Part of the debate – in the Senedd at 3:18 pm on 12 February 2020.
Diolch, Llywydd. There have been many references from many Members in this Chamber to the inverse care law, that, essentially, the section of the population most in need of care services often face the most barriers to accessing them. We've also noted on several occasions that people in the poorest areas also face the greatest burden of disease. This is due to a combination of the industrial legacy and the neglect of those people in those communities when they were de-industrialised.
We've also noted that the dismissive attitude of senior management in the NHS when it came to dealing with complaints that led to the maternity services scandal in Cwm Taf, and noted that it probably wouldn't have happened to people in a more wealthy area. But, again, lessons are not learned, as this Labour Government presides over a policy of closing A&E in one of the most deprived areas in Wales. This is despite the University of Sheffield study in 2007 finding that a 10 km increase in distance is associated with around a one per cent absolute increase in mortality, and that relationship is greater for patients with respiratory conditions. And this has been confirmed by at least two other studies for asthma patients.
Now, the board cites staff shortages for this, and it is, of course, trivially true to say that a unit without doctors is going to be dangerous. But we have to ask why. How have we got to this place?
The figures I quoted yesterday to the First Minister demonstrate that in those areas with A&E units that are not under threat, consultant numbers have increased significantly. Those areas where reconfigured proposals were agreed did not. It's a self-fulfilling prophecy. Nobody chooses to work in a place that is under threat, when management rely on agency staff instead of advertising for long-term vacancies. My office has heard from a number of doctors who want full-time posts in the Royal Glamorgan and would take them if they were offered a little bit of flexibility in the hours.
So, what are the immediate short-term actions that need to be taken now? First of all, make a public commitment to the long-term future of the A&E department in the Royal Glamorgan Hospital. This alone will help recruitment and retention. Offer the existing agency staff full-time employment, making adjustments to the hours if needed. We know that there are many people who would accept this offer. Actually advertise some posts, using some financial incentives, like Cardiff has recently done, if that's necessary for the difficult-to-recruit positions. And, importantly, make the expectations to management clear—they have been operating with the opposite expectations and a belief that the unit should close ever since the south Wales programme was agreed.
In the longer term, Plaid Cymru has well-considered and costed policies for the training and recruitment of an extra 1,000 doctors, and that includes investment in the targeting of local recruits and the expansion of training places for doctors. These policies can and should be put in place for the benefit of all NHS services in Wales now.
I want to turn briefly to tackling some myths. First of all, the Tories need to reflect upon the fact that this process has happened in England. Jeremy Hunt made it clear that he wanted centralisation and he gave the go-ahead for this to happen back when he was health Secretary. Coincidentally, this was the date the performance in the English NHS started to decline, and that decline continues to this day. So, the Tories don't have a good track record in delivering a different model of service configuration.
Secondly, to those who want to abolish the Assembly, they need to consider what would happen if the NHS senior management had no political oversight at all. Some senior managers have been heard privately saying that they want centralisation to go far further. If they had their way, we could end up with A&E units in just Cardiff, Swansea and maybe one or two others. It's only because Labour know that they can't get away with agreeing to that that prevents this process from getting worse. But that also highlights another unavoidable truth: that the health Minister could stop these proposals right now, but he chooses not to.
I want to finish with this: we in Plaid Cymru will do everything we can to stop them closing or reducing those hours in our A&E department at the Royal Glamorgan, and we intend to win this battle. If we do, a future Plaid Cymru Government pledges to keep our A&E for the long term. But if we don't win, then we will pledge to restore it. Diolch.