4. Statement by the Cabinet Secretary for Health and Social Services: Winter Pressures

Part of the debate – in the Senedd at 4:13 pm on 13 February 2018.

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Photo of Vaughan Gething Vaughan Gething Labour 4:13, 13 February 2018

Thank you for the questions and comments. Again, I'm grateful, as I'm sure staff are, for the tribute paid again by the Plaid Cymru spokesperson to the manner in which staff have responded to the at times exceptional pressure and demand that we recognise within the system.

Turning to your questions, this winter, as with last winter and the winter before, we're seeing health and social care some together to plan for winter. So, this isn't an exercise of central Government control. We help to hold the ring with people coming together, and they look at and plan together in their local circumstances. That's actually been helpful, with social care and health recognising that they really do need each other. That may sound obvious, saying that out loud, but for different parts of public services to take time away and actually plan together isn't always a straightforward and easy thing to do. It's consistent with our policy direction and indeed with what the parliamentary review has said, and actually there's something about continuing to do more and to do better with that joint planning right across our system.

It is a system challenge, because your point about medically fit patients, and the fact that they're still often in a hospital bed when they know there are more coming in—well, that is about health and social care together. Some of those people will need to be in a different part of the national health service for the next part of their care and treatment. Some of them could be supported in their own home, whether that's a residential home or a nursing home, or, if you like, a traditional private home, but they'll need social care and support to get there. That's why, in my statement, I pointed out some of the things that are already happening, and things that we could see to, and we'd want to have not just policy levers, but practical incentives to do that as well. The integrated care fund is one of those, but we think we'll need to do more.

That isn't just the Government's view, of course, but that is also the view of the parliamentary review. When they called for a seamless care system, they're looking more and more at examples of what is successful and encouraging us as politicians in the Government and beyond to look at how we actually help healthcare and social care to build on a more consistent basis. Because we always know there will be a winter every time, every year. We know that it may vary in terms of the scale and the pressure, but there will always be extra pressure, because apart from anything else we can expect next year there to be even more people over the age of 85 coming in to our hospitals. We know that is a reality we will face. It's about how fast our system can move to catch up with the challenge of the demand that we see and how fast we can actually move outside the hospital, crucially, to manage some of that demand.

I just want to respond directly to your point about elective procedures. This is something about the contrast between the system here and across our border. In England, they announced a ban on elective procedures to help manage through winter. So, a total ban through England. We didn't do that in Wales. We have unfortunately seen some people have their care interrupted, but I still think that, whilst people are frustrated, if they have their elective procedure cancelled or postponed, most people understand that it's being done because there is an emergency within the system where somebody needs that care on a more urgent basis. 

Nevertheless, 22,000 people have had elective procedures through December. There is significant activity taking place. What we need to be able to do across our whole system, in balancing elective and emergency admissions, is to think about how quickly we can get those people who have had elective procedures postponed back in to have that procedure, which we understand that they will need.

It's part of the challenge in running a dynamic system and an understanding that, even though we have reduced the level of elective admissions to cope with winter, at times of extreme pressure, the system will need to make choices, and that often will be about postponing elective procedures because the emergency is at the door. I know what I would want if that were me or a member of my family. I know how I would feel if that was also my elective procedure being postponed. So, there is a need to be sensible and mature about our system and think about how we improve that again, if at all possible, for the year ahead. That's certainly our expectation in the Government.