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Written Assembly Questions tabled on 4 October 2017 for answer on 11 October 2017

R - Signifies the Member has declared an interest.
W - Signifies that the question was tabled in Welsh.

(Self-identifying question no. shown in brackets)

Written Questions must be tabled at least five working days before they are to be answered. In practice, Ministers aim to answer within seven/eight days but are not bound to do so. Answers are published in the language in which they are provided, with a translation into English of responses provided in Welsh.

To ask the Cabinet Secretary for Economy and Infrastructure

Mark Isherwood (North Wales): How will the tenders of the four bidders for the next Wales and Borders rail service be evaluated by the Welsh Government? (WAQ74325)

Answer received on 11 October 2017

The Cabinet Secretary for Economy and Infrastructure (Ken Skates): The bidders will be assessed according to agreed evaluation criteria, and the contract awarded to the most cost effective way of delivering my priorities as outlined in the Rail Services for the Future documents, I published last month. My ultimate priority is to improve all rail services across Wales and the Borders for the benefit of passengers.
 
Mark Isherwood (North Wales): Will the Cabinet Secretary confirm whether the new Wales and Borders rail franchise will benefit all users and communities in Wales, as well as those who use cross border services? (WAQ74326)

Answer received on 10 October 2017

The Cabinet Secretary for Economy and Infrastructure (Ken Skates): Following constructive engagement with the public, we are developing a model for the Wales and Borders network that will allow us to prioritise service over profit, drive up standards and improve the passenger experience. The next Wales and Borders franchise will be for the benefit of all rail users across Wales and the borders from 2018. We have set out more detail on our approach and what we are procuring in the recent Transport for Wales brochure – Rail Services for the Future. See attached link:
http://gov.wales/docs/det/publications/170922-rail-services-of-the-future-brochure-en.pdf 
 
Darren Millar (Clwyd West): How many young people have registered for the mytravelpass scheme, by Welsh local authority? (WAQ74328)

Answer received on 10 October 2017

Ken Skates: As of the 1^st October a total of 17,295 people have registered for the mytravelpass scheme.
 
Figures by local authority are as follows: 

 
Janet Finch-Saunders (Aberconwy): Will the Cabinet Secretary provide an update on progress with regards the improvement works to junctions 15 and 16 on the A55, to include details of the public consultation, and a detailed timetable for development, consultation, design and construction? (WAQ74331)

Answer received on 10 October 2017

Ken Skates: We recently appointed Carillion as the Early Contractor Involvement (ECI) contractor to progress the improvements of Junctions 15 and 16 on the A55. Over the next 18 months we will be progressing the design development of both junctions which will include public consultations. We are planning to hold Public Information Exhibitions towards the end of the year where further details of the programme for delivering the junction improvements will be presented.

To ask the Cabinet Secretary for Health, Well-being and Sport

Julie Morgan (Cardiff North): Following his announcement in plenary on 14 June that a HCV elimination plan would be issued to NHS Wales and the Health Boards over the summer, will the Cabinet Secretary confirm: a) what discussions have taken place with blood-borne virus leads about the scope of any revised guidance, and; b) when the plan will be issued so that work can continue the great work to work towards elimination of this disease? (WAQ74322)

Answer received on 11 October 2017

The Cabinet Secretary for Health, Well-being and Sport (Vaughan Gething): Work towards the elimination of viral hepatitis has been progressing well during the summer. The Welsh Viral Hepatitis Subgroup submitted a comprehensive framework to my officials in September. Based on the information provided, my officials have considered the most appropriate actions to achieve the targets. The Chief Medical Officer will be issuing a Welsh Health Circular to the NHS and community pharmacies imminently which will focus on those measures that will reduce, and ultimately prevent, ongoing transmission of hepatitis C, whilst ensuring all those currently infected have access to treatment.
 
Nick Ramsay (Monmouth): Has a submission to the All-Wales Medicines Strategy Group been made for the medicine Orkambi to be used in the Welsh NHS? (WAQ74323)

Nick Ramsay (Monmouth): When will the All-Wales Medicines Strategy Group approve Orkambi for use in the Welsh NHS? (WAQ74324)

