Part of the debate – in the Senedd at 3:14 pm on 8 May 2018.
Thank you for the range of questions. Forgive me if I don't answer all of them now in the time available, but I'm happy to take them up with you directly after today's proceedings as well. I think, actually, the point you raise about accident and emergency shows the scale of the challenge we face in dementia care, because people with dementia are a regular feature already of care within the hospital sector, and will become more so in future. We expect more people to be diagnosed, we expect undiagnosed people to arrive in our hospitals requiring care and treatment, whether in accident and emergency or in elective care, and it will be a bigger feature of health and care delivery here in Wales. Actually, the fact that the accident and emergency issue was raised shows that the HASCAS report did listen to what the families were saying, because it wasn't part of the earlier remit, but it was raised by families during the course of the investigation, and so the remit of its investigation was broadened to allow that view of the wider care and treatment pathway, to get a broader view on what was going well, as well as what wasn't going well, in providing health and care within north Wales.
I recognise your points about the range of activities that are provided to people, the range of recovery and rehabilitation that is still possible from a physical point of view, but also the fact that these are people who are, by their nature, vulnerable and often don't have a voice. So, your point about advocacy is well made, about there being a genuinely active offer, and that is work that we are seeking to undertake to make sure that—. The focus that we often have on children's advocacy is not often there when it comes to the older adult, which is surprising, and I think that it's largely because people assume that there is a family waiting to look after that person or advocate for them, and often there isn't, either because they don't have a family or because their family is no longer around, and that is a very sad reality that many of our older citizens face.
I also recognise your point about capacity and the work we're doing on the mental health Act and the review that is taking place across England and Wales with the mental capacity Act, and in particular the deprivation of liberty safeguards. So, there is work that we recognise needs to be done right across our system, not just in Wales, and we're working with partners across the four nations to understand what our approach will need to be in the future, because that can be difficult for the individual, for their family and the health and care system itself as well. We have already provided interim annual investment of more than £300,000 to support health boards and local authorities to deal with the challenge that that has provided.
On the nurse staffing Act, I will come back to you, and I'll happily provide a statement to Members, on the work that we're doing to deliver on the commitment of the Government to extend the nurse staffing Act. There are a range of different options and potential priorities that I've previously reported on, and it probably is time for me to provide an update, whether that looks at in-patient paediatric care, whether it's community nursing or, indeed, around care for older adults as well. So, I will provide a fuller update on that, and it's a useful reminder that it is about time to provide Members with that factual written update.