Cynulliad Cenedlaethol Cymru

Good afternoon and welcome to this Plenary meeting. The first item on our agenda this afternoon will be questions to the Cabinet Secretary for Housing and Local Government, and the first question is from Jenny Rathbone.

The regulatory standards set the Welsh Government’s expectations for housing associations. These standards require associations to provide high-quality services and safe homes, as well as requiring that tenants should be able to influence strategic decisions and service delivery. Compliance with the standards is monitored and reported on through regulatory judgments.

So, in the context of the need to try and get anybody who’s missing out on the pension credit in order to get the winter fuel payment, I’ve been speaking to the housing associations in my constituency of Cardiff Central to see what duty of care they have to the well-being of their tenants to make sure they’re actually getting what they’re entitled to and know how to apply for it before 21 December. I’m very pleased to say that Cardiff Community Housing Association is taking proactive steps to contact all relevant tenants, but others are only assisting residents when they get asked for information. And I just feel that this well-being issue, to ensure that people are getting the income that they need and are entitled to at this difficult time in terms of the fuel bills going up, is something we need to pursue. So, what discussions are you having with housing associations on your expectations about the well-being of tenants as well as local authorities to proactively ensure that anybody who’s in danger of missing out on pension credit and the winter fuel allowance doesn’t get missed out simply because they are not able to apply digitally or they don’t have a family member to do it for them.

Thank you for the question, Jenny—it’s a really important one, and I commend you on the work that you’re doing in your area in particular, and I’m sure other Members will be doing that as well to do everything we can to ensure that people claim everything that they’re entitled to. The Welsh Government is committed to ensuring that people in Wales claim every pound to which they’re entitled. We’ve got our flagship 'Claim what’s yours’ programme take-up campaign, which we’ve seen deliver some really positive results and we’re making sure that we keep on going in that vein.

We’re working collaboratively with the UK Government and our partners, including Community Housing Cymru, to increase that pension credit take-up in Wales, and CHC has developed a cost-of-living support hub to share learning advice and good practice across all housing associations to support tenants in financial difficulties. We would encourage all RSLs and local authorities to work with us and our partners to help maximise benefit take-up, as we know that this is often the gateway for people to access further financial support. So, it’s really important and I’ll continue to monitor this as well, along with Cabinet colleagues.

Housing associations have raised concerns with me that, because they’re taking more tenant allocations from priority lists and therefore working with people in crisis or post crisis, this is having a big impact, where the needs of tenants are becoming more complex and the demands on them are increasing as they work with affected families and maintain their homes, and that they’re also struggling with Welsh Government aspirations over decarbonisation, where their actual ability to deliver is, quote, 'a moot point', with a massive black hole in funding to do it the way they’re being asked to and that there’s a need to balance the ambition with what is realistic, working out with tenants the best way for individual homes. So, in determining the standards of tenant care that it expects housing associations to provide, what consideration is the Welsh Government therefore giving to these concerns?

Thank you, Mark. As I said, we’re working very closely with RSLs, and I think that’s an important partnership approach, as well as with local government, because we all want to see as many people gaining access to their entitlement, as they are. Community Housing Cymru, as I said, have developed a cost-of-living support hub to share that learning, advice and best practice to housing associations, giving essential cost-of-living support to their tenants. So, there is work ongoing. Social landlords do have a duty of care to their tenants though various landlord and tenant legislation, including the Renting Homes (Wales) Act 2016. But, as I said, there is a lot of work going on in this area. We’re very, very alert to it. The Cabinet Secretary for Social Justice is chairing the next Interministerial Group on Work and Pensions, and she’ll discuss the importance of both Governments working together to address the reason why older people fail to take up their entitlements. There is a lot of focus in this area, and I’m sure Members will be kept up to date on this in due course.

Our Transforming Towns regeneration programme provides a co-ordinated package of support, providing local authorities with the opportunity to invest in town centres across Wales. Individual towns can benefit by identifying the mix of interventions that best suits their specific characteristics, local strengths, culture and heritage.

Diolch. Caerphilly County Borough Council have stated that they have a £45 million deficit to plug in their finances. The Blackwood Miners' Institute has been threatened with closure as a result, and the timeline saw the first announcement at the end of July of a potential closure a mere five months later at the end of December. So, following a large-scale protest and march through Blackwood, and a petition of thousands, the proposal has paused as the council seeks legal authority of their legal decision-making powers due to the charitable status of the 'stute'.

Cabinet Secretary, the case study of the Blackwood Miners' Institute and the financial situation faced by Welsh councils demands urgent action and an interventionist approach into what is happening at local government level. Harold Macmillan once warned of the consequences of Thatcherism as selling off the family silver. The sale of assets is

'common with individuals or estates, when they run into financial difficulties.... First, the Georgian silver goes, then all that nice furniture that used to be in the saloon, and then the Canalettos go'.

So, what does the Welsh Government propose to do to ensure that safeguards are in place, so that local authorities have the expertise, support and requirements to work with external partners to ensure that highly treasured community assets are not sacrificed at the altar of accountancy?

Thank you for the question, Rhianon, and I am aware of the situation that you’ve mentioned. The Welsh Government does recognise the key role culture plays within communities across Wales, its contribution in terms of health and well-being, economic impacts, visitor attractions, resources for schools and life-long learning, and that’s all vital. The Welsh Government is aware of the very difficult options that must be explored in the current financial climate. The management and funding of venues such as the Blackwood Miners' Institute is a matter for the governing body. In this case, that’s Caerphilly County Borough Council. I know that the Arts Council of Wales have been in discussion with Caerphilly council regarding the consultation that the local authority has had, and I know that the officers there have been in regular contact with the team at the institute, and they’ve offered support and are keeping the Welsh Government updated on developments.

Cabinet Secretary, I fully support Rhianon Passmore’s concern about Caerphilly Labour council’s lack of support for community venues. However, a quick look at the council’s accounts tells you the problem can be solved. Caerphilly Labour council are sitting on £220 million of reserves. By contrast, Monmouthshire council has £20 million in reserves. Nearly £0.25 billion is sitting in a bank doing nothing while people mourn the loss of important facilities, and, as you say, Cabinet Secretary, cultural assets. Does the Minister agree with me that it’s absolutely obscene that this much-loved community facility in Islwyn—both facilities in Islwyn—are due to close due to lack of funds, when there are huge amounts piling up in bank accounts? Will the Cabinet Secretary have a meeting with the arts council and Caerphilly council to make them try and get some money out of their bank and into the community where it belongs?

Thank you, Laura. We understand how these are difficult decisions for local authorities. As I said, this is a matter for the local authority. I think there’s a conflation there about what the reserves are for, but we are aware of the situation. We know that the local authority has engaged with the public. There’s been a full consultation and effective scrutiny by those elected members, and that is an important element of local decisions on the provisions and the services that are provided. So, as I said, there are discussions within—. The Arts Council of Wales are involved—officers are there. We have been asked to keep in touch with those discussions, so I can assure you that that is happening.

Cabinet Secretary, the fate of Blackwood Miners' Institute hangs in the balance, and residents and staff are deeply worried, particularly after the news last week that Llancaiach Fawr was to close. Caerphilly council, as has been said, has had to pause their decision about the miners' future, but there are many questions that local campaigners are asking. The miners' institute has received funding from the arts council. It was meant to have been awarded money from the shared prosperity fund—the money earmarked for the institute may have already been given to other sources. What urgent support can the Welsh Government give—I do believe that this is something that the Welsh Government should be giving support to—to ensure that a cornerstone of cultural life in the community remains open? There is a real risk that productions will put out before a decision is even made because of the ongoing uncertainty, and staff morale is shockingly low, particularly, again, because of the decision last week about Llancaiach Fawr. Can urgent support be given by the Government, because national support should be given to venues that are of national importance?

Thank you, Delyth. I understand, from all Members, the passionate views that they have on Blackwood Miners' Institute. I know there's been that consultation with Caerphilly County Borough Council that has been ongoing. As I said, the Arts Council of Wales are involved. As you mention, they have funded the Blackwood Miners' Institute, but I know those discussions are ongoing. So, I understand the importance of the building. This is very much a decision for Caerphilly County Borough Council, and, as I say, I really do appreciate the real financial backdrop to all of this as well.

Questions now from party spokespeople. The Conservatives' spokesperson, Peter Fox.

Diolch, Llywydd. Can I firstly welcome you to your new post, Cabinet Secretary? I sincerely wish you the very best, and I'll do my best to be as supportive as I can.

Cabinet Secretary, the First Minister has announced her priorities for this Government. I hope you will bring new ideas and perspectives on the matter of local government finances. Cabinet Secretary, what will your plans be for sustainable local government funding?

Diolch, Peter. Thank you very much for the warm welcome and I look forward to working with you and other colleagues across the Chamber on this portfolio.

I'm early into this—it's really the first month, I think, or the first couple of weeks anyway. We're jointly developing with local authorities a real protocol, looking at how we can go forward in terms of if there was a significant financial challenge. So, we are trying to get some sort of bottom-out of that, really, with local authorities. I'm looking forward to having discussions with local authority leaders across Wales—I've already started that—and looking forward to working with the WLGA. So, I'm keen to get out and about and speak to local authorities directly and hear from them some of the challenges and the opportunities that they face.

Thank you for that, Cabinet Secretary. That's pleasing to know, and I encourage you to have those conversations as soon as possible. We only heard last week, didn't we, from the leader of Flintshire how the local authority there was in a position where it may end up having to declare bankruptcy at some point. And then we heard later on, didn't we, a few days later, similar messages from Neath Port Talbot. We know, and I know, that there will be many other authorities who are extremely concerned about the situation. We know that last year's budget levelled a real-terms cut of around 5 per cent on councils, and the implications of this, and the previous difficult years, are threatening the sustainability of local government in its current form. With this in mind, what actions will the Government be taking to ensure that all councils can continue to deliver the many vital services that our communities pay for and expect? Will you want to review current arrangements for the funding of local government? I know you've said you're going to talk to the WLGA and leaders, but is there an appetite within your portfolio, within the Government, to really look at that local government funding formula?

Thank you for that, Peter. I think there’s an opportunity here also to pay tribute to all those people who work in local authorities and the officers who work hard, day in, day out, to make sure that those services are provided for our local communities. So, I’m very pleased that I have the responsibility for local government within my portfolio, and I just want to pay tribute to the workforce who work hard in difficult situations.

As just mentioned, we are jointly developing with local authorities a protocol to apply in case of significant financial challenge. Once finalised, that protocol will be agreed through the finance sub-group. It’s going to set out a range of potential options for support. This will not include access, though, to additional funding, but rather to non-financial and technical steps, including, where appropriate, capitalisation directions. So, there’s something there that we’re looking at in case, because I recognise the stress on the system at the moment and what we’ve seen across the border as well. So, we’re making sure we’re working with local government to prepare. So, as I said, I’m really keen to have those discussions with local authority leaders and the WLGA, and I’m sure I’ll hear some of those points that you’ve raised today.

Thank you for that. I’m sure those conversations will be productive. I think it’s important and incumbent on me to highlight the wider issues. As you know, with my past experience, I know there is a significant difference in the resilience that many councils have. We heard a case earlier about levels of reserves. I’m not going to talk about reserves, because I know they’re currently being used. However, there is a vulnerability that some have because they haven’t got the resilience, and that’s a result of the funding system and that is not sustainable.

Moving on, Cabinet Secretary, a massive headache for councils, as you’ll very well know, is the pressure surrounding social care. Local authorities faced, last year, around a £260 million financial black hole to address social care, but you’ll know that they received only about 10 per cent of the extra funding from the Welsh Government. That contradicted the need to address the well-being situation, recognising how much money went into health. Clearly, then, there’s a lack of a holistic approach by the Government when it comes to health and well-being. Local government plays an absolutely fundamental role in maintaining our communities' wellness. So, with this in mind, Cabinet Secretary, what can the local government family expect to see from you and your colleagues to put things right for social care?

Thank you, Peter. Again, thank you for all the work that you’ve done in your past life, before coming here, in local government. You talk about the resilience of local authorities, and I know again that people are working really hard within those local authorities, against a difficult backdrop in terms of financial pressures, expectations of services and what local authorities deliver, and as you’ve mentioned, social care is such a crucial aspect of that. We know, and I’ve heard myself already from local authority leaders and councillors, about the pressures that local authorities are under because of social care. I’m keen to work with the Cabinet Member for social care as well, the Minister for social care, around this, and the Cabinet Member for health and social care, because if there’s a way that we can have a real focus in this area, especially in terms of getting people out of hospitals, I know that’s something the First Minister has talked about over time now. So, having that focus and working together across portfolios, I think, will be helpful, as well as with local government, which is really crucial.

Plaid Cymru spokesperson, Siân Gwenllian.

Thank you, Llywydd. I also look forward to working with you on the housing portfolio. Yesterday, we discussed the findings of the Audit Wales report that stated that the Welsh Government target of 20,000 social homes won't be reached without significant additional expenditure. To be specific, the Auditor General for Wales states that there's a need for as much as between £580 million and £740 million of capital expenditure in addition to the current financial assumptions to get close to that target by March 2026. Do you agree with the findings of this report? And how do you respond to that? 

Thank you, Siân. Diolch. As I said, thank you again for your warm welcome as well—I look forward to working with you in this portfolio—and for the work that you've done in your previous capacity as well in local authorities. As I mentioned yesterday, I welcome the Audit Wales report and I put on record my thanks to them for the work that they've done. I have accepted all of the recommendations within that report and officials have responded to that.

Okay. But that didn't answer the question on the additional finance that they've identified as being essential to move things forward.

However, it was noted yesterday that almost 140,000 people were on social housing waiting lists. Although these people are waiting for affordable accommodation, many will be pushed into homelessness, into debt and into poverty. We do know that current pressures on homelessness services are unsustainable and vast, and we also know that the best way of helping people and reducing the pressure on services is to move people to long-term appropriate accommodation. But that won't be possible unless you enhance the social housing stock. So, can I ask, therefore, by how many are you looking to reduce the waiting list for social housing by the end of this Senedd? Or, in other words, how many people do you anticipate will be moved into social housing by the end of this Senedd term? 

Diolch, Siân. And I should have said in response to the first question, in terms of the number that was referred to in the Audit Wales report, you know, it is a complex picture. They've talked about finance, but there are other aspects to the supply that are needed in terms of skills. It's not just a financial issue. I think the other point I'd like to make on that report, really, is that we have looked at that, we've accepted that, we accepted the recommendations within that. And in terms of how I see this part of the portfolio, it's how can we unlock the potential that we already have. You know, I wrote a letter, earlier in the summer, to ask all local authorities and RSLs about where they are, how we can do more, and what are the knotty bits within their areas, just to get some real granular detail, and I'm going to be looking at that very closely to see what else we need to do. So, I don't think all of it is necessarily financial. 

And in terms of the list, we do know we need more homes. You know, we all have a real appetite to see as many homes built as possible, and we want that to happen as quickly as possible, as I said in my statement yesterday, but we've really got to focus on some of the real issues that we're facing in different areas around Wales.

Thank you very much. So, you're saying there's more to this than just financial barriers, but it's entirely clear, isn't it, that there isn't enough money available to reach the Welsh Government's target, as things currently stand. And the results of that are already known to us: more and more people pushed into debt and poverty and homelessness. Recently, the Deputy Prime Minister in Westminster, Angela Rayner, has been suggesting a major package of social housing building in the spending review next month. She's described this as,

'the biggest wave of social...housing for a generation.' 

The housing charity, Shelter, has said that the UK Government would have to build 90,000 homes and flats for social rent in England to meet the UK Government's house building commitments, namely 1.5 million. According to Shelter, that would cost £11.8 billion to the Government in Westminster. So, what discussions are you having with that Government about its intention to increase the budget for building social housing? And more importantly, rather than just having discussions on the issue, what will be the implications in terms of possible consequentials for Wales? That is, what will be the likely consequentials that could emerge in relation to this big wave of social housing that’s going to be built, according to Angela Rayner?

Diolch, Siân. You touched on some of the issues around people. As I said again yesterday, the numbers that we know in temporary accommodation, or people who are homeless, we hear the numbers and the figures, but it’s individuals behind this, and the stress that people are under as well cannot be underestimated.

One of the points I also want to make is around the taskforce that I’ve announced, and that will be happening, and we’ll have further details on that which I’ll bring to the Senedd again. That’s looking at how we can unblock certain areas and have a real focus on how we can build more social homes in Wales.

I have had discussions with colleagues in Westminster. I was at the British-Irish Council recently, and there, I was able to have a discussion with Baroness Stevenage, who’s in the housing portfolio there, and we discussed some of the issues, the challenges we were finding here in Wales. Similarly in England, and looking at how we can work together where we can.

In terms of the figures that you asked for, I don’t have those, and that’s something that I can share when I know more information.

Question 3, Joyce Watson.

Diolch, Llywydd. I welcome the Cabinet Secretary to her new role.

Diolch. The new Welsh housing quality standard was launched in October 2023 and implemented from 1 April 2024. Social landlords are already working towards meeting this bold and ambitious standard. The first reporting on progress towards meeting the standard will be in summer 2025.

Diolch for that answer. The Welsh Government, we know, has led the way on setting out a robust set of standards that have helped to transform some of the social housing stock in my area in Mid and West Wales. The recent update to the standard, which, as you said, came into effect in April, will further improve the social housing stock. I welcome the investment from Welsh Government to local authorities and social landlords in my region for 2024-25, and I hope that will, in turn, help them achieve the changes set out by the updated standard. Cabinet Secretary, do you agree with me that it’s vitally important that the Welsh housing quality standard continues to reflect the way people live, work, and also feel about their homes?

Diolch, Joyce, and thank you for your question, and absolutely, I do agree that that is important. The last few years have brought about some real rapid and unexpected changes, not least with the global pandemic, and that’s fundamentally changed how people live and work and what they need from a home. I think we've all thought about our homes after sitting there through the pandemic. But appreciation of our homes is really higher than ever, which is why the new Welsh housing quality standard is so firmly focused on tenants, and I think that’s really, really important. The standard is about more than bricks and mortar, it’s about creating those homes that are safe, comfortable and sustain that healthy lifestyle. So, I'm really keen that this is followed. I'm glad to see this happening, and I think I wholeheartedly agree with your question.

