Hywel Dda University Health Board

Part of 4. Topical Questions – in the Senedd at 3:59 pm on 8 January 2020.

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Photo of Vaughan Gething Vaughan Gething Labour 3:59, 8 January 2020

Well we've provided significant support as a Government to the health and social care system, sustained investment over and above consequential sums of money. So, in terms of financial support, this Government has absolutely—. And that's objectively undeniable: the Treasury's own figures show that we continue to put more money into our health and health and care system than England, and we've sustained that investment for a deliberate purpose.

It's not just the money. As I've said on several other occasions, it's about how the health and social care parts of the system work together. The BMA and the RCN recognise that it's complex. It's not as simple as saying, 'Provide more money and just try harder and everything will be fine.' It is about the level and the nature of the demand, and one of the best examples of how that demand has increased in complexity is that the red calls that the ambulance service respond to—. When I made the decision to change the red call status, there was some criticism—there's still a bit of it every now and again—to try and suggest that that was really about changing the figures to suit me. It actually came because of a clinical review, supported by our front-line staff, supported by every medical director in Wales. We have a new category, a new definition to get to the sickest people. That's why there's a new red category. And yet, now, we have 15 per cent more red calls to the ambulance service than last winter, and over the last three months there have been record volumes of red calls. These are very, very unwell people who do require hospital care. So, the demand profile has changed since last winter.

So, all the measures we took last winter, the additional measures we've taken now, and our ability to get people out of the hospital system and into social care is the nub of the challenge. That's why the fragility of domiciliary and residential is such a threat and a problem, which is why we look at health and social care more and more closely together. And I'll say it again, without the improved relationships and the steps that local government must take side by side with the health service—those things are taking place now, as I speak, to get more people out of hospital—this problem would be significantly worse.

But, it is not finished. I'm certainly not complacent or satisfied, because I recognise that means that the experience of some people is not what it should be. And the small number of planned operations that were due to take place but have not—that is the system planning for what it can expect to see. But, these are still, nevertheless, acceptable beyond the planned-for activity. So, the deep dive that I've referred to, that Angela Burns referred to, will take place. That will be useful not just for Hywel Dda but for other parts of our system as well. And I look forward to answering probably similar questions next week when I make a statement on winter pressures.