Part of the debate – in the Senedd at 3:52 pm on 16 January 2018.
I thank the Member for most of what she said. There were some points where we'd have to part company on agreement. I don't actually think that fraud related to the European Union and EHIC cards is a big issue that will undermine the future of the service. The challenge that we face in both need and demand, in having a rising and ageing population, in the challenges over money, I do not think are ones where we can say that European citizens, whether legitimately or otherwise, are going to undermine the future of the service. It's not covered in the report, it's not been a significant area of interest, but, of course, I would not want the service to be taken advantage of. There's a difference between saying, 'I don't mind; people can do what they like,' and saying that that's the biggest challenge we face. So, I expect them to play by the rules. Where people don't, I expect the appropriate action to be taken.
On your point about medical negligence, well, this is a constant challenge for any and every health service. Actually, the response is how we improve the quality of care that is delivered, how that improvement action is a real part of what the service does and not just a fig leaf. That's why we need to look again at our own improvement programmes—1000 Lives has done significant work in improving the quality of care and decision making across the health service. We need to look again at that as an improvement programme, the challenge the report sets us, and the quadruple aim, and look at delivering greater value. So, those are things that we absolutely do need to do.
In terms of your point about transforming IT delivery, I think that's been covered in other comments and questions. It's a key challenge for the health and care system, how we take greater advantage of what technology allows us to do and actually catch up with the way citizens currently live their lives.
And your final point about increasing the primary care workforce—we are in a better place than other parts of the UK, in some ways, because we've actually met our numbers and we've overfilled the places we had on the GP training numbers, which you mentioned specifically. The challenge now is to understand what more do we need, and that isn't just a question for the Government. It's also part of the reason we set up Health Education and Improvement Wales—to try and get that broader based understanding of planning for a future workforce, making sure we have the places available, and then the difficult choices about money. Because, if I had the opportunity and ability to, I would invest more money in the future of the health and care workforce. But I have to live within the means that this Assembly votes for me to be able to do that, in the budget that this place will, I hope, choose to pass later on today. So, funding is always a challenge, but we cannot avoid the reality: we need to deliver greater value than the resource we put into our whole system.