3. What further steps will the Welsh Government take to tackle health inequalities in Wales? OQ56499

It is a central ambition of this Government to do everything we can to address unacceptable inequalities in health outcomes between our most and least well-off communities. We will continue to take a whole-Government approach to tackling the root causes of health inequalities.

Minister, health inequalities in the UK and Wales are very, very concerning. Men in the most deprived communities live, on average, 10 years less than those in the least deprived, and, for women, the difference is almost eight years. And in terms of healthy years of life, the difference is almost 19 years, and that applies to both genders. So, with that sort of background, that's why the Royal College of Physicians in Wales got together around 30 organisations to look at this situation, and they were looking at research that showed that the social determinants of health or ill-health—housing, education and poverty—can be more important to health outcomes than healthcare itself or, indeed, lifestyle choices. So, in looking at this situation, they believe that there should be a more strongly cross-cutting approach from Welsh Government to involve all Ministers and all departments in changing what needs to be changed to address this totally unacceptable situation. 

So, I heard what you said, Minister, in terms of a whole-Government approach, but, in terms of those suggestions and proposals from the royal college and those 30-odd organisations, will you carefully consider what they think is needed in deciding how we can make further inroads into these longstanding issues and problems?

Yes, and I think the Royal College of Physicians report is a useful reminder of the need to have cross-Government action, because most healthcare inequalities don't come from healthcare activity, they come from those determinants outside. It's why, for example, the World Health Organization has recognised the direct healthcare impact of our improvements in housing quality. The reality that having a good-quality warm home makes a real difference to your health is something that has been recognised internationally, and praised for our approach here in Wales. I'm pleased to say you can see that continued leadership from Julie James as our housing Minister, improving housing quality stock and the environmental footprint as well. You see it in the work across education, the work we've done and the conversations yesterday with Kirsty Williams and the Chair of the Children, Young People and Education Committee about that broader approach to children and young people's health, and their health literacy for mental and physical health. You'll see that in the work that Ken Skates has undertaken on the economic contract, making sure that mental and physical health are understood as key outcomes from a good working relationship, where people have good work, good terms and conditions. If you look at healthcare inequalities, they always match over economic inequalities as well. We've made some progress, progress that I think we can be proud of. We know that there's much more to do and a real opportunity to do so as we look to rebuild Wales after this pandemic, to finish the job with the pandemic and rebuild a better, fairer Wales. 

Thank you, Minister. Yes, it's very true that it has to be a cross-cutting, cross-Government approach to this to tackle this significant problem. The pandemic has thrown into sharp focus the issue of health inequalities in Wales, and exposed the consequences of longstanding failure to tackle the problem. Tackling the social causes of health inequalities, as you said, has never been more urgent, and the true scale of the implications of the pandemic for the health and well-being of people in Wales may not become clear for a number of years yet.

Tackling the inequalities in our BME communities specifically, how, Minister, are you looking into significantly improving healthcare provision for our BME communities, healthcare provision that respects cultural differences and recognises the many languages that are spoken amongst our communities, so that we really can create equality in provision?

Well, on the specific issues around Black and Asian origin communities here in Wales, we've done quite a lot in recognising our need to improve our services, whether that's mental health or physical health. We've learnt even more and are doing even more work through the pandemic—for example, the work of Professor Emmanuel Ogbonna in understanding more about those inequalities, the work of Professor Keshav Singhal in undertaking the risk-assessment work, a first within the UK that's being rolled out to other parts of the private sector, but also in the vaccination roll-out as well. And it's perhaps appropriate to mention, given that John Griffiths asked the initial question, the work that John Griffiths and Jayne Bryant have done together with Newport City Council, with the health board, on encouraging more people to undertake not just their vaccinations, but the broader re-engagement of the health service and our broader care systems with different communities that aren't always as close to other parts of the country when it comes to accessing good quality healthcare. So, progress is being made not just on a single issue, but to take that forward more generally. 

When it comes, though, to the challenges of healthcare inequalities, I would say to the Member, and any other Conservative who wants to try to claim they have no responsibility in this area, that every objective analysis shows that the Conservative policies of austerity and the attacks on benefits and support for working-age people, including in-work benefits, have had a serious impact on increasing poverty and inequality, especially on the reductions in the gains made over the first part of the last 20 years in reducing child poverty, which have all been lost thanks to choices made by her party. So, perhaps some self-reflection on the role of Conservative policies and the reality that we have had to fight back to undo the damage that her party has chosen to cause. 

I wonder if the Minister agrees with me that siting really world-class healthcare facilities in our poorer communities can contribute to addressing health inequalities. And if he does agree with me in that regard, would he join me in congratulating Carmarthenshire County Council and all the other partners in the development of Pentre Awel in Llanelli, which will be sited right in the middle of some of the poorest wards in Wales? I'm sure he'll be aware that this will include a clinical care centre delivering multidisciplinary care, a clinical research centre and a well-being skills centre, focusing on the health and care training, focusing that training particularly on recruiting from within those communities. So, I hope that the Minister will join me in congratulating all of those involved, and wonder if he agrees with me that these kinds of projects can make a real difference in communities where they're needed most. 

I'm happy to say that I've discussed the matter with the constituency Member for Llanelli, my Government colleague, Lee Waters, and more broadly the challenge of investing in communities across the country. And it's a good example of how local health and care services can and should be drawn together to deliver better quality facilities, to invest within that community and to deliver better services, in exactly the same way as the recently-opened Mountain Ash facility that recently I saw with the council and the local Member for Cynon Valley—the lobbying and the effectiveness of that shows it isn't just health; it's health working with other partners to deliver better facilities. And again, it goes back to the significantly improved relationships between health and local government through the crisis, but before that as well, and there's a real opportunity to carry on investing in local healthcare and delivering much better facilities where they're most needed.