5. 5. Statement: The Neurological Conditions Delivery Plan 2017-2020

Part of the debate – in the Senedd at 5:01 pm on 26 September 2017.

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Photo of Vaughan Gething Vaughan Gething Labour 5:01, 26 September 2017

Thank you for those questions. As you highlight, and as I said in my statement, there are more than 100,000 people in Wales affected by this group of conditions. On top of that, of course, there are their families and carers; there will be an impact on their lives too. I’ll just try and run through your questions. I think with the last point, I certainly tried to answer the point about improving neuro rehab, both in my statement but also in response to Mark Isherwood’s list of questions.

On the broader point about treatment delays from approval to provision, there is always something about how you plan to have a treatment provided once it’s gone through the appraisal process. We’re talking here about medicines rather than other forms of treatment. And there’s something also here about what we’re trying to improve more generally in the way that we manage the system in Wales. It’s why I’ve had very constructive conversations with the Association of the British Pharmaceutical Industry about how this works, and about having an earlier conversation as they have drugs in development and at what point the service will be aware of what they’re doing and what is likely to come up. Because part of the challenge in the past about having some of the variants in treatment in medicines being approved to being available has been the ability to plan for that service, to change different parts of the service itself. It wasn’t just as simple as dropping in a new medicine onto the scripts available, but actually what you need to plan around that as well. That did account for some of the delays in Sativex being available.

And, again, I wrote to Members in March to outline where we were, and I’ve had follow-up correspondence from the Multiple Sclerosis Society in Wales as well, which has been helpful, I think, to get to a point where we do now have genuine nationwide provision. There are particular challenges about having that whole pathway set up in south Wales that I think have been resolved, and if not the offer has been made for the MS Society to meet with the chair of Cardiff and Vale health board to run through any outstanding issues. I think it’s important that we recognise and to have an open door to understand what we can do to improve, but in north Wales there are particular challenges where people are going into the system in north-west England, where some people were not being prescribed Sativex by clinicians based in England, even though it was available for them as patients who were resident in Wales. That highlights the fact that this is an area where we’ve made more progress than other UK nations. We’re still the only UK nation to regularly make Sativex available within the United Kingdom.

On your point about the best use of diagnostic equipment, I think we need to think properly about how we plan and deliver the service, because we have the workforce that we have as well as the equipment. And, actually, we’ll need a workforce to be able to staff that equipment during use, and I need to be persuaded whether we do need more workforce available at different points in the day, and to make sure that equipment is available 24/7. Some of that depends on whether somebody is having an elective or an emergency admission, but, actually, I think that’s a proper case of workforce planning and not just having more equipment. We need to think about how we make best use of our capacity and ability across the system. But there is something there about local healthcare that, again, I think I tried to highlight in answer to other questions about how we equip and support people within our local health service, both to intervene and provide treatment and care when they could and should, as well as to diagnose whether these conditions are there and to understand how that treatment is progressing.