Well, I think we need to be careful about what we’re trying to do and achieve. We want to understand how we can provide more people with the opportunity to train and undertake part or all of their medical education and training in north Wales. There is a different point though, I think, about how we have a more grown-up set of relationships with colleagues in north-west England, and recognise the fact that many Welsh-domiciled students go to north-west England to undertake medical education and training, not because they don’t have opportunities—that may be partly to do with why some people go—but because there are lots of people who opt to leave home and to go further away. That’s part of understanding not just the path that students take, but we need to be better at keeping people within Wales and giving them opportunities to stay here, but also at what we do about recovering those people and bringing them back to Wales. There’s a particular issue here about returning and repatriating Welsh language skills within healthcare professions as well.

I said before that the worst possible outcome would be to invest in additional places in any part of Wales, and then for there to be no increase in the number of graduates that we retain within Wales. So, it’s looking at all parts of it: how many people go into medical education and training within Wales, and also what do we do to keep people when they finish that education and training as well? So, that, in essence, is about much more than medical student numbers and where they are within the system; it’s ensuring we have a genuinely sustainable medical workforce in Wales and all aspects of education and training in the pipeline need to be considered and operate effectively.

This goes back to some of the comments that I’m pleased that people have picked up on, including Hefin David’s regular reference—and can I commend you for it—in referring back to the northern Valleys, but there is a broader point about how we ensure that children do aspire to become doctors: the debate that we have about the health service and people’s understanding that actually you’re in the firing line in many respects if you go into the health service, and the way we talk about the service more generally. There are people who would otherwise have chosen to go into medicine who are choosing different options. That’s a challenge for all of us, wherever we sit politically, about seeing those people have those opportunities regardless of where they live.

There is that point about greater awareness of not just medical roles, but all roles within the national health service. And the consistency of opportunities across Wales for young people to have work experience opportunities to introduce them to healthcare, not just from an employment perspective, but both from an employment perspective and a patient’s perspective too. Because we do recognise that actual work experience opportunities, as they currently exist, have not been as equally distributed as we’d want them to be and, of course, lots of people already in and around the service are more likely to have those opportunities. So, we need to make a proactive effort to ensure those opportunities are more widely spread.

I’m happy to recognise the changes that have been made to admissions processes in both Cardiff and Swansea medical schools and the improvements in the number of Welsh-domiciled students accepted. Admissions data shows that 80 per cent of Welsh-domiciled students were offered a place to study in Swansea. In last year’s intake they took up that place and they say there are 88 Welsh-domiciled students in Cardiff, and that’s the highest number for six years. So, progress has been made, but I certainly recognise there’s more that needs to be done. Part of this is ensuring that our own young students and young people are familiar with the selection process and have the opportunity to practise those skills, so that if they get the opportunity for an interview, they’re in the best place to actually perform well and be offered a place. That’s about positive and constructive feedback, but doing this all on a proactive basis to encourage the applications in the first place.

Because we do need to demonstrate the wider benefit of studying in Wales and that the student experience here is sufficiently positive to encourage individuals to stay and continue working within Wales. That means ensuring there are sufficient opportunities in postgraduate training for people to pursue their careers, including, of course, through the medium of Welsh. That means training in Wales must offer many choices and benefits. But being a compact nation, the experience should be gained in both urban and rural medicine, to provide the opportunities to discover the diversity that accompanies each setting. This does go into some of the work that Julie Morgan referenced, including, in particular, rural opportunities as a positive plus for people who want to just come into and stay within our system. Now, all parts of that jig-saw need to work together if we’re going to capitalise on any additional places that may be established, and I’m already working with the Cabinet Secretary for Education on these issues. As I’ve said, I’ve given my commitment to return specifically to the subject of north Wales this year.

I do welcome the committee’s recognition of and support for the Train, Work, Live campaign. Again, 91 per cent of GP training posts were filled last year, an increase from 75 per cent the previous year, and the increases are in those parts of Wales where the new financial incentive scheme was introduced. I am happy to confirm to Jeremy Miles that we will review the impact of the incentive scheme to make sure we’re genuinely helping to bring more people into our system, rather than shifting numbers around by simply creating different problems in different parts of the country. That also brings me to Hefin’s point about local healthcare. There’s something about the language we use about who is speaking to who about what people can expect. I think often in the health service we use a certain language that actually doesn’t mean much to the public and we exclude them with the language that we use, but also the understanding of what it will mean for them when they still want a service to be provided.

I recognise I need to finish, but I want to point out the Train, Work, Live campaign will continue and there’ll be a particular focus on psychiatry training to address the low fill rates we’ve seen there as well. So, all our efforts, including the establishment of HEIW, which I will return to again in the future, will be about how we improve recruitment and retention across our workforce, and I really do welcome a very constructive report and debate from Members and the committee today.