I’m grateful to Joyce Watson for raising the question on the housing quality standard because, Cabinet Secretary, the requirements within the standards are of course extensive and admirable, but you will know more than anybody that there are thousands of people, around 67,000 people, currently on a social housing waiting list, and the requirements in the housing quality standard, both in terms of retrofit and in terms of new build, are making it more difficult for new houses to be built, and for more houses to be built to support those people who are currently either homeless, living in bed and breakfast or desperately in need of a home of their own. Do you think you've got the balance right at the moment in terms of doing our bit to tackle climate change and ensuring that our houses are the right standard to support that for future generations, whilst also ensuring that today's generation have a house to live in?

Thank you, Sam. I think it is really important to think about that, but it's a real balance, because we mustn't compromise on the standards where we're asking people to live. As I said, this is a home, and we want people to live in good-quality homes and accommodation. The standard does build on the excellent achievements of its predecessor, but the new standard keeps that anti-poverty requirement at its heart and improves energy efficiency with the aim of putting more money into tenants' pockets and supporting their comfort and well-being. It is a bold and progressive standard. I think it's important that we don't compromise, but it is crucial to look at the balance, because we do, as you rightly say, need more homes.

Diolch, John. Rough-sleeping is a complex issue, and we continue to work with local authorities to provide supportive assertive outreach to not only assist people off the streets into accommodation, but to ensure they have the support to help them sustain accommodation.

Thank you for that, Cabinet Secretary. One significant aspect of homelessness concerns prisoners released from custody. Thirteen per cent of prisoners in England and Wales are released without a home to go to, and the Chief Inspector of Probation says homelessness is the biggest driving factor in people reoffending or breaching their licence. Ministry of Justice figures show that some 332 people managed by the Welsh probation services were sleeping on the streets in 2022-23, which was a 210 per cent increase compared with the previous year. So, it's an important part of addressing rough-sleeping in Wales, Cabinet Secretary. Obviously, these people are vulnerable, and if we want them to be rehabilitated and not to reoffend, which would be such a boon to themselves, their families and their communities, we need to make sure that they have a stable and adequate home. Cabinet Secretary, I wonder, especially given the current UK Government's policy of early release from prison, which, obviously, is resulting in a lot more people coming out of custody and needing a home, whether you will look at working with local authorities, prisons and others to see what steps, what measures can be put in place to ensure that all of those released from prison in Wales have a home to go to.

Diolch, John. Absolutely, it's important, and, again, the figures that you raised are individuals, aren't they, and there are the pressures that we do know are on local authorities at the moment in terms of how many people are needing a home. As you've rightly said, there are a number of partners that have to work together on this, because it's not just one responsibility. I think one of the crucial elements is that timely sharing of the high-quality information between the prison service and local authorities that is crucial in ensuring that the housing options teams, who do such great work, can plan effectively to ensure people leaving the secure estate are not at risk of homelessness, so trying to do that at an early stage.

I know that the Welsh Local Government Association is reporting that the first tranche of releases under the UK Government scheme on 10 September went broadly well, so we are learning from that. That was supported by some really effective partnership. We know that devolved services like housing can play a really important role in preventing people from reoffending, and, as I said, we're working closely with HM Prison and Probation Service to give this as much thought as we possibly can. Local authorities are working at pace to source accommodation. I think, sometimes, it might seem a small number in each local authority area, but sometimes that can actually be a pushover, really. So, the presentations for homelessness assistance do remain high. But I know local authorities are working really hard in this area, lots of teams are, and I thank them for all the work they're doing on this, because it is really important that we do as much as we can to prevent that before people are at risk of homelessness.

Thanks, John, for raising this important issue. Cabinet Secretary, sadly, we have seen a 65 per cent increase in the number of rough-sleepers over the past 12 months. In towns across my region, and indeed, Wales-wide, people are forced to sleep in tents on any scrap of available land. In Porthcawl, this includes the roundabout on the main route into the town. However, what shocked me more was yesterday's Sky News special report, which spoke to prisoners on early release who had been forced to rough-sleep. One man interviewed said that he was living in a graveyard in Bridgend and was considering reoffending before the winter so that he would have somewhere warm to stay. Cabinet Secretary, how are you working with local authorities across Wales and the Ministry of Justice to ensure that ex-offenders are provided with accommodation upon release from prison? Thank you.

Diolch, Altaf. As I said, there is a lot of work going on in this area and it's working across Governments, across partnerships. The local authorities are really playing their role within this, and the housing teams that are tasked to do this said that they might seem small in number sometimes, but actually, it can really be quite a critical point for local authorities.

As you know, offender management is the responsibility of the UK Government, but HMPPS are leading to ensure that people in custody and the community are effectively managed so that the risk of reoffending is reduced, and that they are supported towards rehabilitation. So, there is a lot of work going on on this. As I said, we're learning as we go here, because the first tranche of that scheme was on 10 September, so it's still early days, but we will keep a watchful eye on this and continue to work with all involved as closely as possible.

As a Government, we have protected front-line public services as far as possible. Local authorities have a settlement of £5.72 billion this year, an increase of 3.3 per cent on a like-for-like basis compared to 2023-24.

Thank you for your answer, Cabinet Secretary. The Liberal Democrats that are running Powys County Council this year put council tax up by 7.5 per cent and are forecasting putting it up next year by 5 per cent. This has all come to light at a time when the number of senior managers in Powys County Council on over £70,000 a year has doubled. While they've doubled that number, they've decided to cut community cardboard recycling services, take away leisure services in towns and also revert some of our roads back to chippings, all to save money. Cabinet Secretary, what can you do to ensure that the Liberal Democrats in Powys County Council spend the money more wisely and protect front-line services from funding cuts? Because if something isn't done to protect Powys County Council from the Liberal Democrats, all we're going to have is senior managers and no front-line staff to deliver the services that we all need. 

Diolch, James. I see what you're trying to do there, but thank you for the question. The core funding, as you know, is unhypothecated; it's for local authorities to determine the allocation of funding for its services. Local authorities have prioritised social care and education for many years, and this has inevitably meant that other services have borne greater pressure for savings and efficiencies. I look forward to visiting Powys County Council shortly and will hopefully see them soon. I look forward to working with them, as I will with other local authorities in Wales.

Following over a decade of austerity, massive inflationary pressures and rising needs, councils are now, actually, on their knees. They've reorganised, restructured and reformed, with each council having to make millions of pounds of savings. The Welsh Local Government Association financial spokesperson, Anthony Hunt, said that this year is crucial. They're hoping that next year inflationary pressures will level out, so I would like to ask the Cabinet Secretary: would you agree that delegated ring-fenced funding direct to local authorities would help matters so they didn't have to go through long, resource-heavy grant submissions? Also, what representations are you making to the UK Government? They're talking about it taking a while to deal with the deficit and that the future will be better, but this year is absolutely crucial to local authorities, as councils right across the UK, not just in Wales, are facing bankruptcy. Thank you.  

Thank you, Carolyn, for the supplementary question. We are very sympathetic to the financial pressures that local authorities are under, particularly from pay, including that real living wage in social care. We are doing everything we can, but we are really alive to the pressures that are on them. We are looking at reducing unnecessary burdens for local authorities. Within grants, there has been some work that's been done already, and I'm keen to look at other ways that we can do that. That will be done in discussion and in collaboration with local authorities, and I'm sure that this will be something that will be raised with me on my many visits that I look forward to in the coming weeks and months.

Question 6, Mike Hedges.

Sorry, I was waiting to be unmuted then.

Our remediation programme is progressing well. Works are under way on 50 private sector buildings, and all 12 major developers have signed up to our developers' contract.

Bellway Homes last September signed a legal agreement with the Welsh Government regarding the Altamar development. The agreement required an independent survey to be carried out, and this was done in February 2024. Bellway only released the survey results at the start of this month. Bellway have since advised that further surveys need to be done on fire doors and structural steel. When can people living in developments like this expect the remediation work to actually be started?

Diolch, Mike, for that question, and I understand your long-standing interest in building safety here in the Senedd in particular. Our remediation programme has adopted a whole-building approach, which considers both the internal and external fire safety, so not just external cladding, and it really does put people's safety first. There are currently 238 private tenure buildings in Wales; three buildings have been confirmed as complete, and works have started onsite on those 50 buildings that I mentioned. We've been informed that seven buildings do not require fire safety work. Specifically on your point around Altamar in your constituency, officials are working closely with Bellway, the developer for Altamar, ensuring that progress is made and work is started as soon as possible.

Cabinet Secretary, I'm sure many of us here receive several e-mails every day from high-rise residents with concerns about fire safety, the slowness of remediation work and the costs that they are required to pay. They are at their wits' end and they, frankly, feel totally ignored. Following the frightening scenes at the end of August at a high-rise in Dagenham, the Welsh Cladiators wrote to you twice asking to meet. To say they were gutted by your refusal would be an understatement. They have said on several occasions that they don't believe that the stakeholder group is the proper forum to air their concerns, and those of us who have met with them can attest to the powerful testimony that they have, and the very moving testimony. I appreciate that you are very busy—you have a wide portfolio—but could you please reconsider and agree to meet with the campaign group of the building safety scandal here in Wales? Diolch yn fawr.

Diolch, Rhys, and, again, I recognise your work in this area as well. Just to say, I did attend a meeting of the building safety strategic stakeholder group yesterday, in which there were representatives from the Cladiators, as well as others within that group who participate, which is really helpful. I think it's a general feeling, as I did ask how people felt about the group, and if they were able to discuss things there, and I think there was a strong feeling that the group was working well. There was an update on developers and remediation works at that meeting. I thought that that was probably the best meeting to go to straight away, as I've only been in post for a short time. This gave me an opportunity to hear from everybody who's interested in this area and focused on that work. I'm always happy to meet with people on specific issues, but I think, for the first instance, the meeting was yesterday, and everybody had that opportunity to speak to me in that area. But I'm always happy to meet.

While we currently don't have a specific community of practice for social housing grant, we do have extensive collaboration and strong relationships across the housing sector, with both registered social landlords and local authorities. We are, however, open to exploring a more formal community of practice.

Thank you for the answer. Communities of practice have been successfully used in different areas of Welsh Government activity, including the foundational economy and, in fact, the Welsh Government's decarbonisation programme, where, every other month, 70 participants from all sectors meet together to look at how they can spread and scale good practice. Given that the social housing grant accounts for some £250 million of spend every year, and the Government is being challenged to meet its target of 20,000 new homes, would the Minister consider setting up a specific task in order to support the sector, to drive the use of local materials, support the foundational economy, and help different actors to meet our target?

Diolch, Lee. Thank you for that. I know you raised with me this point generally in the Local Government and Housing Committee a couple of weeks ago, and, following that, I have asked my officials to review the existing networks and forums, and to explore whether a more formalised social housing grant community of practice would be something that could be of real value. So, I will keep you updated on that, but we are looking into that. So, thank you for the suggestion.

Finally, question 8, Peredur Owen Griffiths.

Diolch, Peredur. In 2024-25, the Government is providing unhypothecated revenue funding of over £5.72 billion and over £1 billion in specific grant funding to support local authorities to deliver both statutory and non-statutory services. Local councils are directly elected bodies with responsibility for the choices they make on local service priorities.

Thank you for that response, and welcome to your role.

Another method for doing this could be a community right to buy. I note the recent Government statement on the community asset commission, which was issued on 24 September. My question is not in any way a criticism of the people or organisations involved in that commission, but I have to say how deeply disappointing it is that Wales, in 2024, is still without legislation giving communities the right to buy local assets. This is something that communities in England have enjoyed for nearly a decade and a half, and the SNP Government has also introduced similar but much stronger legislation in Scotland. Is it any wonder that the Institute of Welsh Affairs think tank has described Welsh communities as the least empowered in Britain when it comes to the protection of land and assets? This is of particular interest in the region I represent, where Caerphilly's Labour cabinet has just decided to mothball the magnificent Tudor mansion and living museum, Llancaiach Fawr. This type of legislation would have been an alternative option for the local authority and the local community. How long will Welsh communities have to wait to enjoy the rights and benefits of community assets that their counterparts in the UK have had for years? How long will local authorities have to wait for extra tools to be able to help in this field? And how many more buildings will our communities lose before this Government gets its act together?

Diolch, Peredur. Just on the community asset commission that you mentioned, a written statement was published on 24 September. The Welsh Government is committed to ensuring that, wherever possible, community facilities are protected. This commitment has led to the establishment of that commission, following the work undertaken by the Senedd’s Local Government and Housing Committee, which my colleague John Griffiths chairs. Ystadau Cymru developed and published a community asset transfer best practice guide in 2019, and this included a due diligence guide, a practical example of the transfer process and real-life case studies. The guidance is scheduled for review in 2025, in line with recommendations made by the community asset commission. So, there are initiatives ongoing. We know how important community assets are, and I've seen examples where that's worked really, really well. But as I said, there will be a review of that scheduled in 2025.

I thank the Cabinet Secretary. 

The next item will be the questions to the Cabinet Secretary for Education. The first question is from Janet Finch-Saunders. 

Conwy County Borough Council has one pupil referral unit, Canolfan Addysg Conwy, which provides education to children between the ages of five to 16. The pupil referral unit is set over three sites based in Penmaenrhos, Penrhos and Llandudno.

Thank you. I understand that they were contacted for a response to this question, which is very interesting. According to Estyn's annual report, there are 22 pupil referral units in Wales supporting 969 students. PRUs were once the most commonly used setting, accounting for nearly 50 per cent of all enrolments. Estyn have noted that, since the pandemic, local authorities have reported an increase in referral rates. Having spoken to Conwy council myself, they have observed an increase in requests for local authority funded and moderated additional learning provision over recent years, and indeed on a visit around my local schools, they are saying that they're really struggling to get into the PRUs there. That means that these PRUs, and any support for additional need, requires additional funding.

Now, I've raised so many times here about the funding formula being totally inadequate for Conwy County Borough Council, both in the older demographic, but clearly here we need some targeted funding to support those children who really are struggling. What additional funding, therefore, will you provide in 2025-26 to assist with the increased demand for additional learning provision? Diolch.

Can I thank Janet Finch-Saunders for that question, and also welcome her commitment to the young people who are receiving education in education otherwise than at school settings? I know that it's something she's had a long-standing interest in. As she knows, PRUs are an essential part of ensuring that children who cannot attend school receive a suitable education, and they support learners to overcome the challenges they face, to achieve their potential and to make positive transitions back to school, on to college or into work.

As she rightly said, we are aware that, since the pandemic, demand for places at PRUs has increased in Wales substantially, and local authorities are working to respond to this increase and are increasing the places available in PRUs. As you highlighted, officials did contact your local authority and I'm pleased to say that they don't currently have a waiting list for their PRU. [Interruption.] Well, that's what officials have been informed by your local authority. There are no learners waiting, we have been informed by the council, for a placement in Conwy. They have, however, observed an increase in requests for local authority-funded additional learning provision, and have also extended the specialist provision offer for neurodivergent learners in particular.

I'm sure the Member will be pleased to know as well that we're putting in place arrangements to collect data about waiting times for EOTAS and PRU placements nationally, and if the Member is aware of cases that she feels are waiting that the council aren't aware of, then can I suggest that she writes to me?

Ensuring all practitioners can access career-long professional learning is integral to our vision for education in Wales. The national professional learning entitlement, which launched in 2022, is already playing a key role in providing our practitioners with access to high-quality professional learning from early career to system leadership.

Some weeks ago, I asked a written question of you on this issue, asking simply: how many professional learning opportunities have been available to staff in the education profession over the past five years? Now, I was shocked by the answer that I received, namely, and I quote:

'The Welsh Government does not collect the requested information.'

And you encouraged me to contact other stakeholders to get a response to my question. Now, it's important that we should remind each other that the Welsh Government has spent almost £36 million on professional learning opportunities, and that the previous education Minister had made two statements in this Senedd on this issue, outlining the work of Government in this area. So, how on earth can the Cabinet Secretary measure the effectiveness and efficiency of her CPD provision if the most fundamental data on the issue isn't gathered and analysed? 

Can I thank Cefin Campbell for that question, and, obviously, I fully recall the written answer that I gave you? Professional learning is a priority for us; it is the absolute baseline for ensuring that we can raise standards in schools. The national professional learning entitlement outlines our commitment to ensuring that all education practitioners can access high-quality professional learning throughout their career. I do, however, recognise that particularly in the responses we received in the work around the middle-tier review, now the school improvement partnership programme, there was lots of concern amongst practitioners and school leaders about what was described as the 'white heat' around professional learning. And I think, in what you've highlighted in terms of the Education Workforce Council data, that is an example of that. 

We are starting to provide a more coherent centralised system, so we now have a single point of access to high-quality professional learning via a new professional learning area launched on Hwb last year. And we've also taken steps now to guarantee access to high-quality professional learning through a new rigorous endorsement process, launched in March this year, which is led by a national endorsement panel chaired by Professor Ken Jones. 

I'm grateful for your acknowledgement of the funding that we have invested in professional learning, and we have continued to sustain that with a further £12 million awarded directly to schools this year to enable all practitioners to take part in professional learning. And I know from my conversations with schools that they really value that opportunity. It is also the case, though, that we have more work to do in this space. As you're aware, we're working on the school improvement partnership programme. There'll be further announcements about that in due course, and I'll be in a position to say what more we're going to do around a coherent national professional learning offer in that space.

Cabinet Secretary, when I go and talk to teachers and school leaders across my constituency, and in my time on the Children, Young People and Education Committee, a lot of teachers and school leaders will say to me that the additional burdens that are placed on them are actually denying them time to do that CPD and professional learning, whether that's the additional requirements that teachers are having to do around additional learning needs, or around not having enough teachers or school support staff in the classroom to enable them to go and do that. So, what steps are you doing to actually try and reduce the burden on our teachers and school leaders so they can actually go and do the CPD, because if they're not doing that, the people who we are letting down are those teachers and the young people in the classroom who are not getting the most up-to-date methods of teaching that we want to see our young people having, so that they can come out being full and rounded citizens going into the workplace after they leave school? 

