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

Part of the debate – in the Senedd at 4:32 pm on 13 February 2018.

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Photo of Vaughan Gething Vaughan Gething Labour 4:32, 13 February 2018

Thank you for that. Actually, on your last point, it is something that the service definitely does look at, because after a cold snap, you can anticipate that from about five to seven days onwards, you'll see an influx of patients as a result of that cold snap. That's part of the extra exacerbation of pressure in January, because of the December cold snap. But, equally, some of the other cold periods that we've had through the rest of this winter have seen additional flows into our emergency departments. It's an undeniable part of where we are, and having enough flex in our ability to plan for staff capacity and bed capacity is part of our very real challenge in managing and running the service.

I take on board your point about hot food, and I'll come back to you on that particular point, because I do recognise the point you're making about staff. That also goes into your very welcome opening comments about Maria Battle. I think all chairs in health boards take very seriously the privilege they feel about getting to do this job within the national health service and recognising that, as well as challenging the leadership of the health board to have a strategy and success for the future, actually, they want to be there to support staff. And you'll see lots of chairs and vice-chairs who take the opportunity to go around and have that interaction with staff. It is almost always welcomed by people who otherwise may not know who the chair of the health board is, apart from maybe a picture in an entrance that they may well have stopped looking at some time ago. So, it's a really good example of the commitment right across the healthcare system.

I just want to deal with your final point about admissions and recognising age. We come back to this challenge of what that means for our system, because if you admit someone because they have one particular thing that has gone wrong with them that causes an admission, you often find that they have other healthcare challenges as well. The danger is that if you say, 'I will now treat all of those things whilst you're in a hospital', you potentially end up keeping that person there for longer. There's something, then, about what that does to that person, because if they've been managing those other challenges relatively successfully, and they're happy to deal with that risk in their own home, there's something about how paternalistic our system can potentially be, where we're saying to people, 'You are not allowed to manage this risk in your own home', as opposed to, 'How do we help and support you to manage this risk in your own home, which you've done successfully up to this point in time?' That's not to say that people who have undiagnosed conditions that they could and should be helped with shouldn't be, but it's still about a conversation with that person, and that goes into the heart of having a more equal relationship between the healthcare provider and the citizen. What is the challenge? What is the issue? And, how do we talk about it and agree on a way forward? That, in itself, would help to release some of our time and capacity, because hospital is a great place to be if you're really ill and you need a service, and need some emergency care, in particular. But, actually, particularly once you're older, if you're there and you're delayed and you can't get out, it starts to cause a different challenge for you with a lack of mobility and a potential for other risks as well from being in the hospital system. So, it's in everyone's interest to have that greater flow out of our system if they no longer need to be there, and how we help and support people to have as much care as possible in their own homes.