Part of the debate – in the Senedd at 5:23 pm on 13 November 2018.
Cabinet Secretary, thank you for your statement today. One of the things that does seem to mark out the winter months is these winter pressures on the NHS and, obviously, over the Christmas period, as you alluded to in your statement. With the bank holidays and all the rest of it, it is a particularly challenging management time for the NHS, and we do pay tribute to the work of the NHS staff across the whole estate, because it needs everyone within that estate to work, as well as the voluntary sector, to meet those challenges.
I will take a couple of points out of the statement, in particular around the capacity. You can talk about the extra money you've put in, which is very welcome, but is that extra money buying additional capacity, both in hospital beds and access to GP practices and primary locations, in particular? In the statement you talk about increasing access to services in the community over evenings and weekends. Well, if you talked to most people, they do have difficulties at the best of times trying to access appointments in the evenings within the GP sector, for example. So, what additional capacity will the resource that you're identifying buy over these coming months so that that will actually treat patients in the best location, which is the community itself?
Here in Cardiff, for example, over the Christmas period last year, there was a certain period of time when there was no GP out-of-hours provision whatsoever because the health board was unable to attract any GPs to fill those rota slots. Can you give a commitment today that that situation will not happen this winter, given the preparedness that you've identified within your statement this afternoon? In particular, and I did raise it with the leader of the house, could you touch on staffing levels within the NHS, in particular in maternity services? You did indicate that you were going to come back to the Chamber to inform us about staffing levels within maternity services across Wales in light of the Royal Glamorgan Hospital situation and the staffing numbers there. If you could use, maybe, this statement to give us an assurance that your officials now have satisfied themselves and confirmed to you that staffing numbers are robust in the services that will be called upon for the winter months, I think that would be greatly appreciated.
The flu vaccination—obviously there's a widespread campaign around flu vaccine across the length and breadth of Wales. Only this morning I was hearing of issues in north Wales in particular, where there does seem to be a shortage, certainly in some GP surgeries, and patients unable to actually have the jab when they've presented themselves to have that vaccination. Can you confirm whether you are aware of such instances where patients are turned away when they present for the vaccination, and, if that isn't the case, are you able to give an assurance that, if constituents do want to have the flu vaccine, there is ample supply here in Wales for that programme to actually meet the goals that we want it to achieve?
Obviously, what's really important as well is to focus on the wider NHS estate. There is little or no point in having the hospital itself working if the car parks, for example, or the roadways into the car parks, are blocked up. Very often, these are the things that do tend to get overlooked. I can remember in Llandough hospital, some two years ago, the hospital itself was functioning very well but because the car parks were iced up and snowed under, basically they couldn't get any patients in or staff to assist in the changeovers that were required. So, when the hospitals and health boards look at their estate, they should look at the entire estate and the workings on that estate so that we don't find that sort of anomaly happening again that puts undue pressure on the hospital environment itself.
You also touched in your statement on the increase in community facilities that will be made available. Could you explain what increase you're looking at creating this winter that wasn't available last winter in the community, so that patients know where they need to go and present? It is important, as you quite rightly identified within your statement, to say that this is a multi-agency approach that's required, from the voluntary sector, from local authorities and the health service itself. If all walk in unison together, then we can have confidence in the plans that you've outlined today. But what we saw last winter was a breakdown in the service, regrettably, despite the best endeavours of many people across the length and breadth of Wales. I do point to that specific point that I touched on, where, in Cardiff for example, there was no out-of-hours provision whatsoever and so that only leaves the A&E department to take the brunt then of all that extra demand arriving at the doors of the hospital, which puts pressure on the hospital itself, and that pressure drives the service down. So, can you give us the commitment that the capacity will be in the community? Can you give us the commitment that health boards have got the staffing levels they require, and, above all, what new initiatives will you be bringing forward where you've learnt the lessons from last winter?