5. What assessment has the Welsh Government made of the ability of Welsh health authorities to effectively manage staff rotas? OQ58502

Health boards plan, deploy and manage their workforce to meet population needs. E-rostering solutions have been implemented across NHS Wales to support the effective deployment of staff. 

Thank you, First Minister. Unlike many other professions, those who work within the health service and have direct patient contact have to be mindful of the impact that their annual leave has on those whom they care for, often having to plan and arrange annual leave months or even years in advance. Indeed, needing to take sick leave or annual leave at short notice very often translates to patient appointments being cancelled. This is not only frustrating for patients who may themselves have taken annual leave to attend their appointment and will now go back on to a waiting list, but it also means that healthcare professionals lack any flexibility and have to make difficult family decisions—having to miss school plays or sports days, for example. This manifests itself either in poorer working environments when compared to other professions or in healthcare professionals choosing locum positions that have the required flexibility, instead of salaried NHS positions. This is, ultimately, more costly for the NHS. Whilst there may be departments that have good rota systems, I know of many that do not, and this is an issue that has been raised continually with me by healthcare professionals, who struggle to get enough flexibility in work to meet life's demands. Will you agree with me, First Minister, that this shows how the Well-being of Future Generations (Wales) Act 2015 is not being effectively applied and that more needs to be done to help provide better working conditions for our healthcare professionals? Thank you.

Llywydd, I agree with a great deal of what Joel James has just said. As I've explained a number of times on the floor of the Chamber, the NHS continues to have to deal with the COVID impact, with just under 1,000 members of staff not in work today; around 600 to 700 of them are actually ill with COVID themselves and around 300 or so are not in work because they've been in contact with somebody. All of that happens at short notice. And when you're dealing with 1,000, the sudden inability of people to be in the workplace undoubtedly makes the business of managing the workforce, and the impact on patients that flows from it, a challenge.

I recognise the points that the Member makes about some of the factors that pull people into working as locums or in agency arrangements because of the additional flexibility that that allows them, over and above people who are on fixed-term contracts. During the pandemic, we were able to introduce some short-term flexibilities into the way people manage their annual leave, with greater carry-overs and paying people for annual leave days when they simply weren't able to take them. But, I'll ask my officials to look carefully at the points the Member has made this afternoon in case there's anything further that we may be able to draw from them.

The First Minister knows that I've been raising concerns recently about staffing at Ysbyty Gwynedd, and rotas there clearly continue to be a problem. One recent e-mail from staff refers to the Hergest mental health unit, with staff morale at an all-time low, poor recruitment and retention, high sickness and poor working conditions. The result: more and more use of agency staff. When will the Welsh Government really get to grips with this unsustainable and expensive overreliance on agency workers and the rota difficulties that that perpetuates? This is resource that should be spent on supporting and improving working conditions for staff at Ysbyty Gwynedd and hospitals the length and breadth of Wales.

Well, Llywydd, I agree that I would rather have people working directly as employees of the NHS, or in bank arrangements under the control of the NHS, than people working in agency arrangements. In the end, these are individuals making decisions in their own lives. You cannot direct people as to how they would themselves choose to organise their own employment arrangements.

The way the Welsh Government has attempted to make a difference is both in changing the rules—we have a new rules system that makes it more attractive for people to take part in bank arrangements and less attractive for people to be in agencies—and by increasing the number of staff available. There's been a 44 per cent growth in nursing, midwifery and health visitors here in Wales over the period of devolution; we need to grow that further. For each of the last seven years, we have increased the number of nurses and midwives in training here in Wales. When we succeed in getting those people into the workplace, then we will be in a position where we can make working arrangements in the NHS effective so that the attractions of moving to become an agency employee will be lessened and we'll be able to lessen our reliance on those arrangements in return.