Item 4 this afternoon is a statement by the Minister for Health and Social Services on the Health Service Procurement (Wales) Bill. I call on the Minister, Eluned Morgan.

Diolch yn fawr, Dirprwy Lywydd. I'm pleased to have the opportunity to make a statement on the Health Service Procurement (Wales) Bill, which I introduced to the Senedd yesterday, together with the accompanying explanatory memorandum and regulatory impact assessment.

The Bill seeks to reform the way in which certain NHS healthcare services are procured in Wales, bringing forward primary legislative powers and enabling the Welsh Ministers to create a new regime for NHS health service procurement. The powers within the Bill support the aims and objectives of our 'A Healthier Wales' strategy and this Government's commitment to provide effective, high-quality and sustainable health care, by supporting the NHS in Wales to deliver better health outcomes for the citizens of Wales.

The provisions in the Bill are partly in response to proposed changes established as a result of the UK Government's Health and Care Act 2022, under which there are plans to introduce regulations and a new regime for the procurement of NHS health services in England. The Department of Health and Social Care's provider selection regime, applicable only to the procurement of health services in England, will aim to improve patient outcomes by seeking to remove unnecessary bureaucracy from the process of working with independent healthcare providers, by encouraging collaboration and partnerships.

The provider selection regime will therefore give NHS England more flexibility to procure and arrange health services. As a consequence, these new arrangements may have an impact on NHS Wales's ability to maintain and secure health services in Wales when working with independent providers. To ensure that health service procurement in Wales is not disadvantaged as a result of introducing the provider selection regime in England, we too need to ensure that the NHS in Wales also has the ability to benefit from more flexible procurement practices.

The provisions in the Bill and the future regulations will facilitate that flexibility, providing a supportive mechanism that aims to maintain the current procurement level playing field for NHS health services between England and Wales. This will assist in mitigating the risk of NHS Wales being adversely affected by the operation of a different health service procurement regime in England. It will retain the ability for the NHS in Wales to commission independent health service providers on a co-compliant and collaborative basis, in turn supporting and optimising financial and staff resources, supporting the NHS in Wales to deliver efficiently and effectively.

Measures in the Bill will also aim to mitigate any potential market distortion by ensuring that the Welsh health service marketplace remains attractive to independent health service providers who may otherwise be deterred by having to participate in two different procurement regimes between England and Wales. It is hoped that a more flexible, collaborative and less bureaucratic approach will open up more supplier opportunities for small and medium-sized enterprises and third sector organisations based here in Wales and, therefore, as a consequence, bring economic benefits across other programme for government priorities, such as our commitment to the foundational economy of Wales.

The draft Bill seeks to bring forward two regulation-making powers. Firstly, it will include a disapplication power, which will enable Welsh Ministers to dissaply provisions of the UK Government procurement Act that would otherwise apply to NHS health service procurement in Wales. Secondly, it will include a creation power to enable the Welsh Ministers to develop and implement a new, alternative procurement regime for NHS health services in Wales. This will be done through future regulations that will be accompanied by new procurement regime guidance, and these will be co-designed and implemented by the NHS in Wales.

The provider selection regime in England is expected to commence later this year. Therefore, to reduce any potential market distortion and to ensure continued delivery of key NHS health services in Wales, there is some urgency to minimise the period of time when NHS health service procurement platforms in England and Wales will operate on a different basis. And as such, it's proposed that the Bill follows an expedited timetable to seek Royal Assent this summer and to future regulations aiming to come into force early next year. This timeline will also seek to maximise procedural efficiencies for NHS Wales by coinciding with wider changes being brought about as part of the UK Government's Procurement Bill reforms, which are currently programmed for next year.

Whilst we need to be mindful that any new regime and any future regulations and guidelines need to operate on a similar basis to the proposed provider selection regime in England, Welsh Ministers have the necessary legislative competence and ability to design a new regime that best suits the specific needs of Wales in terms of patient care and health outcomes. The practical details of how this will work will be explored further and defined at the future regulation stage.

In conclusion, the proposed Bill will provide the necessary powers to enable future regulations to adapt and respond to proposed changes being introduced to NHS health service procurement in England. Consequently, they will bring about a new procurement regime for NHS health services in Wales to support patient care and better health outcomes for the citizens of Wales. I am pleased to introduce this Bill and very much look forward to the contributions of Senedd Members today, and, of course, in the coming weeks, as part of the Senedd scrutiny process. Thank you.

Minister, can I thank you in advance for the briefing that you gave to the Health and Social Care Committee last week? I know that your officials are going to be providing a technical briefing to Members as well, so that's of course appreciated. Of course, we do need to ensure that the NHS is nimble enough in its procurement practices so it doesn't fall behind other parts of the UK. As I've understood—and I'm still learning—the Bill to date, I understand why you're bringing this Bill forward, but there are some questions I have that sit behind that.

