Today’s Senedd Roundup: Tories attack post-devolution economic policy

Owen Donovan, Senedd Home

AMs debate 20 years of the economy under devolution

The Motion

The Senedd:

• Notes the Welsh Government’s failure to realise Wales’ economic potential over the past 20 years.
• Doesn’t believe the Welsh Government’s Prosperity for All: Economic Action Plan is sufficiently ambitious to deliver significant improvement to the Welsh economy.
• Calls on the Welsh Government to take further action to improve the economy, including: simplifying and improving access to business support; an effective industrial strategy; reforming public procurement to support SMEs; upskilling and re-skilling the workforce to take advantage of new opportunities; and improving infrastructure.

Twenty years of underperformance

Shadow Economy Minister, Russell George AM (Con, Montgomery) said that while devolution was supposed to improve Welsh economic performances, it’s been twenty years of underperformance.

“….of the three economic plans that have been launched since devolution, not one has succeeded in improving earnings or economic output, and the Welsh economy is still the weakest economy in the UK. It has the lowest productivity levels across the UK and of course, those stagnant pay packets are holding us back…. it’s disappointing when we do have those tweets – as was listed on the trade and investment tweet – ‘come to Wales, we’ve got 30% lower salary costs than some other parts of the UK’.”
– Shadow Economy Minister, Russell George AM

He went on to list a number of failings including not doing enough to attract foreign investment, not reforming public procurement procedures to benefit small businesses (22% of Welsh Government procurement spending went outside Wales), and a failure to deliver major infrastructure projects on time and on budget – namely the M4 Newport bypass.

Suzy Davies AM (Con, South Wales West) criticised the Welsh Government’s record on due diligence when it comes to business support: “when you are using my constituents’ money to back a horse, you’d better know how to read a form book”. The UK Government also deserved praise – as did the Welsh Government in some cases – for falls in unemployment.

Mark Isherwood AM (Con, North Wales) said research and development spending in Wales was at a much lower level than the rest of the UK, while Mohammad Asghar AM (Con, South Wales East) said adult learning and upskilling were vital for Wales to meet the challenges of the future.

Thinking long-term

Rhun ap Iorwerth AM (Plaid, Ynys Môn) said there was no lack of ambition on the part of the government, but there’s been a lack of clear direction and lack of economic fairness; Plaid proposes an economic summit and a law which would ensure economic development spending is more evenly spread across Wales and not over-concentrated in and around Cardiff.

Mike Hedges AM (Lab, Swansea East) called for more long-term and joined-up thinking on the economy. Skills within the economy department itself need to be improved to avoid poor due diligence when it comes to business support, and Wales needs to learn lessons from the likes of Dundee – an otherwise provincial city which has become a key hub for digital technologies and has supported a successful games development industry off the back of working with universities on developing specific degrees.

“….what I don’t want is a Government that stands by on the sidelines as a steel company goes to the wall; a Government that fails to invest in electrification of rail in Wales….that fails to recognise and invest in tidal technology; that puts obstacles in the way of public or not-for-profit ownership of rail or water….and to see a devastating indictment of a laissez-faire approach to the economy.”
– Huw Irranca-Davies AM (Lab, Ogmore)

Focus on particular problems

“I think if we’d said to those in the Chamber who were here 20 years ago that rates of economic inactivity in Wales will be broadly comparable with the UK….we will have halved the proportion of working-age people with no qualifications….we’d significantly increase the proportion of higher education qualifications and more active enterprises than ever before….That we have now, in 2019, 300,000 more people in jobs than there were 20 years ago – I think they’d have thought that a reasonable achievement.”
– Deputy Minister for Economy & Transport, Lee Waters (Lab, Llanelli)

Of course, the Deputy Minister accepted that beneath the headline figures, problems remain – in particular, in-work poverty. AMs couldn’t ignore the fact that many of the main economic levers remain controlled by the UK Government, nor could they ignore the negative impact of austerity. The focus was now shifting on to maximising the value of jobs which are already here and rooted in local communities – known as the Foundational Economy.

The motion was defeated by 33 votes to 12.

Call for new approach to manage lung disease

This week’s short debate was lead by John Griffiths AM (Lab, Newport East) on lung diseases caused by smoking.

Wales’ third biggest killer

Lung diseases are the third biggest killer of people in Wales, but waiting times for pulmonary rehabilitation can be up to 77 weeks in some parts of the country. John believes funding should be redirected away from inhaler-based treatments to more cost-effective treatments.

“We need to see greater investment in initiatives to reduce the risk of patients needing unnecessary, avoidable and costly hospital admissions, and this should include patient rescue packs that include a course of antibiotics and corticosteroid tablets to keep at home and self-manage with the advice and encouragement involved. And that would enable a prompt response to symptoms of an exacerbation.”
– John Griffiths AM

In Newport, a lottery-funded scheme has set up a seven-week training and exercise programme for residents suffering from COPD. As a result, 42% of those who took part had a better understanding of what their condition means and many have adopted healthier lifestyles as a result.

There were causes other than smoking which need to be tackled as a matter of urgency too, including air pollution, while people with COPD are at increased risk of being hospitalised due to flu – yet uptake of flu vaccines has been disappointingly low.