Thank you very much, James. And you're absolutely right, high-quality professional learning is absolutely crucial, and we want our teachers and our support staff to be able to have access to that. And it is a challenge, and I've said numerous times in this Chamber that we are asking a lot of our schools with the mission to raise standards, curriculum reform and ALN, and I am extremely mindful of that. That's one of the reasons why we've provided the additional funding for professional learning that can be used in some schools, if they choose to, to release staff to take up professional learning opportunities and that’s very important.

But you also make a really important point about workload. You’ll be aware that this is something that we’re working on closely with our trade union partners. We have a strategic workload group in partnership with the trade unions in Welsh Government—that has three workstreams—and we’re also developing a workload impact tool, which we are using in Welsh Government so that we can assess the likely burden arising from any new duties that we’re going to place on them. So, we are working on this, but recognise there’s more work to do.

Questions now from the party spokespeople. Welsh Conservative spokesperson, Tom Giffard.

Diolch yn fawr iawn, Llywydd. Cabinet Secretary, ITV reported on Thursday last week that 20 per cent of our children in Wales are functionally illiterate at the time they enter secondary school. We also have the worst reading skills of anywhere in the United Kingdom. That's not a record to be proud of after 25 years of Labour running our education system in Wales. And part of the reason is the way in which reading is taught in Wales. 'Cueing'—the practice of teaching reading through using pictures as cues—is an internationally discredited practice, and yet that's how children in much of Wales are being taught to read.

Education expert Rhona Stainthorp, after looking at the way in which reading is taught in Wales, told ITV

'I'm speechless. I really am speechless. I think that is unbelievably awful.'

She went on to say:

'All the evidence from...America, Australia and the UK, is that you must teach young children to read the words. The pictures might be nice and pretty, but they don’t help you to read.'

So, why is cueing still being taught in Welsh schools?

Thank you very much, Tom. I think I’ve been very, very clear with everybody in this Chamber that raising standards is a priority, that improving literacy is a key part of that and that we are not in any way complacent as a Government about the work that we are doing in this. I’ve been clear that literacy’s a top priority for me, and I’ve also already set out in this Chamber a range of additional steps that we’re taking to support literacy, which you will recall from my curriculum statement back in the summer.

I want to be really clear with you, though, that phonics is an absolute expectation that we want to see taught in our schools in Wales. We expect all schools to be using phonics to teach reading. Can I also say that the report that you referred to, which was reported on the ITV piece, was the 2012 Estyn report, so that is now 12 years old. But that doesn’t mean that we’re in any way complacent about the challenges that we face. Our personalised assessment results were concerning, so, this is absolutely a focus, and I also recognise that we do need to do more to be clear with schools about the expectations around phonics.

I think the ITV piece was very clear that schools and teachers were not the problem and it was the advice given by Welsh Government that was the problem in this area. And part of that advice is the statement issued by the Welsh Government saying that it didn't advocate a particular method of teaching reading, which contradicts what you've just said about phonics. But that's exactly the problem: cueing, which is being widely taught in Welsh schools, has been actively described as not only an ineffective way of teaching young people to read, but even damaging for young children, confusing them, and even having the effect of cancelling the benefits of phonics. Cueing was banned in England in 2005 for this exact reason. 

The First Minister said yesterday that you'd make a statement on this in the coming months, but you've known about this problem for 20 years. And since abolishing cueing in England, reading levels there are one of the best in the world, and instead, in Wales, we have children going to school functionally illiterate—a record that your party should be ashamed of. So, having known about the impact that cueing is having on people for 20 years, why on earth hasn't the Welsh Government banned it sooner?

Well, first of all, can I say that I didn't say that schools and teachers were the problem—those are your words, not mine? I have said that we have a clear expectation that all schools will use synthetic phonics to teach reading. I've also said that we are looking at what more we can do to re-emphasise that expectation. If you’d been here for my curriculum statement back in the summer, you would recall that one of the things I announced was that we’re reviewing our literacy and numeracy framework and we’re putting that on a statutory footing. That will provide a further opportunity to strengthen the expectations of schools around phonics. The actual curriculum has it written in law as part of the curriculum framework that phonics have to be taught in languages and communication. So, that is very clear.

Now, in terms of cueing, I think it’s important to recognise that teachers are professionals, they know their learners, and there will be some children who may not be ready for phonics. There might be children—. We know that we’re seeing more children with speech and language problems, especially since the pandemic, so there might be children coming to school who haven't got sufficient knowledge of speech to be able to break down words in the way that synthetic phonics requires. So, on that basis, teachers will have other tools in their toolbox to support the learners, who they know best, but, again, we’re absolutely clear—synthetic phonics is what we expect as the building blocks of reading in Wales.

You said you had clearly advocated for phonics. This is your statement from last week. Quote: the Welsh Government

'do not advocate any one specific method to teach reading'.

That’s your quote from last week. No wonder schools don’t think you’ve been clear, Cabinet Secretary. I can tell you, though, why reading standards in Wales are so poor. It’s the Welsh Labour Government continuing to prioritise ideology over evidence, a desire to do things differently, even if the outcome is worse. Again, to give you an idea of the scale of the issue we’re talking about here, Professor Rhona Stainthorp again—quote—

'That is not something that I would expect to read about teaching in a school in the 21st century. We’ve just moved light years away from that'.

And when concerned parents watched that ITV report on our paltry reading standards in Wales, looking for reassurance from the Welsh Labour Government, what did they see? A Cabinet Secretary who was asked multiple times to speak to ITV to discuss the matter, but refused. They also sent a list of questions to your department and they were not answered. Where were you? I’ll tell you where you were: complacent, missing in action, asleep at the wheel, burying your head in the sand and pretending it isn’t a problem. And that’s just not going to work. It will fail our young people. So, will you commit, for once, to follow the evidence over the ideology, change the guidance today, so no more pupils are the victims of Labour’s educational incompetence?

Well, Tom, I think if you knew me better, you would know that I am the very last person you could describe as being missing in action. I’m also the last person you would expect to put ideology over the needs of children and young people. I have been really clear since coming into this post that that is the only thing I am interested in delivering in this portfolio: what is best for children and young people. That’s why, when I came into post, one of the first things I did was identify that schools needed more support with the curriculum, and that includes literacy and numeracy, and we announced in July that we are delivering that support. Part of that work is nationally-intensive support with literacy that we are rolling out now right across Wales.

And if we can just get away from the political point scoring for just a moment, I do think it is important that we also recognise the very good work that happens in our schools. For instance, Estyn’s most recent, 2022-23, annual report identified that most primary schools planned effectively to develop pupils’ speaking, listening and reading skills, and that the reading and writing skills of many pupils were developed appropriately by practitioners. In secondary schools, the report noted that many pupils demonstrated sound basic reading skills.

But I don’t have a complacent bone in my body. We recognise there’s more work that we have to do. That’s why we are not just rolling out this intensive national support, but we are placing the framework on a statutory footing. We are gathering data through our personalised assessments, which isn’t something that they do in England. We are publishing that information, so that it is open and accessible. And I’m confident that, working together with our excellent teaching professionals, we will make progress.

Plaid Cymru spokesperson, Cefin Campbell.

Thank you very much, Llywydd. How many combined years of experience have left the teaching profession in Wales since 2016?

How many combined years of experience have left—

Yes—have left the teaching profession since 2016.

Well, I don't believe that we would have that data, Cefin.

Well, if you haven’t got the data, I can give you the data right now. According to your own statistics, almost 100,000—well, about 92,000, to be precise—of combined years of experience have left the teaching profession in Wales in the last eight years. Those are your statistics. That leaves a huge gap to fill. But, in that time, the Welsh Government has consistently failed to meet its own recruitment targets, and the number of teachers leaving the profession early in their career is at its highest level ever—over 1,200 since 2016 alone. Cabinet Secretary, my question is very simple: 'yes' or 'no', is this sustainable?

Well, in terms of the figures that you've presented, I will certainly go back and look at those, although I find it very hard to believe that the figures are presented in that way in terms of years of experience, because my experience of Welsh Government data is that the granular detail doesn't go down that far, but I will take a look at that. But, of course, I am not in any way disputing that we face challenges in terms of recruiting and retaining our teachers, and that is something that we've discussed on numerous occasions here in this Chamber. That is a complex picture, isn't it, especially since the pandemic, and there is no one silver bullet in terms of retaining our teachers. It's about well-being support, it's about making sure that our schools are appealing places for teachers to work, it's about how we remunerate them, how we reduce the pressures on their workload.

Now, in terms of recruitment targets, as you call them—. They're actually called allocations now, but we do specify allocations, particularly for shortage subjects. You'll be aware from the response I sent the Children, Young People and Education Committee recently that we're doing really well on primary recruitment; secondary recruitment is much more challenging. It's not just much more challenging in Wales; it's much more challenging across the border as well. That's why we have the priority subject incentives, which provide additional money for subjects like science, technology, engineering and maths, Welsh language, modern foreign languages. But there is always more that we can do, and I very much welcome the inquiry that the committee is doing, and I'm looking forward to hearing your views, based on the evidence that you've taken, about whether there's anything further that we can do in this space.

Well, I'm not sure if I got the simple 'yes' or 'no' answer I was looking for, but, just for the record, it’s Plaid Cymru’s view, and the unions' view, very clearly, that the current situation when it comes to teacher recruitment and retention is not sustainable at all. Now, in answers to written questions that I tabled to you over the summer, I must admit that I was shocked to learn that the Welsh Government’s teacher recruitment and retention advisory board, which was set up to much fanfare in the last Senedd to provide expert advice to you on this issue, was disbanded last year, quietly and without a trace. Also, by your own admission, the Welsh Government doesn't gather even the most basic data on the effectiveness of its teacher training incentive schemes.

Cabinet Secretary, how many incentive schemes have to be left unmeasured, experts ignored, recruitment targets missed and years of teaching experience lost before this Welsh Government will admit that what they've been doing for the last 25 years hasn’t been working?

Thank you for those questions. Obviously, the panel that you've referred to was disbanded before I came into post. That doesn't mean that we don't have expert advice on the recruitment and retention of teachers. We're currently doing a piece of work, actually, with the Organisation for Economic Co-operation and Development to look at some of the issues around why it’s difficult to recruit and retain teachers. So, we are taking advice, and we’re taking advice from a range of sources. It’s also not the case to say that the priority subject incentives are not measured, because, as I’ve said to you in a previous answer, that is something that we are doing. It’s not something that you can do really quickly. So, for example, with the Welsh-medium incentives, it’s going to take a little while for Welsh-medium teachers to go through the system, do their training, get their qualified teacher status, do their induction. But I am very committed. I think data is incredibly important—it really is. It’s something I learnt in my previous role. I’m constantly asking for more data and looking at what we can do to improve the data so that we can measure progress.

Independent schools make up 5.3 per cent of the total number of schools in Wales and contribute to the education of 2.1 per cent of all pupils. Estyn inspect all independent schools to evaluate the quality of education and to ensure each school maintains their compliance with the independent school legislative standards.

Thank you. Cabinet Secretary, independent schools like Haberdashers’ in Monmouth make an enormous contribution not just to the education of children, but also to the local economy, being the town’s largest employer and drawing in visitors who support local businesses. Labour’s proposal to levy VAT on school fees poses a direct threat to the future of this school and other like it, which could force more pupils into the already overstretched state sector. In Monmouthshire, we’ve seen issues with overcrowding, underfunding, lack of teachers in state schools, with pupils in Caldicot, for example, being taught in a maths class of 60. Does the Cabinet Secretary recognise the critical role that independent schools play in alleviating the pressure on the state sector? Where would all these children go if Haberdashers’ in Monmouth, for example, and other schools like it, close? Will you commit to opposing any policies that threaten the viability of independent schools in Wales, which would exacerbate the existing challenges that you’ve already outlined today? Thank you.

Thank you very much, Laura. Well, I'm sure you won't be surprised to learn that investment in our mainstream public education system and schools is my priority. As you've highlighted, there are plans to levy VAT on private schools. That is a UK Government policy that is not devolved, but one that we are liaising with them closely on to make sure that we get the best possible deal and have the needs of our pupils in Wales taken fully into account.

In terms of those pupils who may not continue to go to private schools putting pressure on the state sector, that’s not really something we are particularly worried about at the moment, because there are 10,126 independent school pupils in Wales, and our latest figures show we have 78,970 surplus places in our state schools in Wales. Can I also say to the Member that she may wish to look at the Institute for Fiscal Studies report on this policy proposal, which concluded that there was likely to be little impact in terms of numbers of people going to private schools as a result of this policy. But you’ll also be pleased to know that we have written to all private schools in Wales and all local authorities, encouraging them to respond to the UK Government’s consultation on this, which has now closed. I know that there was an impact assessment undertaken and that the outcome of that will be made known at the budget on 30 October.

The Welsh-medium ALN steering group advises on matters relating to improving and increasing Welsh-medium provision for learners with ALN. The Welsh language ALN national implementation lead has been in post since the spring and will take over as chair of the group this month to drive forward priorities.

Thank you for that response. Thanks to the work of pioneers like Michael and Ethni Jones, and the late beloved Beryl Williams, who died two weeks ago, who worked in this area for decades, there is a commendable tradition of Welsh education for children with additional learning needs here in Cardiff. Before then, a number of families, including my own family, can give you examples of children who were rejected from receiving education in their native language. Unfortunately, the recent tv programme, Y Gymraeg: Hawl Pob Plentyn—every child's right—showed that the fight continues. The Welsh provision is nothing like the English provision. Two examples for you, Minister: there is a specific English unit for autism in south Wales, but there is no Welsh-medium unit; and there is no intensive specialist school through the medium of Welsh here in south Wales. So, how is the Welsh Government going to ensure that all children, whatever their needs, can access Welsh-medium education?

Thank you for those important points. My early experience of the local authority in Cardiff is that they are working very hard on their Welsh-medium provision. I was at an immersion unit last week and they were pulling out all the stops, and it was really very impressive to see the commitment that was there. You're aware that, if a child or young person needs additional learning provision in Welsh, that should be documented in their individual development plan and all reasonable steps must be taken to secure the provision in Welsh. I am, of course, aware of the challenges in relation to ALN and the Welsh language. Welsh-medium providers and families continue to express concerns around the availability of Welsh language workforce, assessments and resources to support ALN identification and provision. That's why the appointment of our Welsh language ALN lead is really important, because that will help join up this provision across Wales. That lead is focused on mapping the availability of Welsh language ALN provision and resources across Wales, improving the quality and availability of resources and supporting the workforce in pursuit of better educational experiences for children and young people with ALN who are accessing Welsh-medium education.

Can I say as well that the Welsh Government are also working with partners, including Adnodd, which is the bilingual educational resources company, to improve Welsh-medium additional learning provision, so that all learners have got the same opportunity to learn and develop, and to also add that I'm very pleased that we've got work being developed on a much called for literacy assessment tool, which is being developed by Cardiff Metropolitan University, to help with standardised tests aimed at improving the identification of literacy difficulties in secondary school pupils who speak Welsh. So, you know, I recognise there's more work to do and ALN is a priority for the Government. And you'll also be aware that the Welsh in education strategic plans are key to this and also have to set out how the local authorities are meeting their additional learning provision demands as well. All the WESPS are now in with the Welsh Government for this year, they're being assessed, and local authorities will have feedback on that, and I can assure you that if we find any particular shortcomings, I will be pursuing those with the local authorities.

I was pleased to read Estyn's recent inspection of Caerphilly education service, which, according to the report, put the best interests of children and young people at the heart of the decisions they make. The report highlights positive findings regarding the authority's education provision, approaches and practices.

Diolch. Caerphilly County Borough Council has 27,576 pupils across 86 schools, including 73 primary schools and one special school. As you said, Estyn, the education watchdog, carried out an in-depth inspection of the council's education services in June. In September, Estyn published their conclusions. Caerphilly County Borough Council's education service received a glowing review. Estyn stated: 

'Caerphilly’s education services are led very capably by the Chief Education Officer and her senior team. The team put the best interests of children and young people at the heart of the decisions they make. The education service receives effective support from the corporate management team. The service makes a strong contribution to the Council’s vision to secure "better futures for all" in Caerphilly.'

Cabinet Secretary, will you join me in congratulating the Labour-run Caerphilly County Borough Council's leadership in ensuring high educational standards for Islwyn children, and will you visit with us in Islwyn to see first-hand the good work taking place?

Thank you very much, Rhianon, and you've done a better job than I could there of highlighting the positive points from the inspection report. I'd just like to thank all the teachers, support staff, headteachers and local authority staff collectively in the local authority for their work, which has led to this excellent report, which was really lovely to read. As you said, there's a clear strategy for school improvement. It was great to see the feedback on the leadership of the chief education officer, who provides

'strategic, empathetic yet firm leadership',

and also great to hear about their approach to managing vacancies among leaders in schools, which means that the schools are working very sustainably in terms of staffing. So, I'm very happy to come to Islwyn to talk to the local authority and maybe visit one of your schools. And, I'd just place on record again my thanks to the authority and everybody else in the area for their hard work.

Cabinet Secretary, as you know, swimming and water competence is part of the national curriculum for all key stage 2 schoolchildren in Wales. In the curriculum it details that 

'Pupils should be taught to:

'develop skills of water safety and personal survival

'swim unaided for a sustained period of time'.

However, Cabinet Secretary, a report co-produced by Disability Sport Wales and the fantastic charity Sparkle in my region of south-east Wales has revealed that children with additional needs in Wales are not being taught these essential skills. The report evaluates specialist swimming lessons offered to children with disabilities in Serennu, in Newport, in comparison with parents' experiences when trying to access school or community swimming lessons for those children without these specialised facilities. So, Cabinet Secretary, currently there are 100 children on a waiting list for swimming lessons in Gwent alone. So, given the curriculum states that all children should have access to these essential skills within their education, what can you do to support organisations such as Sparkle in providing access to this part of curriculum and ensure that children with significant disabilities or learning disabilities are not excluded from this vital task of swimming? Thank you.

