3. What guidance has the Welsh Government provided to local health boards on the transformation of clinical services? OAQ51661

The Welsh Government expects health boards to work together with the public, their staff and others to design and deliver sustainable services that ensure the best possible health outcomes for the population. Guiding principles are contained within the NHS planning framework.

Last week, First Minister, in relation to the options being considered by Hywel Dda health board, you said that the Welsh Government had no policy at present, but that you may have a policy at the end of the process. Isn’t the problem here that you wouldn’t have a mandate for any of these options, because none of them were mentioned during the Assembly election campaign? So, for us to have the minimum democratic accountability, would you commit to holding a vote in this Parliament if one of these options were to be recommended by the Government? Could we assume that that will be a free vote, given that one of your own Ministers has already committed—this is evidence from social media—to oppose any recommendation that would close hospitals, whatever the Government policy? Or will the First Minister censure this Minister, as you did with a former Minister in very similar circumstances? His name was Leighton Andrews.

Why isn’t he participating in the process? Because he hasn't up until now. I can say that the health board has been working with elected politicians. They’ve been working in order to ensure that a working party was established with representatives from across the political parties, and also councillors, in order to see—[Interruption.] Please, listen and learn—what the transformation work is. I can say to Adam Price—it’s extremely important that people know this—that he released a press statement with Jonathan Edwards saying that he intends to meet with the health board as soon as possible, and asking what is the view of the Labour Government. Well, I can say that the health board tried to contact his office. On 8 December, an e-mail was sent to Adam Price inviting him to meet with the health board in order to discuss any concerns that he may have, with no reply. No reply. Then, on 8 January, once again an e-mail was sent inviting him to speak to the health board—no response. No response. He was even offered a telephone call with the health board on 23 January, but he turned that down. He turned it down. So, on one hand he says that he wants to talk, but no, the problem is that he's grandstanding in this place, without doing the work on behalf of his constituents. [Interruption.] 

Paul Davies. [Interruption.] Paul Davies. [Interruption.] Paul Davies. [Interruption.] I would just say that the local health board probably has information regarding whether I answered e-mails or phone calls to them as well. I wouldn't personally want that shared in this place. Paul Davies. [Interruption.]

Okay, okay. Enough. Paul Davies. [Interruption.] Paul Davies. [Interruption.] 

First Minister, if we could return to the issue, five of the nine options being considered by the Hywel Dda University Health Board would lead to the closure of Withybush hospital. Naturally, this is entirely unacceptable to the people of Pembrokeshire. So, in those circumstances, when it comes to any consultation, what assurance can you give the people I represent that any consultation will be meaningful and will truly represent the views of local people? What will you as a Government do to ensure that this happens? Because the people I represent have no confidence in the Hywel Dda health board at the moment. 

As I said, a working party has been established in order to secure the views of politicians across the political spectrum, and also councillors, so that they can be part of the transformation work. So, there is an open invitation to elected members and others so that they can play a part in that process.

First Minister, we accept that we can't deliver the health service in the same way we did 70 years ago—[Interruption.]

I can't hear the question, Llywydd, sorry. I can't hear the question. 

Caroline Jones, carry on. The Plaid Cymru group is agitated, but I understand why they may well be agitated. But can we allow questions to proceed, please? Caroline Jones. 

Diolch, Llywydd. First Minister, we accept that services have to change and that we can't deliver health in the same way we did 70 years ago. However, any change has to be based upon clinical need and be clinically led. By that, I don't mean the clinical director of the local health board. Change needs to be driven by the doctors and nurses and supported by doctors and nurses. I've been contacted by a number of staff protesting about the merger of wards at Morriston Hospital, which has proceeded without the support of clinical staff. Staff believe the change is financially driven. First Minister, can you guarantee that financial pressures will not lead to further such changes in future?  

Financial pressures are not the issue here, it's a question of making sure that a service is sustainable and that they can attract the right staff and the right level of staff. That is what guides the guidance that we give to the health boards; mainly that they want to put in place a safe and sustainable service. 

Question 4, Janet Finch-Saunders. 

First Minister, you may recall that I've previously raised on numerous occasions my concerns and those of my constituents—[Interruption.]

You need to ask the question on the order paper.