2. What action is the Welsh Government taking to improve access to primary care in Wales? OQ57287

Access to primary care services has changed dramatically across Wales over the past two years. Services have had to adapt so that patients can access primary care in a safe and effective manner. Many are using digital technology to help deliver these improvements.

Diolch yn fawr, Weinidog. A number of constituents regularly complain to me that they find it very difficult to obtain an appointment to see their GP. Typically, they ring up at 8 a.m. as required to, but are unable to get through for quite some time, they're constantly telephoning, and then, when they eventually get through to the practice, they're told that all the appointments for that day have been allocated and that they should ring back at 8 a.m. the next morning, when they may well have the same experience all over again. So, in light of those problems, Minister, I very much welcome the announcement you've made today of changes to the GP contract, so that new funding and new systems will be put in place for these telephone services, to enable better access, and we're no longer in this 8 a.m. situation, as it were. But I wonder if you could tell me when these new systems are likely to be in place, and also whether you will work with the health boards to ensure that those practices with the greatest problems are the first to receive this very necessary support?

Diolch yn fawr iawn, John. I'm pleased that we were able to make that announcement today. This has been several months of very sensitive negotiations with those people who have been on the front line for all that time. So, we had to get the balance right here, because, obviously, we have a responsibility to support the GPs, who are in a very difficult situation, but also to make sure that there is a decent provision and service for the people of Wales. And that's why we've really focused that GMS contract on the access issues that, as you have pointed out, so many of your constituents, and others, encounter, with that 8 a.m. bottleneck in particular a problem for so many, people trying time and time again to get through to their surgeries. 

So, we've announced today a £12 million contribution. Some of that will obviously go towards the 3 per cent pay rise, but also, we are ensuring that there will be additional support to invest in systems that will improve the way that people get through, but also, to get better planning in place in those surgeries so that they don't have that charge at a particular time of day. 

So, this is going to happen from April next year, but, obviously, we need to make sure that everything is in place and ready to go from April, which is why we made that announcement today. 

Minister, since primary care practitioners often care for people over extended periods of time, sometimes many years, the relationship between patient and doctor is particularly important. Now, when it comes to mental health issues, trusting relationships have been found wanting, because, simply, they can't get through to their GP. And in my own local health board, I'm seeing now many patients passed between department, between pillar and post, due to such a high turnover of staff in mental health services. 

Now, by having dedicated mental health support workers within their surgeries, or mental health nurses, GPs have found previously these have been really, really useful, and have actually been able to provide support there and then. Local GPs have asked me to raise this again as to when introductions of these nurses could be put back into GP surgeries. Will you confirm what steps you have taken to evaluate the training and recruitment costs required to place a mental health professional in every GP surgery across our constituencies, and will you listen to our GPs on the front line, who are simply asking for this? Diolch. 

Thanks very much. Well, obviously, mental health is an issue that my colleague, Lynne Neagle, leads on, and I know that you'll be aware of her incredible commitment to this cause over many, many years. It's absolutely clear that the number of people who are contacting their GPs for mental health support has increased significantly, and there are lots of ways for us to deal with this. I think one of the key things, though, is that we need to not overmedicalise mental health issues if they are not medical. So, social prescribing is something that we're very keen to encourage, but the early help in our community, I know, is exactly the kind of route that Lynne Neagle is very keen for us to focus on. 

When it comes to specific cases, nurses in our communities, I think what's more likely to happen is that we'll start that on a kind of cluster basis, and I think that's probably the route, so that we know that, at least in a particular area, there will be access. But, as I say, I think we absolutely need to get to the point where we understand that mental health issues are not all medical. Sometimes they're about social issues, they're about relationship issues; they are not medical issues. And we need to make sure that we don't overmedicalise mental health issues if it's unnecessary to do so. 

Good afternoon, Minister. I'm appreciative of all of the work that you've done; you have an incredibly busy job. But I just want to talk about teeth and dentists, specifically the teeth of people in mid and west Wales, and specifically the teeth of the people in the town of Llandrindod Wells. As you know, I've written to you on a number of occasions, but there are massive concerns around the lack of dentists, both across the region, and specifically, in Llandrindod Wells, which has been the case for a number of years, pre COVID. We know that there are significant challenges in COVID with treating people in dentists, but there is a massive difference here. If you go to a private dentist, you can be seen almost straight away. If you go to an NHS dentist, you can't. And that doesn't matter if we're in COVID times or not.

So, I just really want to ask you specifically: could you tell us what your plans are for dentists, both in mid and west Wales, and in Llandrindod Wells, and across the whole of Wales as well? Thank you very much. Diolch yn fawr iawn.  

Thanks very much, and thank you for your perseverance on this issue. And I know it's an issue that matters a huge amount to you in particular; I know that there is a particular problem in the Llandrindod area, and that's why we have been trying to focus our attention on that.

It's not an easy issue to resolve, but one of the things we have done is to make sure that we've injected an extra £2 million this year to try and encourage dentists to take up more opportunities to see those NHS patients that we're so anxious for them to extend their abilities to at the moment. So, that money has been put on the table. Part of the problem we have, frankly, is that lots of dentists won't come in and pick the money up. So, that is part of our problem, and so I think there is a longer term issue that we need to address here.

We need to have a situation, and I've asked my officials to start to develop a 10-year plan, to understand where are we heading with this, because it's absolutely clear to me that more people in Wales want access to NHS dentists than the places available, and, at the moment, the model is not providing for that to happen. So, we need to think fundamentally about how we change the model and what's possible here. So, it's not going to be a quick fix, I'm afraid, and it's not easy to do this whilst dentist services, of course, are still in amber. So, you're aware that, at this time, when COVID is still an issue, and that it is a case where we see the change and things being carried through aerosols, it is really problematic. And the cleaning in between, all of that does not help to speed the situation up. 

We've also got to make use of all of the dental technicians and people who have real skills, and I know a huge amount of good work's been done in Bangor University to demonstrate that actually we could be using those skills to a much broader extent than we are at the moment. But I'm meeting on a monthly basis now—. I've only picked on about five different things to just keep on coming back to to make sure we don't lose focus on this, and I can assure you that dentistry is something that I'm having monthly meetings on so that I keep that focus very clearly on what needs to happen.