Part of the debate – in the Senedd at 3:06 pm on 22 April 2020.
Thank you for that long list of questions, comments and points. When it comes to the starting point about testing and whether we're testing enough—we've talked about this in our other meetings and in the response I've provided in public forum in the commentary and press questions. In terms of whether we're testing enough, we are having enough capacity, and it's about making use of that capacity. That's why the review I ordered needed to look not just at how fast we're growing the capacity, but the use we're making of it and the system we have to get people from referral to testing. I recognise that there were some challenges in our system, which is why there have been some immediate changes to improve that. We've already seen a much greater throughput in terms of the people from the care sector. We've heard from local government already; they're putting through much greater numbers of their staff and people in the independent sector. We've deliberately drawn Care Forum Wales into the work we're doing so that those in the independent sector have a much clearer line of sight into how they can get their members of staff referred, and to understand the policy changes that have been made that I referred to in my statement, and crucially, that the local resilience forums across Wales, which are having to co-ordinate the emergency response across Wales, and the range of services, also understand how they can refer their members of staff through as well, to get that commonality and consistency and efficiency in the process. So, our current capacity is what that is being used for, and I've had a direct conversation with the chief scientific adviser on health, and I've also spoken to the chief medical officer each day as well, and they are confident.
One of the points you raised with me was about what advice we're getting. Where we are will meet the sort of need we have in that sector of workers. But the point that I have regularly made, and I know you referred to it as well in terms of your comment around the value of testing—I've regularly made the point that we need to have a much bigger community infrastructure that is in place and ready to go. That doesn't mean that we're testing it for the first time on the first day and trying to phase our way out of lockdown, but that the capacity is increased steadily, progressively, and that we have it in place before we do come out of lockdown. That's a point I've made several times over the past week.
The reason, though, why we're not having to test 5,000 people a day and more is because of the social distancing that's been introduced, because of the measures we took to put the country into lockdown, because of public response, because we have intervened and flattened so successively the current rate of infection. But that doesn't mean that we can come out of lockdown today, for a range of reasons that I think Members here understand perfectly well. That's why I've made the point successively, and I'll keep on making it, that we need that bigger infrastructure ready and in place before testing comes out. And I don't think there's an anomaly there, because that is exactly what I've said pretty consistently when I've been asked about this for the last week and more.
On the point about the weekly update—in that weekly update that is being published on a Tuesday morning, moving forward I'll not provide an update but I'll give an indication of where we expect to be across the next week. That comes from the advice that we get from within our system and Public Health Wales and other actors on how we're increasing our capacity here, what the UK contracts are providing for us, to give that idea of where we're going to be next. Because I didn't pluck a figure out of thin air—it was based on the advice we had. And in the testing review I indicated the reasons why we weren't able to get that previous figure on tests: the change in behaviour across the rest of the world; the previous arrangements we had in place; the fact that other countries prevented equipment leaving their countries, including some chemical reagents and physical testing kits; and the fact that some of that equipment has been delayed. Those are all very real factors that are outside of our control. So, rather than setting a new target when I can't control a range of those factors, and neither can our own actors here in the health family in Wales, I've committed to providing a regular update on what we are doing and what we expect to do to get to the point where we have that much bigger infrastructure in place.
On PPE, a regular schedule is provided to local authorities and within our healthcare system, in terms of when they can expect deliveries. To be fair, the leadership at the Welsh Local Government Association have recognised that there has been improvement in the understanding of what's coming and the delivery of that. As I said, over 40 per cent of our pandemic national health service stock has been provided to local authorities for use in the care sector, including by those individual businesses as well who would normally source their own PPE but are now having that provided free of charge by us, through the national health service, whereas, actually, in some parts of England they're still paying for that stock despite its provision coming through the healthcare system.
On the review the military have undertaken, it has given us confidence in the logistics in our delivery system. It's given us some pointers for improvement, and we look several times a week at what is happening and our ability to have the right levels of PPE, and where we think that there are potential supply issues. We're also providing some technical briefings to people who really do need to know this in the system, on the trade union side and employers, so they've got confidence to provide to their members and their employees on what actually is happening.
On procurement, we continue to work not just individually to follow up leads that are provided to us, but we're also, as I've indicated, working with Northern Ireland and Scotland, as well as England, and we've also agreed to come together on a four-nation basis. It's not so much a matter of instruction, but it's how we've agreed to work in pursuing those opportunities.
In terms of masks for the wider public—again, I've answered several questions on this in a number of fora over the last week—the evidence base is being reviewed. At present, the advice we have is that the public don't need to wear masks. We know a number of people already are. The wearing of masks is about protecting other people so that you don't spread coronavirus to someone else, and that's most effective for people who may be asymptomatic, but it's worth reminding ourselves that people who are symptomatic and haven't had a test should be self-isolating. People who are COVID-positive should certainly be self-isolating.
We'll need to consider the impact of asking the public to wear masks and what that means, making sure it doesn't compromise the supply of surgical-grade masks, but that, equally, we understand what the evidence base is. If that evidence base changes, then I'll be very happy to shift the position and the advice that we give to the public. We don't know everything about coronavirus—we learn more each day and each week. It's part of the reason why some of the advice has changed throughout the progress of the pandemic. I expect that on a range of things we'll be doing things differently in months to come compared to where we are today.
On non-COVID-related mortality—your final point—last week, of course, the chief executive of NHS Wales raised this point in his press conference. I've referred to it several times this week, including in yesterday's press conference, and I have asked the health service to do some work already to understand those areas of non-COVID-related mortality, to understand how much that need is being suppressed for people who do have urgent care needs. As I've mentioned in my statements previously, the NHS is open for business for people with urgent care needs. I don't want people to be so fearful of coming to the national health service for treatment that they potentially end up risking their own health and well-being. Sometimes that has led to potentially avoidable mortality. It's a matter I did manage to discuss with chief executives and chairs earlier today. I want to provide more focus on that in the week ahead, because public behaviour is a big part of why we've had a success story in preventing the spread of coronavirus, but it's also part of the challenge that you highlighted, and we've talked about before, on those non-COVID-related areas of mortality and how we continue to restart other parts of our national health service in the future.