5. What is the Welsh Government doing to improve waiting times for hospital outpatient appointments in Wales? OAQ51924

Well, the Welsh NHS has shown annual improvement in waiting times since August 2015. There was £50 million of additional expenditure in 2017-18, and ministerial scrutiny will of course make sure that that progress continues in the future and that we maintain the focus on improving the outlook when it comes to referral-to-treatment times, and also in terms of—in terms of referral-to-treatment times and, of course, all the other targets that we have in the NHS.

Thank you for that reply, First Minister. One way to reduce the hospital waiting times is to tackle the problem of missed out-patient appointments. Last year, there were nearly 300,000 missed appointments, at a cost for the NHS of more than £36 million. It is a pretty staggering figure. What action is the Welsh Government taking to reduce the number of missed out-patient hospital appointments, to reduce waiting times and release more money for front-line services in Wales, please?

Well, it's a matter for the health boards. What I have noticed, however, is that, certainly, some health boards send out appointment letters that emphasise the cost of a missed appointment. I think that's important—that people understand that. They also emphasise that if people don't turn up at an appointment, they may end up back, further down the waiting list. That is the stick. The carrot is making it as easy as possible for people to contact the department in which they have the appointment. That means, of course, not just relying on a phone line, which might be busy or only open for a few hours of the day, but being able to have an e-mail address that people can contact, and then, of course, a swift response. That is something that I have seen with ABMU and something that certainly, I think, is good practice for the rest of Wales.

People not turning up to out-patient appointments has a direct effect on ambulances and their capacity to turn up on time. Just in the last few hours, I've had a story from a constituent whereby they contacted the ambulance service at 10 o'clock one evening in Maesteg, it was categorised as a red risk of a heart attack because of the stress on that constituent, who has already had various illnesses, but still no ambulance arrived, after multiple follow-up calls. A family member also contacted the police because they were in such distress. The woman had to stay on the floor in damp weather because they didn't want to move her due to that head injury. Then, eventually, the police turned up, and then an ambulance, almost three hours later.

Now, this is really quite awful, and I think that the person who contacted me doesn't usually complain because they access the health service quite a bit, and they are the first people to praise the health service, in actual fact. My colleague, Rhun ap Iorwerth, raised the fact that this particular element of the system is broken—last week—and was met with disparaging comments from the health Secretary. If it's not broken, First Minister, can you tell us how you're going to alleviate the pain for those people who are waiting for ambulances? Because we will be perhaps criticised for living in a bubble if we're not reactive to the fact that they are experiencing these long delays and want to be seen in an appropriate manner and do not want to be waiting for hours on the streets in damp weather conditions.

Well, I can say that the eight-minute red target has been achieved for 22 consecutive months across south Wales—and South Wales Central particularly—but, of course, there are examples where that hasn't happened. Now, the Member has given an example of that. If the Member could provide me with details, confidentially, if the person doesn't want to give their—

They're happy to share. 

Well, as many details as she feels appropriate. Then I will, of course, make sure that the incident is investigated.

First Minister, a large number of out-patient appointments are for diagnostic tests, where we see massive waiting lists. In December, we saw over 20,000 patients waiting more than eight weeks, and over 1,000 patients waiting for more than 24 weeks. I hope you will agree with me that this is unacceptable and will get worse due to increased demand in the coming years. First Minister, how does your Government plan to increase capacity in diagnostics to ensure nobody waits more than eight weeks?

It has already happened, because the number of people waiting over eight weeks for one of the diagnostic tests at the end of December was 38 per cent lower than at the same point last year. We have invested heavily in diagnostic tests in order to get the waiting times down, and the figures are beginning to show that. Yes, it is, of course, right to say that there is, as ever, increased year-on-year demand in the NHS, but that doesn't mean, of course, that waiting times inevitably will keep rising, as the figures show.