UNCORRECTED TRANSCRIPT OF ORAL EVIDENCE To be published as HC 281-vi

House of COMMONS

MINUTES OF EVIDENCE

TAKEN BEFORE

welsh affairs committee

globalisation and its impact on wales

Tuesday 20 March 2007

MR JULIAN BURRELL and MR DAVE CHAPMAN

MS ANN LLOYD

Evidence heard in Public Questions 457 - 544

USE OF THE TRANSCRIPT

Oral Evidence

Taken before the Welsh Affairs Committee

on Tuesday 20 March 2007

Members present

Dr Hywel Francis, in the Chair

Mr David Jones

Albert Owen

Mark Williams

________________

Memorandum submitted by Wales Tourism Alliance

Examination of Witnesses

Witnesses: Mr Julian Burrell, Chairman, and Mr Dave Chapman, Communications and Policy Consultant, Wales Tourism Alliance, gave evidence.

Q457 Chairman: Good morning. Welcome to the Welsh Affairs Committee and our inquiry into globalisation. For the record, would you introduce yourselves, please?

Mr Burrell: My name is Julian Burrell, Chairman of the Wales Tourism Alliance.

Mr Chapman: I am David Chapman, the Communications and Policy Consultant for the Alliance.

Q458 Chairman: It is our custom to begin our questions by trying to focus globally, so my first question is how conscious are you now that tourism in Wales is very much part of a global economy, particularly in relation to markets and labour, and how have your strategies in recent years changed to take account of that?

Mr Burrell: The tourism industry itself has had to cope with a global marketplace for some 40 years now, so that side of it is nothing new, and I think it is something that Wales, in particular, has coped with. We are still, in 2001, 2005, talking about long-haul, overseas holidays increasing by some 12% and short-break holidays overseas 35%. Those figures as well are very encouraging from Wales's point of view. Although domestic tourism over the last few years showed an overall drop in the UK on spend of something like 22%, Wales has got a plus figure, plus 4.9%, and I think that shows we are coping very much with global marketplaces. On the labour front, this is something which is comparatively new. Going back to 2003, there were something like 5,000, 6000 overseas workers here, most of whom were working in the restaurant industry at that time, and so the influx of some overseas labour, for hotels and other markets, is only comparatively recent and is still quite small. We are talking about, for A8 entrants, out of 100,000 into the hospitality industry in the UK between, I think it is, May 2004 and September 2006, only 2.4% have come to Wales, so they are a vital part of the industry but a small part of the industry.

Q459 Chairman: In general terms, how important is tourism to the Welsh economy and can you identify those parts of the tourism sector which are likely to grow?

Mr Burrell: We employ something like nearly 9% of the workforce, and that is a considerable figure, and that on its own, I think, shows the importance of tourism to the economy in Wales. The growth areas, I think, anything prefaced with 'quality', from quality camp-sites to quality hotels, and that is the essence of what we have got to try to achieve to make Wales stand out, we must have that quality presence. That means as well having the staff and the managers and the owners that can provide that quality service; it is no good having just a quality product without a quality service.

Q460 Chairman: Do you market, in particular, green tourism, or eco-tourism or, dare I say it, food tourism?

Mr Burrell: I am sure you can dare say food tourism. Probably it might seem strange that, ten years ago, we could think of Wales becoming a 'food tourism' important part of the economy, but that is very much what is happening, and that is local food as well, and that is a vital part of the strategy which is with us now and it is something that the Wales Tourism Alliance is pushing and my colleague David here has been dealing with; so that growth area is fine. Environmental tourism, I think that is where the industry needs to take the lead, not wait for our customers to say "Hey, why aren't you doing something?" it is actually to be ahead of our customers' requirements and show that we really care about these environmental issues.

Q461 Chairman: Are you conscious of the importance of economic regeneration, community regeneration, the relationship between them and tourism; is that an important interface and do you have any observations on that?

Mr Burrell: Very much so. A lot of the time regeneration is used in the context of urban regeneration and I think one of the biggest contributions tourism has made has been rural regeneration, especially after foot and mouth. It is the sort of thing which does not show up perhaps in figures and stats all the time but it is a case that tourism has helped to maintain the fabric of rural life, it has sustained farms. You have got a farm which probably was not going to be able to keep going on its own but, with the addition of tourism, with the addition perhaps of a cottage, or bed and breakfast, or whatever, that farm is still viable and that has helped to maintain rural economies.

Q462 Chairman: I am very interested in the impact of tourism on economic and community regeneration in the South Wales Valleys and particularly I was struck by my own birthplace and the way in which St Patrick is being promoted, because it is alleged that he was born in Banwen in the Dulais Valley. Do you notice that there are any significant developments across the South Wales Valleys and the way in which tourism is helping to assist in their regeneration?

Mr Burrell: The obvious example is the Big Pit and that is an iconic destination, as you know, an award-winning destination, and to have achieved something like that in that area, I think, is a real, major, important role of tourism in the Valleys. That has become probably one of the best-known industrial museums in the UK and has had a big influence; we all need iconic buildings, and we have seen what has happened in Cardiff, with the Millennium Centre and Athletic Stadium, but we have got that equivalent in the Valleys and that has made a big difference.

Mr Chapman: In think tourism's role in regeneration is often as a supplementary but essential part which occurs, from our point of view, across the whole of Wales, and that can be replicated in the South Wales Valleys. If you consider the industry, it is locally-based, locally-owned and has an effect on every single constituency in Wales, which makes it pretty unique as an industry. What tends to happen with regeneration projects as a whole is that they rely on the development of a critical mass of regeneration in order to move things up and make things improve for the communities. At the heart of almost all regeneration would be the tourism industry, in some way or other, so we play a part in an awful lot of regeneration, not simply as a focal point for projects as well.

Q463 Mr Jones: Mr Burrell, you mentioned the importance to the agricultural community of diversification into tourism. Frequently this will require the town and country planning system to be used. To what extent are you finding that planning authorities are helpful and sympathetic when planning applications for new tourist projects are made by agriculturalists?

Mr Burrell: As you know, that will vary from region to region, or local planning area to planning area. For the smaller schemes, I do not think there is too much of a problem; it is when you come to the major schemes that you run into a lot of different opinions on the benefits, and the opposite. On the smaller side, what I was talking about, on the farm regeneration, when you are talking about restoring barns or other redundant buildings into cottages, I do not come across too many people saying they have problems in that direction, providing, of course, they are doing the restoration in a sympathetic manner.

Q464 Mark Williams: You highlighted the potential for food tourism. Could you give us some practical examples of the work you have been doing? I am fully aware that there is huge potential there, at a micro level there are many opportunities; how are those all being brought together to all Wales and more fundamentally how are you going about promoting those?

Mr Chapman: I think part of the Alliance's approach to where it can affect and develop policy generally is to try to bring together all of the key partners in a sector and build in this sort of large-scale inclusivity to make it happen, and we are doing that, which I am sure we will come on to later, in the skills area. What we were keen to do, and the Executive of the Alliance was keen to do with the food issue was, as there were a lot of local projects, to produce something which would have an across-Wales influence and be able to flag up some of the best products in some of the best tourist venues. The project we are working on currently is we are tied in with PGI Welsh Lamb and Welsh Beef and we are looking to find, in the very near future I hope, a link-up with the British Hospitality Association's premises in Wales, the top hotels and restaurants and other venues, and to run a promotional campaign highlighting the fact that they are selling and offering local food to the visitors, to raise the profile of both the tourism industry and the food industry. That is pretty near, I hope, ready to take public, probably it will be post-Easter but in time for the main part of the holiday season.

Q465 Mark Williams: There is also a close link there with something to be developed in terms of farm visits, that side of it, as well?

