Part of the debate – in the Senedd at 4:24 pm on 9 February 2022.
Thanks very much, Russell. What we don't lack is a target. We've got the target; we're just not meeting the target yet. What we need is a mechanism to reach the target, and that's certainly something we need to make sure that we can deliver on. Many people have talked today about the need to make sure that staffing is in place, for example, and training is in place. Before Christmas, we announced £0.25 billion to focus on training within the NHS. It has been interesting to look at the English planned care proposals that came out yesterday. A massive criticism of that is: where's the plan in terms of training? Well, we've got training plans in place; Health Education and Improvement Wales is on this, they know what needs to be done. I can give you chapter and verse in terms of how many people are going to be trained in each different area of cancer.
So, we are doing quite a lot of work. The difference is that we haven't packaged it up, in a way, and there's a reason for that, and the reason for that is because what we've got is an integrated set of policy commitments that were described in the national clinical framework, and what you need to understand is the context in which this cancer plan needs to work. Let me remind you what we're trying to do: we want a clearer, more effective, less duplicative set of policy arrangements that our NHS bodies who actually plan and deliver cancer services can then respond to effectively. I understand the attraction of setting out minute detail in one document on how we're going to solve cancer, but that's just not how a really complex health system is delivered. We've heard today about the need to look at prevention. Well, do you want a whole obesity strategy set out within the cancer plan? It doesn't seem to make any sense to me. We've got a smoking plan as well; we've got lots and lots of different plans that all contribute, so I think we've got to understand how complex this is.
At the heart of improving cancer outcomes is identifying someone at risk and getting that diagnostic test done. If we look at who delivers that part of our cancer pathway, they're not cancer services. So, where would we put those? Do we put them in the cancer plan, or do we not put them in the cancer plan? Because they are not cancer specialists; they are general practitioners who first identify whether it needs investigation. They're dentists, they're opticians, they also include screeners and outpatients and emergency department teams. This is where that initial clinical suspicion of cancer arises, and from where people are referred. And when they're referred for an investigation, where do they go? They go to pathologists, they go to radiologists, they go to endoscopists. Do you want all of that? Your plan is going to be massive, Russell. So, I do think that there was an approach that was clearly set out in 'A Healthier Wales', and that's why we've taken this approach.