I do think, Minister, it's right, of course, to highlight that we don't want Wales to fall behind or be disadvantaged compared to England when it comes to health procurement, but I suppose it would be helpful if you could set out anything that helps us to understand how we got into this position in the first place. Then there's the position of whether an LCM could have been brought forward via the legislation being passed through the UK Parliament. That would have, of course, saved the Senedd and indeed Welsh Government valuable time. So, I wonder if the Welsh Government actively sought this legislative route, and if not, perhaps you could outline some of the obstacles that sat behind that decision.

This is an enabling Bill, so, as is often said, the devil is in the detail of the regulations that will be made using the powers that this law will create. So, given that secondary legislation will be perhaps the more significant part of this Bill, I hope that won't be contentious, but I am of course pleased that the Senedd will be allowed to vote on them as they will be part of the affirmative procedure, as I've understood it. But we do need to understand the policy intention behind the Bill, so I wonder, Minister, whether you can tell us what these regulations to follow might look like, and which health services in particular would these powers be used for.

We were also told that it's particularly important for those NHS services that deliver for patients near the England-Wales border, and of course I would have an interest in that. So, can I ask if you have any examples of where this would apply, especially for NHS-to-NHS services? And given that the Bill is about giving the Welsh Government flexibility in procuring the services of independent providers, does this mean at all that the Labour Government here is intent on increasing the use of private services in the NHS at all? Can we expect this to occur?

Also, just to understand how this Bill might help those 50,000 people who are of course waiting for over two years for treatment. I know your target is approaching, to eliminate the backlog by the end of March, and I think you'll probably confirm that that is unlikely to be achieved, but how would this Bill help in that regard?

I think the Senedd and the public perhaps would also benefit from an explanation of how the provider selection regime, or the PSR, would—. How that would—. An explanation of that. It would be good, perhaps, to hear the Minister perhaps illustrate what changes we can expect in that regard.

Finally, when the regulations do come forward, how much can we expect those to mirror the regulations that the UK Government is bringing forward? Will it be, for example, word for word? Would it be lifted out of the UK Government's legislation? And perhaps you could talk about the degree of collaboration, if any, with the Department of Health and Social Care.

Thanks very much. There are lots of questions there. If I'm honest, this is not the most exciting Bill that this Senedd has ever seen. What we're doing here is responding to the fact that what has happened in England is they've presented this new Bill that will allow some organisations, perhaps, not to have to retender. Sometimes that takes a lot of energy, effort and finance, when actually the service that they're providing is pretty good. So, I think that's the intention from the UK Government's point of view.

We did ask, 'Listen, can you just slip us in there? Why don't you just add our name to that?' And actually, they said that they couldn't provide Welsh Ministers with the two necessary powers to disapply the current procurement rules and to create the new rules. That's why we're in this situation. So, we did ask that question, and that's why we're having to bring this forward now, because otherwise there will be, effectively, a gap and there's going to be a difference in terms of the different procurement regimes between Wales and England. 

We don't want to be disadvantaged. This is an enabling Bill, it's a framework Bill. As you said, the more exciting bits, the bits that bring this thing to life, will come when secondary legislation comes in. I'm pleased to say that the Senedd will have a chance to look at that detail through the affirmative procedure. That's the bit that I think everybody needs to get excited about; this is just creating the framework.

In terms of whether we'll just cut and paste whatever they do in England, we haven't seen what they're going to do in England yet. We haven't seen the detail of their secondary legislation. So, we don't know whether we want to copy and paste that. We'll have to have a look. It may be that we want to do things differently. Maybe we want to skew things in a slightly different way from what they're intending to do in England. It's about keeping an open mind and seeing what they come up with. But at least we will have the flexibility to respond if we need to.

There are, I think, opportunities. There are lots of areas where we do procure from across the border in England for highly specialised services, and there's no reason why we would want that to stop, necessarily. There are, for example, renal services, child and adult mental health services where it's really, really specialised, and those services may not be available in Wales. What we can do then is to go under the same procurement banner as they would in England.

You asked about the border, and you're absolutely right; there are examples, for example out-of-hours GP services. There is an example in Powys where the out-of-hours service is shared between Wales and England on the border. That would be really difficult for us to do in future unless we've got a common procurement framework. There will be examples where we want to do this. If the regulations come forward, we'll have to see whether we agree with them or not in terms of what England wants to do. But we'll have a chance to discuss that in the Senedd at that time.  

Thank you for the statement this afternoon, Minister, and for the briefing provided to us beforehand. It's a little unclear at this point some of the things that we will discover as this proceeds over the next weeks and months. I have listened to the Minister's rationale for her belief that this is necessary and that there needs to be a level of protection because of legislation being introduced over the border in England that could create the kind of distortion that may be problematic to us. In that context, I want to be pragmatic and fully understand what the practical impacts of that may be and what is the practical need for taking this step in Wales. The fundamental problem that I have is why the Government in Westminster, or rather in Whitehall, is introducing this change when the Minister tells us today:

'The provider selection regime will therefore give NHS England more flexibility to procure and arrange health services.'