Mr Chapman: On a micro level, there has been a substantial amount of movement into food tourism in recent years and people were realising that visitors, I suppose rather like visitors from Britain to France were in the seventies, eighties and nineties, were going there primarily for the food, if you like, as well as the relaxation of a break in the landscape. I think Wales's reputation, at a time when stress levels rise in complicated lives in inner cities and central cities, as a place to relax and get away from it all, enjoy a wonderful environment, it all ties in with enjoying the local food produce, and particularly the lamb, the beef and the cheese, which actually originate from the countryside they visit.

Q466 Albert Owen: Just before I move on to the migrant workers issue that you mentioned, one area of growth, certainly in west Wales and north-west Wales, is cruise ships bringing in extra revenue to those areas. Is there a development plan for cruise liners in Wales for the future, or is it on a port-to-port basis?

Mr Burrell: There is a coastal strategy being discussed at the moment. One of the questions in there is do we go for more cruise ships; yes, they do bring some benefits, have we got the facilities to be able to bring them in. There are a lot of cruise ships calling just over the other side of the Irish Sea, which easily could call at Holyhead or Milford Haven, it is bettering the infrastructure as well to go with that. As you say, they have increased quite dramatically. One of our member organisations is the Blue Badge Guides and they have been involved with that. Obviously, it requires a considerable amount of work; they are not used to having that number of people turning up in one place at one time, but, yes, it has meant a lot to the industry.

Q467 Albert Owen: I would counter that and say that there are 2.7 million people coming through the port at Holyhead, so they are used to handling numbers, but just not the cruise liners?

Mr Burrell: Yes. Sorry. I meant the numbers of people requiring a guide, all at the same time.

Q468 Albert Owen: I appreciate that. You mentioned that some 2.4% of the labour in tourism was migrant labour, I think that was your figure?

Mr Burrell: Yes; 2.4% was A8 entrants coming in over the last two years.

Q469 Albert Owen: Can you tell us how many people are working in Wales in tourism?

Mr Burrell: That figure actually, 2.4%, was the number of A8 entrants coming into the UK who had come to Wales.

Q470 Albert Owen: Can you tell us how many came in?

Mr Burrell: We had some figures, as I mentioned to you, in about 2003, when the numbers here were only something like 5,000 or 6,000, and obviously those sorts of figures have increased, but they are still not that large, comparatively. We have made the point that a lot of them are waiters, the chief use of these very good people, which means they are very visible, so it tends to look like we have rather more people working in the industry than there are, and until very recently it was something which was apparent only in Cardiff, and I know that has spread to more areas.

Q471 Albert Owen: Previously you mentioned that they are not just in the restaurants any more but they are more central to the wider tourism sector. What kinds of jobs are they doing?

Mr Burrell: Waiting staff. This is a survey which was done for the Tourism Training Programme for Wales, specifically on this subject of overseas workers, and the response from employers was that waiting staff was the biggest, catering assistants second, cooks and chefs third, and one might think that perhaps, cleaning staff are in only fourth place, it was those other jobs, the more skilled jobs, that were being done.

Q472 Albert Owen: You mentioned in your memorandum that local people are hard to place and you have just told us what jobs the migrant workers are doing. What is needed locally, and in Wales, to get people to go into tourism and into catering?

Mr Burrell: Some of it starts from the schools. What we have been trying to do over the years is raise the status of the industry. You may be aware that last week was British Tourism Week. This was done at fairly short notice, and I think, when we do it again, one of the ideas I wanted was a lapel badge for everyone in the tourism industry: "The tourism industry is important. I am in the tourism industry therefore I am important." It is getting over to people that this is a vital part of our economy in Wales, tourism is so important, and to encourage more people to come in. Often we talk just about school-leavers but it is not just that age group. The tourism industry is particularly suitable, because of flexible working hours, for getting to the Government's agenda of getting the economically inactive involved, and that is particularly suitable, the tourism industry, say, for single-parent families, semi-retired people, or whatever, and these people are very valuable; often it is a loss that they are not being employed and the tourism industry can make use of them. It comes down to the fact that the tourism industry is always going to involve unsociable hours, and we have got to the stage now of celebrity chefs and that has had a big impact on some of the local colleges. Often the input to the general tourism courses can be quite low; it is "What shall we do with these people? Oh, they can go into tourism." The chefs have changed; you get some much better people coming in there, but still it comes down to chefs do not work Monday to Friday, nine to five, and a lot of young people understandably are a bit reluctant to come into an industry where it does mean there are unsociable hours.

Q473 Albert Owen: Accepting the unsociable hours point, is it not relatively low wages as well; in areas now where there are relatively good employment opportunities, they are not taking tourism and catering because of the wages?

Mr Burrell: I still do not think you can buy your way out of that problem.

Q474 Albert Owen: I am saying, is it a factor?

Mr Burrell: It is a factor, but not the only one. I do not usually talk about my own company, but do not assume that the whole tourism industry involves just hotels with more menial jobs. My own company is a self-catering agency and we always have trouble, because we are a call centre, open 12 hours a day, seven days a week, and it is the unsociable hours which are the biggest problem.

Q475 Albert Owen: To what extent are employment agencies used to supply labour in tourism in Wales?

Mr Burrell: What did come out in this survey that I mentioned just now was that the local Jobcentre was still the preferred route for most employers, 27%, 22% were using agencies. One important problem which came out from there was, once you get a nucleus of staff from a particular place and they find it is an excellent place in which to work, that soon gets around. Employers are finding 17% mentioned people just passing on a name, writing back home, saying "Here, there's a very good place to work, it's a great industry, a nice place to live," and that was the third most important source of getting people in.

Q476 Albert Owen: What are the advantages of using agencies?

Mr Burrell: I think some employers prefer overseas staff probably; because they perceive it is more complicated, they need some help to take on people there and make sure they look after them properly, and whatever.

Q477 Albert Owen: The paperwork is a burden?

Mr Burrell: Indeed, yes.

Q478 Mr Jones: I would like to ask you a few questions about training, but before I do so there is one paragraph in your memorandum which I did not quite understand. I wonder if you could explain it a bit further. You say: "The merger of the Wales Tourist Board into the Welsh Assembly Government has placed greater responsibility on the industry to project its policies and viewpoints. It has further emphasised the need for all key stakeholders in tourism and hospitality in Wales to work in a cohesive and joined up manner." Why has the merger had that effect?

Mr Burrell: Particularly the smaller players in the industry always thought that the Wales Tourist Board was there to represent them, and of course that was not quite the case, it was there to represent Government, not the industry, and that was more obvious once the merger had taken place, that the industry had to represent itself. After all, it is that way round; that is the way it works in any other industry, and, much of the change which has come about over the last five years, the Wales Tourism Alliance is comparatively new.

Q479 Mr Jones: Is that a real change or is it just a question of perception?

Mr Burrell: No, it is a real change.

Mr Chapman: There is obviously a coincidental thing as well, which is due to the inception and the growth of the Tourism Alliance itself, and it is a very new body, which originated only in 1999 to mirror the beginning of the Welsh Assembly Government, and began from very small origins, and so it has evolved to take its role as the voice of the industry in the period which has seen the pre-merger and the merger arrangements take place. That has happened at exactly the same time maybe as the consequences of the Board becoming a full part of Government, rather than being a somewhat arm's length removed agency, at one time.

Q480 Mr Jones: Thank you for that. In paragraph 4.1 of your memorandum you referred to the Wales Tourism Alliance Conference in 2005 and you said: "it was unanimously agreed that WTA's Executive be charged with bringing together all interested parties to help produce an action plan for a genuine, industry-led training initiative to encourage more local people to seek employment in the industry." Could you tell the Committee how that plan has progressed since 2005?

