Questions to Minister for Communities and Tackling Poverty
Poverty Among People with Disabilities

14:38
Janet Finch-Saunders
5. What plans does the Minister have to eradicate poverty among people with disabilities? OAQ(4)0296(CTP)

14:38
Lesley Griffiths
Our tackling poverty action plan and strategic equality plan include commitments to improve outcomes for disabled people. The framework for action on independent living has seven priorities for action, including housing and employment. These priorities have been identified by disabled people as areas having the biggest impact on their lives.

14:38
Janet Finch-Saunders
Thank you, Minister. I know from visits around my constituency, and a recent stakeholder poverty group with the Royal National Institute of Blind People, that those with disabilities such as sensory loss find it very difficult to find out what financial assistance they’re entitled to, and there are large inconsistencies between those who are able to access all the support and those who are not. What steps is the Welsh Government taking to ensure that the support available is easy to access and adequately signposted?

14:39
Lesley Griffiths
Thank you. We’ve put an additional £4 million into our advice services; you’ll be aware of the national advice network, which will be meeting for the first time next month. That part of their remit will be to ensure that services are very consistent across the country. We know that people with disabilities are often very much hampered in being able to access information. I went to an excellent launch in Bangor—Alun Ffred Jones was also present—of the all-Wales welfare rights service, where the RNIB have been working with partners to ensure that people such as you identified are able to make sure that they are claiming all that they are absolutely entitled to.

Debate on the Health and Social Care Committee's Report on its Inquiry into Access to Medical Technologies in Wales
15:27
Janet Finch-Saunders
I’d like to thank the Chairman for his overall report on that and I’d like to perhaps drill down to some of the more fundamental issues during this inquiry.

I think it’s fair to say that digital and technology now isn’t an option; it’s a necessity. We did hear that whilst healthcare professionals play a key role in technology adoption, there is a serious issue with the absence of a strategic and consistent approach to introducing new technologies. Cancer Research UK believes that all cancer patients should be able to access the best evidence-based treatments for their condition. An example is radiotherapy, which is highly cost-effective, and, every year, cures more patients than some cancer drugs.

The charity also said the proportion of patients receiving radiotherapy in Wales is well below the internationally accepted recommendation. Proton beam therapy: two-year-old Freya Bevan from Bridgend having to travel as far as the United States for this treatment. The use of molecular diagnostic technology is far behind that of the rest of the UK. In a time of austerity and rising demand for our health service, healthcare and diagnostics must be delivered in a prudent way. But that requires a strong approach to medical technologies. So, I was quite enlightened, really, by much of the evidence that was taken during this particular inquiry. Dr Molly Price-Jones of Tybio Ltd commented that despite Wales’s strong medical technology sector there are significant barriers to getting a new technology adopted and enabling patients to get access to improved diagnostic techniques’.

In addition, we heard the approach taken to the commissioning of new medical technologies described as ‘chaotic’, and there were calls on the Minister to identify a way of delivering a more strategic, co-ordinated and streamlined approach to medical technology adaptation and commissioning.

The principles of prudent healthcare include the notion that the promotion of shared responsibility for health and wellbeing will reduce the pressures currently facing our health system. So, I welcome that the Minister has made it clear that the development and delivery of future strategies in this regard will involve the engagement of clinicians, service providers, primary and community care workers and the public and patients, and the point that my colleague David Rees made there—the chairman—about the use of technologies and digital appliances inside the home.

We know that medical technologies are changing rapidly, and it’s hard to keep pace. But, we know too that there’s a huge problem with recruitment in Wales, and Dr Martin Rolles, of the Royal College of Radiologists’ standing committee, said,
‘For consultant specialities, we are in competition nationally across the UK.…One of the things that we can do is make sure that if people are going to come to Wales, they can practise their craft to the best of their ability.’

And that is in terms of using these new technologies. The Welsh Government cannot afford for Welsh NHS departments to be seen as technically backward. The Minister has accepted our recommendation on this, and issued assurances that the Welsh Government will support programmes that will align technology development, to identify needs and challenges.

Now, a number of witnesses emphasised the differences between the medicines and technologies, which make appraisal more complex and a robust assessment of their clinical and cost-effectiveness more difficult to achieve. And it came across loud and clear that, too often, the third sector are coming in to provide some of these technologies when the NHS is not doing it so well. We learned that NICE guidance is not consistently implemented in Wales.
The role of the Welsh Health Specialised Services Committee, WHSSC, was mentioned by a number of witnesses, describing them as specialising in relatively ad hoc services and that its work may involve some duplication of the work of the all-Wales medicines strategy group, and/or NICE, in terms of technology assessments. Of course, in this day and age of prudence and austerity, we simply cannot afford duplication.

