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13 March 2012

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Minutes and papers of a meeting of the Cabinet.
  • Item 1: Minutes of the previous meeting

  • Item 2: First Minister’s Items
  • Item 3: Forthcoming Assembly Plenary Business
  • Item 4: Together for Health – Why Change is needed
  • Item 5: The Welsh National Health Service – Delivery of Financial Balance in 2011-12
  • Item 6: Delivering the Climate Change Strategy: First annual progress report
  • Item 7: Oral Items


  • Rt. Hon. Carwyn Jones AM, First Minister (Chair)
  • Leighton Andrews AM 
  • Edwina Hart MBE OStJ AM (item 4 only)
  • Jane Hutt AM 
  • John Griffiths AM
  • Lesley Griffiths AM 
  • Huw Lewis AM
  • Carl Sargeant AM 
  • Janice Gregory AM
  • Theodore Huckle QC


  • Dame Gillian Morgan, Permanent Secretary
  • Michael Hearty, Director General Strategic Planning, Finance and Performance 
  • Peter Greening, Cabinet Secretary
  • Des Clifford, Principal Private Secretary to the First Minister 
  • Jo Kiernan, Special Adviser
  • Andrew Bold, Special Adviser
  • Chris Roberts, Special Adviser
  • Jonathan Davies, Special Adviser 
  • Matt Greenough, Special Adviser 
  • Steve Jones, Special Adviser 
  • Sophie Howe, Special Adviser
  • Jeff Andrews, Specialist Policy Adviser
  • Christopher W Morgan, Head of Cabinet, Plenary and Committee Business Secretariat (minutes) 
  • David Sissling, Director General Health, Social Services and Children (items 4&5) 
  • Chris Jones, Medical Director NHS Wales (item 5)
  • Alan Brace, Director of Resources, NHS Wales (item 5)
  • Gareth Jones, Acting Director General, Sustainable Futures (item 6)
  • Andy Fraser, Head of Climate Change (item 6)

Item 1:  Minutes of the previous meeting

1.1 Cabinet approved the minutes of the previous meeting.    

Item 2:  First Minister’s Items

First Minister’s visit to the United States of America

2.1 The First Minister advised Cabinet of his recent visit to the United States where he had promoted Wales as a business and tourism location.  During the visit the First Minister had met a number of existing and potential investors.

The Science Strategy

2.2 Cabinet noted that the First Minster had launched the Science Strategy the previous day.  He underlined the encouraging reception which the Strategy had already received and this confirmed his view that the Chief Scientific Adviser had produced an excellent piece of work.   It was noted that there was a need to work with Higher Education and businesses in Wales to help convert science into commerce, thereby underpinning the efforts of the Welsh Government to generate knowledge-based jobs.

The Launch of the Energy Strategy

2.3 The First Minister advised Cabinet that he would be launching the Energy Strategy the following day.  Ministers agreed that, as energy was an important source of jobs and growth, the Welsh Government should embrace the opportunities offered by the Energy Strategy including opportunities offered by generation.  

Item 3: Forthcoming Assembly Plenary Business  

Plenary Business

3.1 Ministers discussed the Plenary Grid and noted that the Assembly’s Business Committee had discussed plans to reschedule business intended for Wednesday 28th March due to possible industrial action by the Public and Commercial Services Trade Union.

Item 4:  Together for Health – Why Change is needed

4.1 The Minister for Health and Social Services introduced the paper, which provided Cabinet with an update on progress to put in place a National Health Service for Wales that provided sustainable high performing services across all areas of the country.  

4.2 In October, Cabinet considered ‘Together for Health’ the Welsh Government’s vision for the NHS in Wales that set out how the health service should look in five years time, after a transformational shift of services to primary and community settings.   The paper provided Cabinet with further detailed information on why change was needed, to enable the NHS to continue to improve and deliver high quality services that were comparable with the best in the world.

4.3 It was reported that the Wales Institute for Health and Social Care had been commissioned by Health Boards to examine the available evidence and to present a national case for change.  The emerging evidence gathered confirms that the status quo was not a sustainable option, and change was needed to secure future sustainability of services, both in terms of the best patient outcomes and financial balance.