Mr Chapman: Going back to what I said really about the food project and about the whole of the approach that the Alliance tries to take to these issues, given the strength of roles, I think, its geographical size, with its own political system and its own economic forces, we seek to harness that and it does take some time to unite the different agencies and bring together some of the different groups which maybe used to work on their own behalf. We set out to make sure that if we were going to try to deliver the skills plan that we had, and it was quite an adventurous one I think, it was not simply utilising the existing government programmes which were there to offer post-school or lifelong learning training, it was there to devise something which sought to address the issues at the roots and to help move things on and it does mix up as well with raising the status. What I think I would like to convey to the Committee is that we have got ambitions to produce a long-lasting, industry-led, inclusive training programme which will also combine its services with raising the status of the industry, to encourage people to join it, to be well resourced, to include People 1st, the Sector Skills Council, the Tourism Training Forum for Wales, the higher and further education bodies and the industry. To bring all of those parties together and make something which will address the difficulties people experience, and realised were actually occurring about 18 months ago, in providing the higher level of local people in local jobs to which we wanted to aspire. That is why it is taking a little bit longer than we planned maybe to get the Forum together, but the Forum is coming together. I understand from the Executive Member who is leading this for the WTA that a programme has virtually been agreed now with People 1st, Tourism Training Forum and the industry, and that will be presented to the Education and Lifelong Learning Committee of the Assembly in April, or so, this year (next month), so we are very near to being able to move that on. There may be a little bit more slippage but we are looking for that to be around the time that we could deliver it, and it would be the beginnings of a programme which I hope would address local choice for local people across Wales, over a long period of time, and also unify the other ambition of raising the status of the industry, which is really central to us achieving that aspiration. A Member made a point earlier about minimum wages and maybe low pay in the sector, but the fact is that low pay exists in a number of other sectors. For instance, the vogue at the moment is for media studies and for people to want to become involved with television or the entertainment world; if you are running a television company you do not get paid very much more than if you are a waiter in a restaurant, sometimes, but the attraction of the job is far higher. The raising of the status element is integral to being able to deliver a unified training programme. It is quite a complicated issue and it is one which we hope will put down solid foundations for training for maybe the next ten or 15 years, and we will be looking to find the support of Members such as yourselves, as well as the Assembly, to try to make this what I hope would be a sort of 'best in class' product for the UK.

Q481 Mr Jones: What factors have you identified which tend to project the industry as a low-status industry?

Mr Chapman: I think overall we have not really had the opportunity to project some of the advantages which exist in working locally, in establishing a long career, and I think too often it is seen as a servile, rather than a service, industry to work in.

Q482 Mr Jones: If I may interrupt you, it seems paradoxical that is the case in Wales. I cannot imagine, for example, in Switzerland or France or Italy, that the tourism industry would be regarded as a low-status industry?

Mr Burrell: Waiting is considered a profession in France and it has never been looked upon in that way here. Everybody has a lack of young people coming along, these days; there are a lot of people leaving rural areas, full stop, not because they do not want to be in the tourism industry. What used to be, that they were going to London, perhaps, or Birmingham, or wherever, now they are going to Cardiff probably, but we are still having from the majority of our rural areas an exodus of young people and that is creating a lot of the problems, not that simply they are going elsewhere because they want to go to the big cities. What we want them to do is come back and be involved in tourism. A lot of the role of the Wales Tourism Alliance, and we are only a small organisation, we have not got much funding, is getting everyone to work together, and that is what I have been trying to do, that is what we have been doing for the last five years, and it is essential to do that as well with the training side.

Q483 Mr Jones: I imagine that a lot of your members are small businesses; what special support do they need, in terms of training?

Mr Burrell: Again a focus in the past has been on training staff and we want to make sure that the small owner, proprietor, has the necessary support that you are talking about as well.

Q484 Mr Jones: What support would you say that is?

Mr Burrell: We are still having the case of the industry not being considered a profession by some people who enter it. Setting up a small hotel, or B&B, "My wife is quite a good cook and I've travelled a lot," that is the sum total of their professional qualifications; that has to change because that does not suit the quality of changes in the industry.

Q485 Mr Jones: I understand that, but what training support can be offered to people?

Mr Burrell: Much the same sort of training that they need in how to run a business, the quality agenda, everything they need to address when they come into a new business.

Q486 Mr Jones: You mentioned the question of quality. What can be done to help the Welsh tourist industry drive up quality in what is an increasingly globalised market, where people are able to travel across Europe or across the Atlantic more easily?

Mr Burrell: It is the awareness of that quality, because the people running the businesses might not do the same as the traveller and they might not be aware of the quality which is available elsewhere. We have got a grading system now which is harmonised throughout the UK; that is with Visit Britain, Visit Scotland, Visit Wales and the AA, they all offer exactly the same criteria, so the public will have an easier time with the quality side. In the past, all quality agenda, criteria, have been led by the state, public sector, and I would like to see the industry itself being a lot more proactive in this and, if I can say, one step ahead of the customer, "What is our customer going to want next year?", not "What did they want last year, and we'll put up our grades to that."

Q487 Mr Jones: Hence, I take it, the need for an action plan, and presumably, again, I take it, the action plan will not be cast in tablets of stone but will be an ongoing development; is that right?

Mr Burrell: Very much, for the tourism industry, and it is adaptable; we do not suddenly become obsolete with other projects, and sometimes the industry does need a wake-up call, because it is far too easy to be complacent and say, "Okay, we've achieved a certain level of quality; that'll do us fine for five years," but it does not, things keep changing, you are right.

Q488 Mr Jones: What contributions can be made, or are made, by the higher and further education sectors to the development of training within the industry?

Mr Chapman: I think that the role of the higher and further education sector has to be part of the package which offers genuine industry-led training in all parts of Wales. Really that is what our members want and I think that is the message we are getting back now from the people who are involved in training courses in the colleges and in the professional training organisations, that probably it is not suitable to be able to set a rigid structure for a course and then expect the people who go through that course then to find their way into a job in the industry. It is far more suitable for the industry to be able to pinpoint its requirements and to use the facilities of the higher and further education system and the training organisations to deliver those jobs on a local basis. To do that we will need to have probably a more regular standard of delivery across Wales so that the training is local as well as the jobs which become local and the resources go up. Resources are important to this as well and I think some of the colleges representing our industry are struggling somewhat to be able to afford some of the basics they need to teach. An example came back to us, from one of our Executive, of a training course for chefs where they were being trained to fillet fish, and there was one piece of fish to fillet with a class of maybe ten or so. It is a simple thing, but maybe it is because of the way that the budgets are arranged and the courses are structured it is easily overlooked for something like that to be most essential, as a practical experience rather than an academic experience. We are not looking to criticise in any way provision, what we are looking to do is see what is available and offer the industry's assistance to utilise the good points of what is available and maybe try to discourage some of the practices which are not as directly useful to us and combine that into an all-Wales scheme which genuinely will offer local people a proper form of training.

Q489 Mr Jones: I was pleased to see that you mentioned Llandrillo College in your memorandum, because of course it is in my constituency, but what sorts of links do you have throughout Wales with the education sector?

Mr Chapman: As an industry, one of our member organisations is the Tourism Training Forum for Wales, which has virtually total representation in that area for us, so because we are an umbrella organisation we tend to pull together the strings which are both sectoral and regional within Wales. The Tourism Training Forum is an organisation which we have respect for and confidence in and we allow them to get on with their work; we put forward then the arguments which have originated from their practical experiences of it. Really it is a matter for the Tourism Training Forum to develop that but they will play an integral part as well in the action plan once it comes together, probably in a month or so.

Q490 Albert Owen: Just to pick up one point you mentioned there, about the whole industry not being attractive for young people, I think, with respect, Mr Burrell, you were talking about people leaving the area and it is not what is happening today; what is happening is that many undergraduates are coming back to the area during their course, when they are in university, and getting jobs in the retail sector, which is growing rapidly and attracting people. Going back to the links between business, industry and the schools, I think there are positives there because a lot of competitions are being promoted in the areas where big companies - Stena, in my constituency - actually have cooking competitions between the schools. Is that something which you actively encourage?

