Part of the debate – in the Senedd at 3:26 pm on 12 February 2019.
Like everybody else, I'd like to thank the Minister for this statement and to express my own appreciation to NHS staff for the tremendous job that they do, often in very difficult and stressful circumstances. And can I start by echoing what Helen Mary Jones said in her questions earlier on, asking the Minister for greater transparency in statements of this kind? I know I'm knew to this brief and therefore don't have the degree of background knowledge that others might possess, but I have found it quite difficult to understand what is actually going on. The statement is fine, as far as it goes—under the emerging evidence section, we hear that hospitals have considerably less time spent at the highest level of escalation; that there are fewer people over 85 treated as emergencies; that the average length of stay for emergencies was at its lowest for over six years; that there's been a reduction in the number of delayed transfers of care. But without statistics, we're not really able to evaluate exactly what these statements mean. And although I've spent a bit of time with my researcher today trying to find out what the situation was last year in detail, I found that some statistics were found on the StatsWales website, others were on the NHS Wales website and others were held by CHC Wales. And sometimes, the tables are not always made user-friendly, forcing the user to create a table for every month within every year, making the deciphering of multi-year trends, therefore, extremely difficult. I wonder if it might be possible, in the digitised version of these statements, to provide links to the information sets that will actually put meat on the dry bone of the generalised statements. I realise that this isn't always possible, but where it is known in advance for some time that there is going to be a statement or a need for a statement on certain areas, it shouldn't be beyond the wit of man to set up a system that enables us to do our jobs better in the Assembly of providing scrutiny, in a constructive way, which is what these exchanges should be about.
I wonder if the Minister can perhaps provide a little more information about some of the statements that were made. In relation to lost hours for patients waiting over an hour for ambulance handovers, it's very good news that there's been a decrease by 30 per cent year on year, but patients waiting over an hour, according to the A&E patient experience review a short time ago, in January of last year, showed that at that stage 30 per cent or so of people were waiting for an ambulance for more than an hour. So, a 30 per cent reduction still means there's a very substantial number of people who are having to wait for more than an hour, and 10 per cent last year had to wait for three hours or more for an ambulance. So, I wonder if the Minister can tell me whether the improvement that is alluded to here has been pretty even throughout the time periods that people have to wait for, or is there still a specific problem in certain areas? Again, fewer people over 85 are treated as emergencies; well, out of 80,000 or so admissions last year, 5,000 of those were over-85s—not surprisingly, it's a significant number. But what has been the pressure this year? Is it related to the weather and perhaps fewer people getting diseases that would otherwise make them have emergency admissions, something over which the Government has no control, and for which they can take no credit, or does it show a real improvement within the system? Again, the average length of stay for patients admitted as emergencies last year, if they were 75 to 84 years old, was seven and a quarter hours, and, for 85 and over, eight and half hours. So, I wonder whether we can show meaningful improvements, because we just say that the average length of stay was the lowest for over six years, but what is the difference that we're talking about here? Is it something that is a very substantial reduction or not? These are all important issues, which are difficult to evaluate in the way in which this statement is made.
I accept that there have been improvements made as a result of the efforts that the Welsh Government has made in the last year; it would be difficult not to, given the extra resources that have been provided, and given the low base upon which we start in many cases. And the Minister, importantly, did say that a small number of hospitals are actually distorting the picture for the whole of Wales. I wonder, therefore, the extent to which Betsi Cadwaladr in particular is still underperforming and dragging the whole system down with it. I note from, particularly, the patient pathways, waiting for more than 36 weeks—in the statistical bulletin that was published last July, about half of those cases were in Betsi Cadwaladr's area. We will need to have Betsi Cadwaladr doing substantially better than the average if we're to make any real difference to these alarming figures. So, I wonder if the Minister is able to tell us whether he thinks that Betsi Cadwaladr is making enough progress towards improving the system for the whole national health service in Wales to appear in a better light.