Part of the debate – in the Senedd at 3:11 pm on 10 January 2023.
Thank you very much. First of all, I think it is important to recognise not just what we've done, but what we intend to do. And you're quite right, just to give you some ideas of where we're going to be going next, we're going to be making sure that we try and expand the number of hours that those urgent primary care centres are open, so that will divert more people out of those normal hours. Certainly, what I was hearing from people in A&E last week is that, actually, the difficult time is when everything else is shut. So, opening those primary care centres for longer hours would be important. The same thing in relation to same-day emergency care centres. So, that's something else that we're working on.
We have those 100 new ambulance workers that are coming on stream this week and next week. So, that will make a big difference. And, of course, we will be pushing ahead to try and create more of those community beds on top of the 500 that we've already delivered. This is not easy stuff, because you still have to find people. Staffing is the big challenge, particularly when it comes to care, and that's why we have committed to making sure that we keep up with the real living wage as the No. 1 priority in our budget when it comes to health and social care.
Industrial action. Let's be clear: industrial action is going to lead to pressure on the NHS. That's the purpose of a strike, to make sure that people feel a bit of tension and to make their voices heard. So, I don't think I should apologise for that—I think they'd be a bit worried if they didn't think it was having an impact. I think it's really important that one of the issues that we will be discussing, I hope, with the unions later this week is a discussion around the pay review body, the independence of the pay review body, and what we can do to build more confidence into that. We've got to be very careful with this, because if we go away from that, then you're going to get into regional pay and that may not work out the way that some people would like to see in Wales. But I do recognise, I think, there are some issues that we need to look at in relation to the pay review body: when you take the temperature of inflation, for example. So, we saw inflation shoot up after the Ukraine war, and that didn't happen until about February. The temperature was taken of the NHS in terms of pay, inflation, in March/April, and that was at about 6 per cent. Well, now, of course, we know it's well over 10 per cent, so I think there are issues there where we need to see what more can be done in relation to the pay review body.
When it comes to beds, step-down facilities, I'm afraid I'm in the same place as the First Minister: there's no point in creating beds if you can't create the staffing that goes alongside them. One of the real challenges we've had in delivering these 500 extra beds is that, as soon as we're appointing people, some of them are leaving. So, we're losing people before they actually get to the job. This is the challenge. So, this is why I find it fascinating that, only today or yesterday, the UK Government think they're going to fix this for winter. That's not going to happen, because we have found this incredibly challenging, even to deliver on those 500 additional beds.
But there are other things that we can do, and one of the things, I think, we can learn from is the models that are happening in terms of hospital at home. So, it's great to see that's already happening in Cardiff: monitoring 60 people at home who would otherwise be in hospital, making sure that everything is available to them and, if there is an issue, that you can send somebody out to them. We're going to have to embrace new technology. We're going to have to do things differently as we become an ageing population with more complex needs.
We are employing more staff than we've ever employed in the NHS before. We employ now 105,000 people in the NHS in Wales. We are employing more nurses than ever before, so we are recruiting more than we're losing. I think it's really important for people to recognise that: that actually we are recruiting more than we're losing, which is not enough. We know it's not enough, and we know we need to do more, which is why we've seen a huge, huge increase in the number of people we are training with Health Education and Improvement Wales and others. And that's why we've given an additional sum to HEIW in the budget: £265 million to train the next generation of health workers.
When it comes to the targets in relation to vaccination, I'm very pleased. We had a target to reach 75 per cent when it came to COVID and the over-65s. We've reached 80 per cent. On flu, we're at 74.6 per cent, so we're nearly there, and we're very confident that we'll get to 75 per cent in the next few days. It is disappointing to see how few NHS and care workers have taken up the opportunity, and in particular for the flu vaccine. This is something that I have asked over and over again of the health boards to really promote with their members. It's very, very disappointing that that is the case, and again we would keep on asking them to take up that opportunity.
You talked about prevention. I think it's really important that we all understand that we have a role to play when it comes to prevention. We can all do what we can to keep ourselves fit, to eat healthily, to take exercise, to not smoke. All of those things are things that actually will make a big difference to our ability to provide what we can in the NHS in the future. We all know there's an obesity crisis, and it's something that we really need to address, because actually it will translate into complex care necessary in things like type 2 diabetes.
The other thing, I think, just to be clear, is that I have set out some very clear guidelines in terms of what I'm expecting from the NHS next year, and priorities. They are going to be far more targeted priorities to make sure that we focus our attention on the things that I think matter most to the people of Wales. One of those things that we've made very clear in our report and in our strategy, 'A Healthier Wales', is that actually we need to see more care in the community. We need to get more support out from our hospitals into our communities. When we're talking about discharge from hospitals, for example, a lot of those assessments at the moment are being done in hospitals. The clinical evidence suggests that you should be doing it in people's homes. So, that shift is something that again we'll be pushing the NHS hard on when it comes to them developing their strategies for the future.