Speeches
and Questions at Welsh Assembly December 2016
7th
December 2016
The ‘A Regional Collaboration for
Health’ Programme
15:07
Mike
Hedges
10. Will
the Minister provide an update on the ‘A Regional Collaboration for Health’
programme? OAQ(5)0080(HWS)
15:07
Vaughan
Gething
Thank you
for the question. The Welsh Government is supporting Abertawe Bro Morgannwg
University Local Health Board and Hywel Dda Local Health Board, together with
Swansea University and Trinity university in the development of a strategic
business case, which we expect to be completed in the spring of next year.
15:07
Mike
Hedges
Can I
thank you for that response? I am also supportive of the principle of closer
working between the two health boards and the two universities. I want to
highlight the importance of Morriston Hospital as a regional centre for the
area covered by the two health boards. What progress is being made on greater
use of the hub-and-spoke model that has worked so well in renal services and
could be applicable to other services, such as the orthodontic service that was
discussed earlier?
15:07
Vaughan
Gething
There’s
real learning to take from renal services within south-west and mid and west
Wales. Investments are being made across the patch in terms of the dialysis
provision, but, in particular, I think it’s a useful opportunity to highlight
that there’s genuine UK-wide leading practice taking place within the renal
unit in Morriston, in particular dialysis at home and overnight dialysis as
well. It makes a really big difference to individuals. If they’re able to
dialyse at home, they get a much better quality in terms of the outcomes of
their patient care, and particularly so for those people who are younger and
those people who have the most active lives, and for parents, with the ability
not to have their normal day-to-day life or working life interrupted by the
need to go into a dialysis centre during the day. So, there’s an awful lot to
learn about the way that’s already been developed.
I’ve been
really clear with the health service that this greater collaboration between
health boards on the delivery of services across health board areas is part of
what we need to see developed and progressed and implemented across the whole
healthcare system within NHS Wales. So, there is lots of learning to take, and
I’m generally encouraged by the progress that’s already been made by the two
health boards and the university partners.
Debate on Welsh Government Budget
17:13
Mike Hedges
This is
the sixth budget I have spoken on in the Senedd. Unfortunately, they have all
been made against the austerity agenda of first the Conservative and Liberal
Democrat Westminster Government and now a Conservative Government. How long
will the austerity path be followed until it suddenly dawns on the Government
that it is not working? As Adam Price said earlier, this is the first lost
decade of economic growth since the 1860s. That was the time of Disraeli and
Gladstone, and Disraeli and Gladstone as young men. [Interruption.] No, I’ll
help Neil Hamilton: Palmerston was there at the beginning, Disraeli and
Gladstone were there at the end. Or is this austerity agenda just a fig leaf to
hide the desire of the Conservatives to shrink the public sector? Where the
state cannot be removed completely, they find a way, such as academy schools in
England, where the private sector can make money out of it.
Turning
to the budget before us, health continues on its journey towards 50 per cent of
the Welsh revenue budget; this time next year, I predict it will actually
exceed 50 per cent of the Welsh revenue budget. I think it’s running at 49 per
cent this year. Health is by far the most important service that the Welsh
Government provides, but money on health must be used to its best effect. I
remain highly sceptical of the current health board structure, which does not
seem to me to be based on natural health boundaries. Some questions on health
need addressing: how much does it cost for agency staff? Why is there not an
all-Wales medicines service so that if medicines are about to become out of
date, they can be redeployed to a different hospital even if it’s in a
different health board so as to avoid waste?
17:14
Darren
Millar
Will you
take an intervention, Mike?
17:14
Mike Hedges Certainly.
17:15
Darren
Millar
Thank
you, I’m very grateful for your taking the intervention. It’s in relation,
specifically, to the costs of agency staff. As you will know, the UK Government
took action to put a cap on the cost of agency staff per hour. The Welsh
Government decided not to follow suit. That’s costing our NHS millions of
pounds every year. Do you share my view that the Welsh Government should
reconsider its position?
