3. Statement by the Cabinet Secretary for Health and Social Services: A Healthier Wales: Update on the Transformation Fund

Part of the debate – in the Senedd at 2:54 pm on 23 October 2018.

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Photo of Vaughan Gething Vaughan Gething Labour 2:54, 23 October 2018

Thank you for the comments and questions. I'm going to start by recognising what you say about the fund, and, of course, some people have all been looking for an extra sum of money. Whenever you announce a certain sum of money, people always try to understand what their part of it is, what their chunk is and whether it will cure all ills. Well, I've been really clear from the outset, as indeed has my colleague Huw Irranca-Davies, that this fund is a specific fund to help deliver change and transformation. It is not a panacea. It really is about supporting and implementing new ways of working to transform our whole service. So, it's a way of leading change to then use the £9 billion to deliver that change on a system-wide level. That's what we're looking for. And, in that, the design principles that I've mentioned several times really matter. If they don't meet the design principles that we set out, they won't get supported. If they are not genuinely scalable, and they can't demonstrate how, if successful, these projects could scale, then again they won't be supported. I accept that not every project that gets supported, even on the best advice, the best design—not every project is likely to succeed. It's important that we accept that and say that again and again at the outset, because there'll still be learning from projects that don't succeed.

That goes back to your final question about evaluation and time frame. With each bid that comes in, there will be something about evaluation within it so that we can understand what good it is or isn't doing, and also the time frame within which to do so. So, these are not never-ending projects. They can't be. They have got to lead to a point where we can understand: is this the right answer, and, if it is, how do we then scale it across our system? And, if it isn't the right answer, then we have to disinvest from it. I'm very, very clear about that and I have no difficulty in saying that, both in the initial launch that I attended in Cardiff and Vale, and the same goes for the Cwmtawe cluster, and whatever projects I decide to support in the coming weeks and months.

So, on the question that you asked about how the decisions are made, the advisory board is there to challenge the work that is being done by the programme board. That group, led by Andrew Goodall, will provide the advice to me, and I will then make decisions, based on that advice, about whether to support projects or not. So, I have decided on the first two projects. The eight areas that I mentioned—I'll get advice on those, and I will then look at them, and I will then make a decision about what to support. I'm happy to confirm that each part of Wales will provide a project to go into the transformation fund, of varying scales and sizes. I can absolutely guarantee that Hywel Dda and north Wales are not about to be screened out of this. So, you will see, in the choices that I make, that we will be making choices across the country. I expect every area, not just the two who have applied—. I expect, before the end of the calendar year, you will see a range of other choices. So, I can't give an exact timescale, because I need to consider the advice when it's given and make a choice when I'm content that it is the right thing to say 'yes' or 'no' to. But I expect to make further choices in the coming weeks, not necessarily waiting a matter of months.

I'm also happy to reprovide the commitments that I have given previously—that this transformation fund is not a way of using extra resources to primarily go into a hospital system. Now, that doesn't mean that projects can't have an impact on our hospital system, or can't use some of the money within the hospital system, but it is primarily about delivering a shift in how we deliver care. So, the primary focus is primary and community services. It really is about the partnership between health and social care and others, including housing and the third sector. That's why we have used regional partnership boards as the initial mechanism. Anything that wants to come to the transformation fund must first have the support of its regional partnership board. That's really important. So, health and local government are in the same place as co-decision makers, for the shared objectives that 'A Healthier Wales' sets out. It is not a question of all of them saying, 'This is my project. I will now decide.' They have to agree with their other partners around the regional partnership board table.

In terms of the £60 million to support the IMPTPs, that is new money. In terms of the £30 million I have announced for the regional partnership boards, that is new money too. Of course, with the transformation fund, if we don't spend all of it, I will then have to make a choice as to whether I can reprovide that money into the next year. I think we'll see an expansion in ambition and scale in the projects we are likely to see, and I want to encourage that, not level it downwards.