Item 6 today is the statement by the Cabinet Secretary for Health and Social Care: investment in the education and training of healthcare professionals—2024-25. I call on the Cabinet Secretary, Eluned Morgan.

Diolch yn fawr. Thank you for the opportunity to make this important statement about investment in education and training of healthcare professionals.

The NHS in Wales makes contact with around 2 million contacts a month in a population of just over 3 million people. The vast Majority of the public are very happy with the service they receive, and this is thanks to the heroic efforts of the 110,000 workers who staff our NHS, in addition to the 80,000 who work in social care. Making sure these staff are highly skilled and well trained is critical to this success, but we must also look to the future to ensure that the workforce of tomorrow is able to be responsive to changes in patients' needs, especially when we consider the changing demography of Wales, with an ageing population with multiple health challenges.

We're determined to ensure that we deliver a workforce that is highly qualified, empowered and inspired. Investment in this area, therefore, is critical. So, despite the extremely challenging financial situation facing the Welsh Government, I agreed this year to maintain the same level of funding for the 2024/25 academic year, as in 2023/24, which was our highest level of investment ever. 

The £283 million invested in the training of healthcare professionals means that we will see an increase in the number of training places compared to the number of places that were actually taken up in the previous year. This investment means we can train up to 2,400 nurses, 224 midwives and 127 paramedics, providing funding in total for over 5,700 training places across various professions and specialties.

Through our continued investment in the provision of NHS education and training, we hope to encourage individuals to consider health and care in Wales as rewarding careers. We will provide excellent learning opportunities to prepare trainees for the future. We're also encouraging innovative and new training and career routes, including 'grow your own' pathways, offering individuals different options from the traditional learning paths, which means that people can train in their own communities, and they don't need to go away to college or university.

Ensuring a sustainable future for general practice in local communities across Wales is a priority, and we've taken steps to improve access to services and incentivise GP recruitment. Our 'Train. Work. Live.' marketing campaign continues to deliver a significant increase in the take-up of GP training places. We've also provided financial incentives to attract GP trainees to specialist training schemes in north, mid and west Wales—areas historically hard to recruit to. Since the introduction of these incentives, 307 trainees have joined the scheme.

There are more front-line NHS Wales staff than ever before. The number of consultants, nurses and midwives has reached a record high. The NHS is the largest employer in Wales, employing over 110,000 people. We are clear that it is equally important to retain our current staff as it is to make sure we're recruiting new staff. This is underpinned via investment in providing vital continued professional development—CPD—opportunities. CPD is essential to support, develop and maintain the skills of our workforce, with clear benefits for workforce well-being, retention and quality and safety of care.

I recognise that work-life balance is becoming increasingly more important, and we need to ensure flexible work and learning opportunities are available. These changes require new thinking at strategic, regional and local levels if we are to maximise our resources and continue to provide high-quality services to patients. This is one of the reasons why I previously announced my decision not just to maintain the NHS Wales bursary, but also to remove the reduced rate maintenance loan. This enables eligible Welsh domiciled NHS bursary students starting or continuing their studies in academic year 2024/25 to access the full amount of the maintenance loan.

Through our programme for government commitment to retain the NHS Wales bursary scheme, we provide a package of financial support for healthcare students who commit to work within the health or social care sectors in Wales for up to two years post qualification. This package of support covers both tuition fees and an element towards living costs. 

I'm considering a public consultation exercise be undertaken in the next 12 months to explore the best and most appropriate way of continuing to support those who choose to study healthcare-related programmes in Wales. As part of this consultation, we aim to ensure that the Welsh system offers comparable benefits with other countries, ensuring Wales remains as a preferred student destination.

Last year,I announced that we will be funding up to 140 medical student places a year at the new north Wales medical school, with direct intake from September of this year onwards. Establishing a medical school in north Wales will help us to train more medical students and will ensure training opportunities and the provision of qualified doctors are spread across Wales. We expect the student numbers to increase steadily and to reach their optimum number from 2029 onwards. The new school will be a boost for the people of north Wales and for the Betsi Cadwaladr University Health Board.

