2. Questions to the Cabinet Secretary for Health and Social Services – in the Senedd on 21 November 2018.
6. Will the Cabinet Secretary make a statement on increased pressures on GPs in North Wales? OAQ52965
Yes. We recognise there are challenges but remain committed to supporting our hard-working GPs and their practice teams throughout Wales. Betsi Cadwaladr University Local Health Board has recently appointed a new executive director of primary care and community services, Dr Chris Stockport, and he will lead and oversee the adoption and adaptation of the primary care model for Wales across the health board to try and help ease pressures on general practice within north Wales.
Thank you for that response. Of course, in addition to the seasonal pressures and the usual pressures that we see on doctors and the health service, there are other problems emerging directly from some of this Government’s policies. The local development plan in Wrexham, for example, anticipates that an additional 10 GPs will be required because of the increase driven in housing development as a result of those local development plans. So, what’s the Government doing to ensure that sufficient numbers of doctors are available to meet the increasing demand that there will be as a direct result of the local development plan in Wrexham, but also across north Wales and across the whole of Wales?
There is always a challenge in linking population growth and housing development with the provision of a range of services including healthcare services. We'll have the same practical challenge in delivering Wylfa Newydd as well. It's a challenge and it's about a conversation with local general practice themselves, but also the wider team as well. The health board are developing a north Wales primary care academy to co-ordinate and develop local training, mentorship and professional development opportunities. They're also looking at how to rearrange and reorganise primary care. In north-east Wales in particular, it's one of the key priorities for Dr Stockport because we recognise the additional pressure there. That is likely to mean that clusters will need to take on more responsibility with new leadership and arrangements for those practices that have handed their contracts back.
I recognise it's a real and practical challenge to maintain and safeguard what we have and to develop it for the future, but the new model for primary care is not simply a reorganisation delivered by Government; it's actually got buy-in from a range of our partners including the Royal College of General Practitioners and the British Medical Association's general practice committee as well. The challenge is how we make it work not if we can make it work, and the different roles that healthcare professionals will have to play to provide the high-quality healthcare that every single part of Wales should be entitled to.
Despite warnings year after year by the Royal College of General Practitioners and the British Medical Association, the number of registered GPs working in Wales is at its lowest level in five years. In 2014, the Royal College of General Practitioners warned that the share of Welsh NHS funding for patient care in general practice had been falling for years, and in the same year the north Wales local medical committee came to this Assembly and warned that several practices had been unable to fill vacancies and many GPs were seriously considering retirement because of their currently expanding workload. Why, therefore, did Welsh Government practice receive the lowest share of NHS spend in the United Kingdom last year despite the rise in patient demand?
The way in which we allocate finance across the service is to try and meet current and future needs. In particular, we're investing in a healthier Wales, and I've made it very clear that as activity is moved around our health and care system, I expect resources to be moved around to enable that to happen. If we look at the broader definition of primary care for all those different primary care services, we actually fund primary care at the same level as they do in Scotland.
The challenge is the right numbers of professionals in the right place to deliver the service that we want. In that regard, looking at the future, we overfilled the year before last on GP training and we had a 98 per cent fill rate in GP speciality training last year here in Wales—the best percentage figures of any UK country. We're looking to slightly expand those numbers and we're looking at a review headed up by Health Education and Improvement Wales this year to look again at how we actually recruit GPs, and included within that is a look at the numbers for training as well.
In terms of making the job easier and a better job for GPs as well, at the recent primary care conference there was a positive message from Charlotte Jones from the BMA about the partnership that exists between GPs themselves, the NHS and the Government, and in particular, the moves forward we've made on the indemnity scheme and the further work we're doing on clusters.
So, not everything is perfect, there are still challenges for all of us to address, but I actually think we're in a good place for that partnership to work. We have a committed group of general practitioners who want to make primary care work with other healthcare professionals. We have the right plan; the challenge will be delivering it in a very contested environment and an environment where we need to do things differently in the future. But that is what this Government is committed to doing.