Diolch yn fawr, Llywydd. I'm pleased to move the amendments in this debate, reflecting the funding pressures on the local authorities—well, not just in my region, but all over Wales. Obviously, I've been receiving letters from people in the local authorities that I cover, so I'm happy to respond and to make the case for local government funding.

Obviously, I'm not also going to rehearse the argument again about Oliver Twist and various Dickensian wordplays, the Cabinet Secretary will be pleased to note, but concentrate my contribution on the wider point of local authority spend and its contribution to the whole Government agenda here in Wales, across portfolio.

Back in the day, I spent many years as a county councillor in Swansea. I do understand the pressures at councillor level—obviously, I'm not the only previous county councillor in Swansea here. But also back in the day, I was a full-time general practitioner. I remain a GP these days, although, obviously, having sacrificed my medical career on the altar of politics, I no longer have a financial interest in anything GP-wise and, in fact, do not any longer take a salary for my continued GP work. But in terms of even back in the day, when I was a full-time GP, I used to be concerned about the welfare of my patients and why they were falling ill all the time. We're always exhorted by our Royal College of General Practitioners to really go after why people are getting ill in the first place. So, I was exhorted to write to the local director of housing and explain wouldn't it be a good idea if we tackled bad housing in Swansea to stop my patients getting ill. And what I discovered as a GP was that I would write letters and, do you know what, absolutely nothing would happen. There was no acknowledgement of having received the letters and certainly no reply. So, eventually, I stood for the council. That's what you do, isn't it? I stood for the council and, eventually, I won a seat on Cockett ward. And now I would write letters to the director of housing as a councillor—still as a GP, but as a councillor with an expectation of a reply and a programme of action, which would follow, now being a councillor, nothing to do with being a GP. 

But I was proud to be a county councillor because it became obvious, even to us in the health service, that actually the factors that influence good health lie outside of the health service and what we could do as doctors and nurses; they lie in local government. That's why I was proud to be a local county councillor, because environmental health is within local government, housing is within local government, public transport, planning, education, social services—they all lie within local government. So, local government has a huge role to play in tackling those determinants of ill health, those matters that make people ill in the first place. We're doing as a health committee now a review into physical activity, roles of leisure centres, school playing fields, schools, teaching—paramount in that in terms of education. The role of libraries, obviously, learning facilities, lifelong learning—paramount in actually staying healthy. There's cross-portfolio work here. And, yes, people want to see more of a spend on health, but I think, more widely, I would warrant people would want to see more spending on prevention of ill health. As a health professional, I'm not steeped in the ability of health promotion, and the dedicated spend within the health service for illness prevention is pitifully small. We depend on illness prevention happening elsewhere, and that elsewhere is in local government, tackling those determinants of ill health that lie outside the NHS but inside local government.

So, I would press the Cabinet Secretary—I'm sure he's aware of those points—to have that cross-portfolio discussion about how local government spend can actually help lessen the spend on health and vice versa. And, in terms of health, to finish, I would like to see free and open pathways for open government to actually accept referrals from health professionals directly. Not just over the years were my housing letters rejected, but now, if I deem that my patients would benefit from an education referral, I cannot refer to education or social services—I cannot refer directly to social services. That is a ridiculous state of affairs, and much of the clamour, I feel, for an autism Act would be removed with true joint working. If you allowed primary healthcare professionals to be able to directly refer to departments of local government, matters would improve significantly. I would implore, in closing, the Cabinet Secretary to engage with the health Cabinet Secretary to this end. Diolch yn fawr.