Mr Chapman: It is something which we would like to see as part of this future way forward. You are right, it is not a massively pessimistic picture which is being painted. I think the percentages of jobs which are taken by people who are not from the local community are smaller in Wales. I think there is an opportunity for us to be able to encourage far more people into the business, and for a rewarding career in the business, and for that to be successful it depends totally on pulling together those different aspects of local life, the local community and the local economy to make it work. I think that is one of the huge attractions that tourism can offer Wales as an economic strength, the fact that it is able to play that part in every part of Wales, so we are not a hot spot which exists in a sort of 'silicon valley' environment, say, and we are not an industry which comes and goes. At the skills summit, which we had about this time last year to launch the Skills Action Plan, it was mentioned by the representative of People 1st about a UK programme for looking ahead 25 years for the tourism industry, and it struck me at that point that it was the total lifespan of the VHS industry. When you consider our economic performance over the decades, I think we can offer Wales something which combines culture and community at the same time as economic influence. We have to maximise that now and if the industry is grown-up enough to be able to do that on an all-Wales basis I think we have got the mechanism now, with the Welsh Assembly Government and its enthusiasm to support that, and now it is a matter of bringing in all the parties to make the most of their resources and their effort.

Q491 Mark Williams: My questions are about infrastructure and communications. What changes, if any, in terms of the transport infrastructure, do you feel would encourage tourism?

Mr Burrell: Starting with Cardiff International Airport, most budget airlines, most airports, will worry about only incoming traffic, if they cannot fill the seats going out. Jon Horne, at Cardiff International Airport, has made big efforts recently to try to ensure that it is two-way traffic, and that is to be encouraged, and hopefully developed. I think that is vitally important; just the way of looking at it. It is so easy to say, yes, people have got the opportunities to go overseas now far more easily, but also it means that people have the opportunity to come here far more easily, and those need to be developed. On the rail side, I know we have got a fast, frequent service, Paddington to South Wales, apparently the figures for that are that those services are not overused by people coming here on holiday and where, in fact, it would be ideal for a city break at the weekend, for example. We have a decent service in the north. Admittedly, the services in mid Wales are lightly used, but they are still there, and that is the important thing, they are there and the fact is that they can be used by more people in the tourism industry, and not just getting here as well. I think the vital part is to encourage people, once they are here, okay, so you have arrived by car, well over 90% of our visitors arrive by car, but to give them the opportunity to say, "Right, we'll leave the car there and we'll travel around Wales by public transport."

Q492 Mark Williams: How much of a dialogue do you have, as a group, with the train operators? You mentioned mid Wales, and I think particularly of Arriva Trains, for instance. How much of a dialogue do you have with them, in terms of service delivery on the ground?

Mr Burrell: The South East Wales Forum, which we operate, they do have representation there; there is someone who represents both Great Western and Arriva, so that is the person I meet most often.

Q493 Mark Williams: Mid Wales specifically?

Mr Burrell: He deals with Arriva for all their services in Wales. I have personal experience of travelling way beyond Arriva and mid Wales, and I am sure you have as well.

Q494 Mark Williams: Yes, indeed. Do you feel that, again, some of the practicalities of the deficiencies in that service in particular are hampering attempts to promote the Cambrian Coast Line, or the Cardigan Bay area? I have the spectre of somebody arriving at Shrewsbury expecting a connection to the west of Wales, finding it does not exist and then, when finally they get herded onto a coach, the great gateway to Cardigan Bay, or south Merioneth, in particular, the gates there will be shut and we are not promoting the area, largely due to people's transport experiences, in the way we should. It is not the best advertisement for an area where, as we said earlier, there is a huge potential.

Mr Burrell: The coach alternative does not happen too often. I have experienced it only once. Perhaps you have been unlucky and had it happen to you rather more frequently. I think that particular trip is fine as long as you treat it in the right way, as something of an adventure. A rather more personal adventure, I know some colleagues, some friends of mine, who came on the train and they got to Machynlledd, where the train divides, and the Aberystwyth section set off but people had been left behind on the other line, so it waited for the other connection to wait for it. That is the sort of friendly way the line operates.

Q495 Mark Williams: On a practical basis, you have said, and I think we all support you, that you are trying to promote the quality image of Wales, in terms of the hotels and the facilities at the other end of the journey; the journey is not enhancing people's image of Wales?

Mr Burrell: No; but the volume of money needed for that infrastructure, and you must be able to convince Government that you will be able to get that number of passengers on there to make something like that viable, the way we are going with environmental issues I think that is even more important. If we are going to encourage more and more people to use public transport to get here, as well as travel around here, you have to provide them with that quality service as well.

Q496 Mark Williams: Notwithstanding the deficiencies, do you think the rail companies could do more to promote - I hesitate to say this - the experience of rail travel? The mid Wales line is travelling largely southwards through Powys, admittedly over the border as well, it is a very positive experience; they should be doing more to promote that?

Mr Burrell: It is a wonderful line, is it not? I know that, even the coastal strategy, I remember being mentioned, there are several parts of Wales where the rail line is the easiest and best way to take full advantage of the scenery, so there is a lot more that we can all do, and that means just working together on projects such as that.

Q497 Mark Williams: You highlighted, in other evidence earlier this morning, the importance of relationships between the tourist industry, yourselves, the Assembly Government and the Westminster Government. How effective are those relationships and how might those relationships be enhanced?

Mr Burrell: In the last five years, they have changed substantially. At the time of foot and mouth really there was very little direct contact at a national level between the industry and the Government, so we have changed that. I think it works far better than it does in Scotland and very much better than it does in any other part of the UK, and I think that is to the benefit of tourism in Wales and the economy of Wales as well. We do have a good working relationship. We are not that big; it is simple. The previous way things worked was that the Wales Tourist Board or Government would announce policy and the industry would jump up and down and complain. Why not sit down and work on it beforehand; it is not too complicated to do, and that is what we have tried to encourage people to do, and for the tourism industry to act responsibly as well and take that responsibility of saying, "Okay, we don't have to do everything through the Western Mail." It means we are not in the headlines. I am afraid we are not good headline-makers because we work behind the scenes.

Q498 Albert Owen: If I could go back to the transport infrastructure and you mentioned Cardiff International Airport, and indeed Jon Horne, with whom I worked on the north-south air link; many other parts of the United Kingdom, and indeed the Republic of Ireland, which has benefited considerably from tourism over many decades, have regional airports. Would you like to see the development of more regional airports in Wales? Particularly a working model is Cornwall, where they attract many weekend tourists from the South East.

Mr Burrell: There is a big debate at the moment to do with the new London-Newquay service as well. I know the environmental issue is being involved there. I must admit, I did not read that article, I saw only the headline in The Independent. I have always had one thing about some of these regional airports being used for very short holidays and that then they have a limited benefit to the local economy. Ireland last year was talking about thank you very much to all these regional airlines for bringing in these people, but they do not stay very long. They do benefit the hotels and a few other facilities when they stay but they do not get out and see Ireland, they do not get much further than the airport or their immediate surroundings, so the attractions, and whatever, will not get any benefit from this at all. We are introducing a long-stay campaign: "Take your car over on the ferry, come and spend ten days in Ireland, not two." That market is important, but I think its importance can be overemphasised at times. The air link you are talking about possibly will help more people in Wales, more so if you live here rather than the tourists, but it is good to have, and let us hope it succeeds as well; with a three-year trial period, we hope very much that it will succeed.

Q499 Mark Williams: The Welsh Assembly Government's tourism strategy states, and I quote: "Wales remains fragmented in its online visibility which reflects the general fragmentation of the industry... Wales needs to extend its visibility and the tourism industry must be encouraged to accept and use modern technological innovations as essential marketing tools." Do you agree with that assessment, and, if so, what steps should be taken to remedy it?