Answer received on 11 October 2017

Vaughan Gething: Orkambi® (lumacaftor/ivacaftor) is indicated for the treatment of cystic fibrosis in patients aged 12 years or older with the F508del gene mutation.
In 2016, the National Institute for Health and Care Excellence (NICE) re-issued their Technology Appraisal guidance under their “Do Not Do” guidance, emphasising that Orkambi® should not be made routinely available.
The All-Wales Medicines Strategy Group (AWMSG) has contacted the pharmaceutical company, Vertex Pharmaceuticals, and has strongly encouraged them to make a submission to the AWMSG for appraisal. Whilst Vertex has agreed in principle to submit clinical data for appraisal by AWMSG, they have not committed to any firm date for doing so. However, discussions have commenced with Vertex on the most effective approaches to appraisal for the additional license extensions due to come on stream over the next few years. My officials will ensure the future appraisal of lumacaftor/ivacaftor (Orkambi®) is covered.
In the interim, the Welsh Health Specialised Services Committee (WHSSC) has agreed a patient access scheme with Vertex Pharmaceuticals and it is available in the Welsh NHS, where clinically appropriate.

Mark Isherwood (North Wales): Does the Welsh Government support the development of a register to record the number of people in Wales who have cerebral palsy, which can then be used to improve clinical outcomes and help plan services for children and adults who have cerebral palsy? (WAQ74327)

Answer received on 11 October 2017

Vaughan Gething: At present, the clinical benefit of a register over and above the coded information on cerebral palsy, routinely collected in NHS Wales has not to our knowledge been described. It would be the responsibility of Health Boards in Wales to consider developing a register to record the numbers of people in Wales who have cerebral palsy; provided there is clinical consensus that this would improve the outcomes and inform service improvements.

Janet Finch-Saunders (Aberconwy): How many people have successfully made a claim for backdated funding under Continuing NHS Healthcare, and what is the total value of these claims? (WAQ74329)

Answer received on 11 October 2017

The Minister for Social Services and Public Health (Rebecca Evans):  Approximately 7,500 claims have been received by health boards in Wales with over 70% of these having been completed.   These claims relate to the period between 1996 and the present.  Whilst Health Boards have not historically collected data on the number of successful claims we do know that just over £70million has been repaid to people that were wrongly charged for their care.

With each successive claim period there are fewer in the system.  However, we must continue to focus on getting it right first time in order to ensure that people are aware of their right to be assessed for CHC and those assessments are undertaken correctly and in a consistent way.  

Janet Finch-Saunders (Aberconwy): Will the Cabinet Secretary make a statement on the formation of the Welsh Health Authority? (WAQ74330)

Answer received on 10 October 2017

The Cabinet Secretary for Health, Well-being and Sport (Vaughan Gething): I have no plans to create a Welsh Health Authority.
 
Janet Finch-Saunders (Aberconwy): Will the Cabinet Secretary provide the number of patients treated over the border in 2014-15, 2015-16 and 2016-16, including a breakdown of the hospital that provided the treatment/operation, and what it was for? (WAQ74332)
 
Answer received on 13 October 2017

Vaughan Gething: The attached pdf shows the number of patient episodes for Welsh residents who were treated across the border, broken down by speciality and hospital for each of the last three years. Specialities where there are less than three patient episodes for every financial year have been excluded. A patient episode is the time a patient spends in the continuous care of one consultant (or GP acting as a consultant). Therefore the attached pdf does not show unique patients, which are shown in Table 1.

A number of Welsh residents are routinely referred to England for elective treatment where those services are not provided in Wales, including some specialised services. In addition, health boards in Wales, particularly those along the border, have contracts with providers in England for elective care. These are a small number of episodes compared to overall number of patients treated in Welsh hospitals which is shown in Table 2:

Table 1: Welsh patients treated in English hospitals

Source: Patient Episode Database Wales, NHS Wales Informatics Service

Table 2: Number of patient episodes in Welsh hospitals

Source: Patient Episode Database Wales, NHS Wales Informatics Service

 
Darren Millar (Clwyd West): With reference to the National Emergency Pressures Escalation and De-Escalation Plan, on how many days in the previous 12 months were Welsh emergency departments at level 4, providing the answer by emergency department? (WAQ74333)

Darren Millar (Clwyd West): With reference to the National Emergency Pressures Escalation and De-Escalation Plan, on how many days in the previous 12 months were Welsh emergency departments at level 5, providing the answer by emergency department? (WAQ74334)

Darren Millar (Clwyd West): With reference to the National Emergency Pressures Escalation and De-Escalation Plan, on how many days in the previous 12 months were Welsh emergency departments at level 6, providing the answer by emergency department? (WAQ74335)

Answer received on 11 October 2017

Vaughan Gething: This information is not held centrally.
Health boards record their escalation levels in accordance with the National Emergency Pressures Escalation and De-Escalation Action Plan. The plan in Wales has four levels of escalation and de-escalation.

