Part of the debate – in the Senedd at 4:55 pm on 1 October 2019.
I recognise also the points that were mentioned about the sums of money. The fantasy sums of money that are being described are not considered real by this or any other part of the national health service. We have a year's worth of money for us to plan a budget for. The idea that I should commit to three years of expenditure on the basis of promises that not even the service believe is fanciful in the extreme.
On your point about food supplies in the NHS, we have had regular engagement with this. We, of course, have the ability to provide food within the national health service. The point that I made in the statement is about the potential for needing to substitute or change some of that, but not to compromise on nutritional standards. It is more difficult for some of our social care providers to do so, particularly those smaller concerns that exist, and, as I say, there is a straightforward point that the choice in food will definitely be affected, but we commit to maintaining nutritional standards.
On staff recruitment, now, we have seen a significant challenge in staff recruitment, in particular, the Nursing and Midwifery Council register. We have been relatively insulated from that, compared to England. There's been a catastrophic fall-off in the number of new registrations on the NMC register from people from across Europe, and it's a real cause of concern. If you had this conversation with the Royal College of Midwives or the Royal College of Nursing or Unison, then they would tell you about the reality of people making a choice to leave England, in particular, because not only of the policy choices, but of the environment and the language used to describe them. I am proud that here in Wales—and in Scotland too, to be fair—we have constantly reiterated the value that we place upon our staff in wanting people to stay, and that will continue.
I do, though, need to point out the immigration cap proposals are an act of wanton vandalism to health and social care services in every part of the United Kingdom. The average pay in the social care sector is under £17,000 in Wales. Having a salary cap of £30,000 would be disastrous for social care, and it would have a serious impact on the health service. It is not too late for Conservatives in the UK Government to recognise common sense and to end those proposals, or they will do serious and significant harm to health and care services.
I'll deal with your points about medicines. In terms of the increased costs being minimised and the points you make about buffer supplies, these are UK-wide arrangements that are being put in place. This is not the Government acting simply for England, and this is part of the responsibilities that the UK has. It's a UK responsibility to deliver medicine supply into the United Kingdom, and there are arrangements involving the chief medical officers and the chief pharmaceutical officers to oversee how shortages would be addressed in terms of making sure there is equitable distribution of medicines across the country.
In terms of transport arrangements, again, this is part of UK-wide responsibilities. About a third of the pharmaceutical industry have made their own arrangements and spent significant amounts of sums in doing so. About two thirds are relying on the transport arrangements provided by the UK Government. And, on this, I will acknowledge there's been an improvement in 'no deal' Brexit preparation by the UK Government from March. You will remember it was farcical, that we had ferry-less ferry companies winning contracts, and moneys had to be paid both to ferry companies and to Eurotunnel for arrangements that were put in place. I acknowledge the UK Government is in a better place now. Having learnt from the mistakes and the significant waste of money that took place, they are now in a better position, but the challenge will be, if two thirds of supply rely on the up-to-date ferry arrangements, we then run into the very real challenges set out in the Yellowhammer document about HGV backlogs.
My biggest concern on medicine supply is actually getting goods around the United Kingdom. The evidence provided in the August release from Yellowhammer is sobering, and no-one should be sanguine about it and simply claim we must get on with 'no deal' if that's all we're left to, because that sets out the real and significant harm that would be caused, and the up to six months' severe disruption that would be faced across the narrow straits. So, this is no matter to trivialise. Medicines are category 1 items; they will have first call on the capacity that exists. We then need to get those goods around the country, and, on that, we are engaged at both official level and in ministerial conversations about those very issues.
I want to make the other final point about medicines, and that is that none of us should be sanguine about the potential shortages caused. There are normal shortages that are managed within the health service, that is true. But the times that we are in are quite extraordinary, and we have never deliberately chosen to do something that we know will risk medicine supplies. For all of the analysis that we have on the arrangements now being put in place, if one single medicine is affected because of a 'no deal' Brexit, then every single person who relies on that medicine will understandably look to us and say, 'Why did you do this? Why did you demand that Brexit happened if you knew that this was a risk to me and my health?' I will comfortably look those people in the eye and say, 'We have done the right thing in raising these issues.' Other Members from whatever party need to think carefully on their position on a 'no deal' Brexit and the risks that that entails to the health and well-being of people in Wales.