4. Statement by the Cabinet Secretary for Health and Social Services: The Long-term Plan for Health and Social Care in Wales

Part of the debate – in the Senedd at 3:48 pm on 12 June 2018.

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Photo of Vaughan Gething Vaughan Gething Labour 3:48, 12 June 2018

Well, that's an interesting set of questions and comments from Rhun ap Iorwerth. I'll deal with your four points and then I'll deal with your more general observations, which you'll not be surprised I don't share.

On the proposals to deliver a new culture, I actually think there's a limited extent to which proposals in a plan can deliver a new culture. Actually, what has started to change the culture is the process that we've undertaken between partners in undertaking the review itself and in the broader work that the Government has undertaken over a period of time. A really good example of that is the integrated care fund, and that came from budget discussions between parties in this Chamber, and that has changed some of the culture and working relationships on the ground. It's given us good examples of what working together delivers: a better place for people to work across health, social care, housing and other areas of our workforce, and equally better outcomes for the citizen. That's crucially what this is about, and that's been reinforced by the way we've gone about developing the plan.

As I've said in my statement, we have done this by working with partners. The Government previously wrote a plan for the health service, gave it to the health service and told it to deliver it. They then told their partners in local government and elsewhere, 'This is what we're going to have to do.' We've done something different this time. It's been positively welcomed and recognised. We have brought together Government, the health service, local government and other partners that I've set out, and there's actually been a joint conversation between different people about their varied roles in delivering better services and better outcomes. So, we've made real progress in taking that forward and, interestingly, the Welsh Local Government Association recognised that themselves in the statements they've issued about how we've got to this point, and in the direct conversations that I've had, together with the Minister, with people of all parties and independents across the country. 

In terms of the challenges about workforce, not only do we have the quadruple aim, but we have a range of actions within the plan—actions 25 to 28 in particular—that talk about how we will take forward getting the right workforce to deliver a different way of providing health and social care services. Interestingly, yesterday when we launched the plan formally, we were very pleased to be in the Cynon valley visiting the Laurels care home in Aberdare, and also then visiting a person in a home in Ynysybwl. That was a really positive and real example of change that we're already delivering that we want to see more of: not just a virtual ward, but, actually, if you could have listened directly to those GPs that talked about how their jobs have changed and the way they believe their job has changed for the better. One said, 'I would not go back to the way we used to do things. We didn't really talk to each other before and we didn't think that we could do. Now we talk to each other, we have the space to do it, and we are delivering better care for the people we are responsible for as a result.' They also recognise that they have different staff doing different things with them. It wasn't just a validation of what I think; it's a validation of what they see in practice, and that's what we need to deliver more of. That's why we're bringing different partners together, and that's why regional partnership boards must be a key driver in delivering that change. 

On your point about performance benchmarking with other UK nations, that requires the other UK nations to want to do that, and thus far I've seen no desire whatsoever from our colleagues across the border to want to do so. The only time we've been able to benchmark quality data between the UK nations, actually, Wales did rather well. We were above the line in the majority of the 13 quality measures. We were below the line on two, but, actually, on five out of the 13 measures, we were above the UK average. That shows that on a quality basis, NHS Wales does quite well in comparison to the other nations across the UK, and every now and again it would be good if you could recognise that, as well as our challenges. 

We recognise the challenges about integration—that's what this plan sets out for us to do—but I just don't accept the starting point of saying that Labour has lost its way. If that were the case, we would not be here in our respective positions in this Chamber. Plaid Cymru pushed for this review, together with other parties, and we all recognised in a moment of maturity that this was the right thing to do. And we recognised that in doing so, it would mean that there wouldn't be a strategy while we had a review and we got to this point as well.

Now, I think that when you look at what other people are saying about where we are, far from saying that this is a disappointment—. If you look at the comments from the Wales Council for Voluntary Action, the range of royal colleges, including the royal colleges of nursing, podiatry, physiotherapy, occupational therapy, the Royal Pharmaceutical Society, the Royal College of General Practitioners, the British Medical Association, the Welsh NHS Confederation, the Health Foundation with a UK perspective, the Bevan Commission and the British Association of Social Workers Cymru—they all say this plan takes us in the right direction, the plan is a good thing, and, as I finished in my statement, the radical thing to do now is to deliver.