4. What support does the Welsh Government provide for GP out-of-hours care? OQ58586

Thank you very much for that question. The Welsh Government sets the policy framework and provides funding for GP services out of hours. Health boards are responsible for delivery of the service in their areas.

On the pressure on the ambulance service, which was mentioned by the leader of the opposition, it's not as simple as just providing more staff in the ambulance service—more ambulance drivers, for example, or paramedics. It isn’t going to solve the problem, partly due to the fact that, further down the line, social care is facing a crisis, which the First Minister acknowledges, and which the UK Government is showing no signs of addressing. In fact, they've taken steps back from that.

One of the key issues that we’ve seen in my constituency, and the experience that someone who works for me has had, being an army reservist working for the ambulance trust, is that very often the pressures come on to the ambulance service through the lack of support from out-of-hours GP care. We were recently contacted by a family of a constituent in Senghenydd who waited over 24 hours for an ambulance after initially calling his GP only to be told to call 999 because the surgery was closing. We feel that this is an opportunity to relook at GPs’ out-of-hours care. He did eventually receive appropriate treatment, but it could have been avoided by an out-of-hours GP visit, which would then have negated the need for the ambulance to be called, which then could have been redirected to other services. Again, I know being in Government is not as simple as saying, ‘We will provide more GP out-of-hours care’, but would the First Minister look more deeply at this, and think about those things that are in that chain of events that lead to pressure on the ambulance service?

Llywydd, I think Hefin David makes an important point—that trying to tackle the pressures in the system by focusing only on one aspect of it will not produce the improvements that we need to see. Many of the pressures on the ambulance service do indeed come because other parts of the system itself are under strain. I’ve tried to explain in my earlier answers that one of the reasons why ambulances don’t get to people as quickly as we would like them to is because they are waiting to discharge patients into hospitals who themselves cannot discharge patients into social care. I agree with Hefin David that the out-of-hours service has a very important part to play in that. It’s why we’re providing more investment—£20 million more investment in the current financial year—to increase capacity in urgent primary care centres and same-day emergency care. We’re diversifying the workforce. It’s not just a matter of out-of-hours doctors—there are other staff that work in that service. We’re expanding the service, with nine urgent primary care centres now open, two of them in the Aneurin Bevan health board area. They see 5,000 patients a month at the moment, and that’s 15 per cent of the capacity in the system for out-of-hours services overall. And we’re recruiting more staff. Aneurin Bevan, the area that Hefin David will know best, Llywydd, recently advertised for more salaried GPs. They’ve appointed four, there may be four more on the way from that recruitment exercise, and those new salaried GPs are all having out-of-hours sessions included within their job plans. Thirty-three thousand people use the out-of-hours service every month in Wales; 94 per cent of those are treated in their own homes either by a home visit, by the advice that they get, or by attending an out-of-hours centre and being sent home. So, only 6 per cent of all the calls that are seen by the out-of-hours service translate into onward pressure into the hospital system. The out-of-hours service does a very important job. We need it to do more as part of the overall effort to improve the way the interrelated parts of the health service can function effectively together. 

I'd like to thank my colleague Hefin David for raising this question. I took everything you said on board, First Minister, in your response to him just now. The doctors and dentists remuneration board, an independent body set up to advise Governments on the pay of doctors and dentists, reported in July this year and advised that salaried GPs should receive a 4.5 per cent increase to their pay, backdated to April 2022. A large number of the GPs who provide out-of-hours care for patients in Wales are salaried GPs, as opposed to GP partners. I'm hearing reports from the British Medical Association Cymru Wales that some salaried GPs in Aneurin Bevan—and, in fact, all across Welsh health boards—are still yet to receive their fully backdated pay uplift. So, First Minister, as we are now three months on from the DDRB's report, can you confirm that all salaried GPs working in Aneurin Bevan—and, in fact, across all Welsh health boards—have now received their full pay uplift and that it has been backdated to April? Thank you. 

I can confirm that the Welsh Government accepted the recommendations of the DDRB, and that all people who work in the Welsh NHS covered by those recommendations will know that they will receive the uplifts that the board proposed. I'm not in a position to know the precise pay arrangements for every health board and for every person who works for them, but I'm sure that if the Member were to take up her concerns with the health board, they will be able to provide her with an answer.