2. Will the Cabinet Secretary outline the progress being made in reducing the budget deficits of local health boards? OAQ52409

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

Thank you for the question. I have been absolutely clear that overspending by health boards is unacceptable. The Welsh Government is providing targeted intervention support to those boards in deficit to develop sustainable financial plans. With this support, both Abertawe Bro Morgannwg University Local Health Board and Cardiff and Vale University Local Health Board both achieved an improved financial position in 2017 compared to the previous year. I have also announced £27 million of additional recurrent funding to Hywel Dda as a consequence of the zero-based review to place the board on a fair funding basis going forward. And, of course, I've issued the next 18-month special measures improvement framework for Betsi Cadwaladr, setting out my very clear expectations for improvement. 

Cabinet Secretary, my local health board, ABMU, has a deficit of over £3 million a month. In order to address this deficit, the health board are proposing to reduce the number of hospital beds that are available. Cabinet Secretary, given that bed occupancy rates in my region are nearly 90 per cent, do you consider the proposal to reduce the number of available beds to be safe?

Thank you for the question. I think it's been positive that ABM had a better financial outturn than the previous year and I want to be positive about their prospects for further improvement, until they get to a position that is generally acceptable when they do live within their means, and indeed they provide an acceptable level of performance right across the whole of their responsibility. 

The current beds consultation should not be driven by financial measures. My understanding is that they're trying to set out a case for changing where care is provided because alternative services are available. That is not driven by money; that is actually driven by where do you provide the right care at the right time and in the right place. I would not support the removing of beds from our system simply as a financial measure. The change in bed capacity and where it is is a different issue. As I say, there is an ongoing consultation. Today is the last day, and if anyone has not taken part in the consultation, I would urge them to make their views clear.

Why has Welsh Government, together with health boards, not done more to reign in the huge amount of spending on agency staff? Couldn't he have better control of these deficits if that was done?

In fact, last year, I issued measures to have a cap on agency staff and that made a real difference in the last quarter of the last year. The challenge now is to not just see the fruits of a full year of that, but to take wider action as well, which is why the ongoing conversation is that we need to come to an end point about changing the use of both agency and bank staff. Because I think there is more opportunity about the way in which the bank is used rather than agency staff, and the way that the quality of care is provided, as well as the financial measures.

So, I am looking for further progress. We've actually managed to take out, largely, some of the higher end agencies as well, but this will continue to be an issue about the financial sustainability of our system. It also means that, in some parts of our healthcare system, we'll need to change the way that care is delivered, because it's actually difficult to recruit people to some of the ways of delivering care that we currently have. So, there is a range of different measures to take, but it will of course be an area that I expect further scrutiny on here, and indeed the director general has regular scrutiny in the Public Accounts Committee on this issue as well.