5. Will the First Minister provide an update on the provision of primary healthcare in Wales? OAQ54730

Thank you for the question. The primary care model for Wales creates multidisciplinary teams, providing a wider range of services in the community. The model requires contribution at the local level though our 64 primary care clusters.  

On 16 October I was informed by the Aneurin Bevan University Health Board that Gelligaer surgery had made a formal request to close their branch in Gilfach, near Bargoed. That's a surgery that's operated as an outreach surgery from Gelligaer for some time. Over 2,000 patients in Gilfach and Bargoed attend the Gilfach surgery, and if they had to move, they'd either have to move some distance to Gelligaer or to nearby Bryntirion surgery, which is already heavily subscribed.

I'm meeting doctors at the Gelligaer practice on Friday to discuss this. I'm also preparing a letter with constituents to write to the health board to make the case to keep the practice in Gilfach open. We need more accessible GP services and there's an urgent need to recruit GPs, particularly to train them and for them to work and live in the northern Valleys in communities like Bargoed and Gilfach, where I'm from. What has the Welsh Government and particularly the health Minister done to achieve that aim of training and recruiting GPs and moving them to live and work in those northern Valleys areas?

Yes, thank you. I recognise the activity the Member's undertaken, particularly during the eight-week consultation about the Gilfach practice. It is worth recalling, of course, and the Member will know from our recent visit to Bryntirion—the second visit I've undertaken—about the changing model for primary healthcare, about having different healthcare professionals involved and engaged, with some general practitioners, but more therapists and in particular pharmacists, but also, in that particular practice, an advanced practice paramedic as well who has been a recognised and valued part of the team.

The change process is difficult and wanting to work deliberately in different ways, having more direct access to a different range of staff, that's the model we're trying to roll out. That doesn't mean to say that you need to have it contracting in the way that the service is provided. It's how they're expanding the number of professionals. That's why I'm so proud of the fact that we have recruited the highest ever number of GP trainees, including in the northern Valleys, because every single GP training scheme is full for the first time ever. And more than that, I look forward to further expanding the number of GP training places across Wales. The limiting factor in that is, actually, the number of practices that are prepared to be training practices themselves, and that actually helps sustainability in those practices that undertake it. So, I look forward to hearing more from the Member about his engagement with the local general practice community and the public, and I look forward to continuing to roll out the successful primary care model here in Wales. 

I'm so pleased to hear your warm words about the importance of maintaining and developing primary care and the importance about it not just being about the GP, but, of course, using all the other allied healthcare professionals that are vital to making community services work.

Now, last week, the First Minister said to me at about this point in time, I think, that,

'the health service needs to be seen in the round, and that cannot mean a focus just on hospitals.'

That's something I completely agree with, something the parliamentary review was very clear about, and something, indeed, you've tried to reflect in 'A Healthier Wales', your vision for healthcare going forward. So, can you please tell me, Minister, when do you intend to actually divert more of the health budget into community services and into primary care? Because we're asking an awful lot of our primary care and community services, but they're doing it on the same levels of budget that they have done. It incrementally grows. The Royal College of General Practitioners would like to see it at 11 to 12 per cent. Can you please tell us how you're going to start to take that money out of secondary care, out of the big, expensive element, see the health service completely in the round, as it should be, and put some of the funding where you're trying to transform the services and make that transition, or else it simply will not happen?

Well, as I've said on a number of occasions, I think artificial percentages are the wrong way to look at dividing up the health budget and actually investing in our priorities. It's a matter of fact that secondary and tertiary care is much more expensive to deliver than primary care, so there's going to be an imbalance in the budget. I'm interested in making sure that we do properly invest in the future of primary care. That's why the additional resource I've put into therapist training, for example, is such an important step forward in continuing to invest in the future of the workforce.

But more than that, of course, you weren't there, so you wouldn't have heard this, but at the recent primary care conference, there was a really positive response from our cluster leads locally and, indeed, the sincerest form of flattery has come from across the border because they're copying the way that we're arranging and engaging the new primary care model and working together in clusters.

But I was able to set out that when we are in a position to set our budget, I expect to invest more in our clusters so they have more freedom to invest money into local choices, so that's the partnership at a primary care level having more of their own freedom, in addition to the wider budget. And I look forward to making the full budget available once we're able to publish our budget after the general election.