Thank you, Natasha, and, just for transparency, I'm aware of the report that you refer to because I met Sparkle myself, in my MS capacity, to discuss their concerns about disabled swimming. I was very concerned to hear about the situation, and I will be discussing that with officials and will also discuss it with my colleague Jayne Bryant. I understand that the issues around it are quite complex, because it's around temperature of water, staffing, appropriate hoists, but I am really keen that disabled children have the same opportunities as non-disabled children, so I will follow that up with officials and write to you.

Policies around value added tax are non-devolved, and Welsh Ministers do not have any powers in this area. Details of the UK Government’s assessment of the expected impacts of these policy changes are expected to be published at the autumn budget on 30 October.

Thank you, Cabinet Secretary, and I'm conscious that you've answered some of my points in your previous response to Laura Anne Jones. But, contrary to common belief, private schools are not just for children of millionaires; many aspiring parents want the best education for their children and have sacrificed and saved up for years to put their children into these schools. Unfortunately, the VAT, which will be levelled from, we know, 1 January next year, will put a burden on schools. I was with Haberdashers' in Monmouth yesterday, and they are under no illusion this will have an implication for people, especially on partial bursaries and the like, and it will force some parents to pull their children out of schools. And, whilst the numbers may be small for individual schools, state schools, that may have to receive children, it will no doubt still be a significant amount when collected across Wales. And, as we heard earlier, we know that a school even, next to where I live in Caldicot, is currently operating with 60 students in a maths class, so they're under immense pressure. So, with that in mind, Cabinet Secretary, what assurances have you been given that money raised via VAT from schools in Wales will be passed on to the Welsh Government and not redistributed into schools in England?

Thank you very much, Peter. As I've said, officials have been having discussions with UK Government officials on this, to make sure that we get the maximum benefits for Wales from this policy. I myself met with one of the Treasury Ministers shortly after the election, and have obviously emphasised to the UK Government that any money that is spent from this policy on devolved services, we would expect to receive a consequential for in Wales. That's very, very important to us. We're also aware that there are provisions being made for those children who are in private schools because of IDP ALN placements, and we've been really clear with the UK Government that it's vital, where local authorities are funding those places because of ALN, that they're able to claim back the money. So, we're very focused on proactively protecting the interests of Wales and making sure that we benefit from any funding that arises from this policy.

The Cabinet Secretary for Transport and North Wales and I have discussed a range of issues relating to learner travel on different occasions. We met again earlier this week to discuss this important issue, and we recognise how important it is for effective learning.

Thank you very much for that. Too many parents across the south-east experience difficulty in sending their children to Welsh schools, and changes to school transport schemes can exacerbate these challenges. Caerphilly County Borough Council is consulting on curtailing its home-to-school transport programme, which is similar to consultations seen over the summer in other counties, such as Monmouthshire. There is a very real risk here that cutting back on these schemes could undermine years of work in those communities to give children opportunities to access Welsh-medium education. So many parents in these areas are people who don't speak the language themselves, but they have fought to give their children this opportunity—an opportunity they didn't have themselves. But without access to safe, free transport, more and more parents may decide not to take that step. It's not realistic, safe, or fair to expect children to walk miles to school in all weathers, and we remember, in many of these areas, the rates of families who own a private car are lower. So, what will the Government do to improve the situation, to give new confidence to parents, and to provide this golden opportunity for children to be able to learn through the medium of the Welsh language?

Thank you very much, Delyth. As you're aware, the Learner Travel (Wales) Measure 2008, which my Cabinet colleague leads on, sets out the duties for the local authority to assess the travel needs of learners in their area and provide free learner transport if eligible, based on age, distance, aptitude and safety criteria to the learner's nearest suitable school as determined by the local authority in accordance with the schools admission policy.

Local authorities are responsible for assessing the needs of learners in their area, and they do have discretionary powers to provide transport according to these needs, for example, below the mileage thresholds to a Welsh-medium school or even for post-16 learners, and it is up to local authorities to decide on their transport provision. As you know, funding for school transport is through the revenue support grant, so local authorities can prioritise their funding according to local need, and we recognise the financial challenges faced by local authorities with regard to delivering learner transport.

As I think you're probably aware, work has commenced on updating the statutory operational guidance document that accompanies the learner travel Measure, setting out legal duties as well as best practice for the provision of transport to schools. This updated guidance reflects the feedback from stakeholders, as well as children and young people and their families, to provide greater clarity on roles and responsibilities and to further amplify relevant legislation.

I thank the Cabinet Secretary.

The next item is the topical question, to be answered by the Cabinet Secretary for Climate Change and Rural Affairs, and the question is to be asked by James Evans.

Diolch, James. I have issued a statement today setting out the latest position in Wales and my advice to farmers. My officials are in daily contact with the Animal and Plant Health Agency and other partners to control bluetongue. Although the virus has been detected in some sheep bought in to north Wales, we currently have no evidence of active infection here, and my policy goal continues to be to keep Wales free of this new disease.

Thank you for your answer, Cabinet Secretary. I also thank the Presiding Officer for accepting this very important topical question today. I did notice, as you say, after my topical question was accepted, that the Welsh Government released a written statement on the spread of bluetongue, which was great timing, I must say. But it was a shame that the Welsh Government couldn't bring forward an oral statement yesterday, because it's a very important issue for farmers across Wales, and it's a shame that we've had to come this way to get you to the Chamber.

As outlined in your response, Cabinet Secretary, and indeed in your written statement, the spread of bluetongue is extremely concerning for our farming community, and it is crucial that we deal with this head on. I welcome the actions that have already been taken, including extensive sampling and laboratory testing, which has been carried out by APHA and the Pirbright Institute.

Nevertheless, Cabinet Secretary, there have been cases of bluetongue in the south-east of England since August, and plans and precautions have been put in place in England by the Department for Environment, Food and Rural Affairs and APHA, but, regrettably, this doesn't seem to be the case in Wales. In light of this, can you elaborate on what discussions you're having with your counterparts in DEFRA regarding the spread? And will you be putting in any biosecurity measures, such as restricted zones and infected areas, which have occurred in England? Because I think that's something we could see in north Wales, and I wonder if you're willing to take that.

Also, we're actually at the height of the stock-buying season at the minute, on breeding stock. So, I'm just interested in what advice you're going to be giving to farmers, through Farming Connect or other agencies, around the purchasing of stock from those high-risk areas in England, because an awful lot of farmers in my constituency are heading off into England to buy their stock ready for next year.

And, in addition to this, something I've heard from farmers is about the messaging from the Welsh Government, that they're getting lots of updates from APHA about cases in England, but there's actually nothing coming through from the Welsh Government. So, I'm just interested in whether you would consider sending mobile alerts to farmers in Wales about cases that are emerging, because I think that would be something that we do need to hear about.

And also, finally, about the compensation regime for our farmers in Wales. Can you explain how that is going to work to make sure that our farmers in Wales are compensated properly for the stock that they lose to bluetongue? Thank you, Llywydd.

James, thank you for those questions, and, Llywydd, just to clarify, we had, in discussion with the chief veterinary officer and officials from APHA, planned to bring to bring forward a statement today, which we brought forward—the written statement—when we knew all the details of the current infected animals that had been brought into Gwynedd, and not before, because we wanted to have a proper statement when we could give all the facts and details. So, I hope you'll understand that the timing of bringing forward the written statement was to bring it forward with the full information, rather than premature information. So, I was glad to bring that statement forward.

You raised a number of questions. First of all, it's not the case in any respect whatsoever that the Welsh Government or APHA or the CVO are late to the game. In fact, a Great Britain bluetongue control strategy has been in place since August 2014, and it's been reviewed regularly. We, in Welsh Government, and our officials and our CVO have had intensive engagement with our UK counterparts and disease experts in the UK, and indeed across Europe, intensifying in fact since the BTV-3 incursion into the Netherlands in September 2023, which brought it closer to us. So, the intensity of engagement stepped up.

We've been raising awareness with the farming and the veterinary community since the incursion into the Netherlands, and more intensively since the disease incursions into England last November and this August. The CVO has established an industry stakeholder workshop. It meets regularly to discuss the risks and the Welsh Government response to an incursion or an outbreak of bluetongue in Wales. I'm making clear, once again, Llywydd, this is not a midge-borne outbreak in Wales: these are three animals that we've identified, because of the efficacy of the whole tracking system here, that have been brought into Wales at this moment. It's not midge borne. This group, the stakeholder group, is updated on the disease picture in Europe, in England, and the increasing risk to Wales at every meeting, and the decision to allow movements from restricted zones to slaughter only at designated abattoirs was taken in consultation with this group.

We're in regular close contact with farming unions and organisations like the National Sheep Association. They're very important partners with us on this group, and they cascade information on the risks to their members. We're very grateful for their co-operation and for their reach into the agricultural communities. We've also run, through the Office of the Chief Veterinary Officer, Llywydd, webinars for vets in practice, to raise awareness, to share details of the clinical signs, so that vets can discuss the disease with their clients. And we do encourage keepers to seek veterinary advice before sourcing animals from high-risk areas, so they can make an informed assessment.

But crucially, Llywydd, currently we have no evidence of active bluetongue infection in Wales. In recent days, what we have is a small number of sheep brought into Wales from the east of England. This does not constitute an outbreak or a midge-borne infection in Wales. And we have to reinforce that message, but we are asking people to be very vigilant.

You mentioned, I think, the issue of compensation. For the three animals that have been culled, compensation has been paid to the farmer affected. Farmers will receive compensation if bluetongue is diagnosed and the chief veterinary officer or the deputy chief veterinary officer orders the killing of affected animals, and that's in line with our normal protocol. I hope that helps to answer some of your questions. I can go into more detail, of course, but I'm conscious of the time as well.

It's heartening to hear what you say about confirming that compensation will be available for those who are directly impacted and where they experience, maybe, the culling and disposal of infected animals, but there is a wider question about the impact within a restricted zone or a controlled zone, isn't there, really, because I'm aware from examples in England—. There was a farm in Suffolk, for example, who say that they've lost upwards of £50,000 this year, due to operating within that bluetongue restriction zone. They haven't had any cases directly on their own farm, but of course they say it's impossible to sell animals, and of course the restriction on movement does have a knock-on effect. So, I'd be interested in understanding your thinking around the potential of working with the industry, maybe, to try and support them through those more indirect impacts, potentially, because thankfully with this case, we have a little bit of time, potentially, to consider those issues.

Similarly with the vaccine, I understand that three unauthorised vaccines have been approved by DEFRA. Can you confirm whether those are available in Wales, if required? And we know the vaccine isn't 100 per cent effective. I believe it's quite expensive. So, what can you tell us about the availability and the affordability of vaccines for Welsh farmers?

And I would reiterate the point about the communications. I think this is an opportunity, isn't it, really, to really hammer home the messages, because people will be much more mindful about the potential impacts of bluetongue after this isolated case in Gwynedd. Some farmers have told me, for example, that they hadn't realised how large the restricted area is in England, and when that comes to, as you mentioned, informed purchasing et cetera, that's very, very critical.

Indeed. Absolutely. And I think one of the biggest services we can do to our constituents, and to keep Wales free of this disease, is to ram home these messages today, and it is the work we've been doing over not just several months, but since we've been aware of this disease approaching us from the near continent. We should emphasise that this is a midge-borne disease. The purpose of us taking the decisive action that we have taken—and my thanks for the work being done by APHA and our CVO and his officials as well—is to take decisive action. The tracking is very effective. What we have been doing is recognising that the situation is very, very different at the moment in the east of England, and our sympathies go to them as well, because they're having to deal with large areas where they've had to lock down movements entirely, but that's part of the response. The animals that have arrived in north Wales, unfortunately, have not arrived there out of the rules or out of the protocol. It's been identified subsequently, when those livestock in the east of England, that it's been identified that it is circulating there, including midge-borne infection, then we've done the tracking of where those have been sold through auction and where they've gone to, and we'll keep on doing that as well.

But it is important that the emphasis of our ongoing campaign of communications is on the safe sourcing of livestock—I think that a lot of farmers around Wales are now going, 'Well, we can see the extent of this in the east of England, we must take care to not bring in from high-risk areas.' We'll keep on reinforcing those through our regular meetings with stakeholders, representatives, veterinary professions, Gwlad, other news articles, other social media posts. The chief vet himself, in fact, has been regularly putting this on social media over the run of the last year as well, on his own Twitter account. So, we're trying to use every possible way of doing it.

In terms of compensation, I can only reiterate that there are very well-established protocols. So, where there has been extensive infection and circulatory infection from midges in the east of England, they have paid a substantial amount of compensation out. We are trying to avoid that situation here in Wales, of course, by keeping the disease out. But, if this were to happen, then clearly those same protocols and compensation would apply. But we have to be cognisant as well of the added trauma for the farmers involved, because if you have lockdown areas, that's quite significant. 

Just to say on vaccination, the situation is very different in the near continent, it's very different in the east of England at the moment. The advice at the moment from our CVO, and in his discussions with UK counterparts as well, is that there is very little purpose in using and deploying the vaccine in Wales while Wales is actually disease free. What we've got are animals who have introduced the disease into a herd, and we're taking the right measures. There are significant issues, and you alluded to this, with the use of some vaccines that are out there at the moment, including, I have to say, unauthorised vaccines. We need to consider this properly. We are keeping the use of vaccines under review, particularly looking at the status of the disease in Wales, which is not the same as it is in England currently. But licensing the use of vaccine in Wales would be considered if there is evidence of circulating bluetongue virus. There is no evidence at the moment that the virus is circulating locally in midges, but we will keep that under review, Llyr. 

I thank the Deputy First Minister.

Item 4 is next, the 90-second statements, and the first is from Russell George. 

Just imagine not just running up each of Wales's three peaks, but running to and between each one of them, all within 34 hours. Well, that's what six people did as part of a relay to raise awareness and highlight the work of the charity Max Appeal. Max Appeal's mission is to increase awareness of, the understanding of and the co-ordination of care for people who have been diagnosed with the genetic disorder 22q11.2 deletion or DiGeorge syndrome, which affects as many as one in 1,000 people in Wales. The disorder can affect health and quality of life from birth, through childhood and into adult life, with over 180 physical, functional and psychological associations having been reported. 

Six of my constituents completed the Welsh three peaks challenge as part of a relay team. They started from Plas Robin Rural Retreats in Llandyssil, Montgomeryshire, to Pen y Fan in the beacons, to Cadair Idris, and finishing with Snowdon—not only tackling these three mountains as quickly as possible, but they ran the whole route from start to finish. That's 200 miles, which is the equivalent of seven and a half marathons performed back to back. Congratulations to Jordan Powell, who led the team, and also to Ria Davey, Connor Parry, Cameron Parry, Huw McGrath and Tim Davies. They have almost raised £2,000, I think, which is a fantastic achievement, as well as raising awareness of this condition. And thanks should also be given to the sponsors and the many people who supported them to complete the challenge in aid of Max Appeal.

I'd like to take this opportunity to wish the New Saints well, in what is a historic moment for both the club and, of course, for Welsh football, because the Cymru Premier champions, TNS, have become the first Welsh team ever to qualify for the group stages of European club football. And, as a consequence, tomorrow night, of course, they will face Fiorentina in the UEFA Conference League.

As we all know, TNS is one of the most successful teams in the history of domestic Welsh football. They've won the Cymru Premier title a record 16 times. The current squad are full-time professionals, of course, led by manager Craig Harrison. And whilst the club almost invariably qualifies for European competitions, it has always been the dream, particularly of the club's chairman, Mike Harris, to qualify for the group stages, and this time, of course, they've done it.

In becoming the first Cymru Premier team to qualify for the group stage, they now face the daunting prospect of playing some of the big names in European football, and the first historic game, of course, will be played tomorrow night against Italian giants Fiorentina at the Stadio Artemio Franchi, with a capacity of 43,000 fans, some away off the 2,000 capacity of TNS's Park Hall ground. And Fiorentina, by the way, have been the losing finalists in this competition for the last two seasons, so it's going to be one mighty experience for Craig Harrison's team.

Many will remember Bangor beating Napoli back in 1962. Some will remember Merthyr beating Atalanta in 1987. Well, will the New Saints be the next Welsh team to beat an Italian giant in Europe? All the best to the New Saints from everyone in the Welsh Parliament. Give them hell. [Laughter.]

Item 5 today is a Member debate under Standing Order 11.21 on women's healthcare, and I call on Delyth Jewell to move the motion.

Diolch, Dirprwy Lywydd. Most women at some point in their lives will hear the words, 'This might hurt'. Not from an aggressor, but from their doctor or nurse, because too many intimate procedures in women's healthcare involve pain. Women are expected to tolerate that pain. And this isn't the fault of individual doctors or nurses, it's because not enough focus or resource has been given to challenging that expectation. The procedures we have, be they smear tests, coil fittings or hysteroscopies, are painful, they're uncomfortable, and all too often as a result, women put off getting the help they need, because they are worried about that pain.

This isn't the only way in which women are expected to put up with pain. The stubbornly grim statistics for gynaecological cancers can partly be put down to the fact that when women talk to their doctors about the pain they're feeling in those parts of the body that are more awkward to talk about, they are not believed. Target Ovarian Cancer research has found that one quarter of women in Wales report visiting their GP three or more times before being referred for tests, and one third report waiting more than three months from their first appointment with the GP to receiving a diagnosis.

Doctors either don't have the training to recognise symptoms of some cancers, or not enough research has been done into finding more accurate ways of interpreting those indistinct types of pain. And then, there are those debilitating conditions affecting women that we still don't know enough about, because of a lack of research or understanding. Endometriosis is a condition that affects roughly one in 10 women and occurs when the tissue inside the uterus begins to grow outside it, leading to chronic pain.