Mr Burrell: The answer to the first question is, no. I would like to have on my tombstone "The industry was fragmented" but it is not as fragmented as it used to be, and that is what we have been trying to do; just because an industry is made up of a lot of small players it does not mean to say that makes it fragmented, industry has proved it can work together. Its knowledge of IT, I think, is far better than some people know. I meant to do this before, I did it yesterday afternoon, just put into Google "Wales plus B&Bs" and you get 1.2 million come up; "Wales plus hotels" 4.4 million. Somebody out there is doing something, and I think you will find that a lot of the small operators actually know a great deal more about IT than some people in the public sector give them credit for, and in fact know themselves. Personally, I started the first online cottage-booking system, ten years ago next month; it is not new, and that is how long it has been going. I was the first one in the UK then. There are a lot of people out there who are really utilising IT, perhaps not in the way that some people thought they might do, but it is there and it is an absolutely vital part of the industry, it is really, really important. In my own business, we are talking about 75% of new business comes from that source, and it is simply there. You cannot ignore some of the more traditional methods, but they are going; probably they will be with us still in some form, people are still going to want hard copy brochures for some time to come, but the tourism industry is ideally suited to the internet. There are some people who have probably too complex a business, perhaps whose activities are a little more difficult just to be able to sell off the internet, but for most of the accommodation sector it is absolutely ideal, and not forgetting a mixture of both. A lot of small operators do not like online bookings; that gets confused with some people, where they think they do not do IT. They would like to speak to people as well. The internet puts them in contact with a customer but then they are able to talk to them, tell them a lot more about their business, give them a personal touch; because this is a people business and you cannot just hide behind a screen all the time. It is absolutely vital. I do not think those comments are justified. I have made my views clear and I do not think I will change them.

Q500 Mark Williams: Thank you. How did the Welsh tourism industry benefit from the previous Structural Funds programme? Your memorandum stated that the tourism sector needs adequate resources from the new EU Convergence Fund. What was the history of funding with the previous Structural Funds programme, and what do you envisage the new funds being used for, if these are successful?

Mr Burrell: The marketing side of it, I think, leads on to everything else. In Wales, with the Wales Tourist Board (now Visit Wales), we have developed some extremely good marketing, with which most of the industry is proud to be associated. Remember, if you think back ten years, an awful lot of time was spent saying the marketing campaign was no good. It was useful, of course, whenever one's own business did not do very well, you could always blame it on somebody else and the marketing, but now it has the support of 99% of the industry, and because we have had that success with the marketing, the Structural Funds then come in to capital grants and skills training, and whatever, and all those funds can be put to far better use simply because the industry has become more successful. It is absolutely vitally important that level of marketing is maintained.

Mr Chapman: I think it is important to say that really the Structural Funds, and particularly the marketing elements, have been the backbone of the developments of tourism enterprise. It is quite easy to separate, easy to take the line that grants aid quality marketing is a sort of difficult to understand semi-science and not really related, but the way that the funds were applied, as Julian said, with great success within the industry, that is quite hard, I think, for the industry to agree that a campaign is very good. That was the case certainly with Big Country and onwards, but it was introduced in a holistic way. The marketing was not designed simply to promote Wales, it was designed to deepen the demand in ways which would have been impossible to do without that support. The deepening of demand created the ability for the entrepreneurial elements and the quality-seeking elements in the industry to expand their businesses, again with some public support and the very useful contributions made by Section Four and some other contributions. In the first wave we have moved forward at a much faster pace, and sustained that movement, than we would have done without funding. I think the difficulty for the industry will be under Convergence Funding where there may be different criteria. If those criteria fail to associate the elements of enterprise which were essential in the marketing section, the holistic approach of the first wave, and try to separate out the marketing from the grant elements as if they were two separate components, I think there will be benefits to the industry but nowhere near as large a benefit as could be created if marketing was to qualify as well. Certainly we are trying to persuade those who are in the decision-making process of the need for this holistic approach, to keep us ahead of the game and sustain the industry's forward movement in the last few years, as well as looking to take on some of the key areas which will attract visitors on their own behalf.

Q501 Mark Williams: Have you quantified the benefits financially with the previous round?

Mr Chapman: We have somewhat limited resources to do it ourselves so probably you have heard most of the statistics that we have got, but they are the ones that will come from the Welsh Assembly Government, with which we solidly concur. We support the information which comes from Visit Wales about the increased visitor spend and the momentum that was gained. I have a list of some data which we have picked up from different meetings which show rises in GVA from the hotel/restaurant sector in the period, AVI figures showing an increase in the number of employees in the hotels and restaurant sector, which is the dominant sector, in financial terms. Just looking at the productivity and wage level increases, VAT registrations, all of the underlying trends and the obvious statistics indicate the success of that and we concur with that on the basis of anecdotal evidence and what statistical evidence we have garnered from our own experience, and I am confident that would be replicated in the next seven years if we were able to have that. To repeat where we came from in the beginning really, if tourism business is assisted, a local community is assisted and often local regeneration, in some way, is assisted. The key for us, I think, is to find a way in future years to tie in the tourism industry to those different levels of local regeneration, particularly in rural areas, where with agriculture and tourism we have two forces which perhaps in the past have not worked too well together, but there are great opportunities to do that actually.

Mr Burrell: If I can add just one thing and it ties in with what you were saying about undergraduates going into retail, we have not mentioned the seasonality, which sometimes gives people lacking in confidence in the tourism industry that they have got a full-time job, and that is something we have made a big progression on over the last five years, turning Wales into a 12 months a year tourism industry. Those are the sorts of uses of the funds which have helped already to do that and should continue to help and to give those graduates you were talking about an added incentive to move into the tourism industry.

Q502 Chairman: We began this session with some questions on globalisation. Earlier today we met with Mr David Parker, Director of International Business Wales, from the Welsh Assembly Government. It reminds us of the need for us to be less introspective, I suppose; that is not necessarily a criticism of tourism, it is a general problem, I think, in Wales. To what extent do you feel that you are constrained in any way in promoting Welsh tourism on the global stage, and to what extent could Mr Parker's new organisation assist you, or any other part of the Welsh Assembly Government?

Mr Burrell: International marketing is very much to do with Visit Britain, with Visit Wales having specific priorities for key markets, Germany, Ireland, France, Holland, and obviously they do some marketing in other countries as well, but for a lot of the world they have to be reliant on the resources of Visit Britain, which are charged with marketing the UK abroad. We have a particular advantage coming up in a few years' time, and that is the Ryder Cup, and a lot is being planned around that which will give far-reaching benefits of just putting Wales on the map; forget golf, it is as vital as that. Part of my role is to make a nuisance of myself, in that every time the 2012 Olympics are mentioned I mention the 2010 Ryder Cup. It is very important to Wales because of the profile it will produce for us on the world stage. That is part of the problem, going back ten, 15 years, we have had marketing projects, not initiated necessarily by ourselves but sometimes the private sector, when they have forgotten perhaps that in the States you have to tell people where Wales is, in the first place, before you can get them to come here. It is a very important point indeed.

Chairman: Thank you very much for your evidence; it has been extremely helpful and informative. If you feel that there is anything further you wish to add, we would be very happy to receive an additional memorandum. Thank you very much.

Memorandum submitted by Mrs Ann Lloyd

Examination of Witness

Witness: Ann Lloyd, Director, Health and Social Services Department, Welsh Assembly Government and Chief Executive of NHS Wales, gave evidence.

Q503 Chairman: Good morning. Could you introduce yourself, for the record, please?

Mrs Lloyd: I am Ann Lloyd. I am the Head of the Health and Social Services Department for the Welsh Assembly Government.