17:15
Mike Hedges
I don’t
share your view. What I would say is that if you put that cap on, you end up
with wards running short of nurses, and you end up with hospitals short of
doctors. The problem is we need agency staff. The challenge to the Welsh
Government and the health service is to get to a situation where we don’t need
agency staff because we’re fully staffed.
Why are
you, as stated by a former health Minister, twice as likely to have your
tonsils removed in Ynys Môn than you are in Wrexham, which are both part of the
same health board? Why does the cost of an operation such as cataracts vary so
much between different hospitals? We recently heard reported that the cost of
locum doctors in Wales exceeds £137 million—an increase from £64 million in the
previous year. The highest paid locum, according to the newspapers, received
£183,000 last year. We need a system where we get more doctors in, and I put my
cards on the table that I believe in salaried GPs.
Why are
medical interventions that do no good for the patient still taking place? The
auditor general reported on this practice, as have NICE. How many patients
overnight does a minor injuries unit need to see for it to be kept open
overnight? Currently, the answer to that is three.
We as a
committee of the Assembly scrutinised the Cabinet Secretary for health and the
Cabinet Secretary for finance as to who engages in the in-depth scrutiny of
health board expenditure, not over accuracy and legality, but over efficiency
and effectiveness.
Whilst
people generally have their major health needs during the last 12 to 24 months
of their lives, they can need social care for up to 40 years, with the level
and complexity of care increasing as people age, often ending up with a
residential care package having to be paid for by the local council. It is also
of no surprise that those living in inadequate housing tend to have greater
health needs. Health is also a lifestyle. Exercising facilities run by local
authorities, and fitness, diet and smoking cessation schemes run by Communities
First all help to improve the health of people in Wales.
While the
autumn statement has added additional capital expenditure to the Welsh
Government’s budget, according to my calculation it still has not even taken us
back to 2008 expenditure in real terms. Additional capital expenditure would
benefit the Welsh economy. Remember that the capital expenditure that Ed Balls
called for and that George Osborne described as wrecking the recovery has now
been brought forward by Philip Hammond. It’s very pleasing that they’ve almost
learned.
Can I
just say something relating to this idea that you have to keep on cutting to
make austerity for things to work? No, you grow your economy. You increase your
tax take by growing the economy. You get more people working; not as we have at
the moment, working limited hours and zero hours and short-term contract hours,
but you actually get them working full time and you get their salaries up. When
that happens, the tax take goes up and people end up better off. Can I just say
that, finally, capital expenditure is desperately needed for things as diverse
as new schools and flood defences, even though the global warming deniers do
not believe that we need the additional flood defences?
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The Welsh Housing Quality
Standard
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13:54 -
Mike Hedges
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3. Will
the First Minister make a statement on progress being made towards achieving
the Welsh housing quality standard? OAQ(5)0328(FM)
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13:54 -
Carwyn Jones
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All
social landlords, including Swansea council, are on track to meet the
standard by 2020. The latest annual statistics show that in March of this
year, 79 per cent of existing social homes now meet the standard—an 8 point
rise over the course of the year—and nearly 18,000 households now live in
better-quality homes than in the previous year.
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13:54 -
Mike Hedges
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Thank
you, First Minister. Can I congratulate the Welsh Government on the success
of reaching the Welsh housing quality standard, and can I also say it’s an
example of an ambitious target that has been financially supported and that
has improved the lives of many, many people, including many of my
constituents? But can the money currently allocated to upgrading council
properties, when all of them have met the Welsh housing quality standard, be
allocated to the building of new council properties?
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13:54 -
Carwyn Jones
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Yes,
we’re very keen to make sure that more councils are able to build council
houses, and we’re interested, of course, in looking at every innovative way
to increase housing supply. The 20,000 affordable homes target includes local
authority on-lending to housing associations to enable them to develop. The
advantage of that, of course, is that the local authority can borrow from the
Public Works Loan Board at a lower rate than would be available from
traditional lenders. There are examples of partnership between local
authorities and housing associations as well. We’ve moved a long way from the
day when local authorities couldn’t build council houses. It’s important that
local authorities are able to provide for their populations and, importantly,
that the accommodation that’s provided is of the best standard possible.
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5. Statement: Child Poverty Strategy for Wales—Progress Report 2016
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