This work started back in the summer of 2016 when we carried out an initial broad piece of evidence-gathering to help understand the key workforce issues across the health and social care sector. This was designed to help inform our approach to looking at workforce issues throughout the fifth Assembly. We heard from a wide range of organisations and individuals across the spectrum of involvement in training, education, and recruitment.

Last autumn, we launched the inquiry into medical recruitment and ran a further written consultation exercise. Our terms of reference included a focus on the capacity of the medical workforce to meet future population needs, the implications of Brexit for the medical workforce, and the factors that influence the recruitment and retention of doctors. We also looked at the extent to which recruitment processes are joined-up, deliver value for money, and ensure a sustainable medical workforce.

We had an excellent response to our consultation exercise, and we’re grateful to everyone who took the time to write to us and present evidence to us in one of our formal meetings. During the formal evidence sessions, we heard evidence from a specially convened panel of trainee doctors from across Wales, from both general practice and a number of different hospital specialties. I would like to take this opportunity to further thank all those who took part.

The evidence we heard helped us come to some very clear conclusions and enabled us to make robust recommendations to the Cabinet Secretary. As Chair of the committee, I was very pleased that so many people who contributed to the inquiry were able to attend the launch of our report back in June of this year, and I think it is safe to say that the report has been very well received.

Our report covers a wide range of issues and we have made a total of 16 recommendations to the Welsh Government. We hope that they will contribute towards delivering the long-term solutions that are needed. These are the areas of particular concern to us: first of all, the low number of Welsh domiciled students securing places at Welsh medical schools—recommendations 2, 4 and 5; the need to increase the number of undergraduate medical education and training places in Wales, mentioned in recommendations 4, 5 and 7; then the need for better engagement with schools to increase the number of Welsh domiciled students applying to medical school, outlined in recommendation 3 in the report; and, finally, the implications of Brexit for medical recruitment mentioned in recommendations 15 and 16.

Our first recommendation relates to the establishment of Health Education and Improvement Wales, the new single body for the commissioning, planning, and development of education and training for the NHS workforce in Wales. We asked for a clear action plan and we noted with interest the Cabinet Secretary’s written statement, issued shortly after our report was launched, which provides an update on the approach to HEIW’s establishment. I’m also aware that the establishment Order and the first set of regulations were laid before the Assembly last week, and I look forward to hearing more from the Cabinet Secretary about a clear action plan and future timeline.

As I said earlier, we are concerned about the low and declining numbers of Welsh-domiciled students applying to medical schools across the UK. Despite some improvement during the 2017 application round, the number of applications from Welsh domiciled students is still considerably lower than other parts of the United Kingdom. Also of particular concern is the low number of Welsh domiciled students securing places at Welsh medical schools. This is especially concerning in light of the evidence we heard that there is a tendency for students, once qualified, to remain in the area where they studied initially. I note that the Cabinet Secretary has partially accepted our recommendations that relate to these concerns, namely recommendations 2, 4 and 5. While I, and my fellow members of the committee, appreciate that admission criteria are a matter for individual medical schools, I am glad that he has agreed to continue to work with those schools with the aim of increasing the number of Welsh-domiciled students applying.

We said we believe there is a clear case for enhancing and increasing medical school capacity within Wales if we are to address the current recruitment and retention issues, and that this must include agreeing a clear plan to develop more opportunities for undergraduate medical training in key pressure areas and in north Wales in particular, receiving evidence in favour of establishing a medical school in Bangor from many witnesses, and this was outlined in recommendations 4, 5 and 7.

Again, I note that the Cabinet Secretary has partially accepted recommendations 4 and 5, and fully accepted recommendation 7, which relate to our concerns on these matters. The Cabinet Secretary’s written statement of 18 July illustrated the recognition that there is a case for an increased level of medical education to take place in north Wales, whilst setting out his position that this does not mean a new medical school should be established, in his opinion. I know the Cabinet Secretary has committed to a number of strands of work that will take this matter forward, and I hope his contribution this afternoon includes an update on the progress being made.

We also heard about the importance of engaging with schools at a much earlier stage than current practice suggests. There is a clear need to take the message out to schools across Wales that medicine is a career that pupils can aspire to, and that it is a realistic and achievable aspiration for students from all communities. We recommended that the Welsh Government should work with the deanery, and, shortly, HEIW, and medical schools in Wales, to develop a programme of support and advice on admissions and interviews for pupils in Wales, mentioned in recommendation 3. I note that the Cabinet Secretary’s response makes reference to the 2016 summer work experience schemes run by both Cardiff and Swansea medical schools, and I welcome the fact that this approach will continue.

I would also like to mention the concerns that we heard about the potential and very uncertain consequences of the United Kingdom leaving the European Union on health and social care staffing, including medical recruitment. We heard strong arguments from a range of stakeholders for an early and clear resolution on the ability of EU nationals to be able to work within the UK. We recommended that the Welsh Government should continue its dialogue with the UK Government to emphasise the importance of quickly clarifying the ability of EU nationals to continue working in the UK, and also commence working in the UK in the future, and that’s mentioned in recommendations 15 and 16. I’m pleased that the Cabinet Secretary has accepted these recommendations and I welcome the Cabinet Secretary’s statement that the Welsh Government is clear that it wants to enable people from the EU and the rest of the world to train and work within our NHS after the United Kingdom exits the EU. That concludes my opening statement and I look forward to the debate. Thank you.