3. Will the Minister make a statement on access to NHS services in north Wales? OAQ(5)0020(HWS)

Thank you for the question. The vast Majority of people access the NHS through primary care. We remain committed to improving access to primary care, working with clusters. This will include new initiatives like improving pharmacy-based services and physiotherapy-based services and other therapies as well. We will of course maintain our commitment to also providing high-quality care within our hospitals.

It doesn’t surprise me, Cabinet Secretary, that you fail to mention the referral-to-treatment-times targets, which of course have been missed on a regular basis and have been for many years here in Wales. And, of course, the hospital that serves my constituents, Ysbyty Glan Clwyd in Bodelwyddan, has some appalling referral-to-treatment times that it’s currently working to: ear, nose and throat appointments, 36 weeks, just for the first outpatient appointment; restorative dentistry, 35 weeks; orthodontics, 76 weeks from referral to first appointment; pain management, 42 weeks. The list goes on. When are you going to pull your finger out and get this situation sorted, so that my constituents can get access to services when they need them?

Thank you for the question, put with your usual calm and dignified manner. I would, of course, note that, in complaining about no reference to RTT, there was no reference to RTT in your question. If you want an RTT question answered, then actually ask it. When it comes to RTT across the NHS, we’ve actually seen significant improvements in the last six months. [Interruption.] I’ll answer your question if you want to be quiet and actually let me speak. In the last six months, we saw significant progress in RTT within Wales—a really impressive improvement right across the NHS. But we recognise that we have real challenges in maintaining and improving headline performance, including RTT, as well as resolving and reforming the services that deliver that. What we can’t do is expect to see sustained improvement in RTT if we don’t change the models of care that we are running. Just putting more resource into that won’t deliver the sort of services that people expect and deserve.

So, we need to manage two things: we need to make sure that, in a difficult time with less financial resource, we do make sure that we see improvement in that headline rate of performance, and, at the same time, the way in which that care is provided changes as well. That’s why the planned care programme, with plans for orthopaedics, ENT and ophthalmology, to name but three, is really important, because changing the way we provide these services is actually the real answer to having the high-quality care people expect in the industrial volumes in which people do now attend for these particular treatments. So, I’m actually optimistic about what we’ll be able to achieve in Wales, and I hope that your constituents, and others, will see a real difference in the quality of care provided, the outcomes of that care, and the experience of the care that they receive from our national health service.

Cabinet Secretary, would you agree with me that giving patients faster access to the appropriate service or healthcare professional is critical to ensuring that people are treated as quickly as possible? Therefore, what steps are being taken in north Wales to ensure that patients have the option to be treated by the right healthcare professionals whilst also supporting our GPs?

Well, I absolutely agree with the point that is being made, and this is part of the challenge of dealing with headline RTT, actually, because lots of people who are on lists at present don’t actually need operative procedures, and so, it’s partly about making sure they go to the right place at the right time at the start of their care journey. So, for example—I’ve talked about this before and I’ll keep on saying it, because it is a really good and obvious example—physiotherapy services and primary care. About 30 per cent of people who attend GP appointments have musculoskeletal problems. Almost all of those people could see the physiotherapist first, and most of those people will have their issues resolved by the physio. If they then need to be referred on, either to a GP or a specialist, that can take place. That will release pressure away from the GP—and also what we’re doing in pharmacy as well. The Choose Pharmacy platform is really important, because of not just the value of the minor ailments scheme, which is of value in itself—and we’ve seen examples of significant percentages of people being deferred away from the GP to pharmacy appropriately—but also the opportunity for more services to be delivered in the community pharmacy setting, releasing time and pressure for GPs to see people who really do need them and the expertise that they provide. So, that will be a consistent theme of this Government, and I believe patients will see a definite difference and improvement as a result.

Following a decision taken by health chiefs in Cheshire to close a special unit for babies born before 32 weeks in the Countess of Chester Hospital because of the increase in the number of deaths there, and to move it to Arrowe Park, can you tell us what impact this will have on babies from Wales and intensive care services for newborn babies in north Wales?

I thank the Member for the question—I’m aware of the issue, which is obviously a serious one. We do have proper commissioning arrangements for care where it’s needed for babies to travel, but the additional potential travel is an issue that we need to think about, and how we support families. I’m interested in making sure that, in the care that we do need to commission, where people will naturally need to go for services across the border in different parts of Wales, that we’re properly assured about the quality of care that is provided, but also that our families are supported when they need to go over the border for this particular specialist care, but also, with the special care that we provide within Wales, that we assure ourselves about the quality of care and the sustainability of that care as well. So, it does mean that there are difficult choices for us to make about properly concentrating the very specialist care that this does represent and making sure that people have good, quality access to the very best care, and not simply making sure that we provide lots of different services that aren’t sustainable and that don’t provide the right quality of care that I think families and babies deserve.