Absolutely. I think the challenge, if I can be blunt, is to turn the rhetoric into reality, because the debate about prevention is not really a controversial one, so far as I can see. It's not unique to Wales, it's a debate that is happening internationally, and there seems to be a broad level of consensus that it is a sensible approach to take. So, there are various parts of challenge, I think, to try to address your question, Anna.
No. 1 is that you as a committee need to be holding the Government to account, I would say, to make sure that the signals that the Government gives to the rest of the system are coherent and consistent with that higher level strategic message of, 'We want to transform our public services to a more sustainable footing, and part of that is a focus on prevention.' So, to give you an example, later this week I will publish a short note that summarises our audit of the NHS accounts for last year. Spoiler alert, it will paint a similar story to one that we are familiar with, where the system as a whole is in deficit and showing no real signs of coming out of that. Well, if we're serious about breaking that cycle, then some of the accountability framework that we have in place needs to shift away from holding organisations to account for this year's budget, or driving down waiting times right in the here and now, to a longer term approach. We still need to hold people to account for it and ensure that they deliver it, but you've got to break that cycle somehow. And part of that from the Welsh Government perspective is about sending signals into the system that are consistent with a higher level message about long-term thinking and prevention. It's not peculiar to the NHS; we see that across the board.
I'll also be publishing this week—I'm having a busy week before I go—a national report, which will come to this committee, I'm sure, on the local government funding formula and approach. And again, that will point to some familiar themes about how the Government funds local government: the relatively short-term time horizon that it gives to the sector, the temptation, always, to push grants out of the door late in the year and say, 'Use this to good effect.' Neither of those things helps if you're serious about saying to the local government sector, 'We want you to think and plan for a five-year or a 10-year time horizon', if your focus is just on the here and now, 'Here's a pot of money that we can't promise you'll have next year either', and 'Here's your funding for this year and we can't tell you what you'll be getting next year.' So, you've got to change that fundamental approach in some way, in my view.
The Welsh Government will kick me for saying this, because they're probably sick of me saying it, because I've said it several times as well, in terms of the prevention agenda. Last year, I published a statutory report, which I have to produce once in every Senedd term, on the Well-being of Future Generations (Wales) Act 2015—my assessment, based on all the work that we do, of how the public service is delivering against that piece of legislation. And one of the core ways of working in the Act, as you know, is prevention and also a long-term approach. I made four recommendations, all of them to the Welsh Government. One of the recommendations related to prevention and, in essence, said that my recommendation to the Welsh Government is that they sit down with all other parts of the system, all those who are subject to the Act, and work together to try to identify, first and foremost, how much we are spending in a preventative way at present, because we don't know; how we can protect those areas of spend from erosion; how we can incentivise other areas of spend; and also how we can learn from what others are doing outside Wales. So, I framed that in a way that I thought was eminently acceptable, but that recommendation was rejected and, to this day, I don't really understand how it can be rejected and how it can square with the higher level message that I hear from the Government about its focus in that area.