Given that the current financial and workforce challenges are not unique to Wales, I understand that education and training alone are not enough to resolve our immediate workforce and system challenges, and those starting to train in September will not be fully qualified for some years. I also recognise the significant challenges facing our services and workforce today, and this is why, alongside maintaining the significant level of funding for training the new workforce into 2024-25, I retained £5 million within the health budget to be used for nationally run programmes to support ethical international recruitment. This isn't a new initiative. For decades, the NHS in Wales has benefited from the skills and dedication of internationally educated healthcare professionals. As part of Wales in India, I signed an agreement on 1 March with the Government of Kerala to bring qualified healthcare professionals from India to work in the NHS in Wales. Up to 250 professional healthcare workers will be recruited under the new agreement between the Welsh Government and the Kerala Government. This is a direct Government-to-Government relationship, working through a not-for-profit Kerala Government agency. Of course, ethical recruitment is paramount. We must ensure that we're not taking vital staff away from countries facing their own challenges. But we also need to continue to invest in training and retaining our own domestic workforce. International recruitment isn't a silver bullet.

Finally, configuring the future NHS workforce requires thinking about the work to be done and how it can be undertaken effectively and efficiently. We will continue to do this in partnership with key stakeholders to provide the NHS with the workforce it needs to respond to the challenges facing it now and in future. Thank you very much.

The Llywydd took the Chair.

Thank you for the statement, Cabinet Secretary, and also thank you for making it available ahead of time today. Of course, an effective healthcare training strategy is absolutely vital for the success of the health service and the well-being of people across the country. Not only do patients benefit from a well-trained workforce, but people in Wales, particularly younger people who are pursuing a career in healthcare, will benefit too.

So, Cabinet Secretary, let me start by joining you in recognising the incredible efforts of those nearly 200,000 people working in our health and social care services, and also in welcoming a number of points that you've shared in your statement this afternoon. Firstly, I'm pleased that you've acknowledged the need to incentivise GP recruitment. It's good to see progress in this area. I'd be keen to see this continue, because we both know the importance of getting primary healthcare right, and our rural communities have some unique challenges when it comes to recruitment of GPs in those areas.

I think you're also right to recognise the work-life balance and the need for more flexible working arrangements. Focus in this area, in my view, will go a long way in improving recruitment and retention. My concern, perhaps, might be how it's being delivered on the ground, and making sure our health boards are looking at new ways of ensure that flexible work-life balance for people on the ground. And the third area that I'd like to welcome from your statement is the progress at the north Wales medical school. Whilst not huge in terms of raw numbers, I think it's big in terms of its intent and futureproofing of services in north Wales in particular, especially whilst Betsi Cadwaladr still aren't at a place where we'd all want them to be as a health board.

I do, though, think, unfortunately, there are areas that need to be highlighted for continued improvement, because I think much of what's been shared this afternoon is, sadly, just too little, too late. We know that HEIW revised down its recommendations for how many student nurse places should be commissioned for the year we're now in, and the Welsh Government-approved final recommendation was 13 per cent lower than what was originally planned, and indeed 11 per cent lower than the previous year. Now, those are quite startling numbers, particularly when you look at the state of the Cardiff Labour-run NHS, with record waiting lists that, sadly, put Wales at the bottom of our UK-wide league table when it comes to health services. And it's a broader issue in that, last year, the target was just over 2,700 places to be filled, yet only 2,260 places were filled, so I think there are questions to be asked there about why those places weren't filled last year. Perhaps it's thanks to some poor management from the Government that the best and brightest potential healthcare professionals in Wales and across the UK are more reluctant, it seems, to practice their profession in Wales, which for me is very sad, because I think Wales is the best place to live and to work and to bring up a family. So, I wonder, Cabinet Secretary, how this plan and future ones will ensure that every spot is filled and that Welsh Government will be more ambitious instead of removing some of those much-needed training places?

Additionally, I'm aware that the Health and Social Care Committee report from earlier this year made a number of recommendations that would go some way to improving the way we approach education and training of healthcare professionals. For example, recommendation 6 from their report calls for you to commission a piece of research into the use of the Welsh levels of care workforce planning tool. Recommendation 10 from that report calls on you to use the all-Wales nurse staffing programme to commission a mapping of the other workforce planning tools that are available. That's just a couple of examples from their report. But, as the recommendations reference, there have been a number of plans in the past. They're recommending some more plans and tools in the future to help improve the situation for healthcare training in Wales. Of course, plans and strategies are a good thing, but what we do need to see is delivery and a grip of the recruitment and training situation here in Wales. So, Cabinet Secretary, much of what you've shared this afternoon, whilst there were some good points in there, as I said I think much of it is too little, too late. So, I wonder: do you think you can grip this situation, turn the ship around, and solve the problems that, sadly, have plagued our health service for far too long? Thank you very much.