Q504 Chairman: Could I begin by making a historical point. Wales NHS, and before the NHS was founded, tended to employ staff, in a way we benefited, I suppose, from Ireland and the Indian subcontinent and, more recently, the Philippines. How has this changed in recent years and given that we operate in more of a globalised economy now?

Mrs Lloyd: I do not think it has changed very much. We have always been an inward recruiter, largely because we could not manage to fill all the posts that we needed for an expanding Health Service, increasing health needs of people, from within our own resources. Therefore, we have always looked to the Indian subcontinent and other areas to provide us with the necessary medical staff, in particular, in order to continue to provide the care that is needed. It is going to change, I think, over the next five years. We have a major problem coming up, as you will know, about the retirement of many of the general practitioners, particularly within the Valleys, who came from the Indian subcontinent all that time ago. Therefore, we have been putting into place schemes whereby we can employ salaried doctors, and I think the Rhondda Cynon Taff Local Health Board scheme has been particularly successful in retaining our own recruits, from our own medical and clinical schools, to work in those more deprived areas. More latterly, because of a shortage of nursing staff in particular, we have had to look to the Philippines and, for a small part, Spain to fill some of the nursing vacancies that we have. As you will know, back in 2002 the Welsh Assembly Government Ministers decided to fund the increased recruitment to undergraduate training, so that by 2010 we would have approximately 600 to 700 additional doctors, 6,000 nurses, 2,000 allied health professionals, and those graduates are now coming through into our own rolls. We have also seen a growth in recruitment from the European Union and I think that has been the most substantial change over the last two years. When we get the results of the Modernising Medical Careers specialist training, the new specialist training, this year, we will know how many people we have attracted from the European Union to fill our posts. We do not know that at the moment because, as you know, there is a review going on into the way in which those posts have been recruited to, but once the review is completed we will know how that is changing. As you know also, there is this judgment about overseas doctors which is being appealed, and until that appeal is heard it is quite difficult for us to estimate to what extent that will affect our inward recruitment to Wales.

Q505 Chairman: Can we pause at that point and ask a more specific question of you, in relation to which sectors of the NHS do you think will have the most acute problems, and which parts of Wales as well?

Mrs Lloyd: General practice in the Valleys will be the area where we have really acute problems. Also there is a recruitment issue around Pembrokeshire at the moment and we are concerned, and we do hope the new clinical school up there will aid this, about the recruitment of sufficient Welsh speakers in the north west of Wales, which is an important consideration.

Q506 Chairman: You have made some observations about the education system; are you happy and comfortable with the progress being made, and what more can be made in order to address some of these issues?

Mrs Lloyd: I think the education system has been very helpful to us. We have a very good recruitment record in Wales and we always get far too many people wanting to come and train in Wales in our undergraduate nursing and other allied health courses.

Q507 Chairman: Train in Wales, or from Wales?

Mrs Lloyd: Training in Wales and from Wales. We are always overrecruiting; the universities will deliberately overrecruit to the numbers that we have told them we will pay for, and the numbers of places that we could always fill far more, so we do not have a problem in that respect. The bursary system, I think, has helped, being non-means-tested, in part, and the childcare package which has been put to underpin it has meant that we have got good recruitment of more mature students. We are finding also, particularly for nursing and the allied health professionals, that our drop-out rates are much lower than ever I was used to in Bristol, where I used to work and manage the education proposals for the Health Service there; it is far, far lower than one was seeing in England, five or six years ago. We are managing to retain those people that we are recruiting into the universities and we are managing to place most of them, but, as you will know, recently there has been some considerable concern expressed that all our newly-qualified staff are not getting jobs within Wales. Therefore, we have been urging the organisations to ensure that either they put them on the bank system, or they give them part-time flexible work, to enable them to complete their professional qualifications and be retained to Wales.

Q508 Chairman: To what extent do the medical staff from outside the United Kingdom require additional training, in terms of developing their clinical skills or their cultural skills or their language skills?

Mrs Lloyd: We would not say that they need any further medical training, clinical training. Some years ago I was the Chairman of the Sub-Group for the CMO in England, looking after the overseas doctors, and we were very mindful of the cultural problems that overseas doctors coming in to train here or to take up posts here had. It was at that time that we recommended to the UK Government that all overseas recruits should go through a formal induction, paid for by the Health Service, to ensure that they could cope with and understand the cultural differences that they would be faced with. That was eagerly taken up by the postgraduate deaneries throughout the United Kingdom and that has been very, very successful. Similarly, nurses who come from overseas have to ensure that they are able to enter the register as qualified, and therefore they will go through language training to ensure that they are coming up to the required quality, and that is the same as the doctors, who have to sit their PLAB tests. We do have to ensure that people we recruit from outside are properly attuned to the culture in which they will be working and that their language skills are appropriate.

Q509 Chairman: To come back to the question of the South Wales Valleys, you will be familiar, of course, with the work over many decades of Dr Julian Tudor Hart, who suggested, I recall, many, many years ago, that in order to address the shortage of GPs the NHS might consider retraining and recruiting people within the NHS who may be what now we would call practice nurses; as they call them in China, barefoot doctors. Is that something the NHS in Wales has considered?

Mrs Lloyd: Yes, indeed, we have; we have set up what we call an Extended Role Sub-Group, looking at ensuring that within general practice itself there is much more scope for more highly specialised nursing staff, or other staff, to take on an extended role, particularly in areas where there is a real deprivation problem, where a different type of access to care is necessary to be provided. We have been quite successful in recruiting and training specialist nurses into the Valleys; but I do have to say that the salaried doctor scheme itself, which is recruiting in young and enthusiastic Welsh graduates, has been particularly successful, more successful than we could have hoped. But we have got to be mindful of that changing medical population up in the Valleys to make sure that we do use skilled staff effectively, to ensure that access is maintained, and where necessary improved, for the more deprived Valleys communities who will not move out of their Valley to obtain work.

Q510 Chairman: Could we envisage a situation where, say, practice nurses could be retrained and become GPs?

Mrs Lloyd: We have the Graduate Entry scheme and that has got a very eager take-up. In Swansea, at the moment, they are piloting it for us; we hope to roll that out to Bangor in the future. It is open to any practice nurse or specialist nurse to go into the graduate training scheme, which, as you know, is shorter than the normal scheme, and they have additional skills they can bring to that.

Q511 Albert Owen: Is there not a greater urgency for this to happen due to the 'out of hours' scheme, which has changed radically the way that we see the GPs?

Mrs Lloyd: It is interesting what has happened with the 'out of hours' schemes, because, many of the more successful 'our of hours' schemes, and if I look at Gwent, for example, where the 'out of hours' scheme for the whole of Gwent is run by the Trust, you will see that extended care practitioners are being used more and more in conjunction with general practice to ensure that there is access for people who need care. The ambulance emergency care practitioners down on the borders, for example, will be allocated people by the general practitioner to look after over the weekend, and on an ongoing basis if there is a continuing healthcare need. There is far more flexible thinking going on about how we deliver care more appropriately, and we have got to look to all our practitioners to make sure that they are competent to undertake the role which is now assigned to them and that we do get really good access, particularly out of hours, because I think people are confused about how to access care out of hours at the moment. We have put in a number of pilots for our Delivering Emergency Care strategy, which will be started in the next month or so, to look at combining access to emergency care, so that the confusion ceases and people are properly channelled to those places which can best deliver the service that they need.

Q512 Mr Jones: Could we turn to dentistry, please. Your memorandum, paragraph 10, says: "At the moment we have a small proportion of non UK dentists." Do you know how many non-UK dentists there are working in Wales in the NHS?

Mrs Lloyd: Yes; approximately 200 at the moment.

Q513 Mr Jones: Are there more, do you know, in the private dental sector?

Mrs Lloyd: I do not know because we do not collect those statistics.

Q514 Mr Jones: Those figures are not available?

