Part of the debate – in the Senedd at 3:13 pm on 23 October 2018.
Thank you for the uncharacteristic generosity that I recognise in your comments. I think the point that you're making about efficiency and about how we gain greater value and productivity, they matter. There's something about doing some things differently, doing them more efficiently, but there's also something in transformation about doing different things as well. And we need to be able to do both of those and judge when we need to do either one.
So, for example, you talked about prescriptions. Well, actually, prescription growth has been slower in Wales since the free prescription policy than it has been in England where people pay for prescriptions, which is an unusual fact—it's counterintuitive—but that's the reality of what has happened. So, people are already making choices about what to prescribe. And, actually, in Wales, we've had a national approach to prescribing on using biosimilars—so, not having branded products, but products where there is exactly the same efficacy and safety for the citizen. So, we've actually taken a national approach and made real financial savings.
But that isn't just the only part of what we have to do. There's a large part of this that is about how we just do different things. Your point about access to accident and emergency and the figures going up, well, of course, access to primary care is part of that story. I don't think it's the whole story, actually. It does, though, partly reinforce why we need to transform primary care to make sure we have GPs working in deliberate partnerships with other healthcare professionals, and not simply as a response to challenges in recruiting general practitioners in different parts of the country, but, actually, in every part of the country it's the right thing to do. It's a better job for the GP, a better job for the physio, for the nurse, and the pharmacist and the occupational therapist that will work with them and, ultimately, a better service for the member of the public, and people will get faster access to the right person. That is also the same reason why we want to have a genuinely more joined up partnership with social care as well. Most GPs will tell you that lots of the people who come through their doors to see them have social problems and not, really, health or medical problems for them to deal with. So, that partnership really does matter.
The point about demand coming into our system—we've rehearsed this many times about the age of our population, about the additional public health challenges we have, about dementia as a particular challenge that we face now and in the future as well. It reinforces why we need to do some things in a different way, but actually to do different things too. So, our 'hear and treat' services and our 'see and treat' services are not just about keeping people out of hospital, they're actually about that being a better way to deliver that care for the person. You'll deliver more local care that is more appropriate for that person and give them a better experience too, and there's actually less risk for that person in making sure they don't have an unnecessary trip to a hospital. That's why we have to have a different conversation about value. It's partly about prudent healthcare and about the value base of what we're doing, and what value are we gaining by spending money and using resources in a different way to provide better care and not just technically more efficient care.
Of course, I look forward to having this conversation in committee during the budget. I'm sure that we'll get asked plenty of questions about this by committee members, but, throughout the life of this plan, it actually underpins much of what we want to do and how we'll actually have a system that is in balance, that is financially sustainable, and is delivering high-quality healthcare to meet the challenges of today and the future.