Angela Burns (Carmarthen West and South Pembrokeshire): Will the Cabinet Secretary outline how the additional funding for mental health services as set out in the draft budget 2018-19 and 2019-20 will be shared between adult, child and older peoples services? (WAQ74344)
Angela Burns (Carmarthen West and South Pembrokeshire): What proportion of the additional investment in mental health services, as announced in the 2018-19 draft budget, will be used to support preventative and community based services? (WAQ74345)
Angela Burns (Carmarthen West and South Pembrokeshire): How will the additional capital funding as outlined in the draft budget 2018-19, be shared across Wales' hospital estate? (WAQ74347)

Answer received on 10 October 2017

Vaughan Gething: Information on detailed spending plans for 2018-19 will be published on 24th October.

Angela Burns (Carmarthen West and South Pembrokeshire): What discussions has the Cabinet Secretary had with Wales' health boards on their projected overspends and what plans are in place to mitigate the long term impacts of each health boards overspend? (WAQ74346)

Answer received on 12 October 2017

Vaughan Gething: The Minister for Social Services and Public Health and I meet regularly with all NHS chairs to share our expectations for their organisations. This will include the requirement to meet their statutory financial duty to operate within their budget over a three-year period. Where organisations are projecting overspends, I have regular discussions with chairs to ensure their boards are putting in place the operational and strategic action required to address their projected deficits in the current financial year, and over the medium term. 
 
Angela Burns (Carmarthen West and South Pembrokeshire): Will the Cabinet Secretary provide details on which treatments have been earmarked to be reviewed by Wales' treatment fund in the next 12 months? (WAQ74348)

Answer received on 11 October 2017

Vaughan Gething: The New Treatment Fund provides substantial, additional central funding to support health boards make medicines recommended by the National Institute for Health and Care Excellence (NICE) and the All Wales Medicines Strategy Group (AWMSG) available faster, and no later than the two month timeframe introduced with the Fund.
The new timeframe established under the fund is designed to ensure all new recommended medicines are considered equally important and made available consistently across Wales where clinically appropriate. Priority is not given for a new treatment for one disease over another. The monitoring system measures health board compliance for each medicine appraised and recommended. There are therefore, no plans to “earmark” for review, any specific medicines.

Suzy Davies (South Wales West): Will the Cabinet Secretary clarify the real term changes to funding for social services in Wales as a result of the draft budget 2018-19? (WAQ74352)

Answer received on 10 October 2017

Mark Drakeford: Within the 2018-19 settlement, we are prioritising funding through the local government settlement for social services to maintain the Welsh Government’s contribution to authorities’ core spending in this area at current levels. Applying the Office for Budget Responsibility GDP deflators[1], this represents a real terms reduction of 1.5% in the Welsh Government’s contribution to social services funding through the local government settlement.

To ask the Cabinet Secretary for Communities and Children

Suzy Davies (South Wales West): Will the Cabinet Secretary outline the real terms changes to funding for the Integrated Care Fund as set out in the draft budgets for 2018-19 and 2019-20, and outline how these changes will impact each regional partnership board? (WAQ74351)

Answer received on 11 October 2017

The Cabinet Secretary for Communities and Children (Carl Sargeant): Our investment of £60m a year in the integrated care fund (ICF) has a capital component which supports new and innovative models of care and support. These approaches help people to maintain their independence whether in their own homes or by providing appropriate accommodation.
Building on this, we are investing an extra £15m over two years - £5 million in 2019-20 and £10 million in 2020-21, in housing, health and social care capital programmes. This additional investment will complement the ICF by developing independent living integrated with care and by supporting local housing and social care partnership working. Any additional integrated living will contribute towards our commitment to create 20,000 affordable homes over the lifetime of this Assembly and will support a number of “Taking Wales Forward” priorities areas including Housing and Social Care.

Mark Isherwood (North Wales): What steps has the Cabinet Secretary taken to engage with people and providers over the design, delivery and monitoring of the Supporting People Programme? (WAQ74353)

Mark Isherwood (North Wales): What steps is the Cabinet Secretary taking to provide local authorities with indicative allocations for the Supporting People Programme on a three year basis rather than a two year basis as outlined in the draft budget? (WAQ74354)

Mark Isherwood (North Wales): What discussions has the Cabinet Secretary had with the Cabinet Secretary for Finance and Local Government about the funding formula for the Supporting People Programme, will he provide dates of those meetings and what were the outcomes of those meetings? (WAQ74355)

