Diolch yn fawr, Dirprwy Lywydd. I'm pleased to make today's statement and publish the outcome of the consultation on the 'Services fit for the future' White Paper published earlier today. This is an important piece of work, forming part of the picture for the future of health and social care services here in Wales.     

The Government remains committed to supporting practical steps that build closer links between health and social services to meet future needs. We restated our commitment to that ambition in the national strategy 'Prosperity for All'.  

As part of our ambition to develop, improve and integrate health and social care services, I launched the 'Services fit for the future' White Paper for consultation on 28 June last year. I asked for views on a range of interrelated proposals for potential legislation.  

The proposals contained in the White Paper looked at how we might futureproof aspects of the health and social care system, with a focus on person-centred care and greater integration across the health and social care system. There is wide agreement that the health and care systems here in Wales need to work differently to deliver those services and outcomes that people across Wales will want to see. That’s why the White Paper looked at a whole-system approach and examined several areas where future legislation might help to achieve this in a new way of working.  

The proposals in the White Paper covered stronger governance and leadership at board level, new duties of quality and candour, and areas such as standards and complaints handling where common processes could support a more integrated approach. There were also proposals relating to citizen voice, pace of service change, regulation and inspection.   

During the consultation a number of stakeholder meetings and focus groups were held across Wales. These included approaches to reach some people who do not traditionally respond to and take part in consultations. The consultation ran until 29 September last year. There were 336 submissions from individuals and organisations, as well as 1,328 pro-forma responses relating to proposals for citizen voice and representation. 

It is clear from the responses and the report of the parliamentary review that we need to act now to preserve our health and care services for generations to come. Responses to the consultation reflected the view that joint working between organisations is essential in order to promote well-being, to identify people’s needs and to plan and provide quality services to a robust and consistent standard. Many respondents agreed in principle with what was being proposed in the White Paper. However, some respondents asked for more information and detail on how some of the proposals might work and be implemented in practice.  

There was support for more effective leadership, for having the right skills and experience at board level and for robust action to be taken if organisations were seen to be failing. In terms of service change decisions, respondents were keen to ensure clinical evidence was considered and that the views of citizens were given real weight, together with experts. 

As in the previous Green Paper consultation, some respondents remained unconvinced about the use of legislation to promote behavioural change such as collaborative working. Some wanted to see the more effective use of provisions set out in existing Assembly legislation. However, many respondents saw the value of the proposed new duties of candour and quality and felt that these could provide further impetus to integrated working and better outcomes for people in Wales.  

There was significant support for an independent voice for the public across the health and social care system. That aligns with the findings of the parliamentary review that Wales must be a listening nation, to accelerate change and improve quality, not just by paying full regard to citizens' experiences of health and care, but actively seeking out diverse views and experiences.

The proposal to replace community health councils with a new national body to represent citizens has, of course, drawn much comment and debate. There was a broad consensus that reform in this area is needed if we are to strengthen the voice of citizens in health and social care. However, we must be careful not to lose things that work well, including representation at a local level.

Linked to this, there was also support for the idea of more common standards across health, social care, the independent and third sectors. We will therefore consider how to develop and take forward proposals on: board leadership, scrutiny and membership; an informed process for service change; duties of candour and quality; a new citizen's voice body across health and social care; and common standards.

There were mixed views in relation to a possible merger of the health and social care inspectorates and making them independent of the Welsh Government. We will not be looking to make these changes at this time, but will instead explore an approach that addresses the regulatory gaps that exist, and futureproof the underpinning legislation for Healthcare Inspectorate Wales. This will allow for more closer working with Care Inspectorate Wales. This very much aligns with the recommendations in the parliamentary review around joining up inspections.

Of course, the outcome of the consultation is of great interest in the context of the recently published final report of the parliamentary review, where aligning actions to continually drive up quality was a key theme. I will of course consider how we link the White Paper consultation to the recommendations of the review.

In light of the responses to this consultation, the Welsh Government will now undertake further policy development. We are actively considering whether legislative solutions are the most appropriate way to meet the challenges identified and commented upon in the consultation. I will of course be happy to continue to update Members in the coming months.