Part of the debate – in the Senedd at 6:35 pm on 19 September 2017.
Thank you, Deputy Presiding Officer, and also thank you to all Members who have contributed in today’s debate. I don’t think I’ll be able to cover all the points, but again, part of the point of having this debate today is for Members to put on the record a range of views as we go forward to the next stage of having the final report and then still having to make some choices. And I think that some of what we’ve heard—it’s been interesting in the debate to hear from a number of people, from Jenny, Caroline, Eluned and others, about the determinants of health and about the social determinants of health as well. And actually, the service, in terms of our health, only contributes a fairly small amount to our health outcomes. It’s actually those other, wider choices that we make and are made for us that contribute to our own health outcomes and the impact that has upon our care needs as well. That’s recognised in ‘Prosperity for All’, the whole-Government approach we’re taking. We recognise it isn’t just about saying the health service could and should do everything in that sense. It’s recognising there’s a relationship with other services, yes, but also that our economic prosperity and future matter so much as well.
I’ll go into some of the specifics that people have mentioned as well. I’m grateful to Angela, Rhun and Caroline as spokespeople, but also the constructive approach they’ve taken to today’s debate and the broad welcome for where we are, and again, highlighting this has been a genuinely independent review where the terms of reference have been agreed and people have had to make compromises and choices about what goes into the terms of reference to make sure we have a manageable piece of work to give us something to come back to that we can then make choices on to help determine the future of our whole system.
On the points made about staff across our whole service, the Minister Rebecca Evans already made some statements about the future for social care staff, career progression and the skill mix in the social care workforce. So, we are going to hear more from the Government on that. We won’t just wait for the report to be published. But there is definitely something there in terms of, in particular, some of the comments that Dawn’s made about needing to make sure that our staff are engaged in the conversation in the here and now, and not just for workforce planning but for determining some of those models for the future and making sure that the wider trade union will be involved in doing that as well.
What I wanted to pick up on, in terms of the comments that Rhun and Angela made as well about needing more doctors, nurses and other healthcare staff as well, is that this is perhaps the only area where we still expect the public sector to expand and for more staff to be available year on year on year. The demand is never, ‘How can you make do with less?’ in terms of staff; it’s always, ‘We need more doctors, more nurses, more healthcare professionals.’ There’s something about the honesty in the debate we need to have about this, because every group will come and make a demand for more of them. That’s understandable. Even as we talk about having a different spread of healthcare professionals delivering services, whether it’s in a hospital setting or within a community setting, we still need to have that honesty about, ‘There is a limited sum of money that all of us have to spend here’. And it doesn’t matter what your position is on austerity, it’s a fact of political life that we need to take account of in making our choices in the here and now and in the short and medium term.