4. Statement by the Minister for Health and Social Services: Update on the Transformation Fund

Part of the debate – in the Senedd at 4:08 pm on 19 February 2019.

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Photo of Darren Millar Darren Millar Conservative 4:08, 19 February 2019

Can I thank you, Minister, for an advanced copy of your statement this afternoon? I'm very pleased to see that cash is being invested in transforming our health services here in Wales. We know that we are behind, in some respects, some other parts of the UK in terms of taking forward particularly closer working between health and social care. But it is encouraging that we're finally investing in these newer models of care in order to get improved outcomes for our patients. The cash, though, that's been spent so far is a bit of a drop in the ocean as far as the overall health budget is concerned, as we all know. So, I think the expectation that you have about this being a catalyst for significant change over the course of this Assembly perhaps is a little bit too ambitious.

Now, I note that you said that you have already approved seven proposals, and I think that that's good. I think in the last statement, only two had been actually confirmed at that time. Can you tell us: have all of these now commenced? You've referred to the fact that they are proposals that reflect all parts of Wales, that there's something operating in each individual regional partnership area, but you've given us precious little detail other than two or three sentences about what is particularly going on in different places. And nor have you given us a breakdown as to where the £41.2 million is actually being spent. So, can I ask you in which health board areas and which regional partnership board areas is that £41.2 million being spent? Is it being spent equally in all parts of Wales, or are some benefiting more than others? 

I also wonder, in particular, what is new about the cash that's being invested, because from what you describe—for example, the use of assistive technology, community assets, intergenerational activity, some of the preventative work that's going on, non-scheduled post-hospital care—a lot of that is going on anyway in our health board areas, and quite rightly. They ought to be investing in these sorts of things because there's a saving to be made further down the line. So, how can you be sure that these are projects that are adding value to the work that's already going on in our health board areas and not simply supporting those health boards, who perhaps may be a little bit lazy about transforming the services in their own areas?

You've mentioned workforce planning, or workforce development, being a strong theme. Pleased to hear that, because we know that we've been abysmal here in Wales when it comes to workforce planning, whether that's the nursing workforce, the midwifery workforce, the GP workforce. I mean, I raised earlier on the fact that you're turning people away who want to train as GPs and come to work in Wales. I mean, it's absolutely barmy, to be honest, that you're not simply just creating more training places to fulfil the need that we have in Wales in terms of the shortages that we've got in some of these disciplines. Can you tell us precisely how many additional staff you expect might be recruited and developed as a result of the proposals that are currently being implemented?

You haven't either given us any indication as to what the split of investment is between social care, community care, primary care, secondary care. I mean, we know that when you invest in primary care and community services, that tends to take the pressure off secondary care, which can often be more expensive. So, where is this cash aimed at? Is it in the hospital end of care, or is it in that primary and community care, which I think is where it may need to be focused?

You made reference to the rapid review, which you've undertaken, into the scale and spread of the proposals. You said that the outcome of that rapid review was encouraging. Can you publish the details of the review? Can you tell us a little bit about how you went about conducting the review, to test what was going on on the ground? I know it's early days for some of these projects, but some have been going for quite a while now, and I think we ought to be able to see pretty quickly whether they are going to be things that have legs or not, and which can be spread in terms of their practice across Wales.

You also made reference to the goodwill of partners in delivering the change that is needed. Now, I know that there's been some good and very positive engagement with partners like St John Ambulance and the British Red Cross of late, and that's work that I applaud, which has been going on in different parts of Wales. Can you tell us whether these partners, particularly third sector partners, are actually engaged in any of these projects, and if so, in what way? Because I think it would be good to know whether you're building on what clearly has been, certainly from my impression, a great deal of success with the British Red Cross up in north Wales.

I think that they're all the questions that I have for the moment, Deputy Llywydd, but I do want to say that we welcome this investment. We do welcome the shift in the right direction. But I do think we have to make sure that this is investment that is being put in the right places and not simply replacing investment that should be in place already, and work that should be under way already in our health board areas.