Thank you very much, Sam. As you know, we were very financially challenged in the budget this year. It was because—. I was very grateful to my colleagues around the Cabinet table that they were willing to support health. We've seen an increase of 4 per cent in the NHS budget in Wales, and it's only gone up by 1 per cent in England. What I can tell you is that, actually, we incentivise, as you say, GP recruitment. I think that's very good, and it's been hugely successful. We give £20,000, which is not a small amount of money, to encourage GPs to train in those areas where previously we found it really hard to recruit to, and I'm really pleased that that has made a significant difference.

You're quite right, Sam, in relation to work-life balance. I do think that that is a major consideration. It's probably worth noting that, if you look at doctors, for example, there are far more women training to be doctors now than men. But also men are choosing not to work full time either, so we do have to take that on board, and I think it's probably worth noting that it's no cheaper to train somebody if they work part time. So, the cost to the taxpayer is actually more; because they're working part time, we have to employ more of them. So, that's a challenge. It's not a Welsh challenge—it's a challenge everywhere—but that is the reality. The world has changed since the days when you could call up your GP in the middle of the night and they would come trotting round with their little bag in the middle of the night. Those days are gone. So, we have lots of different things in place.

The work-life balance thing, though, I think is really important, and I'm really pleased that, in the negotiations we had, in particular with the health trade unions, in relation to the workforce implementation plan, one of the things that we committed to was an assumption in favour of granting flexibility if somebody requested it. That has made a huge difference already. We've still got a bit of a way to go, but that was what the people who chose to work in agency previously told us, that, 'We have more flexibility if we work for an agency.' Well, that's not true anymore—that assumption in favour of flexibility—and we have seen a massive reduction in the use of agency already. We've saved about £64 million just in the past year on agency.

Great that you support the opening of the new medical school in Bangor. I think if you just look, though—. You asked about nursing places. Well, of course, they scrapped the nurse bursary in England in 2016. They had to bring it back in, because it was such a disaster, but we, of course, never scrapped it in Wales. But you ask: what difference is it making? I’ll tell you what difference it’s making: the fact is that we have 12 per cent more medical and dental staff in Wales today than we did three years ago, that’s 892 of them; registered nurses, 10 per cent more than we did three years ago, 2,246 more; NHS consultants, 8 per cent more; scientific, therapeutic and technical staff, 15 per cent; 13 per cent more ambulance staff. This is all, I think, something that should be recognised and celebrated.

And just to correct you, Wales is not bottom of the league table when it comes to waiting lists. I think you’d better look that up, and so should the BBC.

Well, as I’ve mentioned on numerous occasions in the Chamber, the health service is nothing without its ranks of committed staff working within it, but, unfortunately, there have been serious problems in terms of staff recruitment that have been prominent for many years. For example, Wales continues to suffer—whatever the Cabinet Secretary has just said—in terms of a shortage of nurses, with a shortage of around 2,700 nurses, while the number of GPs remains significantly lower than the Organisation for Economic Co-operation and Development average, which is why Plaid Cymru is calling for the introduction of 500 new doctors as part of our priorities for this election.

The situation is particularly acute in the context of cancer, where the NHS record in Wales on waiting times has been declining over a period of time, with the latest statistics showing that almost half of Welsh patients can’t start their treatment within the required 62 days. In terms of our oncology staff, we are 11 per cent below the required number, and, because of the demographic of this particular workforce, it’s estimated that that shortfall will go to below 41 per cent over the next four years. Strong investment in education and training in the sector is therefore crucial in order to ensure that the workforce is sustainable in accordance with the demands placed on our health services.

I note the fact that the Government has been able to maintain the same level of expenditure on this element of the health budget, as the Cabinet Secretary said, and that’s to be welcomed, but it’s also worth bearing in mind that this is the first year where the expenditure hasn’t increased, after almost a decade of ongoing increases.

