1. Will the First Minister provide an update on healthcare provision in north Wales? OQ61115

Thank you. Healthcare overall in north Wales is not where I, nor indeed the staff delivering those services, would want it to be. As part of the special measures escalation, the Welsh Government is working closely with Betsi Cadwaladr University Health Board to improve access to the safe and timely health and care that the people of north Wales deserve.

Well, thank you for your response, First Minister. And, Llywydd, the First Minister will be aware that, just last week, a black alert was issued in the north Wales health board because hospitals could not cope with the bank holiday levels of demand, and, sadly, this is far too often an occurrence for the residents that I represent in north Wales. And you'll also be aware that, of course, just before the last Senedd election, you felt it right to pull that health board out of special measures, and, then, inevitably, very quickly after the Senedd elections, the health board went straight back into special measures.

Now, things are as bad as they ever have been for the residents that I represent in north Wales, and I shared in this Chamber last week the example of one of my residents who is, sadly, terminally ill with cancer, who had to wait more than 24 hours in an A&E department. So, First Minister, because of the regularity of these occurrences, and because of the severity of the issues that my residents are suffering, would you not think that now is the time for an independent review of the health board, so that the people that I represent can get the healthcare that they deserve?

Thank you for the question. Before I deal with the substance of the points, there is a broader point that I want to make, that I hope will have support across the Chamber, because it's just over a week or so ago that there was a case of measles identified following someone who attended Wrexham Maelor. That actual 24-year-old was not vaccinated; they were visiting and actually attended from England to come to the hospital. There's a broader point here—and I think I made this in response to Peter Fox previously—about measles vaccination. It is a serious issue for people across all sides in this Chamber and beyond to encourage adults who are unvaccinated, or under-vaccinated, as well as children, to get vaccinated, because there is a real issue with the scale of measles outbreaks across the country, and it shows that, whilst we have a better position on vaccination than England, we're not immune to the challenges that do exist.

On your questions about, in particular, unscheduled and emergency care, this is an area where we know there's further improvement that is required. I can't comment on individual waits, but I recognise, as indeed does the Cabinet Secretary, that there are too many people who have an experience of waiting too long in an emergency department, or, indeed, an experience that we would not wish for our own loved ones as well. That's why there's a range of improvement action that is taking place. There's some extra resource available. So, there's £2 million for the health board in the financial year that we're just entering, and, indeed, in January, the Cabinet Secretary announced money for the whole of Wales, and Betsi Cadwaladr got the largest share of that. There's quite a lot of work that is being done on trying to make sure that people get to the most appropriate point for their care—so, for example, the same-day emergency service that has been created since Eluned Morgan became the Cabinet Secretary and the additional roll-out of urgent primary care that has taken place across north Wales. Those are thousands of people who are getting seen in a more prompt manner because that is the right thing to do for them. 

What we actually have is both the twin challenges of needing to transform our system whilst at the same time seeing demand increase. I think, in February this year, compared to a year before, there's been a 24 per cent increase in demand coming in through our emergency departments, and that's a huge additional wave of demand that we need to be able to see and cope with. What makes that much harder is that we're not able to get people out of hospital when they're medically fit for discharge. And the Member will know, as a former leader of a local authority, that this is joint work between health and local government, to make sure that when the hospital is no longer the right place for their care, those people can leave. In north Wales, there are regularly more than 300 people who are medically fit for discharge but can't leave. To give context to that, that's about two thirds of the entire bed space in Ysbyty Glan Clwyd. Now, it's in the interest of all of us to work together because, for that person who is in the wrong place, it's actually not a great experience for them, they're actually then subject to additional risks of decommissioning, and the Member will know this from his own time when he had a real job before politics, and actually thinking about the need to make sure that people are properly able to get around and about. So, this is a shared challenge for the two biggest sectors of the public sector, and, crucially, for those individuals as well. Those are the issues we face, and that is what we're going to carry on focusing on with our attention, together with partners and stakeholders.

One of the most prominent issues we have in the healthcare provision in north Wales is the long waiting lists. Take Ehlers-Danlos syndromes patients, for example. Over the border in England, patients there are referred straightaway to specialists, but Ehlers-Danlos patients in north Wales have to make an application for individual patient funding, which is, more often than not, rejected, which means, in turn, that they have to go without the vital care that they need for this serious condition. Do you, First Minister, belive that it's right that Ehlers-Danlos patients have to suffer in this way in north Wales, and will you commit to ensuring that patients in north Wales—and the whole of Wales, indeed—are referred directly, without having to wait and make applications for individual funding?

I'm not aware of the individual issue the Member raises. If he writes to me and the Cabinet Secretary for health, we'll happily look into that to see if there is a system-wide change that we could make. Actually, when it comes to access to new medication, we actually do better in Wales than in other parts of the UK. The new treatment fund, which I was proud that we introduced at the start of the last Senedd term, has made a real difference in getting new treatments available promptly and consistently across Wales. If that isn't the case in the area that the Member refers to, then I'd be interested in how we can look at that to understand if there is improvement action that we can take not just for north Wales, but across the whole country.

There is a lot of positivity happening as well in the NHS—a lot of people are being seen, and I welcome investment in north Wales, with the new orthopaedic unit being built, well-being hubs, investment in community provision, and extended hours to minor injury units, which is making a difference. I also welcome the new medical school for north Wales, and the new medical training centre for nurses, paramedics and other allied health professionals in Wrexham. And there are training pathways for social healthcare learners at Coleg Llandrillo, which is really positive. Recruitment and retention is really important. I don't want to keep talking the NHS down. However, I am concerned about the retention of staff. I've heard that a dermatologist has recently left to work in the private sector, which we don't want to happen. Betsi employs 19,000 people, and it's really important to the local economy as well, as an employer. So, to improve retention, we need to look at working conditions—offering flexibility, through reduced hours, perhaps, and job shares, would be a good way forward, if possible. First Minister, do you agree that, by investing in people, we can grow both our healthcare workforce and our local economy? Thank you.

Thank you for the question. I think it's important to reflect, as the Member does, that, whilst there are challenges on healthcare delivery in north Wales, which we acknowledge—that's why there's the special measures framework, and it's why the Cabinet Secretary spends a lot of her time poring over the detail of the improvements that are still required—for most people, they actually have a good experience of healthcare, and that is because of the fantastic work that our staff do, the dedication and the skill they have, and the continued transformation and improvement we're seeking to make.

I'm glad the Member made the point about the importance of the health board as an employer in the economy. Nearly 20,000 people being employed has a significant impact in local economies, right across the area. And I do think that's, therefore, about how you retain staff. It is about what we're doing to invest in the future—our current staff want to see investment in the future, for them to stay. I'm very proud of the steps that this Government has taken to help create a new medical school. We've worked with other partners in doing that in the past, in conversation with Plaid Cymru and others, but we are delivering a budget to make sure that that happens. And in the autumn of this year, the first intake to Bangor medical school will take place, the first direct students, and, by 2029, it will have reached its full capacity—doctors trained in Wales, for Wales. And that is important for our current medical and allied workforce as well, to see that investment taking place.

That goes alongside the point the Member finished on, about having a flexible approach to conditions. As our workforce shifts and trains, as our expectations have done—. It used to be the case that doctors expected to work punishingly long hours during their training. They accepted that as part of what happened, and yet, actually, none of us, I think, would now say that it's acceptable for doctors to work those extraordinary hours. And doctors are humans who want to have other relationships too. So, a flexible approach, where possible, to meet the needs of the patient and the person is what we do want our NHS to progressively undertake and deliver. It's a point well made. I hope the Member will see good examples of that in the health service across north Wales and beyond.