Part of the debate – in the Senedd at 3:02 pm on 2 July 2019.
Thank you for the series of questions, some of which I think have overlapping themes. I would say I think there's a central point that you're making about whether the report will be delivered and whether the money will deliver against the objectives and how that will be tracked and monitored. Well, I've been clear that the suggested allocation of resource comes from the task and finish group and it's something that we've endorsed. The Wales critical care and trauma network will be involved in looking at the delivery plans from health boards, because it isn't simply a question of saying, 'Please go ahead and do this' to health boards. Actually, we'll need to see those delivery plans to deliver against the increases in capacity that the report has suggested we need to make. So, the money is there, but they need to have proper delivery plans for that to come in. And that will be overseen. The Wales critical care and trauma network will have a view on that as well, the Government will take a view, and it will be on the basis of those delivery plans that the money will actually be released to health boards to deliver against that increase in capacity. So, there is going to be a more central hand. I announced, when I issued a statement last year, that this would be a centrally directed programme of activity, and now we're still making sure that that will be the case. So, it won't disappear into the ether. It will be something where there will be performance measures and outcome measures to understand what's really happening. And, yes, I do expect that the Government will be informed on what is happening there and it won't simply be left to health boards to, if you like, mark their own homework.
And when it comes to the point about whether the money will really get to deliver against the objectives, well, I've been clear in the past, when we've had sums of money that have been earmarked for a particular purpose, that it does need to deliver against that purpose. If you take the example of the performance funds we've had in the last few years, where health boards haven't delivered against the plans they've provided, I've been prepared to claw that money back. So, I am clear that this money will be used for the purpose, and not disappear into a general pot of money. It must be used for the purpose.
And some of the building of capacity is, of course, in staff, so the work around workforce is important not just to understand what we need know, but also in the future. The recruitment activities are already ongoing, the further advice from Healthcare Inspectorate Wales about the groups of staff we'll need, because, actually, the biggest limitation in increasing capacity isn't the bed itself—it's all the staff around it for the different tiers of service that are required—because at the highest level of care, we're talking about one-to-one nursing care and the rest of the team around that person as well. So, staff, actually, are what we do need to invest in in terms of training and upskilling, as well, of course, as the numbers of staff to deliver the additional capacity that the task and fish group recommend and I've accepted we want to try and create.
When it comes to the point about transfers, though, that is something that will go into the emergency ambulance services committee mechanism, working together with—[Inaudible.]—to look at the experience that already exists there. So, you will have an oversight there about what's being commissioned, how it's going to be done, and, again, a specific sum of money to go into delivering that improvement, because if we improve the delayed transfers of care it won't simply be that I or the Deputy Minister will be able to stand up and say, 'Look, delayed transfers of care have improved', but, actually, have a much better and efficient use of our resources across the system. It means that people that no longer need to be in critical care can be moved down to where they need to be, and that will often be closer to home, especially if they move from one of our tertiary centres. But it will also mean that somebody that does need to have that place in critical care will be more likely to be rapidly in the right place, because we do recognise not having the flexibility, the efficiency and the capacity does mean that some people are not in the optimal place for their care. So, it's the whole system. The delayed transfers make a difference to the top level of care, but also to people moving through in the right direction, whether they're up or down in the system. So, I do think we have the right sort of recommendations so that it will now be about the delivery.