Part of the debate – in the Senedd at 3:07 pm on 3 July 2018.
Thank you, Angela. I do welcome what you say about the personal thanks to the NHS, not just the general improvement of public health. You mentioned polio, measles and a whole range of other things that killed lots of people in the 1930s, 1940s and 1950s that have been eradicated because we had a universal service that was able to deliver a comprehensive vaccination programme. So, it has been a tremendous achievement, and just as you have personal reasons to be grateful to the NHS, I too do, and I imagine other people in this room will have their own personal stories for themselves or their loved ones.
I'm going to start with your point about the shared responsibility of people and the health service. I remember one of the first things I voted on when becoming an Assembly Member in 2011 was a report from the Bevan Commission about key principles for the future of the service, and one of those was about the personal responsibility of individual citizens, and how we need to have something where we have a positive conversation and relationship between the citizen, the service and, of course, the rest of the state, because we do have a shared responsibility for the choices that we make. It's one of the things that we regularly talk about on almost every major cause of disease, illness and death—so smoking, how much we drink, how much we exercise and what we eat. In addition to that, we need to make some of those healthier choices—[Inaudible.] —easier. That's part of what we need to do, because if it's simply a finger-pointing or lecturing exercise, then we'll get what we have. So, there is a broad change from the Government, from public services but also from the business world as well, because work has a huge impact on people's health outcomes. Not just work, but good work makes a huge difference to the outcomes that people have. Of course, there is then how we persuade people to accept their own measure for their responsibility for the choices they make, and in particular the choices that we make for our children.
I want to turn next to your point about the political football of the health service, and on the one hand this is, of course, inevitable. Labour Members will understand and I think will, rightly, complain about the way in which the national health service in Wales is regularly talked about in Prime Minister's questions. We heard previously the points about the 'line of life and death' being Offa's Dyke. Now, I think those things of course are bound to produce an inevitable and angry political response. But what we have to be able to do, though, is to recognise that there is innovation that does take place across the United Kingdom, and learning to be taken. There are points that, actually, it's in our interest to work together. The tier 2 visas, for example—I asked for that decision to be made, but I know that every organisation representing staff in the UK did, and I also know that the UK health department wanted the Home Office in the UK to change course rather sooner. So, it was in the interest of all four parts of the UK that that change was made. I welcome the fact that the change was made, even though we'll continue to have arguments about why the change wasn't made earlier, and yet we know that, in innovation, people do look to Wales. I'll give you an example there. On ambulance services, I know we still have scrutiny and disagreement about the changes that I chose to make for the ambulance service, and yet if you talk to people within the ambulance service around the UK, they are coming to Wales to look at what we have done, how and why, and we see pilots from Wales, where Scotland and England look remarkably similar to what we have done here. You won't hear an English Minister stand up and say that they're looking to learn from Wales, but that is practically what happens. So, in some way, the inevitable politics of it are actually about what we have to learn from other parts of the UK, including England, as well as what we have to give.
I just want to come back to your point about it being a service that values people and the huge numbers of employees that we have. We have over 91,000 people employed in the service and nearly 80,000 full-time equivalents, and yet key part of 'A Healthier Wales' is the quadruple aim and the need to value our staff. A good place to work with motivated staff will deliver a better service in every single part of activity, in public service and the private sector. I know you'll know that, having run your own business. I know it from my own time being a manager and an employer.
At the launch of the plan—this is the point I'll finish on, Deputy Presiding Officer—we spoke to staff within the service, and they recognise that changes that have been made to the way they deliver health and care already have not just delivered a better quality of care but a better place for them to work, and they're motivated by that change. I regularly hear on each of the visits that I undertake a sense of frustration about the way politicians behave and talk about the service and about wanting us to not just have the maturity to say, 'Here are the big challenges, let's create a parliamentary review', but it's about the way that each of us choose to behave in taking that plan forward, because most people who work in our national health service want to see a little more honesty about those challenges and some more licence and support for taking on the big challenges that we recognise exist and being brave enough to make choices about them in the future.