Smoking cessation services will remain important

Health Minister, Vaughan Gething (Lab, Cardiff S. & Penarth), said there was a need to ensure people were directed to the most appropriate service – including social prescribing – though there remain challenges in terms of access and waiting times.

“We know that many people don’t actually act on their referral to pulmonary rehab, given the length of time that it can take to access and the time demands it places on people. A significant number of people don’t complete the course, which can last six to eight weeks before people step down into a less intense level of support.”
– Health Minister, Vaughan Gething

Smoking is still linked to 5,000 deaths in Wales each year and costs the Welsh NHS £300million. Welsh Government-backed support to help smokers quit will remain an important part of lung health strategies. In Aneurin Bevan Health Board (south-east Wales), all smokers in pulmonary rehab are referred to the Help Me Quit service and specially-trained nurses support them – something the Minister picked out as an example of good practice.

Government rejects calls for reduction of of anti-depressant prescriptions 

Petition P-05-784: “Prescription drug dependence and withdrawal”
Submitted by Stevie Lewis
Signatures: 213

A summary of the Petitions Committee report is available here.

Petition Supporting Evidence

• A number of prescription drug categories, in particular anti-depressants and opioids, can lead to addiction and withdrawal symptoms.
• 10% of the Welsh population are using anti-depressants and 80-90% of them have been prescribed them for a year or more.
• Prescribing guidelines were inadequate as they don’t take into account the depth and length of possible withdrawal symptoms.

It’s important patients have access to the right information and support

Chair of the Petitions Committee, Janet Finch-Saunders AM (Con, Aberconwy) said withdrawal symptoms relating to prescription drugs can be very severe and some patients can become dependent on the – the petitioner herself became dependent on SSRI anti-depressants and it took 17 years for her to stop taking them.

“….these medications can have a positive impact for many people who are prescribed them. The committee is not suggesting that all prescribing of these medications is problematic – far from it. Rather, it is vitally important that patients have access to the right information and support, certainly at the beginning of their treatment, and also when they want to reduce or stop taking this medication.”
– Chair of the Petitions Committee, Janet Finch-Saunders AM

She welcomed the fact the Welsh Government has formally recognised that anti-depressants do come with withdrawal symptoms and that services relating to prescription drug addiction and withdrawal shouldn’t fall under general substance abuse programmes.

Helen Mary Jones AM (Plaid, Mid & West Wales) said a family member had themselves become addicted on a prescription drug and getting them through the withdrawal period was “horrible”; that was back in the early 1980s yet the problems still persist. It was important to create a culture of honesty around anti-depressants as it’s not a case of them never being used, but being used carefully.

Anti-depressants “can be a safe and effective treatment”

While the Health Minister, Vaughan Gething (Lab, Cardiff S. & Penarth), agreed or agreed in principle to many of the Committee’s recommendations, there was one key area where he disagreed – namely reducing the prescription of anti-depressants.

“Depression is a common, recurrent and, in some cases, debilitating illness. For many people with depression, prescribing an anti-depressant will be a safe and effective treatment option. We believe that a national prescribing indicator that intends to reduce prescribing could have the unintended consequence of discouraging the appropriate use of anti-depressant medication and result in some patients not starting treatment and others stopping prematurely.”
– Health Minister, Vaughan Gething

He believes safe tapering/weaning off of anti-depressants was more appropriate. He will also encourage health boards and GP clusters to work more closely with pharmacists and follow their advice, while consideration will be given to providing the drug advice service (DAN 24/7) staff with additional training on prescription drug addiction.

Committee calls for more flexible dental contract

Health & Social Care Committee
Dentistry in Wales (pdf)
“Paying someone the same amount to deliver a course of treatment on a patient regardless of the amount of work involved makes little sense.

 “Therefore this Committee believes it is time to end the current arrangements and find a new way of making sure everyone in Wales has access to quality dental services regardless of where they are.”
– Committee Chair, Dr Dai Lloyd AM (Plaid, South Wales West)

1. The current dental contract needs to be replaced with a more flexible system

Since 2006, NHS patients in Wales have been charged for dental treatment by three bands and local health boards reimburse dental practices based on the number of units of treatment (UDA) they undertake. The lowest band (check up) is 1 UDA, while the highest band (bridges, dentures etc.) count as 12 UDAs.

Health boards set a UDA allowance for each practice and each practice has to hit 95% of its UDA allowance before being reimbursed in full. The UDA value is usually between £23-30 depending on the health board and dentists can’t take on any more work than the allowance.

Under the UDA system, a patient who needs one filling pays the same as a patient who needs 10 – but in both cases, it only counts as 3 UDAs. This doesn’t properly reflect the cost of treating complex patients, disincentivising dentists from taking on patients with the greatest need.

Health boards claw back money in cases of underperformance by dental practices against UDA allowances and in 2017-18 £6.5million (3.8%) of the £180million primary dental care budget was clawed back. There were assurances this money was being re-invested in dentistry, but the Committee recommended close monitoring by the Welsh Government.

