2. Will the Minister provide an update on the on-going work to ensure equality of care for NHS patients across Wales? OAQ(5)0093(HWS)

I thank the Member for the question. I’ll start by recognising and congratulating her on her award last night in the Welsh Politician of the Year awards. The biggest challenge with equality of care in Wales remains the health inequalities between our wealthier and poorer communities. That’s why we’re rolling out the inverse care law programme more widely, following successful pilots in the Aneurin Bevan and Cwm Taf health board areas. This broad issue was, of course, the focus of this year’s chief medical officer report.

Thank you for your answer, Minister, and for your congratulations. Earlier this year, a constituent of mine, a young mother of three, lost her fight against cancer. Before dying, her partner tried desperately in vain to secure a drug for her that may well have prolonged her life. You may have seen recent media coverage of this case. Her application was rejected on the grounds that her case was not deemed to be exceptional enough, despite the patient’s genetic counsellor telling her that she was the only person in Cwm Taf health board’s boundary to be diagnosed with what I hope is pronounced as Li-Fraumeni syndrome, which is a rare genetic predisposition to cancer. The patient’s oncologist said that they’ve not seen a patient like her, and doubts that she will again. In a heartbreaking account by her partner that I submitted on his behalf to the independent funding request review, he poses the question: what does it take to be clinically exceptional in Wales?

As well as implementing the recommendations from the IPFR review, will you be taking steps to ensure that people with rare forms of illness, including cancer, get the best possible care?

I thank the Member for the question. The case you highlight again reiterates how incredibly difficult these choices are—difficult for clinicians, difficult for the health service in meeting all the various and differing forms of need, in particular the highly specialist and individualised care that you point to, but most of all, incredibly difficult for the individual and their family. I think that’s why it’s important that we’ve agreed to have the review on the independent patient funding request, and that, together with the new treatment fund, demonstrates the commitment we do have to ensuring we do provide the best possible care where medicines are the answer—because they aren’t always the answer. So, I do look forward to what the review has to say about both the national process and the local processes for understanding how the individual patient funding requests are made. In particular, you’ll know that clinical exceptionality is a specific area of the review, and I look forward to receiving the report.

But this Government remains committed to providing the very best care possible, and we will remain committed on the very best basis, the very best evidence base, available to us. That won’t take away from the incredibly difficult decisions that individual clinicians and teams have to make, and that individual families make and have to face up to themselves. But I’m determined we will do the very best possible for each family, wherever they live in Wales.

Cabinet Secretary, obviously the ability to attract staff into the Welsh NHS is a critical component of providing a modern and dynamic NHS here in Wales. The Royal College of Physicians brought forward their survey recently that indicated that of the jobs advertised at consultant level, at least 40 per cent went unfulfilled, and many of them didn’t even have any applicants applying for those jobs. How confident are you that, when this assessment is made in 12 months’ time, the Welsh Government, along with the health boards, will have made progress in attracting more consultants into Wales, and importantly getting applications for jobs wherever those consultant jobs exist in Wales?

Well, the point about the recruitment to the medical workforce are challenges, as you know, across the UK system. Here in Wales, we’re certainly not immune to those challenges, and they vary slightly, but often we see exactly the same challenges in every nation within the UK. So, that’s why our strategy on recruitment and retention is important and that’s why it’s allied to training within Wales and, indeed, encouraging people to come to us to see about the whole package. So, training looks at all those different factors.

But it always goes back to comments I’ve made before, and I’ll make again, about needing to understand what are attractive models of care for people to come to. For example, in Aneurin Bevan, following the reconfiguration of their stroke services, which was difficult—not everyone wanted to see stroke services centralised into a specialised centre—actually we’ve seen outcomes improve for patients. We’ve also made it easier to recruit consultant staff into that new and up-to-date model of care. So, there’s a range of different things that we need to balance.

And part of what we have to do is not just to have an ambition from the Government, but we have to listen to people within the service and work alongside them in understanding how we make Wales a more attractive place for people to come to live in and to work, and what we then need to do for the training and the wider support around that. I also think that the creation of Health Education Wales will put us in a better position to have that broad, strategic overview, to make sure that we have the very best prospects to encourage and recruit and retain all of the staff we need to run a high-quality, modern healthcare system.