As someone who worked on the front line of our NHS for over a decade, I can personally attest to the enormous strain our health and care systems have been under. And when a deadly virus has thrown into the mix, it's a sheer miracle that the system didn't break. But that’s only thanks to the dedication of my former colleagues in the NHS, not because of any leadership from the top.

The vast majority of the problems facing our NHS are down to an absence of leadership. The reason why my constituents and yours cannot see their GP, get an NHS dentist, or have had their surgery cancelled multiple times, is due to one simple fact: successive Governments have failed to do proper integrated workforce planning. The royal colleges and the professional bodies have been warning for at least the past decade that we are not training or recruiting enough front-line staff. And Welsh Government are very good at creating managers, bureaucrats and red tape, but are absolutely useless when it comes to creating doctors, nurses and healthcare professionals.

Things have improved somewhat—I do give credit where it's due—and, with the creation of Health Education and Improvement Wales, we now at least have a workforce plan, but I fear its too little too late. Just last week the Royal College of Nursing released their report on nursing staff levels, and it was a sobering read, because the sheer numbers of nurses leaving the profession should worry us all. There are at least 1,719 nursing vacancies across Welsh health boards, and, over the past five years, we've spent around £0.75 billion on agency staff. The RCN report shows how we are losing almost as many staff as we are recruiting, and last year the workforce only grew by 0.1 per cent. We gained a handful of nurses last year when we need thousands. We lost 6 per cent of the district nursing workforce between June 2020 and June 2021 and, in a survey of its members, the RCN highlights that a third of nurses are strongly considering leaving the profession early, all due to chronic workforce pressures. We are in real danger of creating a negative feedback loop—people leaving healthcare because of the pressures of not having enough staff. And it's not just nurses feeling this pressure; it perpetuates across the health and social care system. General practitioners are also leaving the profession in their droves. GPs are retiring early and some are even surrendering their medical licence, meaning that they can't be called out of retirement in times of crisis.

We were warned by the British Medical Association nearly 10 years ago that we needed to recruit around 200 GPs a year in Wales. For the majority of the intervening years we were lucky if we managed half of that. And because we failed to address the recruitment problems, we created a retention problem. In 2019, before the pandemic, nearly a quarter of practices surveyed were considering handing back their general medical services contracts. Since the pandemic, things have got much worse. GPs are warning that the strain could overwhelm the system, that pressures are putting people off the profession all together, and one in eight GP trainees say they do not intend to work in general practice after qualifying as doctors, according to a recent BMA poll.

All this is having a devastating effect on patients, many of whom are becoming sicker because of a lack of early intervention. My constituents tell me that it can take them weeks to get an appointment with their GP and practices cannot cope with the numbers of people on their lists. And when patients do manage to navigate their way through primary care, they face the same challenges in secondary care. Referral-to-treatment times were already astronomical prior to COVID and have skyrocketed since. The latest figures show that one in five of us are on a list awaiting NHS treatment, two thirds of a million people are waiting years for treatment to end their pain and suffering, and 691,000 Welsh citizens are left in limbo not knowing when their treatment will begin. How many of those one in five will die because they didn’t get a cancer treated soon enough? How many will be forced to give up work because their condition deteriorated to such an extreme that they are unable to function in the workplace?

These are the real impacts treatment delays are having on people's lives. Patients are dying, going blind and losing mobility because they can't be treated soon enough. And they can’t be treated early enough because we don’t have the staff. There are currently over 3,000 vacancies in our NHS and many in my health board, in Betsi Cadwaladr, in north Wales. We have 10,000 fewer beds than we did at the beginning of the century, yet we have frequently breached safe staffing levels over recent months. In recent weeks we saw accident and emergency departments with fewer than a third of the required staff, and if we are to recover adequately from this pandemic and be prepared for the next one, if we're unfortunate to have another one come around, we have to get to grips with the training, recruitment and retention of staff.

We need true integrated workforce planning that anticipates future service demands, and let’s not forget that the parliamentary review of health and social care warned us of the challenges we face as our demographics change. We aren’t planning to meet today’s needs, let alone to respond to future challenges. We need root and branch reform of our recruitment and retention policies, and it would help if we actually had retention policies in the first place.

We need to make working and staying in health and care a more attractive proposition. We need to encourage more young Welsh people to pursue careers in health and care. We need a workforce plan that looks at the whole picture, from science teaching to retirement planning and everything in between. It's time to join up the dots, and that requires leadership. It requires a Welsh Government that can plan for the future. I urge the Minister to grasp this nettle now and make workforce planning her No. 1 priority, otherwise my mailbag and yours will continue to overflow with complaints about not being able to get a face-to-face appointment with a GP, about not being able to see an NHS dentist, or about not being able to get a suitable care package for an elderly relative. We can’t afford to lose any more NHS staff, and my constituents can’t wait any longer for treatment. Diolch yn fawr.