As the British Pregnancy Advisory Service points out, despite the prevalence of endometriosis, it remains underdiagnosed and too often misunderstood. With this condition and so many others, women are too often either gaslit, told not to worry, to wait to see if things get worse, or they're psychologised, asked whether they suffer with anxiety. And all of that makes women, again, less likely to seek out help, because their pain is, if not trivialised, then minimised, played down. They are told not to trust their own gut instincts that something is wrong.

How many women's lives are lost or made miserable through pain because they fall into a gap in our healthcare system where their words aren't trusted, their instincts dismissed, where women are told that they don't understand their own bodies and how they work? In procedures, the pain that is inflicted on women is accepted as normal or downplayed, and the pain women speak about or seek help for is also lessened.

Why should we have to put up with so much pain? Why is that normal? There was a letter in a mainstream newspaper a few years ago where a woman spoke about the pain she endured when having a hysteroscopy—that is where a camera is inserted into the vagina and cervix, into the uterus. No anaesthetic or sedation was offered to her, but some years later when that same woman had to have a colonoscopy for another condition, it was done under sedation. As she said in her letter, 'There was no question of doing it without.'

With more regular procedures too, like smear tests, a certain amount of pain is just expected as normal. We have had debates in this Senedd in recent years focused on the alarmingly low take-up rates of smear tests. The awkwardness and uncomfortableness of the procedure will surely play its part in driving down those figures. I'm not a medical professional, and what's more, I have the utmost respect for those who dedicate their professional lives to helping others. I'm sure the vast majority of doctors, of nurses and healthcare professionals find this situation deeply concerning too.

Again, this is not about individuals; it's about the systemic lack of research, resource and thoughts given over to lessening the need for pain in gynaecological procedures. The absence of a dedicated women and girls' health plan in Wales is unquestionably part of the problem. Other Governments, like the Scottish Government, the Norwegian Government, the Swedish Government, the Canadian Government have published women and girls' health plans, and those have allowed those countries to focus more on ensuring that women's voices are central to their healthcare. Wales is lagging behind. Our first female First Minister has laudably spoken about tackling this issue at long last, but it should not have taken so long. Again, how many women have been lost or have had to endure unacceptable levels of pain because of this delay? It is a delay that has surely cost lives.

Figures sent to me by Claire's Campaign highlight the magnitude of the problem. The target for women starting their gynaecological cancer treatment within 62 days is 75 per cent, yet in July of this year, only 26.9 per cent of women in the Aneurin Bevan health board area managed this. That is only seven in every 26 patients. Between 20 and 30 patients receive a gynaecological cancer diagnosis every month, but the health board only manages to get seven or eight women through to treatment within the target. This is only one reason why I'd agree with Claire's Campaign that the women's health plan must include a specific focus on gynaecological cancers. I'd be grateful to know whether this will happen and whether the plan will also look at clinical culture and some of the hindrances that are costing women's lives.

The women's health plan must learn from the experiences of patients, gynaecologists, midwives and women's health groups. That is why my motion would ensure establishing a legal requirement for healthcare providers to collect feedback from female patients about their experiences, especially gynaecological appointments, midwifery and postnatal services, perinatal health and menopause. Too many women are left feeling isolated, violated and in pain after these appointments. It shouldn't be normal. We have an obligation to ensure that it isn't.

There are so many levers within the Welsh Government's control that they can take to address this endemic problem. The Welsh Government has the ability to influence the curriculums of healthcare courses that are delivered and funded within Wales to provide additional training in women's healthcare. It can influence national regulatory bodies like the General Medical Council and the Royal College of General Practitioners to tailor aspects of its training standards or to implement initiatives to better address women's health.

It can issue guidance as well, Dirprwy Lywydd, to NHS institutions within Wales, and I'd want that guidance in particular to focus on addressing gender bias in pain management. That guidance must surely be coupled with the legal requirement for NHS institutions in Wales to collect feedback from female patients, as I've already mentioned, to identify areas for improvement on addressing the physical and the psychological pain that is accepted as normal in women's healthcare. The Welsh Government should support research into women's health issues, particularly into pain perception and gynaecological cancers. We should be learning from other parts of the world that have found innovative ways of tackling low and late diagnosis rates, like introducing mail-in testing kits for cervical cancer. That happens in Denmark.

I know that some other Members will also be focusing remarks on how we must improve treatment for women going through the menopause and women suffering with postnatal depression. The pain suffered by women in their healthcare can be physical; it can also be psychological. And it is unacceptable, it is costing lives. I hope that if this motion passes it will result in improved guidance, in changes in procedures and better training for health professionals. Women make up half our population. Their suffering should not be treated as normal.

I would like to thank the Member, Delyth Jewell, for bringing this important debate here today. Throughout life, women have to put up with a lot: periods, childbirth, often being the main carer, the organiser, and then the menopause comes along. And it’s often seen as a weakness rather than, actually, showing how strong women are, putting up with it all and doing all that they do. All these can be debilitating, physically, mentally and hormonally, all while trying to keep up appearances, juggling responsibilities and trying to look after dependents. When, as a woman, you may be feeling unwell, the presumption is down to one of these, and then it’s okay, because it’s considered normal for women to live in discomfort and pain. Many illnesses have been hidden behind these presumptions.

Many of you will know about Claire’s campaign for policy changes for gynaecological cancers. Claire was diagnosed with cancer in her uterus two years after first raising her symptoms with her GP, and she was misdiagnosed with irritable bowel syndrome. The survival rate of this aggressive cancer is 65 per cent. If caught at a later stage, then only 14 per cent of people survive up to five years. And very sadly, Claire’s cancer is incurable, and she is bravely fighting for a much-needed culture change within our healthcare system. Women need to be listened to and heard and I pay tribute to Claire for all that she does.

Hormonal changes throughout a woman’s life can have a huge impact on your body. It makes it even harder to cope with the amount of pressure society puts on women’s appearances. During childbirth, hair can thicken, and then you lose it afterwards when going through the menopause. During periods, stomachs can swell. After giving birth, society expects you to soon fit back into your pre-pregnancy clothes. The pain of periods, the awkwardness, the frustration that stops you from functioning normally. I’ve spoken to several women who have been told by a doctor that they likely have endometriosis, but that being diagnosed is a painful process and will make little difference to their condition due to a lack of treatment options. 'Grin and bear it' shouldn’t be the default advice for women struggling with menstrual problems.

The expectation that women should be responsible for contraception, giving up time for multiple doctor appointments, having to deal with hormonal repercussions and sometimes undergoing painful procedures without pain relief, is also something women have to bear. And I totally agree with the motion’s premise that healthcare professionals should aim to reduce situations where pain is expected and accepted as normal in NHS healthcare. This would make such a difference to the experience of so many women.

Above all, we need to recognise that women understand their bodies and the changes they are experiencing—they should be taken seriously. It’s so important in healthcare that patients feel listened to and understood, not feel dismissed and unheard. When I had a baby in hospital, nobody accepted that I was in labour. I knew it, but they didn’t accept it. So, I coped mostly on my own. And I decided to have my last one at home. I remember in the hospital being praised for giving birth without pain relief. Suffering pain is not a badge of honour. In reality, giving birth can be extremely traumatic. The mental health repercussions can be devastating. Unfortunately, many women dislike going for health checks because they don’t like to waste time—I think I’m one of those people as well—both their own, as often the main carer as well, or that of the health professional, who can be dismissive.

At Petitions Committee this week, petitioner Delyth Owen of Ynys Môn wanted to raise awareness of a lack of services in Ysbyty Gwynedd. They have to travel to Wrexham, which could mean a three-hour round trip. And so, if you are a carer, that’s really difficult, trying to juggle all of that, and so, very often, they just don’t bother.

I think women should be invited for regular health checks, if they haven’t seen someone in a while, with someone who’s sympathetic. It would make them actually go and discuss things with somebody. It would be an opportunity to raise issues without a woman thinking they might be wasting their own time or the professional’s time. Whilst check-ups may be routine for the doctor or nurse carrying them out, it can be an uncomfortable experience for women.

We also need to see the women’s health plan come forward, as promised. Taking time to explain the procedure and listening to concerns can make a huge difference to whether someone will come back for their next appointment. And I think that regularly collecting feedback after appointments would hopefully encourage a positive patient-led change in how appointments are run, and I’d like to see that being carried forward.

My daughter gave birth to her second child last week. Both are doing really well, and she’s beautiful—well, my daughter and her baby [Laughter.] But I was upset to hear a young mother in the bed next to her sobbing. It was really sad, and she had the curtains around. So, my daughter said that she’s become her friend and she was going to make sure she’s okay, but that was, you know—

Carolyn, I'm going to ask you to conclude because we've got a lot of speakers. 

Yes, I will, sorry. I'm just proud to be co-submitting the motion, and I hope others in the Chamber will support it. Thank you. 

It is disappointing, I have to say—. I know that the Minister with responsibility for women’s health is here, but the First Minister told us, and made a great show of the fact, that she was listening, and that women’s health was an issue that she’d heard, but, unfortunately, she’s not here this afternoon to hear this important debate.

The Scottish SNP Government has had a women's health plan in place since 2021, and although we’ve had pledges from the Welsh Government, and the First Minister herself, who had responsibility, of course, for health from that year until August this year, we are still waiting.

I’d like to focus in my contribution on the effect of the lack of priority, emphasis and delivery in terms of women's health from the point of view of one thing that affects everyone who has a womb—over half of our population, therefore—namely, the menopause. There have been a number of high-profile campaigns seeking to draw attention to the symptoms, and trying to ensure that workplaces and employers are considerate of people who experience them, and we’ve had several discussions in this Chamber about the importance of educating people about the menopause and to break the historical taboo about it. But the lack of a specific plan in terms of how the health service supports patients with menopause symptoms, and offers them timely and appropriate treatment, has created an entirely unacceptable situation.

Although we’ve heard Eluned Morgan, for example, insisting that nobody in Wales now should be forced to wait in that 8 o'clock queue on the phone if they want to see their GP, that isn’t the norm across Wales, if you want an appointment in advance rather than an emergency appointment, and many surgeries are still failing to provide a way for people to book a face-to-face appointment in advance. Many of my constituents have contacted me to confirm and complain about that. Because if you're not off work sick, you can't spend hours and hours waiting for that phone call to get back to you, and then wait further hours to get that conversation with your doctor, because you have to work. And if you want to discuss the menopause, it’s also understandable that you want to make an appointment with your GP, on a face-to-face basis, to have that discussion, for the reasons that Carolyn set out.

I want to share the experience of one woman who wanted to have a chat with her GP about the symptoms, as they were affecting her physical and mental health. She’d waited in that morning queue, and then she was told that she couldn’t book an advance appointment. She was then phoned back by the doctor on the same day, although they couldn’t provide her with a time slot within an hour or two, so she failed to ensure that she was able to receive that call in a private area. And some of the symptoms that she had were also physical, and she wanted to show the doctor. She was then told that the doctor would have to conclude the call after some minutes as he had a very long list of people to call. She asked if there was some sort of clinic or nurse that she could go to to discuss her symptoms and any possible treatment. She was told that there wasn’t.

She told me that she had been made to feel like she was a nuisance, that she was bothering the doctor over nothing. She didn’t blame the GP for this; she said she could hear the stress and fatigue in the doctor’s voice. But it’s clear that the way we’re providing menopause services is not right. She gave up trying to seek treatment, and she has now just decided to put up with the joint pain, the difficulty sleeping, the periods of low mood. What was worse, she said, was that she knew that some of her friends who were the same age had had an entirely different experience, and were recovering as a result of therapies and drugs provided by their GP. So, there’s a very inconsistent picture across Wales.  

The GP is the key to the door in terms of consistent, standardised healthcare that meets the specific needs of women effectively. But the pressure on the primary care system, together with the lack of a plan to ensure consistency and fairness for every woman in Wales, means that it’s the same old story that’s the true for many women, namely having to put up with the effects of the menopause without support—suffering in silence, which of course can have a grave impact on mental health, as well as physical health, the ability to work and to succeed in your work, the ability to care, the ability to keep fit, the ability to play a full part in society.

So, it is not enough to discuss the menopause, to have political campaigns to raise awareness, without a specific health plan to ensure that the days of suffering in silence are gone forever.

I'm really grateful to Delyth Jewell for bringing forward this debate today on women's healthcare, in which the motion highlights the need for recognition of the unique and often considerably painful aspects of women's health. In all areas of women's health, our anatomy often brings unique struggles and complications, which are just accepted as the norm and something women and girls must just suck up and deal with. Whether it's instrusive tests, undiagnosed symptoms or monthly struggles, we are inclined to accept an inordinate amount of pain, hormonal fluctuations and general discomfort, due to the incredible, often arduous, and severe journey our bodies go on, and, of course, over the course of our lifetime as well. From conditions such as premenstrual syndrome, polycystic ovary syndrome and endometriosis, to pregnancy, fertility, pelvic health and the menopause, there are an abundance of conditions as well as physical and mental challenges that come with them too. We often see them accepted within society, and, quite frankly, they aren't discussed enough. Whilst I do believe that it is important to note advancements to women's healthcare in recent years, not only technical aspects, such as testing, but even discussions around an increasing number of options we now have are indeed improving, we still have a long way to go.

There are so many points I could raise within this debate. However, I want to focus my contribution on one specific area here today. Just this week I had the pleasure of meeting with Breast Cancer Now, a fantastic organisation supporting people going through breast cancer diagnosis, as well as their families. We spoke about the greater need for discussion around the science and symptoms of breast cancer, alongside the need for a holistic approach towards women's healthcare, and screening for conditions such as breast cancer within health hubs. Improving data collection for breast cancer patients specifically, as well as increasing sites where the tests can take place, in tandem with boosting awareness of the signs and symptoms, would not only alleviate pressures on GPs and hospitals, but would ultimately help so many people catch the signs of cancer earlier on, and, therefore, hopefully prevent the later stage diagnoses.

Something else we touched upon was the need for surgery—in many women's cases, this is reconstructive surgery, following breast cancer treatments and procedures—to be seen and included in part of the treatment, and, ultimately, the healing journey as well. Otherwise, if not, we risk many women being left waiting years for their reconstructive surgery, as it is seen often as a separate entity in the healthcare system, and it's something that can have a severe impact on their mental health as well as overall well-being following such intensive treatments.

This conversation led us naturally only to the Welsh Government's proposed women's health plan for Wales and the difference between healthcare plans being created in Northern Ireland, Scotland and England. In Wales, as we know, the NHS Wales Executive and health boards are creating and implementing the women and cancer improvement healthcare plans. However, in England, Northern Ireland and Scotland, the Governments facilitate these plans. I do sincerely believe we do need accountability in this area, and where the Welsh Government have come up with the health plan initiative, there should be a strategic direction that they can then provide to health boards, as well as the NHS Wales Executive team, to help guide and implement this critical piece of work, which could benefit so many women and girls all across Wales.

In addition, it is important to note that these aspects, such as reconstructive surgery, were not included in the cancer improvement plan from 2023 to 2026, and, as I understand it, cancer is not set to be included in the women's healthcare plan either. I do strongly believe it should be, as there are many female-specific cancers that we must continue to raise awareness around and support those going through them. Many see that the outcomes of those could be improved through inclusion being within the plan itself.

So, in conclusion, Deputy Presiding Officer, I would just like to close by again thanking Delyth Jewell for tabling this incredibly important debate here today. I hope that we collectively hold the Government to account in this area, to ensure that the best possible care and outcomes are in place for women and girls, from all corners of Wales. Thank you.

I can't comprehend what women have to endure. Of course, here in Wales we have work outcomes in cancer care, eye care—and I'll be referring to that later, in another debate. We see maternity services creaking, and abortion services that don't exist in many areas of Wales. But I do have empathy, and I do have love—love for my wife, two daughters, mother and sister, and all the other women who have been such an important part of my life. Hearing the stories of the women who come to my surgeries sends a cold shiver down my back.

Before being elected to this place, I had never heard of endometriosis. But, very soon after being elected, a constituent came to one of my surgeries and shared her story. She had been suffering pain for many years, and the doctor could not identify the complaint. Because she also suffers from fibro, the doctors assumed that this was the root cause of the problem and referred her to specialists in that area in Manchester. But there was no improvement in her condition. She was further diagnosed with IBS, and then ME, but, again, there was no improvement. As a result, she has had to pay thousands of pounds for different scans and private medical advice. The end result was that she had to have a complete hysterectomy—against her will, by the way. But, when this procedure was carried out, it was discovered that she was suffering from endometriosis, which has now spread. This woman is now in her 50s. She has been suffering since she was 18, and has paid out over £12,000 in recent years to try and obtain a diagnosis. This all stems from an original misdiagnosis and the failure of the medical profession to recognise her symptoms.

I have had teenage girls come to me living with endometriosis. One of them has just had to pay £8,000 for treatment, and another is on a two-year waiting list, having already waited for over six months. Not only does their condition have harmful physical effects, but these women also suffer mentally, as do their loved ones, and they are also unable to hold down a job, even though they are talented and able women. But, in every case—from the pharmacy through to the surgery and on to the hospital and the clinical specialists—these women are repeatedly let down because of a lack of understanding and acknowledgement of the severity of their situation. And endo is just one condition, of course.

The evidence received by the health committee on gynaecological cancers was extremely powerful, with all of the witnesses telling a similar story of how they had been ignored and passed from pillar to post, either because of systematic sexism in the system or a basic lack of understanding of the female body. The fact that cancer diagnosis statistics continue to be dangerously low in some areas, with women being particularly badly affected due to a failure to identify the disease, should be a huge concern for the Government here, and there are lessons that need to be learned urgently.

Because this motion doesn't really ask for much, in truth. Goodness me, if you look at the motion, it speaks of gathering feedback about women's experiences, which should be an absolutely fundamental part of any health process. Amazon, eBay and almost all companies collect feedback about their users' experiences. It's common sense if someone wants to learn and improve. But not, it seems, when it comes to women's experiences of their medical treatments.

