Part of the debate – in the Senedd at 4:45 pm on 5 June 2018.
On the final point, it's difficult to answer that without some particular examples. So, if you want to come to me with particular examples of where the third sector have been engaged or not engaged, that would be helpful, rather than more general involvement and engagement with the third sector in a wide variety of services, which I can't properly respond to.
On the point about the four-hour deterioration, we have seen a deterioration, and it's due to a range of factors that affect the health service around the UK. It's partly about an increase in demand, it's partly about the ability to have a more joined-up approach with primary care and social care. It's also partly about changing some of the leadership and the challenges within those departments. That's part of the improvement work that we've been doing.
Again, going back to the visit that I had in Ysbyty Glan Clwyd, they recognised that the work that was being done there—they could recognise that it was improving the position for them as staff and the care that they were able to provide. But if we're not able to have something to keep more people in their own homes successfully and get them out of hospital appropriately as well, then we'll continue to see a deterioration that is most recognised at the front door of our hospitals. So, actually, being able to deliver more effectively on resolving delayed transfers of care and moving people out of the hospital sector is a big challenge in the front-door problems that we see in every part of our system where we recognise it, including, and in particular, in north Wales. And again, I've never tried to hide from the fact that the challenges in the four-hour figure are there and are real for staff and patients as well.
I simply reject your assertion that we've seen enhanced suffering from the way in which we're trying to support a shift in local healthcare arrangements. The investment we're making in joint health and social care centres is delivering better care closer to home, and actually, we need to carry on with that journey—it's been validated by the advice and the challenge that we've had in the parliamentary review. We're not going to take a step back to the older provision that we have had, but we do need to think about how we invest in different capacity within our system. Some of that will be in social care, some of that will be in the residential sector, or in step-up and step-down facilities. And that's also why health and local government need to work more effectively together to commission and agree on the funding and provision of those services.
In terms of your point about Tawel Fan families and the report and the difference in the conclusion of the Ockenden and HASCAS reports, we've run through this on a previous occasion when I actually made a statement and answered questions on the HASCAS report. And again I've been clear that there was further information available in much greater clarity, volume and certainty to the HASCAS organisation, and it is understandable to see why, with different information being provided to them that was not available to Donna Ockenden, to be fair to her, when she undertook her first report, different conclusions have been reached. Individual families are still being worked through to have their individual reports provided to them and an explanation from HASCAS about the individual-level challenges they've seen. That is a process that will need to continue and is being worked through with the help of HASCAS and the families in question.