Thank you for your statement, Cabinet Secretary. No-one in the Chamber would disagree with the overarching principles of your plan, which include improving patient experience whilst keeping the costs of care to a reasonable level. And in this respect, the 1000 Lives improvement to help Welsh Government and NHS wales establish sustainable services and improved patient experience in planned care specialities is welcome.

Indeed, the Wales Public Services 2025 programme hosted by Cardiff Business School has put the choices in Wales into sharper relief in its recent report, when it states that under certain assumptions, 56 per cent of the budget could go into the Welsh NHS by 2021 and the percentage might be even greater in subsequent years. So, therefore, we do have an issue here where we put more money in and we’re not achieving our targets, so I wonder if you could make a comment on that please, Cabinet Secretary.

The term ‘patient experience’ covers a number of areas that include both patient outcomes and patient waiting times. As you stated in answers to my questions last January, we need to balance the reduction of waiting times with the quality of interventions and outcomes that patients receive in Wales. So, how do you, as Cabinet Secretary, plan to do this?

I welcome the news in your statement concerning the redesign of the prostate cancer pathway across Wales, having heard from many constituents in my region about the difficulties of previous treatments that were around before the pathway. Similarly, the roll-out of one-stop clinics, mentioned in your statement, is also to be welcomed, and also the intention of the programme to develop patient reported experience measures—PREMs—and patient reported outcome measures—PROMs—to capture and analyse patient experience of services along elected pathways. However, I’d like to ask, Cabinet Secretary, about the extent to which community health councils will be involved in the capturing of patient experiences. If they’re not sufficiently involved, then we may run the risk of having two separate records of patient experiences, one in the PREMs and PROMs reports and the other via community health councils. Would it be far better if patient experiences recorded via each of these avenues were put together in order to gain the most lucid picture of patient experiences?

I welcome a holistic approach to patient care and lifestyle modification, and I would ask: what up-to-date advice and research from other groups will be incorporated into the holistic approach and lifestyle modifications?

Previous documents concerning the care programme mention that one of the aims is to reduce variation across Wales. For example, such an aim may result in reducing the number of follow-up appointments that are offered following surgery, as this may be an accepted practice in other UK health services.

Whilst being broadly supportive of the overarching aim of ensuring that NHS Wales’s costs are kept at reasonable levels, I must emphasise, Cabinet Secretary, that every case is different. Sometimes, a variation in services and appointments to treat the same or similar conditions, maybe in different areas also, is absolutely necessary, so there needs to be room for sufficient flexibility within the programme.

The evidence of 9 per cent of people not attending follow-up appointments mentioned in your statement is disturbing, but every case is different, and we must not seek to reduce follow-up appointments across the board if such a practice does not produce optimal results for the patient. The evidence that your statement cites from Aneurin Bevan university health board, which has the potential to reduce unnecessary appointments across Wales, is welcomed, provided that we can ensure that such appointments are genuinely unnecessary—that is to say that they are routine cases without complications or exceptions. Therefore, Cabinet Secretary, could you ensure that health boards have clear guidance on what constitutes exceptional circumstances in a given case? And, moreover, when a case is deemed exceptional, please could you ensure that health boards have clear guidance concerning what further resourcing would be considered permissible or best practice?

I note that your statement says that there has been a reduction in the number of non-urgent suspected cancer patients. However, I have mentioned in the past that, when someone is given a cancer diagnosis, and diagnosis is of the utmost urgency for them, we need to ensure that they have the best patient outcomes and that when a person is told that they possibly have cancer that we treat all of this as urgent, because to that person, the word ‘cancer’ means that something is going on that needs urgent treatment.

Finally, I understand that the planned care programme currently focuses upon four surgical specialities: ophthalmology; ear, nose and throat; orthopaedics; and neurology. I have read in your statement since that there are more in the pipeline. So, without wishing to run before we can walk, I would like to ask whether there are any long-term plans for the programme to apply to other surgical specialities or other areas within NHS Wales and, if so, what methods would be used to evaluate the effectiveness of the programme upon the initial four surgical specialities. Thank you very much.