Part of the debate – in the Senedd at 3:19 pm on 10 January 2023.
Thanks very much, Alun. Certainly, I think there are major, major challenges for the NHS. It's important that we recognise and talk about them and that that's a conversation we need with the public. This is not something that should remain in this Chamber, because these are going to be really tough decisions that everyone's going to have to live with. So, if you think about the opportunities that are available to us today that weren't available in the past, which are incredible, I saw a baby in the Heath last Friday who was born at 21 weeks—an absolute miracle. And there's no question that that baby would have died in the past. We've got to understand that that's a miracle, it's wonderful, it's because the NHS works that that baby is alive today, but that comes with some choices that we have to make. And so I think we have to have a conversation about where our priorities are within the NHS.
There are also, of course, new developments all of the time. Some of that will be really helpful to us. Digital remote consultations I think are really positive things that have already happened and have transformed the way we deliver care already. But I think the key thing in terms of where the challenges are in future—. I think there are some issues around capital that we're going to have to deal with, how are we going to deliver with the facilities that we've got, but also I think we do have to have that conversation about changes in society. When Aneurin Bevan set up the NHS in 1948, people worked until they were about 65 and they died when they were about 68. And that's the reality. It's great that people live for much, much longer than that, but our structure has not fundamentally changed to reflect that difference.
The missing gap is what do we do within that care space. Obviously, local authorities are doing their very best in that space, but obviously they have limitations also on their economic abilities. So, that is the space, I think, that we need a very challenging conversation with the Welsh public around: what we're going to do to support people in an ageing population with more complex care needs. Because along with an ageing population comes a more challenging situation in relation to what kind of complex cases you're having to deal with. So, we're not just dealing with someone going into hospital, say, with cancer; they might have cancer and diabetes and a bad ear, or lots of things at the same time. And we just have to understand that those are the kind of challenges that we're facing in future.