Part of the debate – in the Senedd at 4:33 pm on 27 February 2018.
Thank you very much for your statement, Cabinet Secretary. I've just got three questions here, I think. I've been looking at responses from those who have contributed to the consultation from within my own region, so this is where this is coming from. Can I just start with common standards to achieve person-centred care? As you know, the NHS is currently characterised by standards reflecting a medical model, whereas in social care, it's very much an alignment with a social model, and I note Rhun mentioned earlier this focus on experience and what we might mean by experience.
Now, I personally still have some underlying anxiety that social care priorities may struggle to compete, if that's the right word, with some medical priorities in an increasing merger. I just wonder if you can explain whether that kind of anxiety is what's at the core of preventing the two inspection regimes coming together at this stage? I recognise the stalling, but I think it'd be quite useful to have a slightly fuller explanation of that. And beyond that, what safeguards are you considering now to ensure that both the patient voice—however that's articulated, and I'll come to that in a minute—and the views of social care professionals are appropriately weighted against those clinicians who are traditionally seen as experts when we come to conversations of this nature? I want to make sure that there is a genuine equality between these voices, rather than the NHS being the loudest and the proudest.
Just briefly on CHCs—I don't want to go through what everyone else has said—I take you completely at your word that it's not your intention to leave a gap at any point in the advocacy, but you've repeated this phrase 'a national body' a few times now, and I think what concerns me in this is it sounds very much like the statement we've had previously earlier today on the comparison between the UK Government trying to take responsibility for imposing a framework and the devolved bodies having to put up with that. Don't you think there's an argument that if you're looking at a national structure here, then, actually, the voices that should be at the forefront of designing that should be the CHCs as modified to cover social care, not a top-down model? I appreciate that you'll want one voice to communicate with Government, but that shouldn't be something that you design, and that CHCs are subsidiary to that. It should be the other way round, surely.
Then, finally, I'm just picking out a few quotes from the responses that I've looked at, where people—and these are individuals, now, rather than big bodies—say that '“Trust” is a misnomer', that they expect to see 'actual penalties' imposed on boards, not people 'pensioned off', and that the whistleblower provisions in existence at the moment don't seem to be very effective. I presume the duty of candour will go some way to addressing that. But I heard what you said to Angela Burns about Government and the stages at which it knows about problems. These responses are more about what does Government do when the working together bit fails and, actually, there is still a problem. There's a genuine sense, in these responses, that nobody gets to carry the can when there's a problem that can't be resolved. If you're hoping for this to create a greater trust in our governance system, which I'm sure we all agree would be great, I think you need to really consider—I say it with a heavy heart—a punitive element at some point, and I'm not getting a sense of that within the statement to date, anyway. Thank you very much.