I don't trust the motives of the Conservative Government for wanting to do that, and there will be issues of principle leading me through this process. The fundamental principle is that I don't want to see this as a means for the private sector to lay down deeper roots within the provision of health services in Wales, and to be able to set those roots far more easily than they would have been able to do in the past. So, I would like to hear from the Minister on the record that she shares those concerns.

It is a concern of mine that there is an expedited process for scrutiny of this. Because I want to be pragmatic and to understand exactly what's at stake here, it's a cause of concern that that scrutiny period is shorter than it perhaps should be. So, what confidence can the Minister give me that the period, even if it is shorter than usual, will allow the same depth of scrutiny? Because we do need to be entirely clear that we look at all of the possible implications here. I will be pragmatic, as I've said, but those concerns do mean that the scrutiny is extremely important. I know that other Members on these benches share my concerns, and I would welcome the Minister's comments on her concerns.

One specific question that I have asked previously, and I just wanted to know if there are any early findings coming from the work done by Government here: procurement in a more streamlined way would make it easier to give contracts to the third sector, not just to the private sector. I have wondered whether we can differentiate between third sector and private-sector provision within this legislation. I would appreciate an update on any work that is been being done on that possibility.

Thank you very much. I do think that we do need to keep a weather eye on what is happening, and we do need to bear in mind that this is a very brief Bill. So, what we're talking about here is a framework, and what will be important is what will go into that framework, and that's why it's important that we'll have an opportunity to come back to discuss the details of what goes into the framework. That'll be the point at which it will be much more of a political issue, and that's the point where we'll have to look at whether what's being proposed in England is appropriate for us here in Wales too. So, I don't think that this initial phase is as contentious as that; it's the second phase that will be, and of course, we'll have to come back to the Senedd for that.

I do share your concerns in terms of the private sector, and we have to be vigilant in that regard, but I also think that there are examples where the third sector, for example, does excellent work, and what is a barrier to them—and I'm sure you've discussed this with some of them, too—is that they have to jump through all of these hoops, even though they provide such a good service. Why do we have to go through that process time and time again even though the service they provide is so good? That causes difficulties in terms of keeping people in their posts and so on. So, I think that there are aspects that will be of assistance to the third sector, and that is something that I would be comfortable with. I just want to be clear: in terms of the reason why—.

Just to go back to Russell's point earlier in terms of why we couldn't get into the first Health and Care Act, the point there is that the scope of the Health and Care Act was for England, so that's why it was difficult for us to say—. It was about the scope of the Act itself, which meant that it was difficult for us to join in. It was just applied to England, so they were reluctant. Usually, I think, when it comes to LCMs, they're dealing with broader issues, but this is very much a very carefully defined devolved area, which is why I guess the scope was quite defined for them.

And finally, Joyce Watson.

Diolch, Dirprwy Lywydd. I thank you, Minister, for your statement. As you say, the first stage of this is a framework Bill, and the second stage will be where the detail lies. When I put the term 'flexible procurement in the NHS' and the Tories together, I get really concerned, as most of the country should be, because we will remember the personal protective equipment fiasco that happened with the flexible VIP fast-tracking, or, if you like, in my words, fast-profiting, regime being put together. We need to clearly keep a watching brief. We know that there's going to be a provider selection regime and we need to know more about how that will look in Wales, because you're absolutely right not to go down the same road as we suspect the Tories in England will do and give jobs to those people who invest in that party. They've got a good track record in putting those two things together. We don't wish to follow that, and we want legislation that will safeguard, first of all, the NHS in Wales in and of itself, but also, of course, the patients, because it would be those people who'd be receiving that care and receiving the outcomes from that care who have to be at the absolute centre of everything that we do. Yes, we would have all liked more time, but, as you say, the first stage is a framework, so it has to go through as it is—

You need to conclude now, Joyce, please.

My question to you, Minister, is: when you exercise the second part of this, will you give adequate time, or more time, certainly, to scrutinise what will be in that framework so that we can all be assured that those things that I've just outlined happening over the border won't happen here in Wales?

Thanks very much, Joyce. I just want to reassure you, really, that we'll be the ones who decide what it looks like in Wales. If we like what they're doing in England, we can copy it. If we don't like it, we don't have to copy it. But we've got the framework now to make those decisions. What we are talking about here is quite often highly specialised services that we can't offer in Wales, so we're not in a position, very often, to make choices; it's either there, or you don't get a service. We've got to keep an eye on what is good for the patient constantly, and that is part of what we need to do here, which is why, for example—. You represent also a border constituency. Shropdoc, the out-of-hours service, is co-commissioned with health boards in England and Powys health authority, so it would be much more difficult to do that in future, which means that the cover for the people living in those border areas out of hours would be very, very difficult to provide. It may be that in that example, there wouldn't be enough people on the Welsh side for people to tender for that service. So, it is about being practical, this, I think, and just keeping our eye on what is best for the patients, but without losing that ideological lens that I think we're all very committed to.

Thank you, Minister.