7. What steps is the Cabinet Secretary taking to ensure that Hywel Dda University Health Board consults widely on proposals for hospital reorganisation? OAQ52240

Thank you for the question. Hywel Dda university health board is currently consulting on proposals to transform community and hospital services across mid and west Wales. I expect the health board to follow the process set out in the guidance for engagement and consultation on changes to health services and to encourage it to ensure the public has every opportunity to participate in the process in traditional and more non-traditional means as well.

Thank you very much. As the Cabinet Secretary knows, there's a lot riding on the results of this consultation, and from the countless conversations I've had, awareness is low, and it's fair to say there's a degree of suspicion that the health board have made their mind up in advance. They've only printed 10,000 copies of a quite hard-to-follow questionnaire, and they're making no envelopes available. I've been contacted by a constituent from Cross Hands last week who wants me to ask you whether or not you'd ask the health board to write to every household in Hywel Dda to make sure that they're aware of the proposals and encouraged to take part.

The health board are holding drop-in sessions, but their session in Llanelli yesterday had fewer than 100 people turn up. And a public meeting I supported, along with Nia Griffith, two weeks ago, had over 200 people turning up and the health board refused to send anybody along to engage in a dialogue and explain to people what the proposals were. Would the Cabinet Secretary ensure that Hywel Dda understands that if they want to take the people with them, they need to engage openly and be seen to be engaging openly?

I do recognise the point the Member is making, and of course, in addition to the traditional paper consultation exercise, there is the challenge of having drop-in sessions, which they've decided to run, where they've got extra sessions that they're putting on through the rest of the consultation period, which doesn't close till, I think, the second week of July. And there's a challenge about whether they will attend public meetings or not. I would expect that there will be members of the public who are also members of the health service who are engaged in those meetings in order to provide a clinical view on it.

What I do recognise is that in social media, and in terms of social media use, they have got a range of clinicians talking about the proposals. I don't think I'll be asking Hywel Dda to write to every household. Part of the challenge is about what you do and how far you go. The cost in actually requiring every consultation to go out, and the return on that, I'm not sure is a sensible one, but I do recognise that they need to take up opportunities to recognise where people aren't being properly reached. I don't think anyone could pretend that there's a low public profile about changes to healthcare proposals in west Wales, but I'm more than happy to sit down with you, if there are specific proposals, to try and look at what could be done to improve the way in which the health service engages with the public and to ensure that Hywel Dda takes up every reasonable opportunity to engage with the public.

And finally, Paul Davies.

Cabinet Secretary, you're already aware of my outright opposition to this consultation, given that all three of the health board's options will actually result in Withybush hospital being downgraded to a community hospital with no accident and emergency facilities. Now, given that you, as a Government, will not intervene specifically on this matter, why will you not, at the very least, confirm that funding will be allocated for all three proposals, so that people can be sure that these proposals are realistic in the first place? If you can't do that, then I put it to you that this consultation is an absolute farce.

The Deputy Presiding Officer (Ann Jones) took the Chair.

Well, I just don't accept that at all, and Paul Davies revealed his position at the outset: he is opposed to any change. And look, that's a position for him to take and for him to explain. This is a consultation that the health board are running that takes seriously the challenges it has and will have in the future. I don't have a view on any of the three options that are available, because I may have to make a choice. I can't therefore confirm that I'm going to fund any of the three options because I put myself in the position where I can't then be a decision maker on what is, potentially, going to be my responsibility. It is also entirely possible that, during the consultation, if it is a real consultation, that some of the options may change. So, actually, you'd be asking me to sign up to funding something that may not be the actual proposal at the end of it, otherwise there would be no consultation—[Inaudible.]—potentially changing or refining any of the proposals.

I go back again to the example of Gwent. Healthcare in Gwent changed significantly because of the clinical futures exercise. It brought together staff who agreed on a broad model and it brought together a wide range of public stakeholders as well. That still took, though, a process to have not just a view about the future, but then to develop a business case for changing the hospital estate as well as community services too. And what has now happened is that this Government has invested in the Grange university hospital to deliver the final piece of that vision that will also require changes to the way that other hospital services are run in other other sites, and most significantly of all, a change in the way in which local healthcare is delivered. Over 90 per cent of our healthcare interactions are within local healthcare. We spend nothing like 90 per cent of our time discussing local healthcare in this Chamber or otherwise.

I will do what I said I would do at the start of this term. I will provide the space for the national health service and the public to have a consultation, a conversation about the future of healthcare and the necessary changes that we all recognise would need to be made when every single party in this place signed up to the parliamentary review. We knew there would be difficult choices to be made at the end of it. I am not going to walk away from potentially having to make a choice, but this is a consultation for the public to be involved and engaged in, for staff to be involved and engaged in, and I look forward to seeing the outcome of that very public consultation.

Thank you very much, Cabinet Secretary.