4.4 The paper set out the strong evidence presented by the case for change, which included highlighting areas where mortality rates for general surgery in Wales was higher than that in England, and where urgent change was needed to ensure high quality services in both urban and rural settings.  There were numerous risks and challenges and the current pattern of services across Wales not only provided sub-optimal quality in some areas, but was more expensive to run.

4.5 The Minister was also committed to driving forward a transparency agenda within the NHS to ensure that the public was aware of what the Welsh Government was doing to make the NHS publicly accountable for the services it provides.

4.6 A programme of external engagement activity had been developed to report the key themes and findings of the ‘Case for Change’ research and inform debate.   This would commence with an event for Assembly members, sponsored by the chair of the Assembly’s Health and Social Committee, on 21st March.   In addition, the Welsh Government’s messages would be unambiguous and direct regarding the need for change and clinicians would play a much more active role in clearly explaining the nature of the proposals.

4.7 The First Minister endorsed the paper particularly the case for change.

4.8 It was acknowledged that communicating the importance of the changes were paramount and the Local Health Boards (LHBs) would need to be timely and sensitive when informing patients.  

4.9 There was also a need to consider the broader relationships with the wider public sector, particularly in relation to transportation.  In addition, further consideration would need to be given to address cross border health issues with England.  There remained opportunities to highlight the continuing existence of the NHS in Wales, while the position in England was changing dramatically under the UK Government’s controversial proposals.

4.10 In relation to the delivery of NHS services, Ministers questioned whether anything could be learnt from the Scottish Health Service, particularly in the availability of technology to support paramedics.  It was reported that some thought was being given to how to extend the current levels of air ambulance cover in Wales.  However, it was acknowledged that the Welsh Government would be looking to achieve a figure of nowhere in Wales being more than 30 minutes away from emergency treatment, compared with 45 minutes in Scotland.  

4.11 Cabinet approved the paper and noted that the Health Service in Wales was leading the way in delivering programmes through the Invest to Save Programme.

Item 5: The Welsh National Health Service – Delivery of Financial Balance in 2011-12

5.1 The Minister for Health and Social Services introduced the paper, which provided Cabinet with an update on the latest financial outlook for the National Health Service in Wales for 2011-12 and the action being taken to secure a financial balance at the end of the financial year.  

5.2 As a result, the ten NHS organisations in Wales had been more effective at managing in-year operational cost pressures this financial year, and had made good progress in delivering savings.  There had also been a pattern of continued improvement in many of the service priority areas, such as Orthopaedic surgery.  

Item 6: Delivering the Climate Change Strategy: First annual progress report

6.1 The Minister for Environment and Sustainable Development introduced the paper, which asked Cabinet to approve the publication of the Welsh Government’s first annual report on delivery of targets set out in the Climate Change Strategy.  Ministers were asked to note progress to date and to agree to explore how the package of measures might be enhanced to help to achieve the 3% emission reduction target.

6.2 It was noted that, while the first report reflected progress on implementing the Delivery Plans associated with the Strategy, actual performance in relation to the 3% target could not be reported on, as the relevant official emission statistics for 2011 would not be available until July 2013.

6.3 It was agreed that a communications plan should support the publication of the annual report to highlight what the Welsh Government was doing to combat climate change, such as providing additional resources to Arbed.   Cabinet approved the paper.

Item 7: Oral Items


7.1 The Minister for Education and Skills advised Cabinet that he would be meeting Maria Miller, the Parliamentary-Under Secretary of State for Disabled People, after the Cabinet meeting to discuss the UK Government’s decision to close seven of the nine Remploy factories in Wales.   He would be asking the UK Government to devolve the budget for Remploy factories in Wales for three years, which would allow the Welsh Government to put in place measures that provided a lasting future for the disabled employees.  The Minister would also be meeting the Chief Executive of Remploy later that week.

7.2 It was noted that the outcome of the discussion with the UK Minister would be shared with the First Minister and the Minister for Finance and the Leader of the House.  

Cabinet, Plenary and Committee Secretariat
March 2012