Mike Hedges AM supports Welsh Government Budget Statement
Speaking after the Plenary debate, Swansea East AM
Mike Hedges said…. I welcome this budget statement as it sets Wales on course
for a stable and secure future for all our citizens. I am pleased to praise the
work done on prevention and early intervention in both Health and Education. Our
aim is to make people healthier so they do not need as many health
interventions. I have concerns however how the costs of dealing with social
care falls almost exclusively on local government. I hope that shared budgets
for Health and Social Care can become the norm.
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Mike Hedges AM - Diolch, Llywydd. I
welcome the Cabinet Secretary for Finance's statement and the draft
budget. As austerity continues, the amount of money needed to run our
public services to the level the public want is not being provided. I'm sure
the Cabinet Secretary will agree with me that austerity is not an economic
policy but a political direction of travel. The Conservatives at Westminster
want to reduce public expenditure and roll back state provision of services.
And as the Cabinet Secretary said earlier today, that £4 billion to £6 billion
are missing from our budget. What a different budget we'd have today with that
extra £4 billion to £6 billion. I think that everybody would leave here
much happier than we will.223
I think that Neil Hamilton made a
very interesting point—live within your means. Can I just say, the key point
is: increase your means? That's called economic growth. What we've had is stagnation
and, as such, we haven't increased it. That's why the deficit's gone up—it's
because growth has been at best sluggish, at worst non-existent.224
I have three questions for the
Cabinet Secretary. One on transaction capital: has the Tory Westminster Government
given any indication on changing the rules on its use? If not, can it be used
as replacement capital for economic development support to private companies,
and thus increase the discretionary capital expenditure available to the Welsh
Government for things such as new schools, which everybody in this Chamber
welcomes?225
Secondly, is there any indication
that the borrowing limit will be increased? Will bonds be made available?
Whilst they would not be mine and I'm sure not the Cabinet Secretary's choice
of means of borrowing, because they tend to be more expensive, what they've
done and why local authorities like them—. You don't want to use them, but what
you want them to do is to keep the public works loan board's lending level's
low. When the public works lending board pushed their rates up, what
happened was that we saw that people started looking at bonds, and all of a
sudden the public works loan board's costs came down quite considerably.
I think that this is really important.226
Finally can I raise primary health,
secondary health and social services expenditure? The auditor general, in about
2015, produced a report on medical interventions that do no good to the
patient, estimated at that time at several hundred million pounds. This did not
include expenditure where the operation was successful, but following
hospitalisation, when the individual was no longer able to look after
themselves and ended up in a nursing home.227
The late Dr Julian Tudor Hart, who
many of us knew, with others, identified expenditure on such things as reducing
slightly raised blood pressure, which does no good in terms of health, but it's
actually expensive. And can I remind the finance Cabinet Secretary, while
health Secretary, you reported, on more than one occasion, on the
different intervention rates for the removal of tonsils between two areas in
the same health board. So, it's not a difference between health
boards—it's basically the difference between two surgeons. You're twice as
likely to have your tonsils removed in one than the other.228
The Royal College of General
Practitioners regularly identify the relative reduction in primary care
expenditure. And I have concerns about the fact that secondary care takes
priority over primary care. The Nuffield Foundation produced research showing
that productivity in hospitals in Wales, in terms of patient-per-doctor
intervention, had reduced between 2003 and 2013.229
Social care is under huge pressure,
especially elderly care and support for children. I understand that support for
children has gone up by 100 per cent over the last 10 years. And we also know
that elderly care is continuing to increase. Many of us think it's a good
thing—we all want to live longer, don't we? But it does come with a cost, and
that is falling, almost exclusively, on local authorities.230
I'm very pleased that from being a
lone voice supporting improving health by dealing with factors such as obesity
and smoking that lead to ill health, there is now a lot of support for
preventative action. In fact, we had Steffan Lewis talking about preventative
action earlier, and I hope we'll get more people talking about preventative
action. Having somebody in hospital being operated on, in many cases, is a
sign of failure, not success. The sign of success is them not ending
up there in the first place. I think our aim has got be to increase health
rather than increase health expenditure or health interventions.231
So, I welcome the budget, I think
that it's the best that can be done. Could we have the £4 billion to £6 billion
we should have? And then both the Cabinet Secretary and most Members in this
room will be very, very happy. We're not going to get that, and under very
difficult circumstances, I commend the Cabinet Secretary for his budget.
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