Comprehensive and useable data are the foundation of any successful business or sector or organisation. This has been routine since the Sumerians gathered data about harvests on clay tablets over 5,000 years ago, but we don’t do it in the health sector in Wales. It’s such a shame that we're still waiting, therefore, for a comprehensive women's health plan today. So, thank you to everyone who has brought forward this motion—I thank Delyth for the opening remarks—and I trust that this Senedd here will see fit to support it.

I want to thank Delyth and her co-submitters and supporters for raising what is an incredibly important issue. We all know that, for too long, women’s experience of pain, be it menstrual, reproductive or chronic, has been dismissed or trivialised. It’s not a matter of individual health, but it’s a systematic failure that impacts the well-being of over half our population. Women often face longer waiting times for diagnosis and treatment and their concerns are frequently overlooked in clinical settings. This normalisation creates a culture where women feel unheard and often unsupported and, in turn, exacerbates the problems that they are presenting with.

One specific women's health condition where this is often the case concerns period pain. The normalisation of pain around periods can cause severe delays in diagnosis for gynaecological conditions, particularly like endometriosis, and those delays can have extremely serious repercussions, impacting the women's physical and mental well-being, their day-to-day life and potentially their chances of conceiving, if they want to have children. I appreciate that Welsh Government is working to address some of these issues and, in the case of endometriosis, a specialist nurse has been employed for each health board region. Of course, I would question whether one specialist health nurse for each healthcare region is a serious commitment. But, above anything, we have to challenge the stigma around women's pain and ensure that healthcare professions are trained to recognise and address it properly. We are developing a women's healthcare plan, and we must have a focus in that plan for this particular area.

But I'm also going to raise a question that hasn't been raised yet, and that is the difference in treatment and expectation of pain when it comes to black and Indian women. There have been many, many reports—multiple reports—and the BBC have also done investigations into it in England, where women have been called 'princess', where they are being referred to in a different way than white women would be, where their pain has been trivialised and where they have been completely ignored. So, what I would call for today, as well as those things in this report, is that we speak with that community or communities of women and get an understanding of their feeling, and also let their voices be heard, because ultimately this is only a form of racism when you are referring to people in a way you wouldn't refer to white people, when you are denying them their voice and when you are ignoring their concerns. It's not an area that we've looked at on the health committee; it wasn't looked at when we were doing our investigation. But I think if we're going to truly represent not only the 50 per cent of the population, but all the people within that 50 per cent, we've got to change our focus and widen it as well. 

Firstly, I'd like to thank Delyth Jewell for bringing this debate forward today, and I'm grateful to be able to contribute to it and support it also as well. Despite women and girls making up more than half of the Welsh population, women's health and well-being is often undervalued and under-resourced, and there is a dire need to reduce health inequalities, improve equity of service and improve health outcomes for women in Wales, which begins by giving parity of attention and deference to women's health. 

I'd like to begin by discussing birth trauma, which can be devastating to a woman's life, particularly with the added responsibilities that come with motherhood and is often something that is minimised or marginalised. One in 25 develop post-traumatic stress disorder after giving birth, yet it still does not garner the attention or consideration it deserves. A report by the all-party parliamentary group on birth trauma had a recurring theme of poor postnatal care, with women often reporting that they were left to lie on blood-stained sheets or that they had rung the buzzer for help without having a response; some were berated for not being able to breastfeed, whilst not receiving any help to do so. Dr Kim Thomas from the Birth Trauma Association said that women they heard from had told maternity professionals that they were concerned that something had gone wrong in labour only to be dismissed as being over-anxious. This failure to listen to women then resulted in catastrophic outcomes; in one instance in a baby being, tragically, stillborn. These distressing testimonies drive home how important it is that birth trauma is recognised, legitimised and addressed, and I'd be keen to know how the Welsh Government is working with health boards to address these issues in postnatal care on a regional basis across Wales.

I'd also like to note that Wales is the only nation in Great Britain without a women's health plan. The UK Conservative Government published its women's health strategy for England in August 2022, and the Welsh Government have committed to publishing their women's health plan by the end of 2024. The Senedd should be updated as to the progress of this commitment. This motion also calls for a requirement for healthcare providers to collect feedback regarding a patient's satisfaction with the care they received in specialities that involve women's health. I think this is an excellent idea that will allow healthcare providers to identify where services can be improved and I hope this will be part of the Welsh Government's women's health plan.

Finally, I'd also like to discuss the national shortage of hormone replacement therapy, which I have raised in the Senedd before and is a long-standing issue affecting many of my constituents. Again, like many of the other issues raised in this debate, it's not treated with the level of seriousness that it deserves, with many unaware just how unpleasant undergoing the menopause is without HRT. Due to the national shortage of HRT, alternatives are often dispensed by pharmacies, but, due to oversights in the serious shortage protocols, many women are not able to check the availability of alternative HRT products across different pharmacies, which has left some of my constituents at times without medication. The results of this can include symptoms such as hot flushes, rapid weight gain, panic attacks, risks to bone and cardiovascular health and much more. I would also argue that someone with hypertension should not be left without blood pressure medication under the same circumstances. So, the shortage of HRT needs a parity of deference in this regard.

Despite women and girls making up more than half of the Welsh population, as previously stated, women's health and well-being is often undervalued and under-resourced. There is a need to reduce health inequalities, improve equity of service and improve heath outcomes for all women in Wales. Thank you.

I'm extremely grateful to Delyth for bringing forward this vital debate, and for the opportunity to support it here on the floor of the Senedd.

As we've already heard, the challenges and disappointments that women have to face when fighting for fair and thorough healthcare are often significant and very frustrating. More often than not, these factors are disproportionately prominent in rural Wales. Here, far too often, there is a lack of expertise in women's health, with medical capacity and support varying greatly from area to area. Of course, the situation has deteriorated recently, as we see more rural surgeries closing and also cuts in public transport services, which makes access to women's health services more difficult, and that means that too many women are suffering in silence.

About two years ago, I drew attention, on the floor of the Chamber, to an example of the suffering that a 23-year-old constituent at the time had suffered in my region, because of endometriosis and adenomyosis. Despite demanding medical attention, time and time again, her condition would be disregarded by doctors, who considered it a mental health condition and offered her antidepressants and so forth, rather than investigating the root cause of the problem. In the end, she had to turn, as we've already heard from Mabon, to private services, having endured physical and mental suffering for many years, and at a very significant financial cost to the family. All in order to be able to identify a condition that affects one in 10 women throughout Wales. Since then, this issue has hit closer to home for me personally, because one member of my family has been diagnosed with adenomyosis. When she was a young girl, she suffered period pains and was given painkillers for years. She knew, because she knew her own body, that that wasn't a solution to the problem. Then, in a state of high emotion, she went to a doctor and it was suggested that she should receive mental health support, which was a very serious thing for a girl who knew that that wasn't what she needed.

I'm very pleased to say that by now she has had a diagnosis after years of suffering, and, hopefully, she's waiting, and has waited for far too long in all honesty—and she's still waiting—to hear what the next steps are. When she looked on the Welsh Government website a little while ago, adenomyosis wasn't listed among the conditions that women were likely to suffer; that, following a petition submitted by a number of women, has been rectified.

So, what I'm saying is, as we've heard so often: these problems have existed, and women have been suffering, for many years and nothing has changed. I can tell you from personal experience how much pain that has caused me, as a parent, and also a close family member. So, we have to move quickly in order to tackle these conditions and give women fairness in order to improve women's health generally, particularly perhaps in our rural communities, but also everywhere.

Wales has some of the worst survival rates for ovarian cancer in Europe. Over 300 women are diagnosed with ovarian cancer each year in Wales, and more women die as a result of ovarian cancer in the UK than any or all other gynaecological cancers combined, yet this disease continues to be overlooked. Speaking here in January 2022, I urged the Welsh Government to respond to the call for an ovarian cancer awareness campaign in Wales. I noted that the earlier ovarian cancer is diagnosed, the easier it is to treat, yet in Wales only 15 per cent of women would make an urgent GP appointment if they were to experience the symptom of persistent bloating, and that needs to change.

In April last year, I hosted Target Ovarian Cancer's Pathfinder Wales Senedd reception, where I emphasised, or expressed disappointment, that despite the then-National Assembly for Wales's Petitions Committee producing a report in 2017 calling for a public-facing ovarian cancer awareness campaign in Wales, there had, to date, been no specific awareness campaign for ovarian cancer. 

Too often, women's pain and discomfort have not been taken seriously, and they've not been equipped with the information they need on gynaecological conditions and cancers. The 'Women's Health in Wales—A Discovery Report: Foundations for a Women's Health Plan' notes that women's health and well-being are 'often undervalued and under-resourced'. The report also shows that research suggests that many women also feel uncomfortable discussing health issues or struggle to be heard when they do.

The Welsh Government must strengthen the expectations for NHS services in the quality statement for women and girls' health, helping improve awareness and GP education. The Welsh Government must consider how it will take action to improve awareness around gynaecological cancers that have no viable screening programme, such as ovarian. Women must feel empowered in their health and have the confidence to visit their GP if they feel something is wrong.

As stated, over 300 women are diagnosed with ovarian cancer each year in Wales; over 150 women lose their lives to ovarian cancer each year in Wales; just over a third of women are diagnosed at an early stage, when outcomes will be better; just 36 per cent of women are diagnosed at an early stage in north Wales; and 64 per cent of women are diagnosed at a late stage in north Wales, when the disease is more difficult to treat.

Target Ovarian Cancer's 'Pathfinder 2022: Faster, Further and Fairer' report found that symptom awareness remains worryingly low and that there are still too many delays in the diagnostic pathway, and that GPs need more training and support. Just 27 per cent of women can name bloating as a symptom. Forty-two per cent of women in Wales wrongly believe that cervical screening will detect ovarian cancer. A quarter of women in Wales reported visiting their GP three or more times before being referred for tests. Forty-three per cent of GPs surveyed in Wales believed incorrectly that symptoms only present in the late stage of the disease. New ways of working are also proving challenging, with 70 per cent of GPs in Wales telling them that they think remote consultations can hinder diagnosis. Target Ovarian Cancer are, therefore, rightly calling for a Government-funded awareness campaign, so everyone knows the symptoms of ovarian cancer, and a shorter diagnostic pathway for ovarian cancer with support and training for GPs. I urge the Welsh Government to heed their call.

I also urge the Welsh Government to heed Marie Curie's findings that gender can affect experiences of palliative and end-of-life care. If current trends continue, approximately 37,000 people will die with palliative care needs each year by the 2040s. Being free of pain is people's biggest priority at the end of life. However, research shows that factors relating to sex and gender have led to discrepancies in how some women report symptoms, the pain they experience and the treatment they receive as they approach the end of life. Some research suggests that women's understanding and views of palliative and end-of-life care can be affected by social norms and gender bias, which could result in inequalities in the way women are approaching, deciding on and, ultimately, accessing treatments that could improve their quality of life. Improved access to data and evidence about women's access to and experience of palliative and end-of-life care is, therefore, needed to ensure that services are meeting women's needs. And palliative and end-of-life care must be included in the women and girls' health plan.

Mark, you need to conclude now, please.

That's it. Thank you. Diolch. [Laughter.]

May I thank Delyth Jewell for bringing this important debate forward? It saddens me that it's necessary to bring it forward. Building on Cefin's comments: these aren't new issues for us to be discussing. In November 2022, the report, 'Women's Health in Wales—A Discovery Report: Foundations for a Women's Health Plan', was published. The plan should have been put in place in 2023. We should be starting to implement that now. That was what was announced in 2022. Three thousand eight hundred women gave of their time, shared their experiences, and so many of the issues that we've been discussing today, have been hearing about, are issues that were contained in that report. It saddens me that we're still having—. It's clear that every one of us still has regular casework—certainly, I have casework—involving women where, unfortunately, it's either too late for them—that the diagnosis came far too late in the day and that they are looking at dying so much younger than they should—. And we also hear of people, as Mabon mentioned, who are unable to work.

We're also hearing of young women who are missing so many days of school. We know that learner absence is something that's been in the headlines again yesterday. How much do we ask about how many school days young women miss because of these conditions? We must also link with the education system, because it's extremely important that we do teach girls from a young age that pain is not the norm. That's why things such as providing free period products is so important. I would like to see that being enshrined in legislation, and that it's normalised, because the more we talk, the more people become aware. And I think that one of the only good things—one of the few good things—to have come out of the social media phenomenon is that more women and girls are sharing their experiences, sharing their symptoms, and people are thinking, 'Well, I'm not strange; there may be something wrong me', and they then go to see their doctor.

There are two things that I want to focus on here, because there's one issue that has emerged, and we all see this through our casework too, in terms of those women who aren't believed when they take that step of approaching their GP—they are ignored. Carolyn mentioned that people didn't believe you were about to give birth—that's a story I've heard from so many different people. You should be able to know your own body, and when somebody tells you, 'No, you're not having a baby', well, you're bound to feel strange. And clearly that's going to have an impact on people's mental health too. If someone tells you, 'No, no, it's just you that can't cope', or 'There's nothing wrong with you', then you do start to question yourself—it's gaslighting—and it happens far too often. And then there's that mental health impact. How much does that cost the health service in having people on medication to deal with the fact that they are anxious? It makes no sense at all. And people lose days in work, too. We have to tackle this issue.

But the other important element—Cefin, you mentioned access to surgeries and so on. We do know and Sioned mentioned this too, about people—. We know that women have to do most of the caring. They don't go to the doctor unless they really have to. They don't want to make a fuss, but then there are so many barriers. We know that there are so many houses and households in Wales where there is no car, or just one car, and very often that one car is used by the male who is going to work. With the cuts in public transport, I know from my own casework how many women find it difficult to get to an appointment on time. So, even if you get that appointment and someone is willing to listen to you, actually getting there can be a barrier. And with the cost-of-living crisis too, it's a huge concern of mine that people are leaving it too late, that they think, 'It's just too much trouble, it's too difficult for me to get to the doctor.' So, there are so many barriers here.

I just want to briefly mention ADHD and autism. We know that the symptoms for women are different, and very often this is ignored. There is a clear link between girls' and women's hormones and how ADHD and autism can become manifest at different times in their lives. We have to ensure that we better understand how different conditions have different impacts on women and men.

So I'm delighted to be supporting Delyth's debate today. But why are we still talking about this issue? We need to see that change, and I do hope that we will hear when the Welsh Government will start to take action, so that we don't have to continue to repeat these arguments time and again.

I call on the Minister for Mental Health and Well-being, Sarah Murphy.

I'm very grateful to Delyth Jewell and all Members who have contributed to this important debate today. Personally, I think the more that we talk about it, the better. Sioned Williams, you talked about the taboo that still exists, and I think that we're doing a lot of good here in the Chamber by talking about these issues as much as possible.

Will you take an intervention?

Of course. 

I completely agree, but the point I was trying to make was, the more we talk about it, you're raising expectations then, and currently the health service is not meeting those expectations.

Absolutely, and I will come to that later in my statement, but point noted. But it is also positive, I think, to hear that Mabon ap Gwynfor hadn’t heard of endometriosis before he came into this role, and actually, by many women speaking out here, raising the voices of other women in Wales, I do think that we're making a difference.

The First Minister recently confirmed in the Senedd that women's health continues to be a priority for this Government. We have made a clear commitment to improving health services for women and girls, to ensure women are listened to, that they can access the care they need in a timely way, and they receive health services that respond to their needs.

Many of you have raised conditions today—[Interruption.] Of course I can.

Thank you, Minister. I'm really pleased with this debate today, and a lot of what Delyth Jewell said chimed with the Health and Social Care Committee's report on gynaecological cancers. So much of it was in common with what Delyth said. Of course, Minister, you were part of that committee, and in fact you were one of the instrumental Members that was very keen for us to do that work as well. Now, the committee weren't particularly keen on the Government's response. I'm probably being polite there. They were very unhappy with the response, I can say—and the Minister’s nodding—with the response to our 26 recommendations. So, do you think, given that you're a new Minister, and having a new casting eye over this work again, whether it would be appropriate to re-evaluate those 26 recommendations and bring forward a new Government response to those recommendations? I wonder if you'd be open to that.

I would say, just to answer that question very firmly, not at the moment, because I have such a hard deadline of making sure that I come before all of you on 10 December, and that I am delivering this plan. So, at the moment I wouldn't, but I hope that you understand that so much of what was in that report, which I was part of producing, will be incorporated into it. It was a seminal, I think, investigation that we did, that came out in December 2023. Many of you will have been on committees with me. I'm very forthright about the responses that we received, and I remember my own frustration, because I was like, 'Why is it going to take another year for this to come forward?' However, it takes time because this has to be led clinically; this has to come through from the NHS. Otherwise, it's not going to be true and it's not going to be real, and it's not going to be sustainable. But as I will also come to later in my speech, it does not mean that things have not been happening. So, I do want to assure everybody of that, but I also really appreciate everybody who's talked about that inquiry, and also about Claire's Campaign. 

Many of you have raised many conditions related to, as we were just talking about, gynaecological and reproductive health, but it is also important that we strengthen these aspects of healthcare, and also just women's experiences in general—the fact that it can be difficult, it varies widely, symptoms can be undervalued, downplayed, overlooked or even dismissed, like cardiovascular, like migraines, like attention deficit hyperactivity disorder. So, we will very much be taking a life-course approach when this plan is brought forward. I also want to thank my colleague Joyce Watson for discussing the diversity that needs to be embedded in this. I was at the St Fagans museum on Saturday at the Race Council Cymru Black Lives Matter celebration. There was so much talk there of mental health, but also women's health, and that's going to be incorporated. 

I also share Members' concerns around the experiences that have been raised in this debate today about the normalisation of women's physical and emotional pain. Evidence about the treatment of pain, whether it's symptomatic, post-operative or in emergency settings, suggests women can wait longer than men for pain relief, and many women report having their symptoms dismissed as normal, or they are just wrongly attributed to psychological causes. The First Minister, while Cabinet Secretary for Health and Social Care, started the process of improving services for women's health and women's experience of health services, and almost 4,000 women and girls have shared their experiences of healthcare in Wales, telling us what really matters for them. A key theme of this motion is about receiving that feedback about their health concerns and how they weren't taken seriously, including pain and it being dismissed or normalised. 

