Part of the debate – in the Senedd at 2:58 pm on 2 July 2019.
Minister, thank you very much for bringing forward your statement on this report. I think this report is very good. I was really pleased to see that it's clear, it's concise, it's got a very well defined set of objectives, and it actually talks about how we can monitor it and measure the outcomes. It is a rare jewel, and I'm delighted to be able to ask you a few questions on this.
It talks about the fact that we have the lowest number of critical care beds per head of population in relation to most other areas, and I wondered if you could perhaps outline how you see the development of those additional critical care beds and how will you ring-fence them so they don't become post-operative anaeth—. I can't say the word; I'll just call them PACU beds. Because I notice that it's quite clear about how many beds should go to what area, which health board, but, again, it's about making sure it actually happens. If I was to read this whole report, very simply I would say, 'Great report, really good analysis, but how will we make sure it actually gets delivered, when we know the health boards are under immense pressure and when we know that targets and objectives are shifted around, are moved about, and that statistics can say pretty much anything?' Because, if this could be made to happen, it would be an enormous step forward.
I note that the task and finish group have suggested that, once this comes to being and it moves forward, they should step down and that it should be left to the critical illness implementation group to measure. But, of course, one of the great criticisms of the critical illness implementation group in 2016 was the fact that they were struggling to offer sustainable solutions, and that they hadn't brought into the whole system the organisational commitment that's required. So, I'd like to know what you will do to ensure that the make-up of the critical illness implementation group is capable of monitoring this ongoing work, because I think it's just telling that we've had to have a task and finish group to tell them what they should do, when, to be frank, they should have been able to come up with this under their own steam.
Will you please just give us a quick overview of where you see the money sitting, because it says very clearly here that funding will be allocated to health boards in their capacity as commissioners, and yet they need to then immediately go and use that money to start building these additional beds, to start putting together the adult emergency transfer system that they're talking about? How will they apply for that, and who will make the decision whether or not their business plan is actually fit enough to be awarded the money to carry on and try and achieve these objectives?
Is there going to be an element of ring-fencing around it? Transparent reporting of critical care outcome measures with robust escalation arrangements: will you, as the health Minister, also be keeping a weather eye on this, or will you be pushing this out to the critical care implementation group to monitor? Because I'd like to think that, actually, this report doesn't just disappear into the ether, but actually you keep, or the Government keeps, tabs on it to make sure that these things happen. My overwhelming fear is that a lot of these really, really excellent recommendations simply will not happen because either the funding isn't in the right place, the skills aren't in the right place, the right people who know how to make change happen, and make change happen successfully, will not be able to carry this out, particularly at a time when we're asking health boards to try to transform the entire way they operate, to follow through on the vision for health, which I think is a particularly good way forward.
I think my final question will be about how the remaining funding is split between Aneurin Bevan, Betsi, Cwm Taf, Hywel Dda and Swansea Bay. It talks about areas of agreed priority for critical care services, and, again, who will have the final say on what those agreed priorities are and whether or not the business case then stacks up.