2. Will the Minister make a statement on the future delivery of services in the Hywel Dda University Health Board area? OQ57631

Thank you very much. The priority for delivering health services in the Hywel Dda area is planning for the continued provision of essential and key services, alongside caring for patients affected by COVID-19, and also working towards the delivery of wider, more routine, services when it is safe to do so.

Minister, last time I raised the delivery of health services with you, you responded with a political rant, but the people that both you and I represent have genuine concerns about local health services, and so I hope this time you'll choose to respond in a much more measured way.

Now, as you're aware, Hywel Dda University Health Board has recently submitted proposals that include repurposing or rebuilding Withybush General Hospital, whatever that means, and I know that you've also been receiving e-mails recently on this issue from worried residents in Pembrokeshire. People are worried that they will have to travel further afield for life-saving services and, as you know, the golden hour is critical in saving people's lives. Therefore, it's absolutely crucial that Withybush hospital retains its emergency services and that the hospital is not downgraded going forwards. So, Minister, will you work with me, and indeed others, to ensure that emergency services stay in Pembrokeshire for the future? 

Llywydd, of course I am more than anxious to listen to the genuine concerns of local people in relation to any developments in the Hywel Dda health board area, and of course, the decision ultimately in terms of configuration is one for Hywel Dda and it will be presented to the Welsh Government.

I would be grateful if you could have a little word with the Secretary of State for Wales to cool down his rhetoric. You talk to me about whipping up political rhetoric; I'm afraid that when he's sending out letters to people, whipping up feelings, telling people that the health Minister has an office in the local area, I don't think that is something for this time and place, when there is a situation where really we're in quite a frenzied atmosphere at the moment. I would be grateful if you could ask him to tone down the political rhetoric on his part.

The reality is that it's the Welsh Labour Government who've been committed to maintaining essential services at Withybush in line with the advice from clinicians and experts. I'd like to make it clear once again that there are no current plans to remove any service from Withybush prior to the opening of any potential new planned or urgent care hospital in west Wales. That decision will not be my decision. I think it's really important that you understand that as well. That will be a decision for somebody else, because, obviously, I represent that area. But I would remind you that the services have changed over the years, because that's been the recommendation of the royal colleges at the time.

Let's not forget also how fragile some of those services in Withybush have been over the years. The recruitment and retention of staff, due to the changing labour markets and the aspirations of clinicians, who choose, very often, to work in larger hospital settings, of course, have impacted on rural hospitals. It's been this Government that's provided millions of pounds of support to accident and emergency in Withybush, when the health board was reliant solely on agency staff to fill those rotas. At one time, it was the most expensive A&E department in the whole of Wales. So, I don't think you can accuse the Labour Government of not standing by the A&E department in Withybush. The Welsh Government didn't turn its back on Withybush then, and, as I've said time and again, Withybush will remain an important asset in the delivery of healthcare for the population of Pembrokeshire. But we must also look to the future. So, repeating the same old fears, repeating tribal arguments and pitting Pembrokeshire against Carmarthenshire is doing a disservice to patients. I'm sure that his constituents, and mine, will expect and deserve the best healthcare that we can provide.

Do you agree with me, Minister, that the future of health services in our region is in need of a genuine discussion, and that politicians should help solve systematic challenges, like how to attract and retain staff and how to deliver as many of the services as possible as close to home and where people live? It would be more useful, rather than simply obstructing change and investment that our constituents deserve, to instead engage in useful, constructive dialogue and engagement with all concerned, including the local health board, the providers and indeed, most of all, the people who rely on sustained and reliable health services. You've already outlined some of the challenges that are faced annually in the local health board area. It's time to get real now and have a genuine discussion about where we are, where we go, and what people need. I really hope, Minister, and I'm sure you will agree with me, that people take part in a measured discussion rather than simply, and I have to agree with you, pointing people towards where your office is, especially in this day and age—it's an absolutely dangerous practice.

Thanks very much, Joyce. I think you're absolutely right; we need a far deeper public conversation about what we want and how the whole range of health services will work, not just for the people of Pembrokeshire, but for Carmarthenshire and for Ceredigion in the years ahead. We haven't had that deeper conversation over the years, because some people have been caught up in the location of buildings rather than focusing our efforts on maximising our resources for the benefit of patients. There's a whole new philosophy that is being developed here. It's about care in the community as far as possible. Of course, Withybush doesn't exist on its own. It is, and will continue to be, part of a network of hospitals that provide health and care for our communities, whether that programme business case goes ahead or not.