I want to assure everybody that the report will contain clear recommendations that will be supported through the development of the 10-year women's health plan. A call for research will also be included, with a focus entirely on women's health priorities, and will be launched next year, and we have committed £750,000 towards crucial women's health projects. Given the importance of women's health and the strength of my commitment to improve health services for women and girls, I am pleased to be able to support the thrust of this motion. However, I do not agree at the moment that there is a need for legislation on this, or statutory obligations for this area. And that is because, coming to what Natasha Asghar mentioned earlier on—[Interruption.] Of course, Gareth. 

Thanks very much. In my speech, I was talking about the disparity across the UK nations. Do you think that it's acceptable that England have had a women's health plan since 2022, and yet in Wales we're still waiting? And we've got now, with your remarks, a Government that's not supporting this motion. What message do you think that sends out to women across Wales?  

As I've already said, we support the thrust of this motion, and we'll be voting in favour of it today because of that—because we take it so seriously—but we do not support the need for legislation at this point. We have set out a quality statement—coming back to what Natasha Asghar raised earlier on—that we're not just leaving this; there is absolutely oversight from the Welsh Government. The now First Minister set out that quality statement. We've been very clear on what we expect. There have been 4,000 pieces of feedback that have come through that are being taken extremely seriously. 

You also mentioned England. Interestingly, on Monday, we had a big meeting of the women's clinical network that came together. We had three presentations from clinicians from England, talking about how things have actually played out in England, and there has been good but there has also been a lot of negative. I think that we're actually very fortunate in Wales that we are going to learn from those experiences now. 

It is not possible to take what has been done in England and completely transpose it onto Wales. We heard today about our rural communities; things are very different here. We have 60 GP clusters across Wales. All of those, really, should be able to give the support that is necessary for women. And there is so much good that is happening out there—there really, really is. We do have somebody now, as was mentioned, for endometriosis in every health board, as well as to have pelvic health checks. It's not as if nothing has been done. 

When this plan is produced in December—as promised, as assured—everything that you've discussed will be incorporated into it. But I also want to say that this is going to be a live document. We're not just going to drop this at the end of the year and then that's going to be it; this is going to be a live document, there's going to be feedback coming through constantly. I really see this as an opportunity for us here in Wales to really listen to women and to really make a difference. We're up against historical, really systemic inequalities here that have been here for absolute generations, that have come from a history of medication, of treatments being tested on men and then just being put onto women. We have been dismissed—and Delyth Jewell mentioned the example of just not being given pain medication for examinations that are obviously painful.

To conclude, let me just assure you I'm glad and welcome this conversation today. I hope that we continue to have more of them, and I look forward to presenting to you the women's health plan, which will have those measurable metrics in in it, and everything that you've discussed today, and the voice of the women of Wales coming through loud and clear. Diolch.

I call on Delyth Jewell to reply to the debate.

Thank you, Dirprwy Lywydd. I thank everyone who has taken part in this debate.

Carolyn, thank you so much. You spoke about how the life cycle of women can be broken up into episodes of pain and how, yes, it's often seen as a weakness. Actually, it is a testament of strength, but, as you say, we shouldn't have to go through this. You talked about how there is this expectation that women should just have to grin and bear the pain and, absolutely, it is not acceptable. As you say, we should trust women. We should listen to them. Why are women praised for giving birth without pain relief? It is something that has always bothered me as well. Why should that be seen as a badge of honour? I can't imagine any other major medical procedure, or whether it sometimes involves some surgery aspects—. Why should it be seen as, 'Oh, and she did it without drugs'? Oh, my goodness me, this is a major thing. Why should that be praised? Diolch, Carolyn.

I do agree with Sioned that it would've been good for the First Minister to have been here to hear this debate; I hope that she will watch this back. Sioned focused her contribution on the menopause and the need to break that taboo. Face-to-face appointments are needed to discuss sensitive issues. And this woman who was made to feel that she was a nuisance—we hear this all the time, the fact that she had given up and that this is just part of her life; pain is part of her life. Our health service is failing women like this, those who are suffering in silence. It's not good enough. It's not acceptable.

Natasha spoke about the expectation that women have to suck it up and deal with the pain. Thank you, Natasha, for talking about Breast Cancer Now's work—a fantastic organisation. We do have to make it easier to get tested. And, yes, your point about reconstructive surgery and how maybe it's treated as though it's cosmetic, nice to have, but, actually, no, it's about women being able to recognise their own bodies again after they've gone through this trauma and the horrors of cancer. It should be able to feel like their own body, so I can completely understand and agree with your points there.

Thank you, Mabon, for speaking. It's important that men have been part of this debate. The woman that Mabon mentioned, who was suffering from endometriosis—the years of waiting and then the terrible things that happened to her. And Mabon said all of it has been a result of a failure in the service that she received. Why should women have to pay privately and get gaslighted because people didn't believe them? It's not good enough, as Mabon said. Data gathering is normal in our capitalist world; why on earth could we not do that in our health service?

Joyce talked about the systemic, systematic failures that affect the lives of half our population, and normalising period pain is one of the things that Joyce talked about. I think that normalising period pain is particularly cruel, because it means that, from a very young age, girls are taught that pain is just going to be part of their life and that it's unavoidable, that it's inescapable. And the stigma that surrounds women's periods, their bodies—why should it be more difficult to talk about? So, thank you, Joyce, very much. We always say, don't we, 'We have to tackle that'. We know what we've got to do. So many of the messages we've heard time and again are the same. But, Joyce, thank you in particular for talking about the layered exacerbated problems that black and Indian women face, that their trauma can be even more hidden. Their voices must be heard. Thank you so much, Joyce.

Thank you, Gareth, for talking about birth trauma. One in 25 women develop PTSD after giving birth. That's a stark statistic. And what you were talking about, the notion of women being left to lie on blood-stained sheets, that is harrowing, it is not acceptable. Women have to be believed about their own bodies. Again, it's coming up time and again.

Cefin talked about the bereavements and disappointments, and how those are worse in rural areas. There is a risk, as I mentioned, that women are isolated in the wake of NHS treatment, and it's worse in rural areas. In terms of the experience that somebody in your family has had, Cefin, she should never have had to battle for that diagnosis—it's entirely unacceptable. As you said, things such as endometriosis are so normalised within our lives. It affects so many women—why did she have to battle? It's terrible. 

Mark spoke about ovarian cancer, one of those diseases where symptoms are so stubbornly misunderstood, where women aren't taken seriously; too often they're not believed. You said, Mark, that women struggle to be heard. As you know, it isn't through lack of trying. Women in their own way have been screaming for help, so much so that so many have lost their voice. They should be believed.

Heledd talked about the thousands of women who had given testimony. There is a cost to all of this, as Heledd said—the lost school days and lost work days. We have to consider that: count the economic cost, but also in terms of living standards. I'm aware that I'm running out of time. 

Thank you to the Minister. I look forward to the plan. I'm glad to hear that you agree with needing to challenge the normalisation of pain. I am disappointed to hear that you don't think there's a need for legislation, but I'm not precious about how these changes are brought about, I just want there to be changes. I do fear that without legal obligations to collate feedback we won't see change, but this issue is so endemic—I am closing, Dirprwy Lywydd, I promise—it's such an endemic issue, if this motion passes today, I hope very much it will be reflected in the plan in December. Thank you to everyone who has taken part, and if there's one thing where we can please bring about change, women's voices should be heard and women must be believed. Diolch yn fawr.

The proposal is to agree the motion. Does any Member object? No. The motion is therefore agreed in accordance with Standing Order 12.36.

Item 6 today is a debate on the Climate Change, Environment and Infrastructure Committee report, 'Natural Resources Wales—Annual Scrutiny 2023-24'. I call on the Chair of the committee to move the motion—Llyr Gruffydd. 

Thank you very much, Dirprwy Lywydd. This, of course, is the third annual report on NRW that the Climate Change, Environment and Infrastructure Committee has published during this Senedd. Although we did see some progress in recent years, I'm afraid that the significant financial challenges faced by NRW and the potential impact that that will have on NRW's ability to fulfil its role has cast a shadow over the debate once again. I hope, however, that the debate will provide Members with an important opportunity to discuss the key challenges and opportunities facing NRW more broadly. 

First of all, we need to face up to the stark reality of NRW’s financial situation. Since the start of this Senedd, the committee has repeatedly raised concern about the increasing financial pressures on NRW. This year, NRW faces a funding gap of £13 million in its budget, and that is projected to rise to £17 million by 2026-27 if no action is taken.

Members will be fully aware that the funding shortfall is already having serious consequences. NRW is planning to cut 265 jobs. Campaigners have described these cuts as 'brutal', and there are concerns that the loss of these jobs could leave Wales without enough staff on the ground to enforce regulations, to protect biodiversity, and to respond to incidents.

Now, we've heard that the funding pressure will lead to the closure of visitor centres, possibly, which provide an important opportunity for people to connect with nature and to reap the well-being benefits that that brings. I am aware that the Petitions Committee has been considering a petition relating to the closure of Bwlch Nant yr Arian, Coed y Brenin and Ynyslas visitor centres. I want to thank those petitioners, and also the committee, for their work on this issue.

We have also heard directly from the Chartered Institute of Library and Information Professionals, the library and information association, which has expressed concerns about the potential closure of NRW’s library and information services, and they've explained how this will impact on the integrity and credibility of NRW, and on the wider fabric of specialist knowledge and research within the UK.

It is important for Members to know that these are deep and far-reaching cuts, and the potential impact on key services is deeply concerning for us as a committee. We have urged both NRW and the Welsh Government to explore all options to mitigate these losses, but the outlook remains uncertain. At a time when Wales should be ramping up action to bring nature back from the brink and to deliver its global biodiversity commitments, we cannot afford to lose any critical capacity within NRW.

Before I move on, I'd like to, on that note, take this opportunity to extend my support to NRW staff members who are going through a very difficult and uncertain period at the moment and, as a committee, we just wanted to put our support to you, as a team of staff, on the record, because we know that you are very committed to your roles, and they are roles that we all appreciate.

I will now turn to another key part of our report, namely NRW's governance arrangements. Now, last year, we welcomed the introduction of service level agreements between NRW and the Welsh Government. The Cabinet Secretary and NRW praised these SLAs at the time as clear and valuable mechanisms to help to align resources with NRW's statutory duties. The committee supported this as a means of helping to provide that stability that NRW so desperately needs.

A year on, it was surprising to see that this approach had been quietly abandoned. There will be no new SLAs. Instead, we've been told that NRW will focus on multi-annual budgeting frameworks. According to NRW and the Welsh Government, this new approach provides more flexibility for them. Well, that might be the case, but we don't see that there's any reason why SLAs couldn't function alongside a multi-annual budgeting framework. We would therefore be grateful for an explanation from the Cabinet Secretary as to why he felt that the SLA approach could not continue.

In any case, we will, of course, be monitoring the new financial planning process closely, and I'm sure that this is an issue that we will discuss further with the Cabinet Secretary during the next round of draft budget scrutiny.

On a more positive note, we are pleased that NRW has accepted the committee's recommendation on strategic performance indicators. These measures are vital for assessing NRW's progress in meeting its goals and addressing environmental challenges. NRW has committed to refining these indicators, and will provide an update later this year. And it's expected that these indicators will be fully implemented in 2025-26, and the committee will, once again, continue to scrutinise these developments to ensure that they provide meaningful insights into NRW's performance.

Finally, the committee's report covers several important policy areas that relate to NRW's responsibilities and, lord only knows, those are very broad indeed. In terms of agricultural pollution, we are all familiar with the differing views held by stakeholders and Members in this Chamber on the most effective approach to managing nutrient pollution. Now, putting that aside for a moment, if the current enhanced nutrient management approach is to be effective, then it is crucial that there are adequate resources for monitoring and enforcement. It is a cause for concern, therefore, that this aspect of the work of NRW is the subject of an SLA that will run out at the end of this year. So, we would appreciate an update from the Cabinet Secretary on that particular issue and where we go next on this.

On tree planting, the committee has emphasised the importance of regular reviews of NRW's forestry resource plans. We have encouraged NRW to focus on increasing the use of native species and mixed planting to promote biodiversity and forest resilience. We are pleased that NRW has accepted this recommendation.

Finally, we raised concerns about the management of internal drainage districts, which play a vital role in flood risk management and environmental protection. Now, in its response, NRW told us that there have been no formal discussions between the body and the Cabinet Secretary, but that a review might be timely. That's what they've told us. Now, we understand that the Cabinet Secretary advised the Economy, Trade and Rural Affairs Committee of this Senedd in May that he has ruled out a review at this time due to resource constraints. We would be grateful, therefore, for an update on this when the Cabinet Secretary responds to the debate.

To conclude, Llywydd, NRW is facing one of its toughest challenges yet. Serious questions are being asked about its ongoing ability to deliver on its responsibilities. NRW plays a crucial role in protecting Wales's environment, and it is vital that we find a way of securing the resource and capacity needed by the body to carry out this work. I don't need to remind Members that we are facing climate and nature emergencies, and there's only so much we can ask NRW to do within its current budget.

We will of course continue to scrutinise NRW's progress over the next year, and I do hope that next year's debate may be more positive. But for now, the road ahead looks difficult, and NRW must be supported appropriately to face the challenges ahead. But I certainly look forward to hearing the comments of Members during this debate and certainly the comments made by the Cabinet Secretary as he explains later what steps he will take to deliver this. Thank you.

I thank Llyr Gruffydd for introducing this report to this Chamber, but also for his able chairmanship of our committee. Now, of course we know that the delayed—much delayed—corporate plan landed in 2023, and we had been asking and asking and asking for this. This is the first one since 2018. That is the first one since the Welsh Government declared a climate emergency, the first one since COVID, the first one since different varying announcements by UK Government in terms of how seriously they were taking climate change. So, whilst we were quite relieved as a committee to receive this report, I've got to be honest, this delay doesn't bode well, nor does it reflect the level of commitment we would expect from Wales's primary environmental regulatory body. Now, some of the points you made there, Chairman, were about their ability to do their work, and given the number of complaints that I receive from all sorts of farmers, in terms of land pollution, in terms of water pollution and things—. I know the resources are stretched, but at the end of the day, we need an environmental enforcement team that actually is able to work, and work appropriately.

Now, we're concerned at the abolishment of service level agreements and how that will impact on NRW's ability to ensure their resources reflect their full statutory duties and functions. In our report, we highlighted that SLAs can serve a valuable purpose for prioritisation, and that we would like NRW to share with us an outline of the next phase of the SLA work, including the areas to be covered and a timeline for their development and implementation. However, the Welsh Government feel that they should be abandoned, and I am worried now that we will not be able to effectively identify and scrutinise the 10 areas that NRW themselves consider priorities. The Welsh Government explain that they will be taking learning from the development and implementation of the SLAs. I'm not really sure what that means. I would like to know how this is going to be possible, especially considering, as was pointed out by Prys Davies in committee, that SLAs had been paused

'partly because of financial pressures'.

And financial pressures, in my book, should never mean less scrutiny. If financial constraints have previously hindered the development and implementation of these SLAs, how does NRW now intend to clearly define the resources needed to ensure the successful achievement of this corporate plan, which has taken so long to achieve? Additionally, how will the Welsh Government determine the necessary resources to deliver various service levels across the 10 priority areas?

In line with recommendation 3, and based on what I've just mentioned, the committee does look forward to receiving the much-promised, after 31 October, update on the progress of developing the final strategic indicators and performance metrics and how they align with this new corporate plan. But we also need assurances. NRW is facing a significant shortfall in its budget and, as such, is having to make sweeping cuts to vital areas. And I'll endorse a point that you made there, Llyr—this is not about the NRW staff. They work incredibly hard, and quite often they're seconded to different projects. And you can tell that this is an organisation that is juggling its priorities. 

I've already been contacted by the UK MTB Trail Alliance, who are deeply concerned because we have 500 km of mountain bike trails across Wales, and NRW have hinted that some of these activities and things—whether they will be able to maintain those trails. That's a really good healthy sport, isn't it, people going off into the forest on mountain bikes. So, it will greatly reduce public access to outdoor leisure activities, which in turn could have a serious negative impact on health and well-being. So, you've got to look at the costs of that on the tourism industry, which north Wales so heavily depends on. I understand from NRW's response that they've identified certain areas where they've decided to cease activities altogether, believing that they are no longer best positioned to deliver them. So, then, how are those areas going to be—where's the transition? Who is going to be picking up the slack for those areas that have been prioritised in the past? Have you as the Cabinet Secretary been updated on what areas these are? If this is the case, will NRW clarify how they plan to hand over these responsibilities? Will it be other organisations, community groups and volunteers that will need to step in?

NRW is expected to report to this committee within six months on the status of its visitor centres. Again, I've had concerns raised by people who really value them. That's recommendation 7. But they sadly appear to be significantly lacking in awareness of nearly half the features on sites of special scientific interest—and we value those in Wales—because of insufficient staff and resources to maintain the required conservation levels. Simply put, there are many areas of responsibility falling within the remit of NRW, and the lack of funding appears to be putting so many of these, now, at serious risk, with further job cuts—

I've been very generous already, Janet, so if you could draw your comments to a close. 

Okay, thank you. So, basically, I'm asking you, Cabinet Secretary: give us some assurances here today as to how some of the priorities they're going to be downscaling now will be taken forward. Diolch.

I would like to thank the committee team, the committee Chair and the Members for their work on this consultation. I would like to start by acknowledging the vital role that NRW plays in protecting our environment, managing our natural resources and tackling the climate crisis. Now, it's clear that NRW is facing a significant financial shortfall, which has been exacerbated by rising costs. This raises numerous concerns about NRW's ability to fulfil its core duties. 

