Part of the debate – in the Senedd at 3:06 pm on 6 March 2018.
Thank you for the comments and questions. I'll start with your first point about, 'We don't have enough staff'. Well, we have record numbers of staff. We will always need to be thinking about how we have those staff organised in the best way to deliver the best possible care, regardless of the financial picture or otherwise. We always have a responsibility to do that, but we are eight years into austerity, and the choices that we are making to put more money into the national health service come at a real cost to every other part of public services and public spending in Wales. If the Cabinet Secretary for Education were on her feet, she would tell me about real pressures, and if the local government Secretary were on his feet, he would tell you about pressures in those sectors as well and beyond. So, let's not pretend that this is simply a matter of political will; this is a matter of our budget being reduced deliberately. You know, people voted for a Government that promised to impose austerity in three successive general elections, and I wish they had not, but that is the choice that people made and I really do think that people who have stood up and campaigned for a Government to do that over three successive general elections need to take some responsibility in those parts of the country in Wales where they are now faced with having to make choices that are as a direct consequence of United Kingdom Government austerity.
On Health Education and Improvement Wales, the purpose of this is to improve strategic planning of the workforce. That's what they will do. As they move into the shadow form for the first six months, I will have more to say specifically about that, so rather than talking off piste now I'll come back, I'm sure, in the future with more to say about them and their way of working.
Just briefly on your point about non-medical endoscopists, we already have some within our system already. I've met a nurse endoscopist within Powys. I think it was actually in Russell George's constituency. So, those people do exist and our challenge is how we have a route for them to continue to do that, as opposed to that person being a one-off.
On your point about the percentage for primary care, I've stood on my feet in this Chamber more than once in the past and talked about the percentage of NHS spend that goes into primary care—it's actually more than 11 per cent. The regular response then back is from the Royal College of GPs, who are actually talking about the general medical services side of it, so a specific part of primary care, not primary care in total. But you will have seen the ambitions that are set out by this Government, but also within the Parliamentary review, to have not just an increasing level of activity within local healthcare, but to actually make sure that resources follow that and we have a plan to deliver more resources in local healthcare where more activity will take place.
On your final point about GPs, I just want to go back to the points that I've made about where our workforce comes from. Many of our GPs, from the implementation of the national health service, have come from other parts of the world. Myself and many other people meet BAPIO, the British Association of Physicians of Indian Origin—a huge part of the history of the national health service and of its future. They too are concerned, as are all GPs, about indemnity. The state-backed scheme that was announced as a preferred option for the UK Government in England is still something we don't have clarity on in terms of what it means and its application. I say again: if there is to be a scheme that is negotiated with the British Medical Association and others to support GPs in England, and the UK Government and the UK Treasury stand behind that, I would expect no less favourable terms to be made available to GPs in every other part of the United Kingdom. But those discussions are not complete. So, I'm not in a position to tell you, because I know that the UK Government Minister is not in a position to tell anybody else whether there's agreement on what that will look like. But there is recognition that indemnity is a real mischief for us to conquer.