Part of the debate – in the Senedd at 3:16 pm on 2 July 2019.
Thank you. On workforce, of course, in terms of stabilisation of the workforce now, we invested £5 million in this particular area over the last winter and that was deliberately to try to stabilise this particular part of the service whilst we're looking to the future. On your point about delayed transfers, it's quite interesting, actually, because, when I've gone through a range of different hospitals across the country, as every health Minister gets the opportunity to do throughout the year and in particular through winter, our emergency medicine consultants are actually quite an honest bunch, and they'll tell you what they think works and what they think doesn't work. What's been really interesting for me is that they have not made a bid for an extra amount of beds within the hospital in general. And we often argue about bed numbers in this place, in saying, 'You've cut too many bed numbers out of the system over a long period of time', but, actually, their bigger ask is for there to be greater capacity in social care. I had a very interesting couple of conversations through the winter where they said, 'We've got a challenge at present, but I don't think having an extra 20 or 30 beds in the hospital over and above what we already have is the answer'. They were saying, 'We want there to be more capacity in social care to release people out of the hospital', because they all knew of the large numbers of medically fit people who existed within the hospital, and that was the challenge about the whole system not being able to move people around to where they needed to go.
I have raised these issues and have discussions with health boards and local government together on delayed transfers. I've recently concluded a series of meetings with each regional partnership board, health and local government leadership, and I've always, since—. Well, following my first discussions about delayed transfers of care, where I talked individually to local authorities and then their health board and finding out that they broadly said it was the partner who wasn't in the room who was responsible, I've always had joint meetings. It's been a much better way of understanding what progress could and should look like. And everyone understands this is a priority for the Government, but, equally for them as well, whether in health or local government, and we are in a much better position with delayed transfers at historic record lows, whereas, in England, the position is going in the other direction. So, we're getting some things right, but it's about how much more we need to do.
And then your point about pension changes: well, this is a big challenge for the health service, not just in this area, but a much broader challenge, and it's not just a challenge for Wales. It affects every single UK nation, every single partner of the national health service, and it is poisoning the well of goodwill that exists from our staff who are prepared to do additional work within the national health service, including waiting list initiatives in evenings and weekends, and they're now finding significant and unexpected tax bills arriving on their doorstep. It's a problem that's been created through a change in Treasury rules and the risk is that we will drive NHS workers out of the health service—not just doctors, but other staff too—and we'll then have to buy those services and it will cost us as much if not more than what we would otherwise pay to NHS staff. The other risk is, of course, that, if we drive high earners out of the NHS pension scheme, then we potentially undermine the scheme for the future. So, I've already had correspondence with the UK Government on this point; there is due to be a formal consultation in the imminent future. But I do hope that the Treasury are prepared to listen to every part of the national health service and to do the right thing by our NHS, or we'll all pay a price if they refuse to do so.