Mrs Lloyd: No.

Q515 Mr Jones: Has the expansion of the EU over the last three or four years made any difference to the availability of dentists?

Mrs Lloyd: We have recruited only a very small number of EU dentists; most of them have come through the dental consortia which have been established recently, but we have not made particular use of that at the moment.

Q516 Mr Jones: Can you explain how that works; does the NHS in Wales recruit, or is that left to the Local Health Boards, or, in turn, is it left to the consortia which you mentioned to recruit dentists from abroad?

Mrs Lloyd: For those dental consortia, it will be for them to recruit to those practices.

Q517 Mr Jones: Effectively, they are commissioned by Local Health Boards, is that right?

Mrs Lloyd: Yes; they will ask the consortium to establish an NHS dental service in a particular area, and it will be for those consortia to do their own recruitment.

Q518 Mr Jones: Do those consortia rely heavily on overseas dentists?

Mrs Lloyd: I would not say that they rely heavily on EU dentists, but they have started to bring in more.

Q519 Mr Jones: In future, do you think that the proportion of non-UK dentists practising in the NHS in Wales is likely to increase?

Mrs Lloyd: It might do, although we have again increased the number of undergraduate dental trainees in Wales latterly, to try to ensure that we can maintain a stream of NHS dentists for the future; also we are starting to train them in deprived areas so that they will be attracted to those areas to work for the future. We are not averse to recruiting EU dentists into Wales; it just depends on how many we manage to retain in the NHS in Wales at the moment, and we still have some problems but it is getting much better.

Q520 Mr Jones: How optimistic are you that UK-trained dentists will want to remain within the NHS rather than going to the private sector?

Mrs Lloyd: I think in here it says that we have managed to retain most of the dentists who were undertaking NHS work. The dental consortia are putting pressure on the people who opted out, because they are starting to fill the positions which previously they occupied. There will always be private dentists and there will always be a proportion of the population which wishes to go to a private dentist, and we are going to be tracking this market very carefully indeed.

Q521 Mr Jones: Do I understand, from that answer, that you think the drift away from the NHS has been stemmed, or is it likely to continue?

Mrs Lloyd: Certainly it has been stemmed over the past six months in Wales, yes.

Q522 Mark Williams: I would like to turn to the recruitment of doctors, which you mentioned in your initial remarks. Your memorandum states that up to 40% of the training grade places in Wales may be filled with International Medical Graduates and the figure is higher in Wales than in other parts of the UK. What do you put that down to?

Mrs Lloyd: I think probably it is down to the way in which care is delivered throughout Wales. We have got a number of small hospitals which might not have been able to produce an attractive training portfolio, a comprehensive training portfolio, in the past. To overcome that, we have set up the clinical schools in different parts of Wales with their network of placements out into the more rural communities, like Swansea, partnering up with Aberystwyth and Carmarthen and Pembrokeshire, and things like that, to increase the range and scope of the training programmes, to increase the number of placements, which are tied into a central unit in Swansea. That, I think, starts to give you the breadth which is necessary.

Q523 Mark Williams: How big a problem was that before the development of those partnerships?

Mrs Lloyd: I think it was a considerable problem, because each of the small district general hospitals could provide only a certain amount of the necessary training, and it is something which is happening in England as well. It has been necessary to ensure that these services network together to provide the whole range and breadth of training that is necessary.

Q524 Mark Williams: Given that Wales is dependent upon those IMGs to fill its training places, again you alluded to this earlier, how would the proposed changes to the guidance on recruitment of postgraduate medical trainees affect us in Wales?

Mrs Lloyd: That question is difficult to answer until we know the outcome of this recent MTAS exercise, which has received so much publicity. We have approximately 1,100 posts in Wales. We know very well that we have had 4,500 applicants for those posts. We do not yet know, until the Postgraduate Dean analyses it for us, how many of those were overseas graduates, how many came from the EU, how many were coming from England. The Chief Medical Officer and I do have a concern that posts in England now are being overwhelmed by people applying, that the entry of the EU graduates into the pool for this first MTAS route was not anticipated and actually it has increased considerably the number of people who are able to apply for that scheme. We believe that there will be more people who are English graduates, and particularly Welsh residents who are in English universities, who will be applying for posts in Wales. Whereas we are seeing in England a real pressure on graduates now to obtain their posts in specialist training, we believe that drift is going to come westward and that we might also have too many people applying for the posts that we have. Until we analyse this first round and know where we are going for the second round, we will know how many posts we have vacant and how many came from the EU, how many came from overseas and how this judgment is going to fall, it will be quite difficult to track what our strategy really will be in Wales to fill our posts.

Q525 Mark Williams: Turning to GPs, how many doctors from outside the UK are practising as GPs in Wales at the moment, and again is that proportion likely to increase in the future?

Mrs Lloyd: There are 450 at the moment, and that again is part of the legacy of recruitment back in the fifties and sixties. We are getting more interest from our own graduates to enter general practice, probably because of the change in the GMS contracts and the opportunities that gives them. Hopefully, because of the direction of travel of the delivery of healthcare within Wales more to a primary care focus, away from a secondary care focus, so with the whole of the chronic disease management problems that we have in Wales, where we require, via the strategy, for care to be provided in the community and not people moved into hospitals all the time, as happens now, we should be able to reduce our requirement for overseas doctors. Of course, they are very well trained, if they apply for a job they are perfectly entitled to that job, and we might see the balance between the UK graduates and EU graduates starting to change even more.

Q526 Mark Williams: Notwithstanding what you said, in answer to the Chairman's question, about the pilot scheme in Rhondda Cynon Taff, do you detect any different geographical trends in Wales between the urban areas and the rural ones, in that regard?

Mrs Lloyd: We are concerned about the rural areas, and just last week the Postgraduate Dean and I were discussing whether or not we could initiate a rural training programme for postgraduate entrants in Wales, to attract them to the rural areas. We have, I think, a lot to offer them; it will be interesting practice. If we roll out our telemedicine systems, where they will be linked into the major centres to get immediate access to diagnostics, etc., we could provide, I think, quite an interesting career pathway for people who wish to practise in rural areas.

Q527 Mark Williams: What are the biggest challenges, whether it be home-trained graduates, if you like, or those from overseas, in promoting the rural areas?

Mrs Lloyd: I think the biggest challenge is that they might see themselves as stuck and dealing with just very routine work all the time, that their training and development opportunities might be very limited, that they might be stuck in a backwater, and it is those sorts of challenges that we have got to overcome and ensure that they are given training and development opportunities. They will have to be very skilled, they have got to manage a wide range of diseases within a rural community; they have got to be properly linked up to specialist centres to be able to acquire the back-up advice that they need. Also, they have to work with a really, really skilled team of individuals, nurses, AHPs. I think there are ways in which you can start to make that a very attractive job, but you have got to look after them.

Q528 Albert Owen: You mentioned the dentists in previous responses, and indeed GPs in two responses, and the amount that are coming in from abroad. In the nursing profession, we have seen extra places and increased scales for local and national nurses and health professionals in Wales. How do you see the trend, in the future, of the reliance on non-UK nurses?

Mrs Lloyd: We have relied on non-UK nurses a little, not enormously; given that there are about 28,000 nurses, we recruited only approximately 700 from overseas, from the Philippines, and Spain to a very small extent. Our worry is the draw of America, where the Americans are saying that they will need massive numbers of additional nurses over the next five to ten years; it can be seen as a very attractive place to go for our own recruits and for the overseas recruits that we have attracted. Certainly a number of the Philippino nurses have gone to America, and that is a drift which the whole of the UK is seeing; so we have got to be mindful that we have to look to the west to see what those trends in recruitment are going to be. We have access interviews, so we can gather some of our important evidence from there. There does seem to be this western pull, either to us or away from us.

