6. Statement by the Minister for Health and Social Services: Update on 'Train. Work. Live.' Campaign

Part of the debate – in the Senedd at 5:02 pm on 2 April 2019.

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Photo of Vaughan Gething Vaughan Gething Labour 5:02, 2 April 2019

I think, on that final point, you'll have heard the First Minister talk earlier about our expectations that we're able to service the healthcare needs of people and to improve the ability of the primary care team to do so. That requires us to take GPs with us and to help them acquire language skills and value those skills. It's also why we've been interested in investing in specific recruitment and training opportunities.

So, I think I've mentioned here before some of the programmes that we have on recruiting and engaging people from those communities that are not usually going to medical school, and the opportunities are being provided, and a lot of that has been targeted delivery at Welsh speakers, for example. I met a group of people from Blaenau Gwent, Welsh speakers from Blaenau Gwent, who were going to a day of engagement to look at the possibility of careers in medical education on a day run by Cardiff University. So there is real, deliberate engagement looking at the future workforce as well as the workforce we have today. And when we look at the workforce plan you mentioned earlier, actually that is partly what HIW are looking at. They're looking at the workforce plan for the future to help reform what our health boards do and the opportunities to think about what medical education and non-medical education will provide, and the ability to plan that with our higher education sector, together with the training they'll undertake within a professional setting. 

On your broader point about practice sustainability, I've regularly said that we will have a different number of general practices in the future, and if you go to a practice with one person, one doctor partner in there, that is a practice that is unlikely to exist in the future if it remains like that. The days of single-handed GPs are unlikely to return, and actually, going back to the comments made by Vikki Howells and the points you made as well, people expect to see different healthcare professionals in the one setting. So, I don't think a single-handed practice is likely to be robust and sustainable for the future, and some of that change is going to need to be managed and planned properly. There's a challenge about people engaging with their local health board to have that conversation, and crucially to engage with their peers in clusters where they discuss these matters. Actually, clusters have promoted much better working between different general practices, and that was not the feeling that people had at the start of clusters. People viewed them as a bureaucratic exercise to get money, and some people were resentful, and yet now people talk about the opportunities that they deliver because they are used to working with different practices in the same local area, serving broadly the same community. That is a positive step forward.

On your point about understanding the right numbers of staff, well, of course, we have a piece of legislation on nursing in particular that the then backbench Member for Brecon and Radnorshire piloted through the Assembly with cross-party support, and so we'll look at the roll-out for that piece of legislation. But that relies on professional judgment and relies on an evidence base for the difference that nurse staffing numbers would make, and it also relies, of course, on our ability to fulfil the role of that legislation by actually recruiting and training more nurses. And compared to just a few years ago, we train nearly two thirds more nurses here in Wales now who are going through our education system. So we are making real steps forward.

The final point I'll make is in response to, if you like, your opening gambit about the fact that there are too few doctors and nurses. Well, we are recruiting more and we are training more, but not only that, though, we should remember that this is the only area of the public service where there is an undimmed public appetite for more staff and an expectation that those staff will be delivered, and that has a real consequence. We're nearly 10 years deep into austerity. You're about to hear a statement from the Minister for Education, and because we are prioritising the national health service and more staff in the national health service, that means there are even more difficult choices to make in every single other part of our budget and it means there are fewer staff available in other public services. And I have never forgotten that in the budget choices that I then get to make.

So, austerity is, of course, a really big issue, but Brexit is, too. If you look at the number of people who have left the nursing and midwifery register across the United Kingdom, the biggest drop has been in EU nationals who have left the register and returned to mainland Europe. So, actually, the choices we make, the way we talk about Brexit, the way we talk about European Union nationals really matters and it has a real-world impact in every part of the United Kingdom. So, our ability to recruit relies on our standing in the world and our willingness to recruit people and welcome them into our country, not just as health and care professionals, but as citizens of this country. And I do want to reiterate, from the Welsh Government's point of view, European Union nationals are welcome, not just in our health service, but welcome as citizens of our country.