3. Statement by the Cabinet Secretary for Health and Social Services: The Parliamentary Review of Health and Social Care in Wales

Part of the debate – in the Senedd at 3:38 pm on 16 January 2018.

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Photo of Vaughan Gething Vaughan Gething Labour 3:38, 16 January 2018

Thank you for those questions. A couple of comments, and then I'll try and address, I think, your five specific areas of questions. I want to start by recognising, of course, the role of Plaid Cymru in this review coming into being. We tried before the last election to have cross-party agreement on a health and care review and there's something about timing in all of this and recognising timing, because actually within the last year of the last Government, it was difficult to get parties to agree to do it. And it's understandable why. There's no criticism of individual parties, but a year before the election it's difficult to get people to say, 'Let's be cross-party and work together.' We've taken that opportunity at the start of this term to start this process of having an independent review, agreeing on the terms and agreeing on the membership. We now need to make choices together as well. 

The challenge for all of us, in Government, of course, as well—. I quite enjoy having the responsibility of being in Government and I've got a responsibility to make choices now and in the future as well. But there is a central challenge to all of us as political representatives in what we choose to do and how we have the debate and how we make choices together about the future, because if we stop choices being made that is a choice in itself, and the report tells us that, in many ways, that is the biggest danger for the future of health and care. We've got to have the space, the vision, the ability and the willingness to make some difficult choices about the future, and that was a choice we made at the start, but not, as I said to Angela Burns—. We did not replace 'Together for Health' at the start of this term, because we were going to have this review instead, and that was the right choice to make and that's the comment the panel are making about having a vision. We need to have that vision—that is the long term plan that I've talked about for health and care—by the end of spring. That is what we want to provide, that vision for the future, to take forward the review and not, as Angela has suggested, leave it on a shelf in the Government.

And I guess on that point about engagement ahead of the long-term plan—your first question—we do expect to engage openly with stakeholders, within the health service, with different staff groups and different royal college representation as well. It's interesting how royal colleges themselves are actually welcoming and agitating for more change as well. That can be difficult for them and some of their members, as well as our broader trade union colleagues representing workers in the health service, but much more than that of course, our partners in local government and beyond. This has been deliberately a health and social care review. This isn't simply about the health service; it is about how health and social care are part of a broader system, with colleagues in housing as well. I expect them all to be interested in that future plan and, of course, the public as well. We want to have an open public engagement and voice within that long-term plan for the future.

In terms of your point about measuring patient experience, again, it is, of course, important as part of the quadruple aim about understanding how we measure patient experience and enhancing and valuing it. We need to find some measures that are useful to add real value to what we're measuring. Otherwise, the danger is that we simply measure numbers, and that always gets you back to activity, the volume of activity, the time in which something is done rather than the quality of what's done and someone's experience, and that's a bit more difficult. But I think it's more valuable in doing that as well.

I would politely disagree with you about not abolishing community health councils. If we wish to have a citizen voice, advocacy across our health and social care system, we actually need to have a new legislative footing for that group. You can't simply do it the way that CHCs are currently constituted, so you have to find a new way to constitute a new body. The discussion is about what powers and what responsibilities they have with the new system. You can paint it as abolition, but they're going to be replaced with a new body to work across the whole health and social care system, and I think that is the right thing to do. Indeed, the national Board of Community Health Councils in Wales agree that that's the right thing to do as well.

On workforce, we've been clear previously in our response on your specific points about medical training in north Wales, and I will of course bring forward a statement on the work that the three universities are already doing on how we equip more people more generally across the country to have a career in medicine and in particular how we deliver more medical training within north Wales.

On technology-led innovation and the figures, again, there is a range of people, both within this Chamber and outside, who recognise the real potential and, indeed, the real need to gain more from technology in delivering innovation and improvement that will deliver real value. It's not just about shaving a few pound signs off, but actually recognising the way that people live their lives and make choices. Actually, the health service needs to catch up with that. Again, there are some parts of social care where, working together, we've got to design systems that actually work together and can talk to each other to again make it easier for the citizen. We should not expect an individual who has health and care needs to navigate their way through a complex system. We have to make it easier for them to do so.

Finally, on your point about measures, I've indicated that we need to take seriously the review and respond to it properly, but there will be a need, and I recognise that now to come back, at the very least within a year, to look at the progress that we've then made, as well as being open to scrutiny, not just in the normal way in the Chamber and through the Health, Social Care and Sport Committee, but from a Government point of view to think seriously about the recommendation in the review that, each year, we provide an annual update from the Government and the health service and the social care system on where we think we are, the challenges we still have and what else we need to do. I think that's a worthwhile suggestion that we do need to give serious consideration to, because I think that would provide some of the clarity that you yourself have suggested we should look to provide.