The Royal College of Nurses Wales has described NHS medical technology as underfunded, with the associate director saying the provision of up-to-date medical technology should be a vital focus for health boards in Wales, in order to ensure that the best possible care can be provided to our patients in a timely and effective manner, using high-quality and innovative equipment.

I think there’s much to be done, but I personally would like some assurances from the Minister that those recommendations that he’s only agreed to in principle he will give serious consideration to, and the ones he has actually agreed to in full, he will actually implement, as soon as possible. Thank you.

Metal Health Debate
17:05
Janet Finch-Saunders
I’d really like to pay tribute to the Liberal Democrats for bringing this debate. We’ve spoken many times in this Chamber on mental health, and I felt that that was a very excellent contribution.

One in every four adults in Wales is living with a mental health condition. Suicide rates in Wales are currently at their highest levels since 1981; the UK average for 2013 was 11.9 deaths per 100,000, comparable, here in Wales, to that of 15.6. Recent statistics have shown the number of A&E visits by children and young people relating to mental health in Wales have almost doubled since 2010-11. A recent survey revealed that 10% of patients who visit their GP to discuss their mental health felt that there was no understanding or empathy.

I believe there is very little understanding or recognition of the difficulties and emotional turmoil that some sufferers feel when identifying a need for support. I know, from first-hand experience, as an Assembly Member, when people find it really difficult to identify that mental health problem in themselves and then have to go and ask for help—say, access to a GP—it becomes even more problematic. Following their GP appointment, only 33% report easy access to the advice, treatment and support service that they actually require, and only 20% felt that these services led to any actual or significant improvement in their mental health and wellbeing.

Recent studies show that, in terms of mental health prevention, intervention and treatment, for every £1 spent for people with psychosis and schizophrenia, the return is significant. A third of workers do not feel comfortable talking openly with their line managers about stress, and evidence suggests that untreated mental health conditions can result in long-term absences from employment. Too often, these delays in intervention can lead to sufferers finding their own prop, such as drugs and/or alcohol.
Recent evidence taken during one of our Assembly workshops on alcohol abuse revealed many still feeling very let down, having been in the system for years, and feeling completely unsupported. Despite this being raised in many debates here by all Assembly Members, many in Wales feel stigmatised or afraid to admit their own mental health concerns, and feel that greater support and intervention are needed whilst still young, and that picks up on the point made by Eluned Parrott. Thirty per cent of parents of those aged five to 18 say they would feel embarrassed if their child wanted support or counselling in school, and, in Wales, one in 10 children and young people aged five to 16 suffer from a diagnosable mental health disorder.

Yesterday, I was at the Member’s—Bethan Jenkins—group on eating disorders, and that was a really good group, made up of stakeholders, service users and politicians. The subject of CAMHS came up. I must confess that, when I first became an Assembly Member, I thought—maybe quite wrongly, I don’t know—that CAMHS were there to pick up these kinds of issues when children find themselves needing support. I understand there is to be a review, because I’ve certainly raised concerns about CAMHS and specialist CAMHS, but I also understand from yesterday that Dame Sue Bailey, charged with this review, has only been given 12 days in which to actually carry out—12 paid days—this review, and I would just ask the Minister whether he feels that that kind of review that’s needed—such a complex review—can be carried out in that kind of timescale.

Among teenagers, rates of depression and anxiety have increased by 70% in the past 25 years. How sad, as Eluned has mentioned, that one in every 12 children and young people now deliberately self-harm. In 2013-14, 1,542 10 to 19-year-olds were admitted to hospital after self-harming, and that’s 36% more than the year before. This is a ticking time-bomb, Minister; this needs intervention and support from the Welsh Government now.

A third of 16 to 25-year-olds have thought about or attempted suicide, and with three quarters of adult mental disorders in evidence by the age of 21, it is extremely disappointing that these are not adequately diagnosed or treated at the time. These are shocking statistics, and I know that much has been done in the past, but we’re not there yet. We do have a lack of emergency beds; we do know of overprescribing of antidepressants; and we know of poor collaboration between education and health services. Minister, this must be your top priority.