Part of the debate – in the Senedd at 3:43 pm on 3 July 2018.
Good to hear mention of one of my predecessors, Dr Gibbons, who I saw recently, in reference to Julian Tudor Hart as well—and Dr Gibbons is still full of ideas and views about the future of the service.
On your point about clinical strategy, there is a challenge about what should be national and what should be regional, and how that clinical strategy needs to rub up against and be designed in concert with the wider care strategy within regions. That's why we're looking at how social care and health have high-level plans that are designed together, as well, indeed, as health boards themselves working alongside each other. So, the work that Abertawe Bro Morgannwg University Local Health Board, for example, are progressively doing more of with Hywel Dda Local Health Board is really important. They have a more joined-up view of what services should be provided where, and what that means in terms of both access and excellence for those services as well, and never forgetting, of course, that we still want to maintain local services. Because when we talk about joining services up, it's often a focus again on hospital-based services rather than where over 90 per cent of ill-health interactions take place. That again comes back to the point about our staff, and the crucial importance of staff leading a conversation about what change looks like and why it is or isn't a good thing. As I was saying, me turning up in a suit doesn't persuade a whole bunch of people about what the future of the service should be—having six different health and care professionals is much, much more persuasive, particularly if they recognise them as people who live in that community and serve that particular community, wherever it is.
Your point about the South Wales Programme is well-made. It was clinician-led. There was agreement on what to do, and we have achieved a number of those things but, again, it usefully highlights the point about the pace and the scale of change. We have taken a long time not to deliver all of the programme, and that's one of the things we need to be able to get over and get around for the future, because the pace at which we're able to move frustrates everyone, it makes people anxious about whether change will really happen and it means that we don't deliver the improvements we recognise are necessary as quickly as possible. So, yes, the south Wales work is still being delivered, and key building blocks have happened, but I want to see much greater pace in the future for the change that we are talking about. Otherwise, whoever is a successor in this role at some point in the future will still be talking about the same things, the same challenges and the same problems, and not being able to make change happen. I can assure you, I hope, that Health Education and Improvement Wales will take an all-staff approach to all grades and types of staff. It is about a holistic and genuinely integrated approach to the future of the staff that we need today and, of course, for tomorrow.