3. Will the First Minister make a statement on the availability of out-of-hours doctors in the Hywel Dda University Health Board area? OAQ52153

I expect Hywel Dda Local Health Board to provide a range of safe and effective services out of hours to respond to the urgent healthcare needs of their population when GP surgeries are closed.

Well, perhaps the Welsh Government expect them to do that, but, on a number of occasions this year, patients within Hywel Dda have been left without out-of-hours cover on weekends, because of what the health board itself describes as a dire shortage of GPs. It affects the three counties within their area, but it is specifically having an impact on Carmarthenshire, because of particular problems at Glangwili and Prince Philip hospitals. Now, the health board itself has apologised to patients on a number of occasions. Is the Welsh Government going to apologise too? You decided not to include Carmarthenshire in the 'Train. Work. Live.' programme to attract GPs to Carmarthenshire. Doesn't some of the responsibility fall on your shoulders?

Well, what we wish to ensure, of course, is that people do come to work in Wales. We have seen the numbers increasing because of that. We've seen, for example, the numbers increase in Ceredigion and in Pembrokeshire. Also, in Pembrokeshire, for example, in 2016, in terms of doctors coming into the training places, the percentage was zero, and then it's increased to 100 per cent within a year, in 2017. Now, is it true that there are pressures? Yes. Is it true to say that some services have not been sustained? Yes, that's correct. So, what's next? Well, Hywel Dda is employing advanced paramedic practitioners—people who can work within the local area. Adverts have been placed by the health board seeking to attract people into the Hywel Dda area. There is discussion ongoing at present on the potential to develop regional working, particularly during the night hours, and those are discussions with ABMU and Hywel Dda and also the Welsh Ambulance Services NHS Trust. We are also looking at GPs working from home. That is being considered at present, and that, of course, will need to be considered to see how effective it is. So, yes, it’s true to say that the service has not been of the quality that we would expect, but the health board is working on resolving the situation.

First Minister, there is clearly a huge problem in terms of out-of-hours doctors in the Hywel Dda health board area, and one of the impacts of this is to place significant pressures on A&E services, for example. Now, the options for the health board's current consultation mean that Withybush hospital will be downgraded to a community hospital without A&E services, which is entirely unacceptable. Would you agree with me, therefore, that it is even more important that A&E services should be available to people in Pembrokeshire, given that there is a huge problem with out-of-hours doctors, and that the Hywel Dda health board should at least recognise this in its consultation on reconfiguring health services in west Wales?

Well, I cannot express a view on the consultation, of course. It's important that this takes place and that it is an open consultation where people have the opportunity to express their view on the process itself, and to say how strongly they feel about any issue. As regards Pembrokeshire, there are an additional six GPs that are being trained in Pembrokeshire, and that, of course, will be of assistance to the area. Also, there are an additional six doctors on the hospital rota in the local area, because those doctors will have a role to play in the hospital itself. So, we have succeeded in attracting doctors to the Ceredigion and northern Pembrokeshire area, and we would expect Hywel Dda to continue to attract more doctors in order to ensure that there is a sufficient number of doctors available out of hours.