Part of the debate – in the Senedd at 4:46 pm on 6 February 2018.
Thank you for the comments and the questions. I note everyone's preference to have a debate not a statement, although, actually, to be fair, statements provide more questions from Ministers to answer and more scrutiny in that sense, but these are choices that are made.
I broadly share your concern about the impact of austerity on health and health outcomes. I think both Dai Lloyd and Simon Thomas from your party have also indicated their concern and interest in reports and studies that have been done trying to look at the impact of different changes driven by austerity to welfare benefits, for example, and in physical and mental health outcomes as well. They're things that we should continue to be cognisant of—the evidence over and our ability and our choices in what we choose to do in running the health and care system here in Wales and recognising the different drivers of healthcare need in the country.
On your three substantive points about fixed-odds betting terminals and also, then, planning, public health, betting shops and hepatitis C—. On fixed-odds betting terminals, the UK Government are out to consultation on this issue, and one of the proposals is that they could actually reduce the maximum stake down to £2. Now, actually, we think that would be a good thing to do, and the chief medical officer has submitted evidence to that effect as part of that consultation. The odd thing is, we're about to get powers in April that will allow this place to reduce the maximum amount—you might want to give local authorities the power to reduce it to £10. So, if we got to the point where we reduce it to £10, there's a potential opportunity to reduce it to £2. Actually, if we're clear that the UK Government are going to act in that way, I think that would be preferable. It would be a consistent system across the UK, and we could indicate that in itself. If that isn't going to happen, then we will of course look to use our powers here in any event. We ought to be really clear about—. There's very clear advice from the chief medical officer about wanting to take a deliberately proactive approach in this area, and I'm sure that I—whether it's me or another Member of this Chamber who's in this particular role—will want to take this seriously and take appropriate action.
On betting shops and priority health impact, there's a broader context—not just about betting shops but a range of public health considerations in planning. I'm quite open-minded about how we could do that, but we need to have a conversation across the Government about the planning policy and governance that we currently have—from a national perspective as well as that in place in local authorities. But we should certainly be prepared to again be led by evidence on what we could and should do to deliver a greater public health benefit.
On hepatitis C, I know that you, Angela Burns, and Julie Morgan and others have raised the progress that is being made, and, again, I welcome the fact it's been highlighted in the CMO's report about what they're actually doing on hepatitis C. We have a genuine national approach that—. It was really interesting and I've actually—. I don't always read journals and medical publications, but there was real praise for the approach that's been taken here, in professions in England and in Scotland too. They like what we're doing and, in fact, people in England would rather like to have a generally nationally joined-up approach, where they're looking at the most effective medication and not always the most expensive, but it's delivering the real benefit. It's the next stage in eradication in terms of getting to those people who're the hardest to reach, and that, I think, is the point you're making: how do we get to those people who either don't present to healthcare services, present infrequently, or are living chaotic lives, and, actually, even if they may want to, how do you maintain a link with them to actually deal with the challenges that they have?
As I set out in a previous statement in this place, we think we're in a good place to carry on making further progress. The ambition remains, though, that we want to be a country that eradicates hepatitis C. We're now at the more difficult end, and it's the best problem to have, but I'm confident that we'll continue to make further progress, and, indeed, whatever progress we do make, we'll update this place and the committee as to the progress that is being made by staff within our national health service.