Part of the debate – in the Senedd at 4:53 pm on 26 September 2017.
Thank you for those questions. On your point about the increase in funding, we recognised that it’s a greater priority for us. Having the conditions plan itself has been a focus for attention. I think it’s a fact that reflects we’re better meeting the needs of people within the public, but also the progress in developing treatment. So, I don’t think there’s any suspicion about it, it’s really about how we make best use of that as well. I think it’s a good thing. We can point at the fact that we’re spending more on these particular conditions that affect a relatively wide range of people and can have a significant impact on them as well.
On your point about PROMs and PREMs and comparison with the other three nations of the UK, this is one of the challenges, isn’t it? Because if we develop bespoke measures in Wales that meet the needs of people here in Wales and you ask those people, ‘What matters to you, how do we record that properly, about your experience and your outcomes, as that helps us to drive where we are?’, the challenge will be that there may be different statements made or a different level of willingness to do so in other nations.
I’m certainly not going to try and speak for Jeremy Hunt on these issues, but I would not expect that he would be interested in developing a series of measures that properly take account of the experiences and desired outcomes for Welsh patients. I’m interested in doing the right thing here. I’d like to have a sensible conversation. Rather than with politicians, it’s probably easier across the service for patients, third sector groups and clinicians to have a conversation about the sort of measures and experiences that matter and whether there is a way to have something that allows you some form of comparison across the other UK nations. But I have to say, from my own point of view, whilst it would be desirable to do that, it isn’t my first point of interest in this work. My first point of interest is how do we make sure that we have a service that is properly responsive to what matters to the citizen in their experience and their outcomes, which helps to drive service improvement, service planning and delivery.
On investment and earlier diagnosis, this partly goes into our understanding of awareness, because awareness isn’t just for the general population, it is actually about healthcare professionals being able to spot earlier and refer people into the right part of a treatment and care pathway. So, that’s part of what we set out in terms of the priorities for the implementation group in the years ahead, and the challenge will be, given the basket of conditions we’re talking about, that some of that will vary from one condition to another. When we talk about someone, say, with cerebral palsy, well, that’s easier to understand in terms of how you diagnose than, say, for example, some of our more progressive conditions as well. So, there’s a challenge in understanding how we do all of that. So, rather than giving a one-size-fits-all, it’s really about how we invest in that wider picture.
And on your final point on nurses particularly—. And I’m pleased that you’re talking about a healthcare profession that is more than medicine, because we need to understand, in lots of the improvement that we see happening, that the role of nurses and specialist nurses in particular is really important in that, and that’s one of the things that we ought to try and highlight in the opportunities that exist within our system. It’s also part of when we look at, ‘What is the offer to encourage people to come in and to stay here in Wales?’—both people who are local and those who may want to move to come here as well. Interestingly, as I’ve been going around and about listening to healthcare staff, you do see a range of senior nurses who move for jobs and opportunities. I’ve met quite a few people who have positively moved from the system in England to either come to Wales or to come back to Wales as well. But I actually think the greater gain to be made is how we recruit, retain and train our own. Because many, many people going into nursing are local. The typical age, as you will know, of a nurse trainee going into the undergraduate programme is in the late twenties. These are mostly people who have responsibilities and ties and who are unlikely to be particularly mobile in the way that, for example—. Training people for medicine is one of our challenges. Getting people who are undergraduate and then keeping them is more difficult, rather than someone who’s in their late twenties. So, I’m particularly interested in seeing the success we’ll have with our broad ‘Train. Work. Live.’ campaign for nurses, to understand how successful we have been, and I think we’ll directly benefit patients in these areas, but also our staff and the opportunities we want to give them as well.