2. Will the Cabinet Secretary make a statement on the availability of beds within the Welsh NHS? OAQ52594

Thank you for the question in your new role on the back benches, figuratively at least. I expect all health boards to plan and provide services that meet the needs of their people. This includes the provision of sufficient numbers of beds in different settings across our healthcare system to meet local and national expected demand. That, of course, must take into account the fluctuations in demand that occur throughout the year.

Thank you for your good wishes—I'll take it as a backhanded compliment, Cabinet Secretary. [Laughter.] Cabinet Secretary, we know full well that one of the big issues that arrive in the winter pressure months in particular is access to beds within the Welsh NHS. I'm sure, through the summer recess, you and your officials have been working with health boards the length and breadth of Wales over winter preparedness plans. What confidence can you give people working within the Welsh NHS, and the people of Wales, that you have addressed the crisis in bed availability that exists in some health boards across Wales, so that we will have some respite from some of the backlog that happens in accident and emergency departments because people cannot progress through the hospital through lack of beds within district general hospitals across Wales? 

I thank you for that question. I really do wish you well in your new role in the Chamber. I expect to see you on many occasions in these questions, no doubt.

When you actually look at our bed numbers, last year we had over 400 additional beds throughout the whole system created to deal with winter pressure. So, that's essentially the size of a reasonably sized district general hospital of extra capacity within our system.

We do find even more acute pressure in the winter, as we regularly rehearse, and I'm sure we'll have opportunities to do so in the coming months. That is not just about beds within the hospital part of this; it's actually about getting people into supported social care to get them out of the hospitals. The flow is our biggest problem.

So, in that sense that isn't just about capacity; that's about how we manage demand and manage flows throughout our whole system. That is work that is being done in planning for this winter, with the Government working together with health boards, trusts and partners to try to make sure that we have the best possible response to the extraordinary demands we know our system faces in the winter.

We do still, though, have a higher proportion of beds for the population within Wales compared to England. We still look again at both bed numbers and bed occupancy, and, crucially, at how those numbers are used to make the whole system work and, in particular, the join between health and the social care system.

Following a campaign and a subsequent post on social media, I received numerous distressing e-mails from women who have suffered as a result of inadequate provision of support and suitable hospital beds for women experiencing miscarriage. One woman told me a harrowing story of being admitted to a hospital with a suspected miscarriage, only to be placed on a ward next to the labour unit. During the evening, in extreme pain, she was forced to see one of a pair of miscarried twins on the floor of a toilet. She described this as 'the most horrific, heart-breaking episode of my life', as I'm sure we can all imagine.

Yesterday, the campaign group, Fair Treatment for the Women of Wales, published their report with recommendations for improving miscarriage care. These include ensuring that early pregnancy units provide support services in line with National Institute for Health and Care Excellence guidelines, improved emotional support and establishing recurrent pregnancy-loss clinics. Will you commit, Cabinet Secretary, to working with the campaigners on this important issue and to implement the recommendations in that report?

I recognise the distressing picture that you paint, which spells out people's real experience within our system. We regularly talk about when healthcare goes right—as we should do to celebrate that, as we have done this year—but we recognise that when healthcare goes wrong it can have a significant and continuing impact on people's general health and well-being.

I'll be more than happy to make sure that my officials, including, if it would be appropriate, the chief nurse's department, I think, have a look at the report to see what constructive progress we can make in having a conversation with the campaigners about the current state of affairs within the NHS, and, in particular, about how we make further improvements.

Cabinet Secretary, we all understand that the availability of beds is critical, particularly with winter pressures, and Andrew R.T. Davies has highlighted that very much. In May, my local health board undertook a consultation on what it called service changes, but what, in fact, were bed closures. They recommended that 79 temporarily closed beds would be permanently closed and another 46 would be closed. As a result of my objections, and others objecting to some of that, we had a watered-down version, but I still worry very much that that watered-down version will result in that total of 125 beds being closed.

I ask the question: why aren't you looking at relocating those beds to other services, because there is demand elsewhere? The reason they're closing them is that they say they've improved services—they're getting people through the hospital faster, therefore the beds become less used as people move on. But, there are many other areas in hospitals where beds are being waited for. Will you now go to health boards and say to them, before they close any further beds, they must look at the service provision across their services to see if they can relocate those beds to other clinical needs to ensure that people don't have to wait for a hip operation or other purposes because there isn't a bed for them?

I recognise the point you're making, and we've had several discussions outside the Chamber about issues in ABMU and I know you've been engaged directly with the health board. In terms of the health boards discharging their responsibilities on this issue, they of course need to have a plan about the appropriate number of beds in the appropriate part of the system and the staff to go with them. And, here, the health board said that they had improved services so they didn't need beds in one part of the system so they could appropriately treat and look after people throughout the wider health and care system. I actually think that the biggest limiting step in actually having bed numbers in different parts of our service is about actually having the appropriate staff to deliver the services in them. But I'm clear about the processes the health boards must go through about needing to have evidence of the impact and the benefit to be delivered by changing bed numbers and what that means in terms of the staff and the service provision and, crucially, of course, the quality of care that people are provided. We have lots of good examples in 'A Healthier Wales' of where we do need to see a shift in our system to move people out of hospital care more quickly. That means different capacity within social care as well. So, I will look again at the experience of ABMU, and I'm sure you'll take the opportunity to talk to me about it as well to make sure they do get this right in the future as well.