6. Statement by the Cabinet Secretary for Health and Social Services: The Public Health Wales Review of Sexual Health Services

Part of the debate – in the Senedd at 5:37 pm on 17 April 2018.

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Photo of Vaughan Gething Vaughan Gething Labour 5:37, 17 April 2018

Well, on the final point, the data is the best available. It allows us to make the conclusions that we can. There will always be more to do to improve the evidence we have to base policy choices on. That's not just in this area but in every other one. I don't think it undermines the nature of the recommendations or the work we still have to do, actually. 

I was pleased to hear you again welcome what we've been doing on PrEP and the significant reduction in teenage pregnancies. I recognise what you have to say on what's in the report about recognising that we do need to improve access. That's part of what was in my statement as well. That's part of what I expect to see worked through with that timetable for improvement.

I also come then to your point about spend and outcomes, because I'm interested in how we improve outcomes. We've had to make difficult budget choices, as everyone knows, but I'm especially interested in—. The reason why the review was commissioned by Rebecca Evans in her former role was to ensure that we are sighted properly on the way in which services are being delivered and where they're actually properly meeting the needs of citizens, because we were concerned that we weren't meeting those needs on a consistent basis. The reason why we will have a programme board with a sexual health steer in place is to have a properly costed implementation plan to try and understand not just whether we're interested in the recommendations but how we take them forward, what that means and who needs to do them and to have some clarity and consistency then between health boards and partners about what they will need to do.

I fully expect that once we come up with a costed implementation plan over the next two years, not only will I report back to this place, but I would fully expect that one committee or another and this place would be interested to understand whether that's been taken forward and then whether we've actually achieved what we set out in our plan.

I have to say that I recognise the points you make about Public Health Wales and their overall budget, and the point that I would politely but firmly make back is that we are in a position of having to make really difficult budget choices, and there is no getting around it. Even within the health service, which has been the area that has done better than every other part of the Government, there are still incredibly difficult choices to make, and simply saying that you want more money spent in one part of the health service than another is not going to be an answer to where we are. We've had a focused review to give us an idea on what to do to improve, we'll come back on outcomes, and we need to understand how we do that, and at the same time we always need to deliver the greatest value for the money that we spend in every part of the public service given that we are eight years and counting into austerity.

On your two final points, on the variation in abortion services and access, I recognise that and, in fact, I've had a conversation with Jenny Rathbone about pretty much the same point, about a variation in services between different parts of Wales and where we are, and I've committed to actually taking an interest in that and looking at what we could and should do to actually try and level up the variation that exists and to have a proper answer. It should not matter which part of the country you live in and it shouldn't make a real difference in terms of the service that is available to you.

And, finally, the point about—I recognise this is difficult—the current regulatory environment and how records are and aren't shared. On the one hand, you understand that people may feel that the local healthcare professional may know someone that I don't want them to know and I may feel difficult about them having access to parts of the record. The challenge is that, actually, there's a potential clinical risk in that as well, if the person who may be responsible for your care in another area doesn't know.

Now, we currently have the interestingly—well, the aptly titled the National Health Service (Venereal Diseases) Regulations 1974. Now, England have repealed and replaced those with different ones. We're now considering on the back of the review whether we could and should replace those with a different set of standards and measures. So, the recommendation in the report is the one that we'll take through, and we will need to consider and talk to stakeholders, including the patients, about whether we should change those and, if so, what the settlement should be and understanding those different issues between clinical safety and the choice of a person about how those records are used because, ultimately, our ambition across health and care is to have more sharing of health and care records between relevant healthcare professionals, both to eliminate the time that is potentially lost, for people not to have to explain the same thing more than once, and to eliminate areas of clinical risk. So, there isn't a finalised viewpoint on that, but there is a commitment to look at and to take advice on whether we should amend, repeal or do something different and how we actually take that forward here in Wales.