Part of the debate – in the Senedd at 3:41 pm on 12 June 2018.
Thank you for your comments and the questions. I want to start off by, again, recognising and welcoming the cross-party work that went into the parliamentary review, the membership and the terms, and where we are now. And I expect, of course, that there will be slightly a different character where we are as you quite rightly scrutinise me and the Government on taking this plan forward.
I understand your concern about some of the centralised functions that we've been advised and recommended to create, not just in the review, but also in the Organisation for Economic Co-operation and Development review as well. I think your question of are there enough people of the right calibre to deliver national transformation comes to that, together with your question about the scrutiny of the national executive. We may want to bring more people in. That's part of what we're looking to do to deliver a national executive. Some of that is about bringing together, in a more coherent way, different parts of our health and care system and to have those, I think it's likely, to be responsible to the director general and the chief executive of the NHS. That then means, of course, that that's going to be responsible to a member linked to the Government and, of course, I expect to be scrutinised on what happens both in committee and here in the Chamber as well.
Now, I do actually think that, across Wales, our—. We could always look for would we want more people of greater calibre and quality, and we would always want to say, 'Well, you can never have too many good people'. I actually think our first challenge, though, is to get organisations pointing in the right direction at the same time and the leadership that already exists at not just the senior level, but at peer and delivery and front-line level, and we'll actually see real gain being made in doing so. And that's why the plan sets out that regional partnership boards—which already exist, so we're not going to create a whole new plethora of boards and organisations—they'll be empowered to take forward some of the transformation that we are discussing.
And, really, your point about the place of staff—I think it's pretty clear, in having a quadruple aim that we've validated and agreed to take forward in this plan, that the key additional in the quadruple aim is ensuring we have a motivated and sustainable health and care workforce. And that will be hugely important, not just as something to talk about but to deliver in practice. And the challenge in the detail of the delivery on this and on a number of other things is that I don't think you'd expect to see a high level of detail in this plan. I think you have to see the ambition and the clarity in the targets, the actions to be taken, in the timescale to deliver them, rather than a very detailed operational plan for the service. That would, very quickly, become out of date. But the challenge is how we achieve our targets and the actions that we have set out. It's also worth mentioning that the NHS staff survey has just recently opened, so, if any members of the NHS staff family are watching, then I'd encourage you to take part in the staff survey and tell it how it is about what's good, what's bad and what's indifferent within your organisation. We have a similar challenge about keeping on board the social care workforce, and I'm pleased to note that the British Association of Social Workers in Wales have welcomed the plan as well.
I just want to finish by dealing with your point about transformation. In the plan, you will have seen that we've asked each regional partnership board to develop two particular models to try and deliver some of that transformation. Now, there's a deliberate ask there to make sure that we're having something done on a large enough scale—so, not just a small area of transformation that is isolated to a single community, but a much larger level of transformation that all of those regional board partners can agree on and get behind. And that's really important, because that again reinforces our view that it must be the health service and local government and other partners who are agreeing on what our transformational areas of activity are for them all to engage in and support, to make the change that we've discussed many times in the past. And the transformation fund will help to promote that and to take it forward. But we also think that's likely to generate a number of areas where partners don't need the transformation fund to agree on doing something together. Because the real priority is not how we use £100 million of transformation funding, important as that is in advancing and kick-starting the pace of some of the change want to see, it's actually how we more progressively use the £9 billion of money on health and social care spend together and that's a challenge. How much more of it will they spend together on the same objective to the same high level plan and with the same workforce working closer and closer together and that is what we're looking to achieve.