Q529 Albert Owen: It is exciting. Is there much differential in wages or career opportunities?

Mrs Lloyd: One of the things with the American nurses is that they are very tied to protocols. Some of the American nurses that I know have said they are very, very tied to "That is what you're allowed to do." In the way in which we are structuring the nursing profession in the UK at the moment, I think there is more scope for them. I think the wages are better, but actually the practice might not be as satisfying. What we are worried about is that our highly-skilled nurses will be dragged westward; therefore, we have got to ensure that we give them the opportunities, which they are quite capable of taking, to improve and increase their skills, because they are going to be needed here.

Q530 Albert Owen: In your memorandum, you mentioned that nurses and allied health professionals who are granted asylum in the UK are faced with an overwhelming number of agencies and barriers, which they have to negotiate to register. What are these barriers and how can they be overcome?

Mrs Lloyd: The barriers are those of trying to find somewhere that will allow them to ensure that they can become registered. The same thing happens with doctors who are asylum-seekers. In Wales, starting with the doctors, in 2004 we set up our asylum-seekers scheme, led by Professor Bhowmick, who was a real enthusiast, and we started in a small way by making sure that we could track the asylum-seeking qualified doctors that were coming into our part of the UK and ensure that they were trained and educated to take the PLAB tests so that they could gain employment. That scheme has grown enormously, from a very small start, where we had about 16 to 20 coming in, it is now 40 and it is increasing by about two a month, and many of them have been successful in obtaining their employment here. The nurses are much smaller; it is actually much more difficult to attract the nurses. We think we have got, according to the RCN Register, only about eight, in Wales, at the moment, which seems unbelievable, I cannot believe the figures, but that is all we have got. We have set up in Gwent, because they are acting as a pilot, with the Royal College of Nursing and with my Welsh Educational Development Consortium, a scheme to ensure that they can pass the language tests, that they can reskill themselves, in order to be able to be registered and therefore seek employment. It is very small at the moment but it is a start. Those are the sorts of barriers. I think one of the biggest barriers is the fact that we do not know particularly where they are, so we might be missing people who could contribute, and we could help them gain employment.

Q531 Albert Owen: You say this is very tiny in Wales; what comparative figures do you have for the rest of the United Kingdom?

Mrs Lloyd: It is not very big in the rest of the United Kingdom. We were able to track the doctors better because the issue of asylum-seeking doctors was being discussed seven, eight years ago, but it was not quite so pertinent at that time for other professional staff and we have rushed to catch up, I think. Our information systems for other staff are not so great, but the RCN is putting an awful lot of effort into trying to track down relevant asylum-seekers to ensure that they are afforded the opportunity to become registered.

Q532 Albert Owen: How reliant is the NHS in Wales on migrant workers to take the more menial tasks, such as administrative roles and care assistants and manual work?

Mrs Lloyd: The Health Service is not so reliant. My concern is in the social care sector, and particularly the independent sector, where they are quite heavily reliant on migrant workers; they are not subject to the Code, as we are in Health and Social Services, so the independent sector has been drawing staff from elsewhere. Again, we do not have the precise figures and details of that; they are not required to register with our information systems.

Q533 Albert Owen: The local area is able to produce enough labour in these particular areas?

Mrs Lloyd: Yes.

Q534 Mr Jones: Could I ask you about the Code of Practice for the International Recruitment of Healthcare Professionals: how effective do you assess that Code to be?

Mrs Lloyd: I think it has been effective, because we have not gone to those areas which were precluded by the Code and we have really wound down overseas recruitment, and particularly in the Philippines, where the professors of nursing education were advising that there was a major problem growing for them, that they would not be able to retain sufficient nursing staff to manage their own health needs, and so we racked that recruitment down and that has now ceased.

Q535 Mr Jones: I was particularly concerned about the Philippines. Is there a total moratorium now on recruitment from the Philippines?

Mrs Lloyd: There is not a total moratorium throughout the UK, but we are not recruiting, in Wales.

Q536 Mr Jones: Given that there is widespread use of agencies for the recruitment of staff in Wales, what safeguards are in place to ensure that staff from developing countries, which might be adversely affected, are not being recruited through the agency portal into the NHS in Wales?

Mrs Lloyd: We set up contracts with the agencies which preclude our accepting anybody who is precluded by the Code, and our use of agencies is very much reducing.

Q537 Albert Owen: To what extent do you monitor the agencies, to ensure that they are complying with their part of the bargain?

Mrs Lloyd: That is part of the responsibility of the Trusts. They are bound by the Code.

Q538 Albert Owen: They do actually scrutinise the agencies and from where they recruit staff?

Mrs Lloyd: Yes.

Q539 Chairman: Can I end by asking you to comment on the observation made by the Chief Nursing Officer for Wales, in November of last year, in giving evidence to the Assembly's Health and Social Services Committee, who said that the NHS may lose nurses to other countries if it does not, in the words of the Chief Nursing Officer, "value and employ" them? Is there any information available on how many nurses are being lost and how many other professionals are being lost to other countries?

Mrs Lloyd: There is very little evidence at the moment and the Trusts are reporting only very moderate numbers moving out. We are managing to retain our staff quite well. We have initiated a new recruitment and retention strategy in Wales, which looks very much at better flexible working, more training and development opportunities, because it is pointless our pouring millions into training staff if Trusts do not appropriately recognise them and look after them well and ensure that they can develop.

Q540 Chairman: Was that a problem? Anecdotal evidence, and I am sure other evidence, indicates that, over the years, the last ten, 20 years, a lot of nurses were leaving the NHS because of the lack of flexibility.

Mrs Lloyd: Yes, that is right; that is quite true, and that has been true throughout the United Kingdom. That is why we have had to concentrate on retention policies for our staff for ensuring that there is sufficient resource for them to be developed and receive their training; but there have been rules laid down about the continuing education of nurses and allied health professionals to which Trusts must adhere. We are scrutinising the Trusts quite rigorously about their retention policies, because it is important that we are able to retain the skilled staff that we need.

Q541 Chairman: Aside from nurses, other health professionals, such as GPs and dentists, is there any evidence at all on the statistics of how many we are losing to other countries?

Mrs Lloyd: No, there is not.

Q542 Chairman: Should there not be?

Mrs Lloyd: Yes, there should be, and that is what we have asked the Postgraduate Deans to collect for us. The Chief Medical Officer and I have asked the new Postgraduate Dean, who has been in post for only about four months, to do a renewed workforce plan, based on what is happening with Modernising Medical Careers, with the retirement ratios for consultants and general practitioners. Given the intake of undergraduates and their retention within Wales, to scope out for us, over the next three months, how that workforce pattern is changing and what our workforce planning numbers need to be for the next five years, so that we can get a proper baseline against which to plan, now that there has been so much change in medical education.

Q543 Chairman: With the increasing pace of globalisation, does Wales compare itself with other, similar-size countries throughout the world, in terms of how globalisation is impacting itself on you?

Mrs Lloyd: Yes, we do. We are part of a European network of small countries and we meet a couple of times a year. Part of the evidence that the Postgraduate and other Deans, Deans of Nursing and other professionals, are gathering for us is how we are comparing. We must remember also, with globalisation, that we must not be just an input, we have got to look very carefully at how we can help the other developing countries. The Chief Medical Officer and I are heading up a group to respond to Nigel Crisp's recent report, but there is, and has been, a history in Wales of various groups of consultants and other professional staff having very close links to developing countries and providing staff to educate and train and deliver care during intervals. I think that globalisation is not just about our taking; we have got to give it back.

Q544 Chairman: On that positive note, can I ask if it is possible for you to write us a memorandum explaining that perspective you have just described? It would be very interesting and very helpful to our work if you were able to describe to us the work of that network and also that wider global perspective which you have just described.

Mrs Lloyd: Yes. Thank you.

Chairman: Thank you very much.