2. A prototype new contract has boosted dentists’ morale and enables better long-term treatment planning

The Welsh Government are trialling a new dental contract at a number of practices. The UDA system is relaxed and instead of trying to undertake work in as quick a time as possible, dentists are encouraged to improve the oral health of their patients and prevent problems before they start.

Higher cost treatments are reserved for people who can maintain their oral health, while high-need patients are helped by a wider range of oral health professional; they go through a “care pathway” similar to that you might get at a GP or over a course of hospital treatment.

The Committee agrees that moving away from the UDA system would benefit dentists and patients, but warned the Welsh Government to prevent “unintended consequences” of introducing a new contract without full and proper field testing. Also, any new contract has to incentivise treating high-need patients.

3. There are no recruitment problems, but there are issues in retaining dentists after foundation training and orthodontists

Dental recruitment is now done on an England-Wales-Northern Ireland basis, though Swansea Bay Health Board said this was counter-productive as English recruits in Wales may stay a year but move back to where they have roots. The retention rate of Welsh-domiciled dental postgraduates and foundation dentists is around 50-65% in any given year. Also, English trainees earn up to £4,000 a year more than in Wales.

While there’s no struggle to fill dental school places, just 15% of applications to study dentistry at Cardiff University are from Wales – though this could be simple geography as prospective dentists from north Wales may prefer to study at Manchester or Liverpool. Witnesses supported introducing a “pre-year” to attract Welsh-speaking students and students from less well-off backgrounds.

There’s also a backlog for orthodontic treatment (braces etc.), with a fall in the number of orthodontic service providers since 2012. A new electronic referral management system has been introduced to triage patients based on clinical need and give a better idea of how long orthodontic waiting lists actually are.

4. Dental decay amongst children is at its lowest rate since records began

Since the introduction of the “Designed to Smile” initiative, the proportion of children with at least one decayed tooth fell from 45.1% in 2011-12 to 29.6% in 2016-17. The programme targets schools in deprived areas, but tooth decay rates amongst children in these areas remain higher than average. People living in deprived areas also have reduced access to dental services.

Designed to Smile has stopped applying fluoride varnish to children at school after their permanent teeth have erupted and instead left it to high-street dentists – something the Committee said needs to be reconsidered. Witnesses called for oral health programmes to be introduced for older children as many won’t have benefited from Designed to Smile.

Brexit Party AM “could have broken Senedd rules” by employing daughter

A BBC Wales investigation has found that David Rowlands AM (BXP, South Wales East) – who defected from UKIP to the Brexit Party last week – could have breached Senedd guidelines by employing his daughter without declaring it.

The practice of employing relatives by AMs is due to be phased out, but while Mr Rowlands’ wife is declared as staff on his register of interests, his daughter hasn’t been despite working for her father for more than a year. Under Senedd rules, employment of relatives has to be declared within four weeks of them starting work.

The mistake has been blamed on a political aide, while Plaid Cymru (who ban AMs from employing relatives) have called on Mr Rowlands – who’s also an Assembly Commissioner – to refer himself to the Standards Committee for investigation.

Deputy Minister criticises quality of Welsh language news

Deputy Minister for Culture, Dafydd Elis-Thomas (Ind, Dwyfor Meirionnyd), has criticised the depth of news coverage provided on S4C, after it was revealed the flagship Newyddion 9 programme will be cut to just 10 minutes on Fridays from 2020 – though a half-hourly programme will remain in the 7:30 pm slot from Monday-Thursday.

The Deputy Minister told the Senedd’s Culture Committee, “What is important for me is that news is presented interestingly and I am a big fan of Channel 4 News.” His comments were criticised as belittling journalists.

Welsh contaminated blood scandal compensation “unfair”

Welsh victims of the contaminated blood scandal from the 1970s-1980s – where haemophiliacs were infected with hepatitis C and HIV – will be paid £10,000 less per person than victims in England.

Victims in England receive around £28,000 a year but the figure in Wales was just £18,500. Scottish victims receive £27,000. 175 people in Wales receive payments.

A public inquiry into the scandal started in April 2019, though victims argue that as the NHS was a single UK-wide system at the time there’s no justification for such disparity in payments.

Campaign launched to boost the number of male nurses

NHS Wales has launched a campaign under the “Train, Work, Live” programme to encourage more men to train as nurses. At the moment, just 12% of nurses, midwives and health visitors in Wales are men.

The Royal College of Nursing said: “Having more male nurses may change men’s perceptions of their health and abilities to use services. Research tells us that men are often reluctant to talk about their health concerns and seek help.”

Direct rail services between north Wales, Cheshire and Liverpool start

On May 20th, Transport for Wales started direct services between north Wales, Chester and Liverpool via the Halton Curve near Runcorn. The service will provide two services direct services a day between Wrexham and Liverpool Monday-Saturday, with a two-hourly Cardiff-Liverpool service set to be introduced by 2023.

Economy & Transport Minister, Ken Skates (Lab, Clwyd South) said: “Each day thousands of commuters travel between north Wales and north-west England, meaning excellent rail connectivity is vital to the economy on both sides of the border.”

Integrated ticketing is key to fully uniting bus and rail travel