2. What consideration did the Welsh Government give to the NHS when allocating funding for the 2019-20 final budget? OAQ53707

We continue to prioritise funding for the NHS in Wales, and the 2019-20 budget approved by the Assembly in January provides £7.4 billion for core NHS funding, representing record levels of investment in the NHS in Wales.

Diolch. In his response to Paul Davies yesterday, the First Minister said that,

'our GP community has to do more to match the expectations of patient populations'.

But it's now over seven years since the British Medical Association Cymru and the Royal College of General Practitioners launched campaigns aimed at Assembly Members, warning of a ticking time-bomb and that 90 per cent of patient contacts are with general practice, and yet funding as the share of the NHS cake had fallen. And they've continuously relaunched those campaigns since. It's almost five years since the North Wales Local Medical Committee came to the Assembly to say we had a crisis in north Wales, warning that several practices couldn't fill vacancies and that many GPs were seriously considering retirement because of the expanding workload. Only last week, the north Wales community health council wrote to the health Minister here in response to the Welsh Government consultation on the options paper, 'NHS Wales Performers List', saying that their members were disappointed and that the difficulties in north Wales have been present and increasing for at least five years and that there's no question about if or whether the difficulties in recruitment and retention will continue. In terms of allocating funds for GP services within the NHS budget, how would you therefore respond to the final sentence of their letter last week that the Welsh Government needs to demonstrate that it is working hard to develop a robust and inventive approach to this crisis that makes the most of the freedom to innovate that is afforded to NHS Wales?

You'll remember, of course, that the health Minister responded to many of those concerns, particularly regarding the GP service in Wales during his statement on 'Train. Work. Live.' yesterday afternoon. And, of course, the First Minister also made some comments on the same during the First Minister's questions session yesterday afternoon.

But in terms of our overall investment in the NHS, of course, core NHS funding with a total investment of £7.4 billion in 2019-20 represents the single largest budget within the Welsh Government and contains our core funding for the NHS Welsh health boards and trusts, and we're investing more than £0.5 billion extra on health and social care in 2019-20. This will be used to fund performance, NHS pay and prevention, including £192 million to take forward the implementation of our long-term plan for health and social care, 'A Healthier Wales'. And, of course, there is £14 million over two years, from 2018 to 2020, as part of our agreement with Plaid Cymru, which includes the commitment to establish medical education in north Wales. Alongside that, we have a serious programme of capital investment in the NHS, not least in north Wales. So, we're demonstrating very clearly that health remains a key priority for Welsh Government.

It is clear, of course, that effective co-operation between health and social care services can reduce the pressure on both health and care budgets. I'm very grateful to the Minister for agreeing to meet me yesterday to discuss the ways forward to potentially develop some consensus around innovative ways of funding care. Does the Minister agree with me that we will continue to face increased pressures on health budgets unless we can solve the issues of the interface between health and care? And does she also agree with me that there will need to be substantial investment in our care services if we are to create that parity of esteem between the two services that we agree across this Chamber, I think, is desirable?

Thank you very much for the question and thank you also for the very useful meeting that we had yesterday to discuss innovative ways in which we can fund social care in future, given the huge pressures that we know already exist in the system, but also the anticipated increasing pressures due to the ageing population that we have here in Wales and the escalating needs that some people will have in Wales as well.

So, one of those options that we discussed was the social care levy. It's one of the options that the inter-ministerial group is looking at in terms of how we prepare ourselves to meet that challenge. We're also looking at other innovative ways of funding. I'm really keen to take this piece of work forward on a cross-party basis because it is something that we will all be keen to work together on, I'm sure. We've had some good, I think, cross-party consensus in debates on that.

I'm really excited by the work of the integrated care fund, because that genuinely brings together health and social services. The transformation fund is also doing some good work in that area. So, it demonstrates really that if we are to achieve good outcomes for people, we need to ensure that we're not separating health and social care in our minds, but also giving the opportunity to bring those two things together through budgets and we do see health boards and local authorities working in a very different way alongside the third sector when we enable them to share those budgets.