Diolch, Dirprwy Lywydd. I note Russell George's question just now. Minister, you'll be familiar with the case of my constituent, Maria Wallpott—

No, can you ask the question first of all, please?

Oh, forgive me, Dirprwy Lywydd. Forgive me for that. 

5. What are the principles the Welsh Government expects the Welsh Health Specialised Services Committee to follow when making decisions about whether to provide treatment for rare cancers? OQ57851

Forgive me, again, for not asking that. 

Thank you very much. 

We expect the Welsh Health Specialised Services Committee to provide all treatments, including those for rare cancers, if they are recommended by the National Institute for Health and Care Excellence—NICE—or the All Wales Medicines Strategy Group.

Now you can ask your supplementary.

Thank you, Dirprwy Lywydd. Diolch. Forgive me, Minister, it's because it's on a very similar—well, the same topic. You'll be familiar with the case of my constituent, Maria Wallpott. Earlier this year, she won her case in the High Court to be allowed potentially life-saving cancer treatment. The treatment would have been automatically available to patients elsewhere in the UK, but she was refused by a committee that is tasked with taking into account economic factors when deciding whether to approve treatments in Wales. Several similar cases have been raised with me; most recently, a constituent whose father has a cancer that needs treatment but was told that funding was, again, unavailable in Wales. Mrs Wallpott's case has shown that the decision to refuse that treatment was unlawful. Now, other patients are being refused cancer treatments that could save their lives, and I'm concerned that decisions are being made based on funding instead of on only clinical deliberations. So, Minister, could you tell me, again, in addition to what you've said already on this, why the situation is so different in Wales? And will the outcome of Maria Wallpott's case have any effect on how these decisions are made, please?

Well, the Member will understand that I can't comment on individual cases, but I am keen that WHSSC considers the finding of the judicial review and that they ensure that the individual patient funding requests policy is adopted fairly, consistently and equitably. So, whilst Welsh Ministers can generally direct local health boards in Wales as to the functions they exercise, responsibility for individual patient funding requests ultimately rests with LHBs and with health specialised services. We have intervened in the past to make sure that they speed up the handling of IPFRs by the NHS, and I'm pleased to say that we have seen good progress. But, of course, I am anxious that we learn from any case where judicial reviews have come against and worked against the Welsh Government. 

As the Senedd will know, it is a sub-committee of WHSSC that holds delegated joint committee authority to consider and make decisions on requests to fund NHS healthcare for individual patients who fall outside the range of services and treatments that a health board has agreed to routinely provide. For us in north Wales, this has seen patients go to Manchester and Liverpool for cancer treatment, Oswestry for orthopaedic operations and Liverpool for heart treatment. When the national health service was founded, it could not have been envisaged that there would now be, with devolution, bureaucratic borders between treatments offered in the four corners of the United Kingdom. There are severe delays in access to treatment by requesting that the panel sees written evidence, a request form, other documentary evidence, and it is so complex, Minister. And for the Member that's muttering over there, during my first—

You have less time to ask the question, so focus on the question.

During my first term in this Senedd and in the Health and Social Care Committee, concerns were raised about these delays and this complex bureaucracy around WHSSC. Could you, Minister, have a look at reviewing the bureaucratic delays on treatments? And will you liaise with all Welsh health boards to ensure that they do have agreements in place with health boards elsewhere in the UK that provide treatments that we do not, and just make it more of a seamless way of going about things? Because I have many, many constituents now in Aberconwy who are really caught up in the bureaucracy of all this. Thank you.

Thanks. Well, I think that it's fair to say that there have been issues in the past, and I think that we've made good progress since 2016. The fact is that the total number of IPFR requests is decreasing, while the proportion of those approved is increasing. So, those are the facts. So, things are definitely improving. I do think that it's fair to say—. Look, we're never going to have a situation where highly, highly specialised medicine, that you can do all of that within the confines of Wales. Frankly, if you have a very, very rare condition, then wouldn't you want to go to the best place possible in order to get that sorted? And if that's in England, so be it. That's fine. So, I think that we've just got to be realistic about getting the best care for individuals within Wales. Certainly, of course we want to try to get those treatments done as quickly as possible, but I do think that the situation has improved quite dramatically since 2016.