Part of the debate – in the Senedd at 4:33 pm on 2 April 2019.
I thank the Member for his series of questions and comments, and I hope that, assuming Darren Millar is genuinely interested in where we are and where we could be, he'll be interested in what I hope will be a helpful correction on some of the points that he's made.
I'll start by saying—you know, it's good to see you recognise three years of real progress in terms of GP recruitment and GP training. The choices that we have made—and this is a difficulty across the UK and, actually, compared to other UK nations, we are doing better in terms of our GP fill rates over the last three years, and that's a real cause of celebration. It's the Government, the health service, and doctors themselves working together to attract people into the country, and that is a real success story that we should be proud of. And that includes filling and overfilling where possible. Your point about north Wales—I actually made sure that, where there were people who wanted to go to north Wales to do their training in the last year, there were places available for them to go rather than the simple targets that were in place for each of those training schemes, and we were able to overfill them where that capacity was possible. That's the point about the review, which I referred to in my statement, that HIW are undertaking, because they're going to look at where we are with the training places and the capacity across the whole system. You can't simply decide to over-flex the system if there isn't a capacity from the training practice that exists to actually train people here in Wales. So, it's about our whole system and a way that is sensible and managed, as opposed to simply being led by whatever demands are made by an angry and ill-informed commentator.
Now, we'll have more places this year as well, Deputy Presiding Officer, because of a choice that I've made and referred to in my statement, and I'm optimistic about our ability to fill those places. Most of the questions and comments, of course, referred to the ongoing contract negotiations with the British Medical Association General Practice Committee Wales, and I should point out you referred to negotiating with the Royal College of GPs. We don't negotiate the contract with the royal college because it's a trade union matter, hence why we're negotiating with the General Practice Committee of the BMA here in Wales.
The indemnity scheme is a positive step forward, and it's a positive step forward in every part of the United Kingdom, including here in Wales, where we've introduced a new state-backed scheme because one of the big issues that was threatening the future of general practice was the rise in indemnity insurance, and in the last few years, those premiums rose significantly. So, what we have done by introducing the scheme from 1 April—it means that those premiums will not be rising year on year and threatening general practice here in Wales. So, actually, there's widespread agreement that that's been the right thing to do, and, actually, having access to a scheme that's funded in a way that the Welsh risk pool recognises too places GPs on a par with their colleagues in secondary care, and that's broadly recognised.
We're still negotiating with the BMA about all aspects of the contract, but I should point out a couple of facts about where we are: (a) the negotiations aren't complete,(b) the proposals are along the same principles as agreed in England—the idea that there is an entirely different approach in England is simply not true, and, in fact, as we know, we have made a more generous offer here in Wales compared to that in England. Now, that's where we are, but it's entirely appropriate for the trade union side to say during the negotiations they haven't agreed the current offer that's on the table. That's the whole point: it's a negotiation process that we are involved in. But I would say that it is not just the fact that in the last few years we have delivered a consistently more generous offer in the contract of GPs in Wales—that should provide confidence to Members here in every party, as well as GPs—but the fact is we are sitting down again with the BMA next week to go through this negotiation, and the only reason we're not sitting down this week is about the availability in people's diaries on the negotiating committee. Now, that's a matter for the BMA. I'm happy that we'll be sitting down again, and I'm confident we'll reach a deal that when GPs look at it and compare it with their colleagues across the border, they'll recognise that there's a better deal on offer here in Wales. This is a moment for calm and for trust and good faith between partners to find that agreed way forward, and I look forward to reporting back on those negotiations to the Chamber in due course.
But I fully expect we can continue to make progress to de-risk the future of general practice, to reduce insurance premiums with the indemnity offer we have made and implemented, to make progress on the last GP standing challenges, to improve access, which is a key issue for the public, and to continue to invest in general practice. And I think that that is a message the public will welcome, and I hope at the end of these negotiations we can all reflect on where we've got to and recognise general practice has a Government that is definitely on its side here in Wales.