, Health and Social Care Committee
Welsh Government draft budget 2025-26
Okay. That is obviously not the totality of the funding that the health service draws on to grapple with waiting times. So, if you look at the pattern, for example, over the last two years, you'll have seen in the longest waits a progressive reduction…
, Health and Social Care Committee
Welsh Government draft budget 2025-26
So, do you mean the most recent funding?
, Health and Social Care Committee
Welsh Government draft budget 2025-26
Which funding are you referring to?
, Health and Social Care Committee
Welsh Government draft budget 2025-26
We are in regular discussions with hospices. I met with hospices the week before Christmas, I met Hospices Cymru the week before that, so there's ongoing discussion with them. I would make more than one point in response to what you've just said. I think it…
, Health and Social Care Committee
Welsh Government draft budget 2025-26
Well, hospices are a good example of the situation. We have invested around £13 million year after year in hospices. Last year, we saw the cost-of-living pressures increase significantly, so we provided a payment of around £4 million in year, and we've made…
, Health and Social Care Committee
Welsh Government draft budget 2025-26
That's why I'm setting the challenge in that context, due to the complex nature of its effects. What I'm saying is that the budget decisions that have been made in Westminster are not ones that the Welsh Government can really address, but, in the discussions…
, Health and Social Care Committee
Welsh Government draft budget 2025-26
Well, it's not an admission; I'm trying to have an open conversation with you about the challenges.
, Health and Social Care Committee
Welsh Government draft budget 2025-26
Well, the broader context for these decisions to increase national insurance across the United Kingdom was the fact that the funds available to invest in public services needed to be increased. So, that's the very challenging context, I understand, for that…
, Health and Social Care Committee
Welsh Government draft budget 2025-26
We've had these very live discussions in the context of how we invest the £50 million into speeding up treatment. Obviously, we've commissioned activity from the independent sector, from the private sector, and also from across the border. Our understanding…
, Health and Social Care Committee
Welsh Government draft budget 2025-26
I'm not following the question, I'm afraid.
, Health and Social Care Committee
Welsh Government draft budget 2025-26
Well, the waiting lists are where they are for a range of different reasons, Chair. So—
, Health and Social Care Committee
Welsh Government draft budget 2025-26
I'm not aware of that, and I would be surprised if that were the case, because it would assume a material level of unused capacity in the health service in Wales, which I don't think is the experience, generally speaking. I think, in the longer term, though…
, Health and Social Care Committee
Welsh Government draft budget 2025-26
Well, there's an element of that in the system already, and I think one of the opportunities, if you like, in having more regional working in the future is an ability to do that in the longer term. We absolutely aren't there yet, because the capacity isn't…
, Health and Social Care Committee
Welsh Government draft budget 2025-26
It absolutely is because it's historically been one of the largest areas of waiting lists for us, as it is in many other places as well. And, as you say, people are waiting in pain for too long, aren't they, so it's a big challenge. So, the way our budget is…
, Health and Social Care Committee
Welsh Government draft budget 2025-26
Well, that is one possible advantage, I agree. I don't think it necessarily results in that outcome, but I absolutely accept that it's a possible outcome. As you know, some commissioning happens on a Wales-wide basis anyway through the newly constituted joint…
, Health and Social Care Committee
Welsh Government draft budget 2025-26
On the detail of that, I might ask Hywel to come in for me.
, Health and Social Care Committee
Welsh Government draft budget 2025-26
Well, there's a range of whether they're much longer, Chair. I think that's a value judgment. It's not quite as clear cut as you suggest. But the point is a valid point to make, obviously. We delegate budgets to health boards and they are required to…
, Health and Social Care Committee
Welsh Government draft budget 2025-26
Well, they will have predated me, Chair, personally, given the time point in the year at which I came into post. But, at the start of the year, or in advance of the year, they will have obviously been in the same planning process, responding to last year's…
, Health and Social Care Committee
Welsh Government draft budget 2025-26
They haven't come to me yet with those, but I'm starting the new year's cycle of meetings from next week onwards, so I'm assuming they'll be part of those.
, Health and Social Care Committee
Welsh Government draft budget 2025-26
Yes. Well I, in the letter that I sent before Christmas, have said that I recognise, just as you've said, that if you're going to focus in on—. Just to say, as you will obviously know, there are dozens of priorities that we set the health service that go way…
, Health and Social Care Committee
Welsh Government draft budget 2025-26
So, from the point of view of reserves, none of it has been funded using reserves. I mentioned earlier that we'd made provision in the MEG, so the MEG can balance, and that's what those figures are. They're not to draw on the reserves, they are a provision in…
, Health and Social Care Committee
Welsh Government draft budget 2025-26
Yes. Most of these things, as you say in your question, are very well evidenced. So, the twin challenges that we try and negotiate are: the overall funding pressure, which is obvious, and the points that I made earlier about the investment in diagnostic…
, Health and Social Care Committee
Welsh Government draft budget 2025-26
No, not necessarily. If you have an opportunity to go through that table, you will see that there is a very wide range of different approaches. Some of it is digital, and therefore there is a lead-in time. Some of it isn't in that space at all. We know that…
, Health and Social Care Committee
Welsh Government draft budget 2025-26
I can see why you ask the question. It's obviously a fair question to ask. I, myself, wouldn’t put it in quite those terms. Obviously, we have set the allocations, as Hywel has just explained; we have set the planning framework, which has our expectations of…
, Health and Social Care Committee
Welsh Government draft budget 2025-26
Well, some health boards will not be able to get to a balanced budget next year, but we will have set them a figure that they will need to deliver in order to have met the plans that they have been set, effectively. And that varies from health board to health…
