Mike Hedges AM supports Welsh Government Budget Statement

Mike Hedges AM supports Welsh Government Budget Statement

Speaking after the Plenary debate, Swansea East AM Mike Hedges said…. I welcome this budget statement as it sets Wales on course for a stable and secure future for all our citizens. I am pleased to praise the work done on prevention and early intervention in both Health and Education. Our aim is to make people healthier so they do not need as many health interventions. I have concerns however how the costs of dealing with social care falls almost exclusively on local government. I hope that shared budgets for Health and Social Care can become the norm.

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Mike Hedges AM – Diolch, Llywydd. I welcome the Cabinet Secretary for Finance’s statement and the draft budget. As austerity continues, the amount of money needed to run our public services to the level the public want is not being provided. I’m sure the Cabinet Secretary will agree with me that austerity is not an economic policy but a political direction of travel. The Conservatives at Westminster want to reduce public expenditure and roll back state provision of services. And as the Cabinet Secretary said earlier today, that £4 billion to £6 billion are missing from our budget. What a different budget we’d have today with that extra £4 billion to £6 billion. I think that everybody would leave here much happier than we will.223
I think that Neil Hamilton made a very interesting point—live within your means. Can I just say, the key point is: increase your means? That’s called economic growth. What we’ve had is stagnation and, as such, we haven’t increased it. That’s why the deficit’s gone up—it’s because growth has been at best sluggish, at worst non-existent.224
I have three questions for the Cabinet Secretary. One on transaction capital: has the Tory Westminster Government given any indication on changing the rules on its use? If not, can it be used as replacement capital for economic development support to private companies, and thus increase the discretionary capital expenditure available to the Welsh Government for things such as new schools, which everybody in this Chamber welcomes?225
Secondly, is there any indication that the borrowing limit will be increased? Will bonds be made available? Whilst they would not be mine and I’m sure not the Cabinet Secretary’s choice of means of borrowing, because they tend to be more expensive, what they’ve done and why local authorities like them—. You don’t want to use them, but what you want them to do is to keep the public works loan board’s lending level’s low. When the public works lending board pushed their rates up, what happened was that we saw that people started looking at bonds, and all of a sudden the public works loan board’s costs came down quite considerably. I think that this is really important.226
Finally can I raise primary health, secondary health and social services expenditure? The auditor general, in about 2015, produced a report on medical interventions that do no good to the patient, estimated at that time at several hundred million pounds. This did not include expenditure where the operation was successful, but following hospitalisation, when the individual was no longer able to look after themselves and ended up in a nursing home.227
The late Dr Julian Tudor Hart, who many of us knew, with others, identified expenditure on such things as reducing slightly raised blood pressure, which does no good in terms of health, but it’s actually expensive. And can I remind the finance Cabinet Secretary, while health Secretary, you reported, on more than one occasion, on the different intervention rates for the removal of tonsils between two areas in the same health board. So, it’s not a difference between health boards—it’s basically the difference between two surgeons. You’re twice as likely to have your tonsils removed in one than the other.228
The Royal College of General Practitioners regularly identify the relative reduction in primary care expenditure. And I have concerns about the fact that secondary care takes priority over primary care. The Nuffield Foundation produced research showing that productivity in hospitals in Wales, in terms of patient-per-doctor intervention, had reduced between 2003 and 2013.229
Social care is under huge pressure, especially elderly care and support for children. I understand that support for children has gone up by 100 per cent over the last 10 years. And we also know that elderly care is continuing to increase. Many of us think it’s a good thing—we all want to live longer, don’t we? But it does come with a cost, and that is falling, almost exclusively, on local authorities.230
I’m very pleased that from being a lone voice supporting improving health by dealing with factors such as obesity and smoking that lead to ill health, there is now a lot of support for preventative action. In fact, we had Steffan Lewis talking about preventative action earlier, and I hope we’ll get more people talking about preventative action. Having somebody in hospital being operated on, in many cases, is a sign of failure, not success. The sign of success is them not ending up there in the first place. I think our aim has got be to increase health rather than increase health expenditure or health interventions.231
So, I welcome the budget, I think that it’s the best that can be done. Could we have the £4 billion to £6 billion we should have? And then both the Cabinet Secretary and most Members in this room will be very, very happy. We’re not going to get that, and under very difficult circumstances, I commend the Cabinet Secretary for his budget.