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Wales’ new health minister has laid out his priorities for the NHS, including tackling waiting lists, service modernisation, and a focus on preventative health.

Addressing the Siambr on Tuesday June 2, Mabon ap Gwynfor told colleagues he is “under no illusions” about the state of the Welsh NHS – and said his government has “inherited a health system beset by crises, and that is perhaps more precarious and more vulnerable than at any point in its history.”

The minister said his “immediate priority” was waiting lists, and said: “These [waiting lists], for too long, have been a debilitating millstone around the neck of the NHS and are imposing unacceptable strains on staff and patients alike.

“Having to wait years for treatment, with all the pain and anxiety that that entails, is an intolerable reality for far too many people the length and breadth of Wales, and I am determined to turn the page on this sorry legacy once and for all.”

Mr ap Gwynfor pledged to implement an “ambitious national programme” to expand surgical and diagnostic hubs across Wales, as well as a new approach to planned care that is “clinically-led, nationally-directed, and with a clear emphasis on service modernisation” to reduce waiting lists.

The Gwynedd Maldwyn MS said: “Through these measures, we will see two-year waits eliminated within a matter of months and the overall backlog reduced to pre-pandemic levels before the end of this Senedd term.”

He continued: “But this isn’t just a case of addressing the immediate pressures of long waits, as urgent as they are; it’s putting the foundations in place so that we’re never in this position again and to ensure that the NHS can sustainably manage demand.

“That’s why our plan for surgical hubs is predicated on reinforcing local capacity and expertise first and foremost, creating centres of excellence for long-neglected specialisms such as ophthalmology, and providing vital training opportunities for medical graduates.”

‘Healthier and happier lives’

Promising a focus on prevention, Mr ap Gwynfor referred to First Minister Rhun ap Iorwerth’s decision to appoint a deputy minister for public and preventative health to his cabinet last month – fulfilling a Plaid Cymru manifesto pledge.

The cabinet minister pledged to act across the cabinet to address the “wider determinants of poor health” by tackling child poverty, healthy eating, physical activity, housing and employment.

He said: “We will move away from managing sickness to ensuring that people have the means to lead healthier and happier lives.

“And on my watch, I won’t measure success on the basis of the number of people in hospital, but rather by the number who didn’t have to go there in the first place.”

Concluding his speech to the Senedd, Mr ap Gwynfor said: “What I have set out today are the first steps along a long-term path of renewal.

“I’m under no illusions as to the scale of the challenge, and I won’t promise that the benefits of our agenda will manifest immediately, because I’m not here to indulge in quick fixes and easy answers, and nor should anyone who truly has the best interests of the NHS at heart.

“But, through our laser focus on the ultimate destination, I’m confident that, by the end of this Senedd term, we’ll have started to write a bright new chapter in the history of our health and social care system.

“With urgency, decisive action and ambition, we will protect the NHS and build a healthier, fairer Wales with a health and care system that puts people first and delivers the change our nation needs.”

‘Greatest responsibility’

Reform’s shadow minister for health and prevention, James Evans, challenged the health minister on his plans, noting “the Welsh NHS doesn’t need any more slogans; it needs delivery”.

Mr Evans described responsibility for health and care as one of the “greatest responsibilities” a minister can hold “because behind every statistic is a person, a family, and often someone who has waited far too long.”

He pressed the cabinet minister on his claim that two year waits will be eliminated “within a matter of months”, asking Mr ap Gwynfor for a “straight answer” on exactly how many months this will be.

Adding that while “’within months’ might sound good in a press release, it means very little to someone who’s waiting in pain at home for their operation”.

In response, Mr ap Gwynfor did not provide an exact timeline for when waiting lists will reduced, and instead focused on sharing how the Plaid government intends to tackle the backlog.

He said: “Absolutely, this is about delivery. That’s why we’ve spoken about delivering elective care hubs across Wales, making sure that we can get those people seen quicker, the high-volume treatments done, and people can go home on the same day.

“We know that there’s a lack of efficiency and productivity in the NHS in Wales. That’s why we will ensure that theatre space and theatre time is utilised to its maximum.”

Labour’s Ken Skates and Conservative Natasha Asghar also pressed Mr ap Gwynfor on his waiting lists timeline, but he did not provide a clear deadline.

‘Still more to do’

Reminding the Siambr of the work Welsh Labour did in the previous Senedd to maintain the NHS, interim Labour leader Ken Skates told the minister “there is still more to do”.

Referring back to Plaid Cymru’s time in opposition, Mr Skates reminded the cabinet secretary that he once presented 29 recommendations in a document entitled, ‘The Welsh Health System: Accountability, Performance and Culture’.

Mr Skates told the Siambr that he sees “very few” of those recommendations in the minister’s statement, one of which was to establish pay parity between social care workers and NHS staff.

He pressed the cabinet secretary to confirm if he stands by these recommendations and to confirm when social care workers can expect pay parity.

In response, Mr ap Gwynfor said: “Yes, absolutely, we talk about pay parity, and that’s why, once again, I refer to the proud record that Plaid Cymru has of starting the process of merging health and social care, and that’s what we will be completing as a Plaid Cymru government.

“At the moment, my colleague Delyth Jewell will be looking at that and ensuring that that is delivered, and that we can see the fruits of that under a Plaid Cymru government.”

‘Perilous state’

Welsh Conservative health and social care spokesperson, Natasha Asghar, described the Welsh NHS as being in a “perilous state” with waiting lists remaining “shamefully high” and “patients in all four corners of Wales languishing in pain”.

Describing improving access to care as “paramount”, Ms Asghar referred to calls for an A&E department at the Royal Gwent Hospital in Newport to be reopened.

Having raised the issue in First Minister’s Questions earlier in plenary, Ms Asghar called for the minister to engage with the Aneurin Bevan University Health Board and to look into opening the A&E.

More broadly, she pressed the minister to “shed a bit more light” on how the Welsh Government is going to reduce pressure on A&E departments across Wales.

Sharing that he and his officials have “regular engagement” with the Aneurin Bevan health board, Mr ap Gwynfor confirmed that he would be “happy to raise those issues” in discussions.

Social care

Welsh Liberal Democrats leader, Jane Dodds, also questioned the cabinet secretary, focusing on the government’s plans for social care.

She said: “1,275 people are stuck in hospital beds unnecessarily. They are waiting for social care, either for delivery of the services or for assessments.

“These people, the ones deteriorating in wards when they should be at home, are the ones that need urgent results.

“We know that the Welsh Local Government Association has projected a social care funding gap of over £200 million this year alone, yet the previous budget provided only £180 million across both health and social care.

“In November, your good self described social care as the most underfunded and overlooked pillar of Welsh healthcare, and you were absolutely right. So, could you please outline exactly what your response is to those people stuck in hospitals right now?”

Describing social care as “crucial”, Mr ap Gwynfor agreed the importance of social care and said: “If we are going to resolve the issues facing our health service, we need to resolve the issues facing social care, but the issues facing those who are being delayed from discharge, those who can’t get a care package, are more than just the social care, they’re also in primary care.

“It’s the whole-system approach, which is what we’re looking at here, ensuring that we invest, yes, in primary care, making sure that people don’t clog up the system on that front end, and then making sure that people can be discharged safely, so that there’s care in the community.

“And that’s what the plans we’ve put forward look at, ensuring that that care is in the community, closer to home, so that people are seen closer to their home.”