7. What is the Welsh Government doing to encourage the shift in resources from secondary to primary health care? OAQ51452

Thank you for the question. I've just recently announced plans to deliver 19 new integrated health and care centres across Wales by 2021, to help deliver care closer to people's homes in their communities. I've identified up to £68 million for the centres. Construction will be subject to the agreement of a successful business case. The expectation is that those schemes will be delivered by 2021 to make sure the estate is fit for purpose to deliver a new integrated health and care system.

The money for delivering a much more appropriate primary healthcare estate is much appreciated, but I want to focus my question today on the delivery of services. I was particularly interested to read a report from The King's Fund on the success of Canterbury in New Zealand in limiting the rise and rise in demand for emergency services because of the investment in primary care services. This included having integrated teams, all of whom were valued. This included much better—many more primary care services, including 24-hour GP services, including observation beds to ensure that people weren't inappropriately admitted to hospital because people weren't sure whether or not they were seriously ill, and targeted falls prevention, which we know is one of the main causes why older people are admitted to hospital for emergency treatment. So, I'm just wondering whether you are thinking about the Canterbury, New Zealand service and the way in which it could influence the Welsh health service, because I know that Cardiff and the Vale is looking very closely at this. Do you think this is something that all health boards should be looking at as a model for future care or do you think this is very specific to Cardiff and the Vale?

No, I don't think it's just specific to Cardiff and the Vale. I think there is a range of elements, both within the UK and internationally, about the requirement to shift even more to a primary care-led system, and having a shift not just in services from hospital-based to a community base, but, actually, the appropriate shift in resources to make that happen as well. We've already seen some of that taking place already within Wales—community cardiology being a good example. What I think is instructive about Canterbury is that it took determination and it took consistency. What Canterbury have achieved has taken place over a decade, and there's something there about the challenge for all of us as policymakers and decision makers, scrutineers and Government members, which is that understanding the challenge is much easier than understanding the answer and, actually, how we get there often takes time. So, the decade Canterbury have taken—. We've already made steps in Wales, not just with my immediate predecessor in the room but other health Ministers in looking to shift resources into primary care and having a much greater focus on trying to get away from the health service just equalling hospitals.

That's the path we've set ourselves. That's why I've made sure that primary care is a national focus of attention. It's why we've had a national primary care conference. But it says something about the time that Ministers are prepared to use in directing the service to say, 'This is the direction we must take in having more care closer to home', and I fully expect that the parliamentary review, when it reports early in the new year, will say more about having a primary care-led service and integration at that very local level being the path that we must take if we're going to do something about resolving our public health challenges and also providing the right quality of care in each of our communities across the country.

Thank you, Cabinet Secretary.