5. Statement by the Cabinet Secretary for Health and Social Care: Access to Primary and Community Care Services

Part of the debate – in the Senedd at 4:27 pm on 21 January 2025.

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Photo of James Evans James Evans Conservative 4:27, 21 January 2025

I would like to thank the Cabinet Secretary for his statement today, and I'd also like to add my thanks to all those people working in community and primary care, right the way across Wales.

Just to pick up, Cabinet Secretary, on the £5 million of recurring funding for community allied health professional services, it would be interesting to know from you how that money is allocated across health boards across Wales, and how the Welsh Government tracks that to measure on deliverability across the service. The statement indicated that primary care professionals are managing increased patient load and offering a broader range of services closer to home. Yet the data from the British Medical Association's Save our Surgeries campaign reveals concerning trends. As of 31 March last year, the number of GP practices in Wales decreased from 474 down to 374—a reduction of 100 surgeries—and the full-time-equivalent number of GPs has declined by 25 per cent since 2012, with a further 3.8 per cent decrease since the campaign's inception in 2023. So, given these statistics, Cabinet Secretary, how does the Welsh Government plan to address the diminishing number of GP practices to the escalating patient/GP ratio, to make sure that people can have that efficient care right the way across Wales? Because we've heard examples, haven't we, from Members? I'm thinking of Alun Davies, up in Blaenau Gwent, about the eHarleyStreet practice, about the number of people there seeing the number of GPs available.

The Government's commitment to upskilling healthcare professionals is very commendable. However, the Royal College of General Practitioners has highlighted some significant challenges and that, in 2024, nearly 20 per cent of GPs reported feeling stressed and unable to cope with most days, and over 40 per cent experiencing such feelings at least once or twice a week, and more than 40 per cent of GPs are considering leaving the profession within five years, citing work-life balances and the stresses as primary factors. Given these statistics, Cabinet Secretary, what measures is the Welsh Government implementing to improve the retention of GPs and their well-being, to ensure that we invest in training, and that it does translate into sustained patient care across Wales?

You mentioned optometry and pharmacy services, and the expansion of those services is a positive development. It's something that we on these benches welcomed. However, the effectiveness of these services depends on public awareness and accessibility, doesn't it? Public Health Wales introduced the new primary care clusters dashboard in September last year to aid in the planning and address inequality. So, how is the Welsh Government utilising this dashboard to promote and monitor the effectiveness of expanded optometry and pharmacy services to make sure there's equitable access for all communities? And as I said, we need to ensure that people know that these services are out there. A lot of people who I speak to don't know about the common ailments service, and that actually they can go to their pharmacies to actually get these conditions seen—as I say, sore throats and different things, chest infections, for example—so it's good to know what the Welsh Government is doing to promote that across the system.

It did touch, the statement did, on dentistry. While the statement notes that over 420,000 new patients received full dental treatment since April 2022, access to NHS dentistry remains a concern. The Royal College of General Practitioners 2024 general election manifesto emphasised the need for sustainable career options in NHS dentistry. So, what strategies are being implemented to make sure that NHS dentistry is an attractive and sustainable career choice? Because many of the dentists that I speak to say that they cannot afford to continue doing what they do now. And you said about the contract reforms coming into place, which you hope will be in place by the end of 2026. This has been ongoing since 2021. The now First Minister Eluned Morgan made a statement on this in 2021, saying it was going to be done and dusted very shortly, so I'd like to know what assurance you can give to the dentists across the country that this is going to be addressed. And also on dentistry as well, there's a growing concern about dental decay in young children across the country; 32.4 per cent of children in Wales are presenting with dental decay, compared to 23.7 per cent in England, so I'd like to know what more you're doing to improve access for children to dentist services as well.

So, I want to talk just a bit more about community care services. The addition of over 100 allied health professional positions and the 49 full-time district nurses is encouraging, and I just want to pay tribute to the role of our district nurses. They do an absolutely fantastic job across our communities. However, the Health Education and Improvement Wales strategic workforce plan for primary care highlights the need for ongoing workforce stability, so how is the Welsh Government ensuring the long-term sustainability of the community care workforce to meet future health demands across Wales. And the statement emphasises the need for consistent access across Wales. The introduction of the primary care cluster dashboard aimed to address that, as I mentioned earlier. So, I just want to emphasise to you, Cabinet Secretary—. What are you doing to make sure that all areas of Wales—whether that's north, south, east or west—have equal access to services, especially those pharmacy services, when we haven't actually seen everybody being independent prescribers? And it would be interesting to know what work you're doing around that as well. Diolch, Llywydd—Deputy Llywydd.