Mark Isherwood (North Wales): What changes will the Cabinet Secretary be making to procurement guidance under the Supporting People Programme after the Wales Audit Office termed it misleading in August 2017? (WAQ74356)

Mark Isherwood (North Wales): What steps is the Cabinet Secretary making to ensure that Regional Collaborative Committees and local authority providers are fully aware of and prepared for any further policy changes by the Welsh Government to the Supporting People Programme? (WAQ74357)

Mark Isherwood (North Wales): What measures has the Cabinet Secretary taken to ensure that Regional Collaborative Committees under the Supporting People Programme have provider and third sector representation, and will the Cabinet Secretary outline the future of the Committees, along with the effects any changes will have on the ring-fencing of funding for the Programme? (WAQ74358)

Mark Isherwood (North Wales): What discussions has the Cabinet Secretary with the Cabinet Secretary for Finance and Local Government about the role of the Supporting People Programme's Regional Collaborative Committees in his proposals for local government reform and will he also provide the dates for these meetings? (WAQ74359)

Mark Isherwood (North Wales): Will the Cabinet Secretary provide a breakdown of the reviews his department have undertaken of the local authority delivery of the Supporting People Programme, including the scores of individual councils? (WAQ74360)

Mark Isherwood (North Wales): Will the Cabinet Secretary make a statement on the Wales Audit Office's report on the Supporting People Programme, published in August 2017? (WAQ74361)

Answer received on 16 October 2017

Carl Sargeant:  Given their related nature, a single answer has been provided to address these questions comprehensively
 
Welsh Government has recently completed a consultation exercise on "Draft Supporting People guidance and outcomes framework". The consultation ended on the 4^th August 2017 and we are currently considering the responses to this comprehensive engagement with stakeholders.
 
As part of this consideration we are seeking to absorb the lessons to be learned from the Auditor General's report on Supporting People; this will include revisions to the draft guidance to reflect the recommendations made. In particular we will be revising the procurement guidance to ensure that the mechanisms deliver value for money whilst balancing the risks identified by the Auditor General. Namely;

• reducing the pool of potential suppliers;
• inadvertently working against the Welsh Government's objective of local authorities developing local third-sector organisations;
• creating frustration amongst providers where they consider such closed approaches inequitable; and
• limiting opportunities for local authorities to drive further improvements and efficiencies.
  
   

With respect to monitoring, the system of local authority Supporting People visits has been developed in agreement with the Supporting People National Advisory Board. The visits provide constructive challenge for local authority Supporting People teams. In order to ensure an open and frank dialogue the reports of these visits are not scored and are not published.
 
Experience has shown that efforts to provide indicative allocations beyond the period for which Welsh Government budgets have been set, has proved futile, reflecting the fact that we can not provide  assurance where Welsh Government itself is not certain of the funding parameters. As a result, indicative allocations are not set beyond the known budget period. The ability to set a two year budget in the current round is therefore a significant step forward where Welsh Government is able to offer indicative allocations for which it can enjoy a level of confidence.

Issues of distribution formula were discussed by the Distribution Sub-Group of the Local Authority Partnership Council at the time of the Mansel Aylward review and I continue to discuss formula matters with my Supporting People National Advisory Board. However, distribution formulae for revenue grants are within my gift as part of my portfolio responsibilities and I have not therefore had formal discussions with the Cabinet Secretary for Finance and Local Government on this matter.

I am seeking advice on the opportunities to rationalise grant administration within my portfolio in order to increase flexibility, reduce bureaucracy and help address future budget pressures which we anticipate in future Welsh settlements from U.K.  Treasury. As part of this process I have asked officials to meet with chairs of the Regional Collaborative Committees and other key stakeholder representatives to discuss the opportunities and risks such an approach may present. In addition I have asked the Supporting People National Advisory Board to provide me with their views. The Board includes representatives of Local Authority Supporting People teams and the Welsh Local Government Association.

Welsh Government has published guidance and a Memorandum of Understanding governing Regional Collaborative Committees (RCCs). This guidance makes clear that RCCs should include: "Providers (representing long term and short term services) elected and supported by Cymorth Cymru and Landlords elected and supported by Community Housing Cymru," as well as service user representation. Whilst, I have been clear that I am listening to thoughts on how I might remove unnecessary barriers within the grant mechanism in my portfolio, this has not as yet translated to any proposals to change the role of the RCCs.

I have instructed my officials to engage with those in the Cabinet Secretary for Finance and Local Government's department on the implications of Local Government Modernisation for Regional Collaborative Committees. To date this has not necessitated any specific discussion with The Cabinet Secretary although of course the broader issues are the subject of regular discussion within Cabinet.

