The NHS have cut bed numbers by a staggering 45 per cent. In 1990 there were nearly 20,000 beds in the Welsh NHS. Today, there are just over 10,000. Community hospitals across the country have shut, wards have been closed or merged, and plans have been unveiled for further closures. We have also seen a lack of investment and planning in the social care sector, which has accelerated under austerity, and in the last five years, per capita spending for social care has fallen by over 13 per cent. This has a knock-on effect on our hospitals, and in the last 10 years, there have only been slight improvements to delayed transfers of care, which month to month hover around 400 to 500.

Each month we have hundreds of patients who are unable to leave hospital, simply because there is no social care available. In December, we had 238 people who had been waiting for more than three weeks to leave hospital, and of those, 51 had been waiting between 13 and 26 weeks, and 25 people had been waiting for more than 26 weeks—25 people spending half a year longer in hospital than they need to, simply because there is no step-down care available. Hundreds of people are spending weeks in a hospital bed they don’t need to be in. Not only does this impair recovery, it also reduces our already limited bed numbers.

A hospital stay is estimated to cost an average of £400 per day, so the cost of these unnecessary stays is costing our NHS millions of pounds in care. This will place our health and social care services under a tremendous strain. Services are already at breaking point, and despite months of planning, millions of pounds of investment and assurances that the chaos of previous winters was a thing of the past, our NHS struggled to cope this winter. It was so bad that emergency consultants took the unprecedented step of writing to the First Minister to warn that they could no longer guarantee patient safety. Our top accident and emergency consultants told the First Minister that a lack of beds was hampering their ability to treat patients in a safe and timely manner. And despite all the innovations in NHS care over the last 70 years, one thing that hasn’t improved is the ability of those at the top to forward plan. Over the last three decades, our population has grown by over 10 per cent, yet those in charge of the NHS have cut the beds by a staggering 45 per cent.

In the past, we had the perfect solution for those patients who didn’t need acute care but were unable to go home for whatever reason. It was the community hospital, or cottage hospital, as we used to refer to them. The community hospital offered step-down care to those patients who no longer needed the same level of care provided at the district or general hospital. Unfortunately, many of these hospitals have closed, not because they didn’t provide excellent care or that we no longer needed to provide step-down care—many of our community hospitals closed because of poor planning, particularly workforce planning. Successive Governments have failed to recruit sufficient clinical staff for those hospitals. As a result, many of our community hospitals have been forced to close because a lack of staff has left the services unsafe and unsustainable. Short-term cost-saving decisions have led to a number of other closures.

Within my region, South Wales West, years before the closure of Fairwood Hospital, nurses warned that NHS managers were deliberately running down the service in order to justify its closure, because the health board needed to save money. Managers got their wish and Fairwood, indeed, did close. This has left a black hole in step-down care. Social services have been unable to pick up the slack in the system. I have dealt with a number of cases where constituents have left hospital without any care plan in place. The most recent case involved an elderly gentleman in his 80s who was sent home days after receiving bypass surgery. There was no step-down care, and without the help of friends and neighbours, the poor gentleman would have been unable to feed or, indeed, dress himself. This is totally unacceptable, and we shouldn’t expect care to be dependent upon the generosity of neighbours and friends.

It’s clear that we can't depend on local authority social services, who are facing unsustainable cuts to their budgets, and it's no wonder that we are seeing reports of patients spending years in hospital. Social services are also at breaking point and are unable to cope with the demand.

We had the answer in the past—the community hospital. My constituent would have been transferred to Fairwood for nurse-led care to give him the time to recuperate and be able to fend for himself. Unfortunately, bad planning and poor decisions led to Fairwood’s closure. So, today, the only choice is to keep him on an acute ward or turf him out to fend for himself.

This is not the NHS Aneurin Bevan envisioned nearly 70 years ago. We have made so many advances, but proper planning of care hasn’t been one of them. We have to stop taking short-term decisions based on financial pressures, and deliver an NHS with a complete care pathway—a pathway that involves step-down care at a community hospital.

The Cabinet Secretary is working on a long-term plan for health and social care, and I hope that he doesn’t make the same mistakes as his predecessors. We have to stop closing community hospitals and hope that local authorities will provide the step-down care. We know that this is not happening. Community hospitals are not an anachronism of nineteenth and twentieth-century care. They have a key role to play in our twenty-first century NHS.

I urge the Cabinet Secretary to stop local health boards from closing any further community hospitals and plan for the reopening of hospitals like Fairwood that were wrongly closed. Events of the past few months have shown us how wrong the decisions to cut beds were, and it’s time we reversed those decisions if we are to have any hope of celebrating the NHS’s one hundredth birthday. Diolch yn fawr. Thank you.