5. Will the First Minister make a statement on the services provided to the people of Powys by Shropdoc? OAQ51594

Powys Teaching Local Health Board currently commission Shropdoc to provide GP out-of-hours services to the people of Powys.

Thank you, First Minister. You'll be aware, of course, that Powys doesn't have a district general hospital, which makes it all the more important to my constituents that there is an excellent out-of-hours GP service. The current out-of-hours service is run by Shropdoc, and the health board has said that they want to end that service and the contract with Shropdoc and replace it with the 111 out-of-hours service by this spring. I have no doubt in my own mind that neither the health board nor any other organisation can currently provide the same level of support as Shropdoc provides. Shropdoc also provide services to GP practices, and I think there's a real significant risk here that some GP practices could fold if those services are no longer available. It seems that the health board hasn't properly consulted on these proposals or consulted GPs correctly.

So, can I ask: has the Welsh Government exerted any influence over the health board in changing to a 111 model? Can you give any assurance to my constituents that any change would not be detrimental to them? And, if you can't give that assurance, will you examine this situation in Powys?

Well, the situation has arisen because Shropdoc itself has faced financial challenges during 2017. Those challenges do remain. As a result, the health board have been working with Shropdoc and the English clinical commissioning groups to support them while they address those challenges. I understand that the health board did establish a taskforce to assess and deliver potential alternative solutions for the provision of out-of-hours services in Powys. That taskforce has developed short- and medium-term plans. The current contract with Shropdoc does end, I understand, in the spring, so there is an opportunity there now to work on new models and to work with Shropdoc itself. This is a situation that's not been chosen by the health board, but there have been challenges that have been placed before them as a result of Shropdoc's own financial situation, which we hope can be resolved.

As has just been mentioned, many of the residents of Powys are reliant on services that are either provided from England or are located in England. Given the news that I'm hearing that there is a delay in terms of a decision on the location of the general hospital for the west of Shropshire, wherever that is to be located—it’s an argument between Telford and Shrewsbury itself, which is ongoing, and there has been no money from the Westminster Government yet to invest in that—what discussions are you having as Government—because it’s beyond the health board, to be honest—with the Government in England to ensure that those services continue to be available and there is no gap in the services provided in Powys?

Well, the health board have been in discussion with Shropshire and also Telford and Wrekin in order to work with them to develop new services, if that’s the path they choose to take, and to see in what way they can support Shropdoc to be sustainable in the long term. So, those discussions have taken place between the health board and also the organisations in England.

First Minister, Shropdoc has provided out-of-hours GP services to Powys for 22 years, but, like every part of the NHS, they've also felt financial pressures. The decision not to renew the contract is extremely disappointing, as Shropdoc have provided one of the best out-of-hours services in the country and provided a first-class service to the people of Powys. First Minister, can you assure this Chamber that the decision to end the Shropdoc contract was not financially motivated and can you assure the people of Powys that the replacement service will be as good, if not better, than the out-of-hours service provided by Shropdoc? 

That's what we want to do, but Shropdoc, remember, has financial problems of its own and that's the reason why this situation has arisen. One of the concerns as well is that the two English clinical commissioning groups that currently commission Shropdoc will re-tender during 2018 and, of course, it's important that both sides of the border work together in order to commission a new service. But this is not a situation where the health board have chosen to be in a position where they want to offload Shropdoc, if I can put it that way. It's because of Shropdoc's financial challenges that the situation has arisen. But everybody wants to get to a situation where the service is at least as good as the service that currently exists.