I made a written statement on the Wales Audit Office report on Supporting People on the 31^st August. In that statement I welcomed the Auditor General's recognition of the progress that has been made and the value of the programme. However, I also acknowledged the work that remains to be done. An initial response has been provided and a fuller formal response will follow in due course. In that statement I offered to make a statement or answer questions and would be happy to do so should Assembly Members wish me to do so.

To ask the Cabinet Secretary for Finance and Local Government

Janet Finch-Saunders (Aberconwy): Will the Cabinet Secretary provide a breakdown of senior officers' remuneration in local authorities in the years 2015-16 and 2016-17? (WAQ74336)

Janet Finch-Saunders (Aberconwy): Will the Cabinet Secretary provide a breakdown of the councils who were unable to properly prepare disclosures on senior officer remuneration in 2015-16? (WAQ74337)

Janet Finch-Saunders (Aberconwy): Will the Cabinet Secretary make a statement on the Wales Audit Office's findings that approximately 50 per cent of local government bodies did not properly prepare disclosures on senior officer remuneration? (WAQ74343)

Answer received on 10 October 2017

The Cabinet Secretary for Finance and Local Government (Mark Drakeford): The Accounts and Audit (Wales) Regulations 2014, require a breakdown of senior officers' remuneration to be set out in each local authority's statement of accounts.  This information is not held centrally by the Welsh Government. 

It is the responsibility of each local authority to ensure it complies with legislative requirements relating to the disclosure of information related to their senior officers' remuneration. 

I expect local authorities to uphold the common set of core principles and minimum standards set out in the Welsh Government report 'Transparency of senior remuneration in the devolved Welsh public sector'. 

Janet Finch-Saunders (Aberconwy): Will the Cabinet Secretary make a statement on the Wales Audit Office's findings that 52 per cent of financial statements in 2015-16 contained material errors? (WAQ74338)

Janet Finch-Saunders (Aberconwy): Will the Cabinet Secretary make a statement on the Wales Audit Office's report Local Government Financial Statements 2015-16? (WAQ74341)

Answer received on 10 October 2017

Mark Drakeford: It is vital that local authority’s service delivery is underpinned by robust financial reporting which is accurate and high quality, so it is encouraging that the Auditor General for Wales concluded that local government bodies generally prepared good-quality financial statements.
It is important that in planning for the future challenges authorities face, they take account of the need to ensure financial reporting continues to improve and become more timely.

Janet Finch-Saunders (Aberconwy): Will the Cabinet Secretary make a statement on the Wales Audit Office's findings that local authorities' total useable reserves rose by 7 per cent since 2011-12? (WAQ74339)

Janet Finch-Saunders (Aberconwy): Will the Cabinet Secretary provide a breakdown of useable reserves by local authorities in the years 2015-16 and 2016-17? (WAQ74340)

Janet Finch-Saunders (Aberconwy): What steps is the Cabinet Secretary taking to encourage councils to make further use of their useable reserves? (WAQ74342)

Answer received on 10 October 2017

Mark Drakeford: It is the responsibility of each authority to ensure it has an appropriate strategy in place for holding and using its reserves. The strategy should include regular reviews of holdings of reserves to ensure they are being deployed strategically to maintain and improve vital local services and to support the necessary longer term reforms.
The latest data on levels of reserves held by each local authority are published on the Welsh Government’s website. http://gov.wales/topics/localgovernment/finandfunding/whole-government-accounts/publications/whole-government-accounts-reserves/?lang=en

Suzy Davies (South Wales West): How will increased funding for social care as set out in the draft budget 2018-19 be shared between each of Wales's local authorities? (WAQ74349)

Answer received on 10 October 2017

Mark Drakeford: The funding for social care set out in the draft budget 2018-19 will be distributed across the Welsh local authorities according to the personal social services element of the local government settlement formula. Further information can be found on the Welsh Government settlement web pages:
http://gov.wales/topics/localgovernment/finandfunding/settlement/?lang=en
 
Suzy Davies (South Wales West): Will the Cabinet Secretary outline which additional funding allocations for Wales' social services, if any, will be protected by a ring fence in the draft budget 2018-19? (WAQ74350)

Answer received on 10 October 2017

Mark Drakeford: Within the 2018-19 settlement we are prioritising funding for social services. While there is no ring fencing on any specific element of the settlement, I am prioritising funding through £42 million in 2018-19 within the settlement to maintain the Welsh Government’s contribution to social services and enable authorities to maintain core spending in this area at current levels.