2. Will the Minister make a statement on the delivery of planned healthcare in Montgomeryshire? OAQ53117

We continue to work with Powys teaching health board and other partners to take a range of actions to improve access to planned healthcare services that are safe, sustainable and as close to people’s homes as possible.

Thank you, Minister. I'm pleased to hear that. We're soon to hear the conclusion of a consultation that will see the outcome of a consultation in Shropshire. That will see the reconfiguration of services in Shropshire, and I believe, certainly, it's essential that we see some planned delivery delivered locally in our local community hospitals such as Newtown, Llanidloes, Welshpool or Machynlleth, to, of course, reduce the need for patients to travel even further following changes in Shropshire. And, of course, some—I emphasise 'some'—planned care procedures can be delivered more locally, which of course makes community hospitals more sustainable, and there are obvious other benefits of patients and families not having to travel even further again for some planned care. So, I'd be keen to understand how you believe that the Welsh Government, in partnership with Powys health board—how you can work with the health board, taking into account the expected changes that we're expecting to see happening in Shropshire.

There are two points here. The first is that Powys teaching health board already deliver a range of planned healthcare, and they actually have a very good track record on delivering that within time. They also have real ambition, which we're happy to support, to continue to deliver as much planned healthcare within Powys or as local to Powys as possible too. On a range of visits that I've undertaken out to settings within Powys, they've been talking about what else they are able to deliver within those settings, to reduce the time that people would otherwise take to travel to different centres. For example, in maternity care, more women are able to access complex maternity care that is midwife led within Powys, rather than having to travel further afield to do so, and those aspirations are, of course, supported by the general scheme within our plan, 'A Healthier Wales', the long-term plan for health and social care here in Wales.

I also recognise your broader point about the consultation within Shropshire, the Future Fit consultation, and I know that you've spoken about this on a number of occasions. The preferred option, option 1, would see the emergency care site remain in Shrewsbury, with planned care moving further away, and that is also the preference of the health board. We will know at the end of this month what option is to be pursued, and I look forward to having a properly constructive relationship between Powys health board and their partners. Of course, that will include seeing them through the current period of special measures within Shrewsbury, but Powys health board, you will be pleased to know, are on top of that situation and making sure that work that they commission on behalf of Powys residents is undertaken at the right time and at the right quality.

Can I just take the opportunity formally to congratulate you on retaining your post? I look forward to working with you. I meant to do that in committee this morning and apologise for neglecting to do so. 

To return, obviously, to the issue of planned healthcare in Montgomeryshire, you'll be aware, of course, of the important role that GP surgeries can play in this regard and some of the major challenges that Powys health board is facing in recruiting and retaining GPs. One of the issues that has been put to me as a matter of concern is that GPs often have large and quite-expensive-to-run-and-maintain premises, and that there is increasing reluctance amongst younger doctors to take on the kind of commitment required to run those kinds of premises, as well as to be delivering primary healthcare. What support and guidance is the Welsh Government giving to health boards to enable them to work constructively with GPs, particularly as those GPs may be moving up towards the age of retirement, to ensure that we can retain these important facilities, particularly in those rural communities?

Yes, of course I recognise the challenge. It's not simply local to Montgomeryshire, as I'm sure you and other Members know. Around the country there are challenges with facilities that have served their local population well over a period of time, but we now recognise we all want to see them reformed and improved. So, that's being resolved in a number of different ways, with health boards having partnerships with individual practices, with groups of practices, and indeed with local government and housing partners too. You can see a range of areas where that partnership has been a good thing for the provision of local services to move into new purpose-built facilities. 

There's also the broader challenge, not just about premises, but indemnity and last-man or last-person-standing potential liabilities, which are a real issue for younger GPs, who may not wish to enter into a partnership, but more than that, a change in the way that people want to work. A number of younger GPs, regardless of those issues, simply don't want to buy into a practice and give a very long-term commitment. All of those things are a regular part of our discussion within the general practice committee of the British Medical Association, and they're a regular feature of my discussions with each individual health board and their partners.