MIKE HEDGES AM ASKS CABINET MEMBER FOR FINANCE TO CONSIDER
DEFINNG EXPENDETURE WHICH CONTRIBUTES TO LONG TERM GOOD
Speaking after the Senedd Question Time to Mark Drakeford,
Mike said….. I have long argued that it is better to spend money to prevent
something than to deal with something after it has occurred, when it often
costs more to remedy. Health expenditure is a good example of this and I strongly
believe that more should be put into primary care such as provided by GP’s as
opposed to Hospital services when you are often dealing with a problem which
might have been avoided if managed earlier.
I made this point to the Minister at Question Time and a
meeting I Chaired this morning with the BMA which allowed Assembly Members to
have an update on GP services in Wales. Type 2 Diabetes was given as an
exemplar of a condition where most hospitalisations could be prevented with
better management of the condition at an earlier stage and the condition
avoided all together through life style changes before medical intervention
becomes necessary. Better resourced Primary Care would provide better quality
of life for patients and reduce the need for expensive hospital treatment later
on.
Mike Hedges AM - Does the Cabinet Secretary accept that it
is difficult to define preventative spend? For example, spending on home social
care is preventative of needing residential care and hospital care. Expenditure
on GPs is also preventative of hospital care. Would it not be better to define
the expenditure as that which provides long-term good?9
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I thank Mike Hedges for
that supplementary question. He will know that, when I was in front of the
Finance Committee last week, I set out the new agreed definition that we have
used in this budget of what we mean by 'preventative spend', a definition
developed by the third sector and Public Health Wales in consultation with the
commissioner for the well-being of future generations Act. And it's not
perfect, I'm sure, and we'll develop it further, but it is a genuine step
forward in having a common language. That divides what we mean by 'preventative
spend' into a number of categories, from primary to acute. Any definition only
helps us so far in the decisions we have to make, and Mike Hedges's idea of defining
expenditure against long-term good, I can well see the sense that that would
bring. By itself, it would not avoid decision making.10
Dirprwy Lywydd, I was
reminded, listening to that supplementary question, of a day that I
spent when I was health Minister. I had two pieces of advice on the table.
One was to use a sum of money that would have made a profound difference in the
lives of very few people in Wales—fewer than 20 people, each one of them at a
very high cost per person. On the same day, I had advice that told me how I
could spend the same amount of money on a new cadre of, as I remember, epilepsy
nurses around Wales—people who would have been able to do good things in the
lives of a far larger number of people but where that difference would have
been incremental to services that they provided rather than transformative.
Both of those were possibilities that would have promoted long-term good. So,
whatever definitions we have, and helpful as they can be, in the end they can't
make decisions for us, and decisions are always difficult when you are
faced with a finite sum of money and many different ways in which that
money could be usefully spent.
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