2. Will the Cabinet Secretary make a statement on changes to the pay of doctors and dentists in Wales? 214

Thank you for the question. Earlier this week, I was pleased to announce that I'd accepted in full the recommendations of the independent doctors and dentists review body. This gives doctors and dentists in Wales a pay rise beyond what was given to their counterparts in England and Scotland. It further demonstrates how much this Government values our doctors and dentists.

Thank you very much for that answer. And thank you for accepting, Presiding Officer, the topical question. I would like to have been able to have had a statement on this where we could have actually asked you some questions, because, like you, I welcome the increase in the pay award to doctors and dentists in Wales, but there are a couple of areas that need some clarity.

We've seen a 4.6 per cent reduction in GP practices in Wales over the last year and 10 per cent more locum GPs in Wales in 2017. Do you believe that this award will be able to help us to address the chronic shortages that we have in this area? And do you believe that this pay award will also go towards addressing the chronic shortages we face particularly in rural areas? And do you believe this award will enable us to increase, perhaps, or renew some of those many practices that have indeed closed down in the last 24 to 48 months?

Could you also please confirm whether or not the proposed increase in funding will affect locum and agency professionals? And what would be your view, given how much we spend in the NHS on locums, both within hospital settings and within general practice, on how much this will affect our spend on locum and agency—or the amount of money we spend on locums and agency—professionals? Because I am really concerned about the fact that, if the locum offering becomes ever more attractive, we will find it harder and harder to recruit full-time, permanent posts within the Welsh NHS.

I'd also ask if you could just confirm what the increase for consultants will be. In 4.5 of the report by the pay review body, they talk about the fact that there shouldn't be an increase for consultants over the base rate, and I would just like to have an understanding of some of the changes that you've made to independent contractors and to some of the specialised associates and specialist doctors and consultants. If you could just clarify that for us, that would be very helpful.

And finally, I do accept that you feel very happy about the fact that you are paying more money than England and Scotland, but you were very clear to the health board, you were very clear to the review body, and I quote:

'We have noted in this respect the Welsh Government’s view that considerations of fairness dictate that pay should align across the UK for the individuals fulfilling equivalent roles across the UK NHS and to avoid unhelpful internal competition for staff within the NHS workforce.'

Do you feel that this might undermine any of that? Thank you.

Thank you for that. I think there were four broad questions there. On whether this award is the answer to the range of challenges that you've set out regarding recruitment and retention, on its own, no, of course it is not, but the award itself is an important part of the answer about encouraging doctors, dentists and other healthcare professionals to train, work and live in Wales. It's part of a suite of measures, it's part of the approach that we take and the genuine social partnership we have, and not just with doctors and dentists, but it's consistent with the approach that we took with our 'Agenda for Change' staff, where we listened to what the independent body had to say, where there were negotiations between staff side and employers, and we managed to find a way to invest in their pay, because, as you will know, Angela Burns, the UK Treasury did not provide additional funding to cover the independent review body's recommendations. We had to invest additional Welsh Government resources in this pay deal, as in the 'Agenda for Change' one. So, we have made a deliberate choice, with Welsh Government resources. That is a Welsh Labour choice that I am proud to have made.

On locum pay, locum pay is different. It is generally negotiated outside normal contractual arrangements, but I'll have more to say on locum pay later in the year in reporting the impact of the cap that I introduced in Wales and its impact upon variable pay across the national health service—again, a measure that I took last year—and I'm more than happy to report back to Members on the impact of that after a full year of operation.

On consultant and specialist doctors' pay, I'm happy to confirm that this is a 2 per cent base increase in the salary of doctors and dentists, including doctors in training and consultants. There's an additional 2 per cent for general practice. There is also an additional 1.5 per cent for specialist doctors. So, we are dealing with the recommendations that we have been provided with.

On your point about avoiding unhelpful internal competition, the way in which you phrased the question suggests that we should have simply followed what England or Scotland did when they chose, having received the independent review body's advice, not to implement it. They chose to impose a cut compared to the review body's recommendation, and your colleagues in England chose not only to cut the recommendation, they chose to implement it from October rather than the April that it was recommended from. I have to say that, in your press release, it was rather mean spirited and not wholly accurate to suggest that we had held this up. We have had a genuine conversation in partnership with the British Medical Association and the BDA and I am pleased to confirm that this Welsh Government does respect the recommendations of independent pay review bodies, and we have invested in our staff, in the future of our health service, and there could not be a clearer contrast between this Welsh Labour Government and the Tories across our border.

Thank you, Llywydd. In announcing your decision on salaries, you said that the Treasury hadn’t given any additional funding and that, therefore, you’d had discussions with the Cabinet Secretary for Finance so that this pay deal could be delivered without impacting services. My question, very simply, is: what has changed? Don’t misunderstand me—I’m very happy that these salaries are going to be higher for dentists and doctors here, but the Government’s stance in the past was to say, ‘No pay rise unless there is additional funding made available from the Treasury.'

I’m very pleased that you now have accepted that it is possible for you to take action without always waiting for the Treasury. I’m thinking of other examples, such as zero-hours contracts or the cap on other public sector workers’ pay, and your party has also in the past rejected the idea of allowing or supporting regionalised pay in different parts of the UK on the basis that it would surely drive wages down in Wales. By tailoring things to our own needs in Wales, we are showing, as in this case, that it is possible for salaries to be higher in Wales. So, has that fundamental principle on which the Government operates changed?

No, I think we've been entirely consistent. What we have done, though, is from reserves had to fund the pay award for this year, and we will now have to absorb that additional cost in future years. These come on the back of very difficult choices this Welsh Labour Government continues to make, and in a climate of eight years of continuing austerity our choices get tighter and more difficult every year. We understand the value the public place on our national health service. We've all seen that in this seventieth year since the creation of our national health service. So, that's why we're continuing to make those difficult choices, but it comes at a cost; there is no consequence-free choice that this Government can make. That's why I say, not just to the Members behind me, but to all Members in this Chamber: if we really do want to continue to invest in our national health service, in the staff numbers, and in their rates of pay moving forward, there will continue to be even more difficult choices. Our values continue to guide us. I am pleased that we have made the right choice not just for the staff of our national health service, but the right choice for the people of Wales.

Thank you, Cabinet Secretary. The next question is to the Cabinet Secretary for Finance and it's from Steffan Lewis.