6. How does the Welsh Government ensure that patients in Wales have access to orthopaedic surgeons? OAQ52936

We expect health boards to have suitable resources in place, including staffing, to provide services to meet the needs of their local population.

On a number of occasions over the years of devolution, Welsh Government has produced pots of money to reduce waiting times if they've become excessive. In 2017-18, the median waiting time for knee surgery in Betsi Cadwaladr University Local Health Board was 339 days, up 95 days on the previous year. Over 61 per cent of those currently waiting for trauma and orthopaedic operations are waiting over a year. How do you respond to my constituent, let's say Mr LB, who's been on a waiting list since 8 December 2016 for bilateral total knee replacements? The health board wrote to me this month, saying, 'We estimate we won't be able to offer him a date for surgery now until May 2019'—over 500 days. Mr LB says he has nothing but the greatest support from his GP and his consultant, but he's a virtual cripple at 63, in constant, excruciating pain.   

It's very difficult, of course, to pass comment on an individual. I have no doubt that where somebody's waiting for an operation they are in pain, and they will be anxious to know when that operation will take place. They'll also be anxious to know what resources are being made available in order that the time waiting for an operation is expedited. What I can say is that the number of whole-time trauma and orthopaedic surgery consultants at BCU increased from 23 in 2009 to 29.2 in 2017. That's reflected in an increase across the whole of Wales. At the end of August this year, there was an 11 per cent reduction in the number of people waiting over 36 weeks for orthopaedic treatment in the BCU area, and that is reflected across the whole of Wales. So, additional resources have been made available to appoint more consultants and surgeons, and we are seeing that reflected in the reduction in the number of people waiting. And as far as Mr LB is concerned, I can give him the assurance that we will continue to look at how we can provide more resources and I hope that he gets his operation soon.

First Minister, we often hear in the winter period of orthopaedic operations and other planned surgery being cancelled because of winter pressures. How confident are you that the arrangements that have been put in place by the local health boards and by the Cabinet Secretary for health for this winter will avoid those levels of cancellation that we have seen in the past? 

Well, there's always a level of cancellation that takes place beforehand in order to create the spare capacity for the winter period, given the winter pressures that we've seen over the last few years, although I would argue that certainly last year and the year before, those pressures were dealt with even though they were substantial and took up a lot of staff resources and time. Of course, health boards have to have in place their winter plans, which over the past few years have proven to be durable and I've no reason to suspect that that won't be the case this year.