servants face or that our communities face.

The other aspect in the recruitment that none of us should forget is the onrushing juggernaut of Brexit. If we don’t have a proper deal about what this will look like, those European Union staff who have already left all parts of the service that you refer to, and those who are already considering leaving as well—that will make it worse, not better. If we can’t understand that all of those issues have an impact in every single part of Wales, then we will fail to not just understand the challenge, but to actually have a proper answer to make sure that we have a well-funded and well-resourced public health service, including, of course, the staff to actually undertake the work.

As has been pointed out in this Chamber on numerous occasions, there’s a nurse shortage in the NHS. This shortage has been getting progressively worse for years, and that’s basically because both UK and Welsh Governments have failed to ensure that there are sufficient nurse training places being funded to provide care for an ever-increasing population. What measures are you taking to increase the number of nurse training places in Wales?

I’m happy to confirm that this Government has progressively increased the number of nurse training places within Wales. I announced in February this year another significant increase on the back of increases in the previous two years. If you went and spoke to the Royal College of Nursing, or to Unison, as the trade union representing the largest number of nurses in Wales, they would recognise that this Government is increasing training places, in addition to the ‘Train. Work. Live.’ campaign that we’ve introduced, working alongside stakeholders within the service, and in addition to keeping the NHS bursary that we are proud to have kept, unlike the decision made across our border.

This is a Government that is serious about workforce planning, serious about working alongside staff representatives and serious about having the staff to undertake the job to do. But that does require a different conversation about resources, and Members from any party cannot simply point the finger to this Government and say, ‘Make more resources available to the national health service’ without then setting out which other parts of public service spending in Wales will have further cuts imposed upon them to do that. We already make incredibly painful choices to put extra resources into the national health service. I think that our staff and our public deserve honesty in this debate and that is what this Government will do.