5. What action is the Government taking to ensure that the capacity of the NHS in north Wales is sufficient to meet demand? OQ58528

Betsi Cadwaladr University Health Board is responsible for the provision of safe, sustainable, high-quality healthcare services for its local population, based on the best and most up-to-date clinical evidence and advice. We've also provided additional investment to support them.

We know, of course, that one in eight nursing posts is vacant in north Wales. We also know from the chair of the health board that of the 642 GPs that we have in north Wales, a quarter of them are over 65, and a third of that 642 are expected to retire in the next five years. And we also know that there aren't adequate numbers coming through to fill those posts. Twenty per cent of posts are filled by locum doctors at the moment, before those I mentioned will retire.

Do you therefore accept that one of the historical failings of this Government, and previous Governments, is the failure to sufficiently plan for the future workforce in this sector, and the upshot of that failure, then, is that we have shrinking staffing levels, that it costs more to the public purse to fill those vacant posts, and it puts more pressure and burden on the shoulders of those left behind?

Well, we have been training people, and we have seen 54 per cent more people working in the NHS over the past 20 years. In Betsi now, we see that almost 20,000 people work for the health board, and there are plans to recruit 380 more during the next two years. And the idea there is that the board wants to get local people to take those posts, so they have a plan for that. And what is important therefore is that that planning is done. I had a meeting with the General Medical Council last week. They demonstrated exactly how many people are going to leave because they're going to retire—'retirement', that's the word. 

So, what is important now is that we take all of those figures on board. You know that the Labour Party nationally have said that they are eager to see far more doctors being trained. And certainly, in terms of nurse training, as you heard from the previous question, we are already training far more nurses than we were in the past; more than 69 per cent more than we have in the past. The difficulty is is that we have to retain people in the system; that's where the tension is. And we understand that there has been great deal of pressure on these people over the past two years. 

Minister, you'll know I've raised in the past my concerns about the length of delays at our hospitals—Ysbyty Gwynedd, Ysbyty Glan Clwyd and, of course, Maelor. Now, you'll also know that I believe that community hospitals, and in particular Llandudno district general hospital, have a key role to play in addressing some of these issues. I know that you've been listening, because a bridging service trial has now been undertaken at the Aberconwy ward, an operating theatre has been reintroduced, and a new stroke unit is going to be based there. I'd love a timescale on that, please. But there's more that can be done. Only 43.7 per cent of patients spent less than the four-hour target time at A&E Glan Clwyd, yet at MIU Llandudno the figure is a stomping 97.6 per cent. So there we have it: the MIU is performing exceptionally well. So, Minister, will you look at—? It hasn't got an overnight doctor and things like that, and there are ways where, I think, you could enhance provision in these community hospitals, and, without doubt, that will take the pressure of these larger hospitals, which are really struggling to cope. Thank you. 

Thanks very much. I'm really pleased to hear that things are going from strength to strength in Llandudno, and, certainly, when I visited there, one of the things I really focused on was what are these people doing there, how long have they been here, what's the plan for these people, and it was clear. I met one man there, I remember, who'd had his leg amputated, but he was in a second floor flat. So, it was clear that he was never going to be able to go home, but they hadn't started working that out until he was coming to the end of his treatment. Well, you could have been working that out weeks before, so it's trying to get people to understand the need to work through those things. As soon as they come in through the door, what is the plan to exit these people? I'm really pleased to hear that that bridging service is working really well. And you're quite right—part of what we need to do now across the whole of Wales is to make sure that people understand that there are alternatives to A&E: that they can go to urgent primary care centres, that they can go to same-day emergency care centres, that they can phone 111, they can go their local pharmacy. All of these things are options that weren't there a few years ago, but we have got a plan, obviously, and we have been trying a campaign, Help Us to Help You, to make sure that people know where they should go to get the right help at the right place at the right time.