We heard about people who are in pain, discomfort or experiencing anxiety. And we heard about people whose needs are becoming more complex, which puts more pressure on health services and on unpaid carers, who may be asked to take on more complex caring responsibilities. We also heard about people who are less able to work, study or undertake their usual caring responsibilities, and whose costs of living have increased, of course, as a result of their condition. We also heard about the pressures facing the health service, and by the health and social care workforce, as they tackle the pandemic and the waiting times backlog. And, of course, we thank the social care workforce, including unpaid carers and volunteers, for all the work that they have done and continue to do. Without a sustainable, engaged and supported workforce—we must remember that the workforce is far broader than just doctors and nurses—we simply will not have the transformation in our health and care services that we need to see. 

Our report focused on the impact of the waiting times backlog, and what can be done to help people wait well. We are pleased that the Welsh Government accepted 26 of our recommendations in full, and the remaining one recommendation in principle. The vehicle for addressing many of our recommendations is the Welsh Government’s plan for transformation and modernisation in planned care and in reducing waiting lists in Wales. In recent weeks, we have gathered views on the plan in writing, and earlier today, actually, we as a committee, as members, met with stakeholders here at the Senedd. Stakeholders broadly welcome the plan; they want to see it succeed, as, of course, do I, but they also have concerns about whether the plan is sufficiently detailed, whether it provides a clear enough vision for the transformation of our health services, and whether there is enough capacity to deliver it. And that's a key message, actually, from the group of stakeholders I spoke with this morning. The key message was that the plan is great, the plan is ambitious, but they were concerned there is not enough capacity to deliver the plan. 

We all know it will take time to bring waiting times down. Audit Wales, in its recent report on planned care, estimates that it could take seven years or more to return waiting lists to pre-pandemic levels. It is vital, therefore, that people are supported to wait well. That's part of our recommendation 1. So, we strongly welcome the inclusion in the Welsh Government’s plan of a commitment to improve the information and support available to people while they wait for diagnosis and care.

However, while we welcome the developments such as the commitment to improving patient communication, particularly coming across this morning with stakeholders as well, they've told us that more information is needed about the time frame for delivery, how the power and experience of the third sector will be harnessed and how risks of digital exclusion will be managed. Some information and communications will need to be personalised and tailored to individuals’ needs to make sure that they have the right information for their circumstances. I heard a shocking experience this morning about how a template letter can sometimes have to go through 20 stages before it's finally agreed. However, stakeholders told us this morning that time, resource and expertise will be required for communication to be effective and accessible, and I would welcome further clarity from the Minister about what the Welsh Government can do to ensure that sufficient resource is available, and how a balance will be struck in national co-ordination to provide consistency of messaging and avoid duplication.

Health inequalities is a key priority for us, and we asked the Minister to explain how support would be targeted to people living in more deprived areas. We welcome the indication that a national group is being established to develop solutions to support local populations and identify how inequality gaps in prevention and planned care will be closed. We look forward to hearing more about the work of this important group in due course. However, in the meantime, stakeholders, including the Royal College of Physicians, and Macmillan Cancer Support, have told us that they are concerned that the Welsh Government’s plan lacks detail on how it will take account of and tackle health inequality. So, I would be grateful if the Minister could say something today about the work of the national group and how that will inform the implementation of the Welsh Government's plan to transform and modernise planned care.

Our report calls for the routine publication of waiting times data, disaggregated by specialty and hospital. The availability, transparency and detail of data was a real key issue that was raised by stakeholders this morning. Like us, they want to see more detail about the types of treatments people are waiting for, and that data broken down further. The Minister accepted our recommendation, but said that she is still considering her approach, including what information will be useful and meaningful. Stakeholders also told us that better data was needed about the health and social care workforce, warning us this morning as well that the age profile of staff in some specialties represents a cliff edge in terms of workforce capacity. It would be helpful if the Minister could tell us more this afternoon about the timescales for improving the availability of data in relation to waiting times and the workforce.

Reducing waiting times will require leadership and national direction. Stakeholders have told us that they broadly support the plan’s ambition, but that further detail is needed on the leadership arrangements and how change will be delivered, including how health, social care and third sector partners will be engaged and involved. Key issues raised include the role of the new NHS executive and regional partnership boards, and the need for greater clarity about how overall accountability for delivery is distributed between different local, regional and national planning programmes, project groups and networks. We also heard concerns about whether the plan does enough to recognise the impact of challenges in social care.

In her response to our recommendation 26, the Minister explained that she would hold health boards to account against their integrated medium-term plans, and that a new national director of planned care, improvement and recovery has been appointed to work with the NHS to ensure that local improvement plans meet the Welsh Government’s commitments and ambitions. However, I would welcome the Minister’s views this afternoon on stakeholders’ suggestions that an annual progress report should be laid before the Senedd, and that more needs to be done to encourage health boards to work together and increase the pace of developing regional models.

Finally, in our report, we explored the different ways in which the waiting times backlog is affecting different physical and mental health conditions and services. Stakeholders have told us that it isn’t clear to them whether all specialties are covered by the Welsh Government’s plan. For example, Cymru Versus Arthritis notes that it isn’t clear whether orthopaedics is included, and Mind Cymru has called for urgent clarification of whether the recovery targets apply to mental health services, particularly as delays to the mental health core data set mean that detailed waiting times for many mental health services are not available. I would be grateful if the Minister could clarify whether orthopaedics and mental health services are included within the scope of the recovery targets in the Welsh Government's plan. I look forward to contributions from Members this afternoon.