The Welsh Conservatives will support today’s motion to note the interim report by the parliamentary review of health and social care. The interim report makes for thought-provoking reading. It lays out, with a degree of frankness not often allowed, the scale of the challenge that faces our country in terms of how we sustain and renew both the Welsh national health service and the care sector.

The panel have made great strides in talking to users, patients, clinicians, experts, management and—for this I’m most grateful—us politicians, but it is only an interim report, and we have discussed this interim report in committees and in a Plenary statement, so I don’t want to rehearse all my previous commentary. The reality is that we need stage 2. The final report will, I hope, give suggestions as to how we might resolve some of the more intractable challenges. Some of these challenges are self-evident, and I am concerned that we may not strive to meet those challenges because we’re waiting with bated breath for the concluding document.

I would like to know what areas, if any, that were identified by the interim report have already been taken forward by the Welsh Government. For example, we all know that the Welsh care sector is very fragile. The employed care force are not always paid fairly or treated well; training is not always available or is minimal; the turnover of staff is high; we have a high reliance on temporary workers; there is little or no career progression available to the employed carer; the unpaid care force is exhausted and often ignored; there’s no cavalry coming to rescue the desperate carer at home who longs for support, for respite, for recognition. It’s a profession that’s often deemed as semi-skilled or unskilled, which is the unkindest cut of all when, actually, to care for another human being goes to the essence of our humanity.

The interim report recognises this fragility and lack of skill base. The report heard that informal carers need to be involved in planning and developing the workforce, that we need to increase skills and develop a career path. These conclusions simply reinforce a situation we’re aware of and that we could start addressing now. I’d be interested to know, Cabinet Secretary, what can be taken. Of course, in the NHS, the position is, if anything, more difficult. We all know of the recruitment issue that is hindering the delivery of first-class care consistently and comprehensively across Wales. We know that we need more doctors and nurses and more allied healthcare workers. But let me give you yet another example where lack of staff is proving problematic. I have an e-mail from an eminent consultant and he says,

‘The difficulty now is that I have no secretary for the foreseeable future, meaning that I cannot organise appointments or tests. I’ve been without a functioning secretary for one and a half years, and I’ve exhausted what I can do to get them to sort this out.’

So, because he doesn’t have his own secretary, he can’t get on and do his job to the top level. He’s unproductive and costly. Therefore, we pay intelligent people lots of money to perform complex tasks and then render them unproductive. This individual is from a health board in south Wales, but I’ve also had this complaint from clinicians across Wales. So, for me, the real strength of this report lies in the recognition of the commitment and intent of the individual within the NHS and the acknowledgement of the difficulties within the system, of which this is a prime example.

I’m pleased that the panel have identified that one of the key barriers to the successful implementation of change is centred around the how. How do we fill the gap between good policies and outstanding local initiatives? How do we ensure that the green shoots of success in local areas are scaled up and applied coherently and with consistency? How do we look at users holistically from illness to housing to end-of-life care? The history of the Welsh Government is littered with reports and policies that have not translated successfully to the front line, and why? It’s because of the how. We need to change some of the culture as well as some of the practices. We need to understand that successful transformation cannot sweep through everything and all at once, but that it needs to be measured and tested. We need a coherent framework and skilled people. Yet the Organisation for Economic Co-operation and Development, in a recent report, identified that Wales lacked the capacity to exploit the innovative practices that we have developed.

The health debate is usually framed around numbers of front-line staff, hospital locations or where the services are. So, I was relieved to find that the interim report challenges culture and process. It identified issues with maturity and flexibility, and skills and training. It’s not all about new policies, new programmes and new initiatives, Minister. I believe this report lays out a vision and a canvas, but stage 2 must now sketch in the details. We need a clear identification of the barriers to change and imaginative proposals to bridge the gap between idea and action.