Thank you very much, Llywydd. With just over 49 per cent of the whole Assembly budget falling in the health sector—some £7.3 billion of a budget of £15 billion—then, naturally, members of the health committee scrutinised the budget very enthusiastically in terms of all the funds spent in this sector under the new system that we’ve already discussed. May I thank my fellow Members for their work and the clerks and researchers for their support?

There was a substantial evidence-gathering process from June onwards—in-year financial scrutiny with the Cabinet Secretary, and then, through September and October, written and oral evidence from all health boards in Wales. In October, we took evidence from the WLGA and the ADSS, who appeared in committee, and, in November, we took additional evidence from the Cabinet Secretary for Health and Social Services and the Minister for Children and Social Care—they all appeared before the committee.

A number of themes emerged: transformative change is the main theme. Transformation of the service is central to the long-term success of a financially viable NHS, alongside funding to lever this change. If this does not happen, we will remain in a position where additional sums of Welsh Government funding are being used to maintain current delivery models, without any transformative change. The Cabinet Secretary told us about the additional investment of a further £450 million in the Welsh NHS over the next two years. These allocations to the NHS must be used to lever long-term change.

The committee’s recommendation is that the Welsh Government should ensure, following the publication of the parliamentary review of health and social care in January of next year, that it fully costs plans to take forward transformational change in terms of health and social care. Additional funding for the NHS must be premised on delivering change. The Welsh Government should identify ways in which transformation and transition funding is prioritised and made available for NHS organisations from within existing budgets.

Turning now to health board finances, we know that the largest proportion of the Welsh Government’s funding for the NHS in Wales goes directly to the health boards, and the committee sought to examine the current financial position in detail. This year, we have focused specifically on health boards. We note that the ambitions of the National Health Service Finance (Wales) Act 2014 have not been fully realised by all NHS bodies. It’s very disappointing that four of the seven local health boards have noted a deficit in at least one of the past three years, and it’s a cause of concern specifically that the Betsi Cadwaladr health board and the Hywel Dda health board have reported a deficit each year from 2014 onwards.

The Welsh Government should therefore review the current methodology of setting health board budgets and publish its findings. We know that the Health Foundation has said that the health service in Wales is facing the most financially challenging period in its history and, therefore, seeking savings of some £700 million, as has already been mentioned. The Welsh Government should develop an all-Wales efficiency programme in order to ensure that local best practice is rolled out across all services throughout Wales.

Funding for social care is crucially important and we should ensure that sustainable, quality social care should be provided. We mentioned in our recommendation that we need a whole-systems approach in terms of health and social care. That must be planned year on year so that additional funding is available for social care and so it is sufficient to reflect increasing demands. Losing social care will mean damage to the health service as a whole.

Turning to sport, the committee was surprised to see the most recent change to the Welsh Government portfolios. I have no time to go into the detail, but just to note that it moved from one portfolio to another. As has already been mentioned, we should prioritise capital investment for primary care in the community and ensure that we enhance capacity in terms of buildings in the community in order for multidisciplinary work to take place and new models of care. The Welsh Government should also undertake a further review of the mental health ring-fenced funds to assess whether it has led to effective and appropriate expenditure on mental health and ensured improved outcomes for patients. The Welsh Government should also look at the way the UK Government funds prisoner health, because we don't receive half enough funds for that.

To conclude, we need to take into account the substantial amount of money spent by NHS Wales on agency staff, and the Welsh Government should commission a review of all the anomalies and perverse incentives across agency and bank arrangements.

Therefore, I'd like to think that the most detailed scrutiny ever on the health budget is going to bring about the necessary changes in expenditure of that budget to improve health and social care services for the people of Wales. Thank you very much.