4. Will the First Minister make a statement on the increased use of private health care by patients awaiting treatment on the NHS? OQ58843

I thank Llyr Gruffydd for the question. I want to see an NHS that can respond to need in a clinically timely way and that is available to all who choose to use it. The NHS provides almost all of the primary and emergency care provided in Wales. Where patients choose to use the independent sector, they are, of course, free to do so.

Thank you for that response. I want to share with you the experience of a constituent of mine who's a nurse and suffers with carpal tunnel syndrome on both hands. That causes the hands to swell, it brings a burning pain and shooting pain up the arms up to the elbows and, as she is a dental nurse, that has an impact on her ability to work. It also has an impact on her quality of life and well-being as an individual too. Now, having being told that the waiting list, back in July, was 12 months for emergency cases, she received confirmation in September that she is now considered an emergency case, but the waiting list is now two years long. Now, in despair, she's decided that she has no option but to access private treatment and, to fund that, she is having to sell her home. Now, you can accuse us of being pessimists if you choose, but do you think it's acceptable that somebody has to turn to a scenario where they have to sell their home to have access to a private service that should be available on the NHS? And doesn't this highlight the fact that there is an increasing move towards the use of private services, be that intentional or not, under your Government's leadership?

The Member knows that it's impossible for me to respond to a case when I'm hearing the details for the first time in the Chamber. As I said in the original answer, I want to see an NHS in Wales that can provide services to people in a timely way, in every regard and in every part of the service.

And while it's very difficult to hear the sort of case that the Member has outlined this afternoon, it's still important to say that, even if you take the figures that are published by the private sector themselves—and, of course, they are there to make the case for their sector—but if you take their own figures on the use of the private sector in Wales, then, in planned care, 5 per cent of planned care in Wales is provided by the private sector; 95 per cent of it continues to be provided by the NHS. If you take into account the fact that half of operations in Wales are carried out as a result of emergency admission rather than planned admission, that falls to 2 per cent of people in Wales receiving their care through the private sector. And if you begin to take into account things like out-patient appointments, then actually, the fraction of care that is provided by the private sector in Wales falls to less than 1 per cent. So, while I'm always sorry to hear of anybody who has felt obliged to seek treatment outside the Welsh NHS, the global picture continues to show that people in Wales, quite rightly, are able to rely on the NHS to meet their needs, and that it does so for thousands and thousands and thousands of people across Wales every single week.

First Minister, what I've noted is that over the last 12 months in particular, more of my constituents are opting to go for private treatment because they have made that decision that they no longer want to wait on an NHS waiting list, often in pain. On one occasion, one constituent, I know, went into debt in order to pay for private treatment.

Now, the Health and Social Care Committee has heard quite a number of harrowing accounts of people waiting for private health care that has left them in serious debt. One person said this, and I quote: 'The NHS cancelled my scheduled surgery three times, even after my gynaecologist had emphasised how important it was that I have surgery urgently in order to preserve my bowel. Because of this, I paid over £15,000 to have two private surgeries that were essential for my health. This has made a huge impact on my finances and life plans'. My question is, First Minister: what is your advice to people who are on a waiting list, who have the ability to pay for private treatment, and are able to afford to do so? What is your advice to them, and what is your advice to people in the same situation who can't afford to pay but are considering going private, putting themselves into potential debt, because they're concerned about the pain that they're in?

Well, my advice to them is to seek advice from their clinician and then to make an assessment that only they can make. There's no possible advice that either the Member or I can give to people standing here. They should get clinical advice, and then they should make their minds up.

Good afternoon, First Minister. One area where people do not have a choice in relation to whether they go private or not is dental treatment. Getting a dentist in Wales, particularly in a rural area like many of us represent here, is almost impossible. Dentists are choosing, now, to go private. Now, whilst we have always, as adults, paid something towards our treatment, there are many adults who now cannot afford to get dental treatment. But even more concerning, children cannot get an NHS dentist. I'm sure that we would agree that that is an intolerable situation. So, my questions are: do we know how many children in Wales are waiting for an NHS dentist? And could I ask what the Welsh Government is planning to do about that? Diolch yn fawr iawn.

Well, thank you for the question, of course.

In many ways, the core of the problem was set out in the question, which is that dentists are private businesses; they are contractors. They cannot be made to work for the NHS. And we have seen, to a very small extent, in fact, some dentists in Wales move out of the NHS and into private practice. What is the Welsh Government doing about it? Well, I've set this out on the floor a number of times, Llywydd. At the core of what we will do is to change the contract of dentists in the Welsh NHS, and we've done that since 1 April. The huge majority of dentists in Wales have opted for the new contract, and the new contract by itself will create some 126,000 additional NHS appointments here in Wales in the first year of that contract. In the Hywel Dda area, which is part of the area represented by the Member, that has already produced over 8,000 additional NHS appointments, and around half of those are for children. So, there are immediate steps that the Welsh Government has taken, in addition to the further investment that the Minister has made available to health boards for dental purposes this year.

In the longer run, the answer lies in reforming the nature of the profession, to liberalise the profession. We have dentists carrying out activity that you simply do not need somebody with the training and the seniority of a fully qualified dentist to carry out, but the profession has been slower than other parts of primary care to diversify so that there are other people trained and capable of carrying out some of the activities that are needed in dentistry, freeing up the time of the dentist—the most precious resource that we have—to do the things that only a dentist can do. And through the training body that we have, we are increasing the number of people being trained to be able to work alongside dentists to offer those sorts of treatments. The faster we can make that happen, the more treatments there will be and the more children will be able to receive NHS dentistry in the way that we would wish to have in Wales.