Now, I fully recognise the huge financial pressures that continue to face the Government here, and that is why Plaid Cymru’s demand for fair funding for Wales is so crucial, and why the stance of the Labour leadership on this issue that we saw clearly in the interview with Jo Stevens last week shows a lack complete lack of understanding in terms of our health needs as a nation. Financial fairness for Wales isn’t just a slogan, but the key to creating a health system that can tackle the challenges of the twenty-first century, which includes a population that’s growing older at a faster rate than the rest of the UK. It was very disappointing therefore to hear the words of the First Minister during the leadership debate on Friday that he’d received everything that he'd requested in the Labour manifesto, which suggests clearly that he didn’t ask for financial fairness for Wales from a Labour Government that will come into power next week.

Can I ask the Cabinet Secretary therefore to confirm if a change from the current Barnett formula to a funding formula based on need continues to be a priority for the Welsh Government? And if so, why didn’t the First Minister make a stronger case for this so that it could have been included in the Labour UK manifesto?

It’s also true to say that Wales still isn’t seeing the benefits of the investment going into the health sector in terms of education and training; for example, according to a recent Audit Wales assessment on the NHS workforce, only 43 per cent of doctors trained in Wales actually remain here to work after graduating. So, what plans does the Government have to ensure that Wales can retain more of these health students that do study here in Wales?

And to conclude, I’ve often mentioned the need for the Government to agree a fair settlement with the Royal College of Nursing in their ongoing dispute. Now, clearly, most of this relates to pay, but issues related to internal training opportunities have also been an important issue for nurses in Wales for quite some time. Specifically, CPD opportunities aren't a formal part of nurse contracts, unlike doctors' contracts, which means that nurses don't have the same opportunity in terms of personal development compared to their colleagues in other health sectors. Now, I welcome the fact that the Cabinet Secretary had referred to the need to improve CPD in a number of areas in the health sector, but she didn't specifically refer to nurses in this regard. So, can I ask her whether the Government has any intention to include that as part of the new nurse contract for Wales in the future? Thank you.

Thank you very much, Mabon, and the fact that we have made those changes in terms of ensuring that people can be more flexible in their work, hopefully, will lead to a shift in terms of the number working as agency staff and they'll work directly for the NHS. That's already happening and, as I've said, £64 million has already been saved as a result of that. 

You asked about the report regarding cancer and the number of people working in that field. It's true to say that there's still a gap, and that is a specific concern. Of course, that's partly because we've seen a significant increase in the number of people referred for a cancer investigation—a 50 per cent increase over the past three years. But what I can tell you is that the Royal College of Radiologists has stated that there is a major gap, 41 per cent, and that's come down now to 28 per cent; so, it has come down significantly. They also acknowledge that Wales has had the— 

—largest proportional increase in oncologists across the four nations.

So, 12 per cent of an increase in Wales, 3 per cent in England. The number of oncologists has increased significantly, and there are many more in the pipeline, but these aren't people you can switch on overnight.

In terms of the priorities, we've made it clear, and it's been demonstrated clearly, that this is a priority for the Welsh Government, as was to be seen in the additional funding that we provided for health last year. It's true that we need to retain our workforce; that's vital. One of the ways of doing that is to ensure, if we can, that we get more people to train in that particular area.

It was a very special day last Friday, there was a scheme that had been arranged by the head of Glantaf school that brought students from across south Wales together, those who had an interest in working as doctors or dentists in future. The medical schools were there, and the dentistry school, to ensure that there are more opportunities for people from Wales to access places on courses in Wales.

So, we've seen a huge increase in terms of medicine, we're eager now to see that increase in terms of dentistry. If you train people from Wales, the chances are that they're more likely to stay here, and I think that's vitally important. But I'm very eager to do more work to see how we can retain those people who have been trained here or to ensure, if we're paying for the training, what we get in return as a nation.

I welcome the investment in north Wales at Wrexham University, the training already of allied health professionals, nurses, paramedics, physiotherapists and others. We have got the nursing bursary, unlike in England, and we're also paying social care workers the living wage. We also have a new medical school at Bangor, which is welcome, and social care pathways through Coleg Llandrillo, working with sector partners and employers, which is really welcome. Cabinet Secretary, this is the Welsh Government investing in action and bringing people into the healthcare workforce, which is really valued.

But we also must retain staff, and I welcome what you're saying about this flexibility, because that's what's been told to me, as well, by people there. They were just saying if they could do permanent nights or permanent days, job share, that would be really helpful. So, I really welcome that. But, Cabinet Secretary, if you had adequate funding and if we stopped talking down the NHS, as well, that surely would help with recruitment. I understand that, just before 2010, the uplift every year was 5.4 per cent into the NHS in the UK. Then, after 2010, it was 0.5 per cent and then it stagnated for four years up to COVID, and then, since COVID, we have to really invest to get things going again and reduce those waiting lists. So, that's my question to you: if we'd have had adequate funding and we have it now, will it really make a difference for you?

Thanks very much, and thank you, also, for drawing attention to the fact that it's not just Bangor in north Wales where we're training people for healthcare; Wrexham is really quite significant, and we've got to be absolutely clear that training people in the allied health professions and others is absolutely critical. What we're interested in in the NHS is getting a team. It's got to be a team approach, not just all about doctors and nurses; it's got to be about the broader team. 

I absolutely endorse what you say around flexibility, so I'm really pleased that that's happening. I'd be interested to hear some feedback, if that's not happening. So, obviously, there will be times when it'll be really difficult to offer that flexibility, but there is an assumption in favour of flexibility. That's what we've asked health boards to take on board now. But you're quite right. At the end of the day, it's about funding—how much money do you put in? It's not just about funding, though, because, to be honest, I'm absolutely focused on getting much better efficiency into the system, as well; getting more for what we put in. So, we're doing a huge amount of work on productivity and efficiency and I think we need to go a bit further on that, as well.

But, you're right, if you look at the amount we put in compared to the EU average—. And if you remember, under Tony Blair, he said, 'I'm taking the country up to the EU average'—Gordon Brown was a bit upset, he stole his budget, do you remember that? He used a big word in there, as well. But that's exactly what happened; we came up to the EU average. We are now way below the EU average and that makes a difference. If they don't spend the money in England, we do not get a consequential in Wales and there is a result to that, there is a consequence, and the consequence is that we can't provide the kind of quality that they can provide on the continent, simply because we've seen that erosion over 14 years of a Tory Government.

Thank you very much for your statement this afternoon, Cabinet Secretary. I want to begin by saying how important it is to ensure that Wales provides easy and affordable access to high-quality education and training of healthcare professionals, and we have to be realistic that we're not going to hire more healthcare professionals for our NHS without training and the educational opportunities being available. So, it's very disappointing that the £283 million allocated for the training of healthcare professionals last year has not been increased this year. And I'm disappointed that HEIW were forced to revise their nursing student places downwards.

It's important to bear in mind that not all student healthcare professionals are school leavers; many have been working in the NHS for years, but hit a ceiling when they need to return to education to progress to the next stage of their career—a glass ceiling, in layman's terms. For a working parent, this may not be a possibility. It would be nice, therefore, to see the Welsh Government explore other avenues of training that would allow healthcare professionals to upskill without putting their professional lives on hold for three years.

In north Wales, we need more specialist healthcare courses offered at local universities and we need to retain those professionals in the region. To take speech and language therapy, for example, Wrexham University offers 15 places—the smallest in the country—and this is not enough to keep up with the rising demand for specialists in that particular field.

Secondly, I would like to hear more from the Welsh Government regarding protected time for learning, as I hear regularly from those in the NHS that protected time for training is difficult to obtain, with busy practices and demands, and this would not require a large investment by the Welsh Government, but would pay dividends and would be easier to achieve through management processes and internal matters within health boards. So, I'd be grateful if you could respond to that point as well. Thank you.

Thanks very much. Of course, Gareth, you are one of those people who were trained in the NHS, I don't know if you were trained in Wales—

I was.

—but that is really good, and it's important, I think, that we keep on training the next generation. But, as you say, keeping people in the workforce is also important. What we did do is that we kept the same amount of money, and I think that that is not insignificant in light of the kind of pressures that we were up against in the budget last year. What I can tell you is that there will be more nurse training places available in 2024-25—2,400—than were actually filled last year—2,213. And we are hoping that the nurse bursary and the fact that we've removed the cap on the specific extra support that we give will help us to fill those places.

You're quite right, I think it's really important that we don't just have one channel for people to train. That's why I think growing your own locally makes a lot of sense. There are some great apprenticeship courses, there are some great programmes in places like Hywel Dda and Betsi, where they really are doing that. And, of course, things like the opening of the new nursing facility, which I know the Presiding Officer is very supportive of, in Aberystwyth will pay dividends. They are about to come out, and those people are already making a difference in their communities.

But, you're quite right, I know that there's a big appetite for protected time for learning. With the kind of pressures we see on the system, you can understand why sometimes that is not where it might be, but it's certainly one of those issues that the trade unions raise with us very often. 

Cabinet Secretary, I support a family whose son, Elliot, now six years old, has Duchenne muscular dystrophy, a condition that impacts around 2,500 people in Wales, and they are part of around 170,000 people in Wales in total who have a rare disease. From supporting Elliot and his family, and speaking to experts more broadly about rare diseases, one of the common themes has been a lack of relevant education for health professionals. I am aware that some universities, such as Cardiff, have a rare disease teaching week for undergraduate medical health professionals, and I wonder if that model could be adapted for other undergraduate healthcare courses, such as nursing, midwifery and allied health professionals. I'm also aware that Wales Gene Park embed understanding about rare diseases through their living with genetic conditions education programme. This involves genetic counsellors and someone with lived experience of a rare or genetic condition sharing how the condition impacts them and their family. Do you agree that more awareness raising through sharing lived experience and embedding this kind of teaching across the curriculum would have huge benefits for health professionals, patients and their families? 

Thanks very much, John, and thank you also for the work that you do with Elliot and his family. We are quite focused on rare diseases and, as you know, we have a special programme that really focuses on that. But, you're quite right, we do need to make sure that it's not just a small number of people who are looking out for that and who are expert in it. I think there are real opportunities for us to do a lot more when it comes to online learning. So, to try to encourage more people, scaling up is part of the issue that we really need to address within the NHS, and certainly I'll look into the rare disease teaching week and see if there's anything that we can learn from that. But, you're absolutely right, I think that there's a lot that healthcare workers can learn from simply listening to people with lived experience of that disease. And that is an important thing for us to do. It's important that Llais also gets involved with that. But, I'll take that away and see if there's something else we can do in that space. Diolch yn fawr.

I just wanted to pick up on what you said earlier about how it costs the same to train somebody for a part-time post as for a full-time one. It's an important point, but it's also important that the work that we ask people to do isn't so intense that people can't actually do full-time. And that's why a lot of GPs I know don't work five days a week, because it's relentless, the demand on GPs. They are left, at the end of the day, not having done any of the paperwork that goes with the follow-up of seeing somebody.

Two questions arise out of that. One is how good are, for example, GPs at doing multidisciplinary working, so that it's the diabetes nurse who sees the person with diabetes—a much better outcome there. But also, could you comment on the use of physician associates, which is happening a lot in England, where a lot of primary care services have been taken over by large private companies? They are basically kidding people into thinking that these people, who are semi-trained and simply don't have the training and experience to be able to spot the really serious conditions from the everyday—. Is this something that GPs are considering in Wales, given that a lot of people who have trained to be GPs in England are saying that they can't get jobs? Or is it something that we are going to resist?

Thanks very much. You are quite right, Jenny. I just think about how tiring it is to have a meeting every half an hour, and our GPs are asked to have a meeting every eight minutes. You can imagine the intensity of that, and how difficult that is. So, of course, we need to understand that. But, actually, a lot of them undertake different kinds of work. They don't just do GP work. They might do cluster work or some other work. So, actually, it's much more interesting. It's not all about being on the front line all of the time, and I don't think that that's a bad thing. In relation to paperwork, I am hoping that we are going to see a transformation in relation to that. I think that we have got to start using AI, so that they don't have to be writing everything down—you can be recording something, it can be transposed. The world is just about to change, and we need to make sure that we are ready for that change.

I'm not going to apologise for the fact that we have multidisciplinary teams in Wales. It's a good thing, and that includes physician associates. I think that it's really important to recognise that physician associates have been around for about 20 years in the NHS. In Wales, there are about 220 physician associates working in hospital and general practice, and I can tell you that I have spoken to a lot of GPs who wouldn't be without their physician associates. They do precisely what you are talking about, in terms of that multidisciplinary work. They may be experts in diabetes, for example. They can be taking bloods. They can do lots of things that take the burden away from the GPs. They are always managed by GPs. So, it is important that we make sure that we are very clear about what their role is, and know that they won't be taking over the work of GPs. But I don't think it's something that we should be closing off as an option here in Wales.

I thank the Cabinet Secretary.