We understand that the Welsh Government and NRW must work together to mitigate the negative effects of this restricted budget. However, I am very concerned about the reality that NRW now faces, particularly, as has been mentioned, the recruitment freeze, which could undermine its ability to provide key services. How exactly does the Government plan to tackle this recruitment freeze to ensure that critical environmental functions are not compromised? And if we scale back services in any way, what mechanisms are in place to ensure that the most vulnerable and high-risk areas are protected?

NRW’s decision to prioritise certain services and reduce others is understandable, but it is essential that this is done in a strategic and transparent way. Has NRW implemented a comprehensive prioritisation process that ensures that essential services, such as flood control, for example, are protected? I'd encourage the Welsh Government to press for this, to find out, and I’d like to know how the Cabinet Secretary intends to support NRW in this regard.

Now, one issue that concerns me is the lack of consultation with the public that has taken place regarding these changes. The public deserves, I think, to be part of this conversation, particularly those communities that are most dependent on NRW services. So, could the Cabinet Secretary, when he responds, confirm whether there are any plans to ensure that public consultation happens regarding budget decisions and services relating to NRW in the future?

I also want to highlight the ongoing issue of funding gaps, particularly those relating to staffing. This has already been mentioned by the Chair. There are serious concerns about the ability of NRW to achieve conservation goals, particularly when we consider that half of the features on sites of special scientific interest remain unmonitored. We have heard that NRW may need to double its staffing levels to address these challenges effectively, so how will the Government reconcile these additional staffing needs with the current budget constraints? Does the Cabinet Secretary agree that failure to invest in the NRW workforce could have serious long-term consequences for our natural environment?

And I’d like to say finally, in closing, Llywydd, that I’d like to echo what the Chair has said about the importance of thanking staff at NRW for the vital work that they do. I’d like to know what plans are in place to support their well-being, because it must be a very difficult situation for staff, and I’d like to place on record again our thanks to them. They hear negative stories all the time, and they have to put up with people’s frustration about the things that they cannot do, so what support is available for those that are struggling or who are under extra pressure or will be under extra pressure in the future? Thank you.

I would also like to pay tribute to NRW staff and all they’re doing in difficult circumstances. NRW’s most recent corporate plan, ‘Nature and People Thriving Together’, was published in April last year, and aligned with the terms of Government remit letter and is centred around the three well-being objectives: nature is recovering, communities are resilient to climate change and pollution is minimised. But I am concerned that all these can be met. NRW’s performance report for 2022-23 emphasised that recruitment continued to be a significant challenge, particularly in flood risk management and engineering. I’m aware that local authorities face the same challenges—all this at a time when flooding is a significant concern.

From early August last year, recruitment had, effectively, been frozen and the response was that NRW had become better at moving staff around the organisation to areas where staffing resource was needed. But, with ongoing inflationary pressures and a lack of public funding from the UK Government, they are now facing brutal cuts, as was described, and environmental campaigners are very concerned.

The workforce want to be part of planning the solution to these pressures and we believe that NRW must respond to these budgetary constraints by enhancing internal staff development and mobility to ensure these business-critical vacant posts can be filled quickly. If not, staff with years of experience will be lost and there will be no succession or continuity of planning, which is really important. Our committee is currently doing an investigation into biodiversity and whether the Government is on target to halt the decline by 2030. So far, it's depressing, and we need to strengthen environmental conservation, and I'm worried that this will happen.

Residents and organisations want to be part of a consultation regarding the visitor centres, and as Chair of the Petitions Committee, I want to say that the committee is currently considering two petitions relating to the visitor centres, and we'll be holding our own debate on this issue next Wednesday. Petition P-06-1474 is 'Stop Natural Resources Wales closing Bwlch Nant yr Arian, Coed y Brenin & Ynyslas visitor centres' and also petition P-06-1447 is 'Stop Natural Resources Wales closing the visitor centre at Ynyslas National Nature Reserve'. The first petition has 13,245 signatures, and the second one has 2,422 signatures. I believe the volume of signatures demonstrates the deep public concern arising from the proposals and the potential impact these decisions might have on the future of these sites.

The committee received correspondence from NRW yesterday that puts a greater emphasis on maintaining these facilities now, but bringing in external expertise to run catering and retail facilities. However, time is important, as is continuity, so we have concerns about that. I will be visiting Ynyslas at the weekend, and I look forward to seeing for myself the current facilities and hearing what users think about the changes we might see.

NRW's dedicated environmental library in Bangor is set to close, and is used to help with planning applications and monitoring rare species. I'd like to know if an impact assessment has been done regarding this and if there are alternatives available, such as using Cofnod. Environmentalists are concerned that there will be crime that doesn't go detected and incidents that NRW do not have the capacity to deal with.

I understand public bodies right across Governments, including councils, right across the UK are facing terrible decisions after so many years of austerity and massive inflationary pressures, but Wales and the UK is one of the most nature-depleted countries in the world. SSSIs need to be monitored, we have polluted rivers, and marine life is suffering. Planning applications are being held up waiting for responses from NRW, and, when developing legislation such as the sustainable farming scheme, we need experts to be able to work with farmers. Thank you.

I'm not on this committee, but I do welcome the opportunity to speak in this debate today. It'll just be a short contribution on something that's playing on my mind. Obviously, there's a lot to talk about when it comes to NRW, and I concur with everything that my colleagues have said right across the Chamber, actually, so far on it.

But I just wanted to talk about something that I've done recently. Last week, I had the pleasure of attending a welcome to off-road wheeling event deep in the Wye valley woods. It was a really enlightening and uplifting event, where you saw wheelchair users try out wheelchairs that have been adapted to go over the terrain to make walkways in forests and woods and stuff more accessible. It was all fantastic stuff. NRW were there and many other relevant organisations, and it was all about improving that access for wheelchair users.

My question to you, Cabinet Secretary, was that I spoke to these relevant organisations on this visit, and they raised a point, a good point, and were concerned about the fact that they'd heard that the NRW website would be taken away because of staff cuts. They said that on the NRW website at the moment it highlights the accessible routes that are accessible for wheelchair users, and, if this website is taken down, who else is going to fill the shoes of that, who else is going to do that job and promote and let wheelchair users know which routes will be accessible to them? So, it's something to bear in mind when we're talking about funding, but also, as a result of that, I'm also concerned about the continuation of much-needed adaptations to walkways, getting rid of kissing gates and that sort of thing, simple things that will make our walkways more accessible to wheelchair users in the future. Thank you.

May I also thank the committee for its work on this? I think we should be gravely concerned, given the comments made by the Chair in introducing this report and opening this debate in terms of the increasing pressures on NRW. If you look, following the destructive floods of 2020, at the NRW report on that flooding incident, it became clear that a shortage of staff had been a grave problem for them. That report was clear that 70 more staff were needed in order to meet the needs of that body. Delyth Jewell mentioned that in her contribution, but I would like to know where we are now in terms of the staff dealing with flooding, because, as we heard yesterday following the statement by the Minister, this is going to be an increasing problem because of the climate emergency. We know that we're expecting more extreme weather, we know that flooding will become more prevalent; that's obvious to us all. But do NRW have the resources to cope with that challenge? Because I don't want to see another report following destructive flooding on the scale that we have seen in the past—because there will be at some point, unfortunately; that's the reality of the situation—saying again that we're not just short of one or two staff, but 70 staff on that team.

There is huge pressure on the staff, and I am pleased that we have recognised, in this Chamber today, the excellent staff working for NRW, and that we also acknowledge the huge pressure upon them. It's quite clear that there are so many people within the organisation who are gravely concerned about our natural resources, but they also know that they're unable to do some of the things that they would want to do. If you look at the work in supporting local flood groups, that team within NRW is very small. And what concerns me most, given the cuts they're now facing, is to see that some of that engagement work will have to come to an end, some of the educational work will cease, and they're also saying that they won't be able to do as much in tackling the climate emergency. Well, it was us, in this Chamber, who declared that nature, climate and biodiversity emergency. So, the fact that they're not going to be able to do what we've asked them to do and that we voted on as being a priority, is a real concern.

So, there are so many areas here, and I do think it's about time we had a conversation, because, clearly, the decision was made to create a single body, bringing all those individual organisations together, and what we have seen is cut and cut again and huge pressure. So, I'm pleased to see the committee's work, but in terms of the follow-on work and the work done in our communities and on the ground, I do think we need to start to find solutions, not just accept that the budgetary position is challenging and that we are going to lose some of these important posts.

So, could I ask the Cabinet Secretary specifically, having looked at the flood mitigation work and supporting communities, are you confident that NRW, since the report into the flooding in February 2020, have the staff necessary, because they did warn that, if they didn't have those resources, they wouldn't be able to respond in the future? So, I would like an assurance for those communities that the Welsh Government has listened to NRW.

I read this report. Like Laura, I am not a member of the committee, but NRW comes up regularly in my casework. And as has been said, the responsibilities are broad and expectations are high. As everyone who has contributed already has said, it's clear from the committee's report that these harsh cuts are undermining the important work done.

Three areas struck me; three areas of interest to me, also. The first is the point that Janet has alluded to already with regard to the features on sites of special scientific interest—this is a matter that's been raised in the Pentyrch area of Cardiff—and that half of those features are of unknown condition. Well, I find that incredible.

The current level of staffing is inadequate for conservation purposes. Wales Environment Link states that the current levels of staffing at Natural Resources Wales would probably need to be doubled—not just increased, but doubled—in order to address the biodiversity challenges here in Wales. Well, as Heledd Fychan mentioned, there's no point in us declaring emergencies if we don't put the resources there to tackle these problems. Words are simply not enough. The lack of funding is destroying, by omission, areas of scientific interest that would improve academic understanding of the environment here in Wales and, with that, across the world.

Secondly, Heledd has already mentioned flooding. As Clare Pillman states in her evidence to the committee, drainage districts in Wales are now experiencing increased flooding—it's getting worse. Part of the cause, according to her, is a lack of strategic re-evaluation, with some areas not as efficient as others in using what limited funding they have.

Thirdly, tree planting. Now, we've heard a lot in this Senedd about tree planting, and that being one of the key priorities of the Welsh Government's climate change plan—the planting of trees to capture carbon. But this has also been stunted by budgetary cuts. Progress on new tree planting is not nearly as far along as it should be, if we want to reach net zero by 2050.

Again, there's no point having targets if we just cannot, simply, achieve them. The budget cuts that the Welsh Government has handed out to Natural Resources Wales have, essentially, shot its own climate targets in the foot. Unless we take action now to improve recruitment and retention of expert staff who can look after the environment, I worry that this will be perpetuated year after year, as has already been alluded to by others.

The new First Minister said on her election that the Welsh Government could tackle many challenges, such as the climate crisis, whilst focusing on health. But, as Llyr Huws Gruffydd said in opening the debate, our environment is essential to our health; there is no health without a healthy environment. Unless we support Natural Resources Wales sufficiently, then we are at risk of damaging not only the environment, not only our countryside and our waters, but our nation and, more importantly, our children and future generations. Thank you.

I'm grateful to Llyr Gruffydd and the committee for their work in producing the report that we are debating here today. Also, I want to echo comments made by Members already, in terms of the work carried out by NRW teams up and down Wales. I'm just speaking briefly today, Llywydd, in my capacity as chair of the cross-party group on outdoor activities—as the Cabinet Secretary will be well aware—with a vast array of groups and individuals who do great work to promote the outdoor sector in Wales. And I know that the Cabinet Secretary's personal support and involvement in this area are important to him as well, and he'll know that that sector does a huge amount of work alongside Natural Resources Wales as they go about their work.

We had a meeting just a couple of weeks ago here in the Senedd, and it was primarily around the existing proposals around the restructure and the cuts involved with Natural Resources Wales. I just wanted to be clear that there are serious concerns that have been expressed by the members of the cross-party group about NRW's future operational capacity, about the proposed cuts that Members in this Chamber have already outlined this afternoon, but particularly the impact on public access and recreation provision—Janet Finch-Saunders mentioned this as well—in addition to the management and maintenance of existing infrastructure at these sites.

Cabinet Secretary, you'll be aware that those organisations in the cross-party group certainly understand some of the issues and reasoning behind some of this, and they also want to be part of the solution to provide support as well. But they have expressed concerns that there's excessive bureaucracy within NRW when it comes to community groups supporting some of these sites, and I think they'd be grateful to understand how some of that bureaucracy could be removed. Because we know that it's important that people are able to access these spaces, many of which NRW have control of, because we know that they play a huge role in promoting physical and mental health, in addition to making the Welsh tourism offer even better and more attractive.

I was struck by the comments of the Chair of the committee, and, rightfully, he spoke about the important role that NRW have in protecting the environment. That's absolutely right. But NRW also have a role to promote the environment that we have around us, and the use of that environment, so that people are physically healthy, and can access those spaces to help their mental health as well.

Llywydd, the Cabinet Secretary will be aware that the cross-party group has written a letter—it's on its way through to him now, if it's not already arrived—just outlining these points in more detail. But I'd be grateful to hear today from the Cabinet Secretary, in his response, his thoughts on what work the Welsh Government have done to look at the impact of cuts in the areas, as have been described, and if he'd be willing to meet with myself, in my capacity as chair of the cross-party group, to discuss these points in more detail. Diolch yn fawr iawn.

I thank Llyr Gruffydd, the committee and the clerking team, and the research team, for the comprehensive work that they've done on this report. When the current Llywydd was the Minister for Rural Affairs, many years ago now, Wales showed vision and leadership that has given rise to an industry that is now worth hundreds of millions of pounds to the British economy, namely downhill mountain biking. Because it can be said that this started at the magnificent Coed y Brenin centre, near Ganllwyd in Meirionnydd. If you haven't been there, Cabinet Secretary, then I would encourage you to visit the place. It is a wonderful place, and it has grown in status and has a reputation that is internationally renowned. According to the Scottish Government, downhill mountain biking contributes up to £150 million to the country's economy. No similar assessment has been made here in Wales yet, but we can be sure that this sector contributes tens of millions of pounds to our economy in Wales.

But the birthplace of this sector, the cradle of a sector, which continues to be a popular attraction, namely Coed y Brenin, is now under threat. When this report was written, there was uncertainty about the future of the visitor centres. Things have now changed, and the body, NRW, is looking to close the visitor centres at Coed y Brenin, Nant yr Arian—another excellent cycling centre, by the way—and Ynyslas, in order to make savings of £1.2 million in this financial year. Although NRW is looking to close the visitor centres, the truth is that closing the visitor centres would have a detrimental impact on these places as visitor attractions, and would affect the maintenance of the trails as well. Although we do not know what the financial value of downhill mountain biking is to the Welsh economy, an assessment has been made of the economic value of these centres to mid Wales, and they contribute up to £67 million to the region's economy.

I understand that NRW is under significant financial pressure, but there are local, experienced and informed groups that are willing to collaborate with the body in order to take these assets forward. The trouble is that a very tight timetable has been imposed on NRW, and the staff at the visitor centres will be made unemployed by April. And once this happens, and the centres close, then it will be more difficult to reopen them, and so time is very short.

If we want to protect these pearls that attract so many people, and ensure that they continue to contribute tens of millions of pounds to the region's economy, then the Government must step in. The request that I have for you, therefore, Cabinet Secretary, is for you and the Welsh Government to provide the necessary £1.2 million to NRW in order to maintain the centres for this year, and to give time for these companies to put together their business plans, and to be part of the tendering process, without the centres having to close. I am sure that you would agree that this would be a very small contribution in order to maintain such valuable attractions.

Finally, I want to thank the committee also for taking the time to look at the inland drainage areas. I'm afraid that the Government's policy on flood protection has proven to be counterproductive. In prioritising property and people only, the result of this has been that rivers and streams are not dredged. This is harmful across Wales, as it means that water backs up and does not flow out into the sea to the extent that it should, as the bed and mouth of the river have silted up. But the situation is even worse in internal drainage areas. We must look again, therefore, at this policy, and secure capital investment for long-term work, or look again at the whole system and empower landowners to carry out the necessary work.

So, I would like to hear what the Minister's intentions are in these areas. Thank you, Llywydd.

The Cabinet Secretary now to contribute to the debate, Huw Irranca-Davies.

Diolch, Dirprwy Lywydd, and thank you very much to the Chair and the committee, and also the other speakers today who've spoken very eloquently and passionately, either on local issues or on particular issues of interest, but also on strategic issues to do with NRW as well. And let me say at the outset, can I just echo the comments that have been made about the NRW staff, who do work hard every day, day in, day out, to help protect our natural environment? Many speakers have made that point today and I would echo it. The other thing I would echo is that actually tackling the climate and nature emergencies is fundamental to the objectives of this Government, to me personally, and also to this and future generations here in Wales and across the world. We have a part to play in what we do.

We're painfully aware, as we've seen in debates earlier this week, of the risks that people and nature are facing, from flooding to river pollution, to more extreme weather patterns and more, and it's the NRW staff that are at the front line of dealing with these crises in our own nation. I welcome, by the way, the committee's scrutiny and the remarks that have been made today, particularly in light of those climate and nature emergencies. We have to have a strong and effective regulator to protect the natural world. It's of the utmost importance, and that's also why it's important in terms of the reporting function that NRW and its leadership team are scrutinised and are held to account on the exercise of its legislative and statutory functions, even in, including in, particularly in challenging times. So, let me turn first of all to the detail of the report, and I'll try and address some of the matters that have been raised, Llywydd, but I won't be able to do all of them within the time available to me, I don't think. We've had a number of speakers, but I'll do my best.

The committee has made 13 recommendations, 10 of which we've accepted, and the remaining three have not been accepted, but we think with reasons that we've laid out within our written response. We published that full written response to the committee's report on 4 July, and firstly, just let me cover recommendations 1, 2 and 9, which were the ones that were not accepted. Recommendation 9 related to NRW providing the committee with an update on progress of developing statutory biodiversity targets. This has not been accepted because the responsibility for this lies with Welsh Government rather than NRW, and we've gone into more detail in the written response about how we'll take that forward.

Recommendations 1 and 2 focused on NRW's service level agreement, the SLA process. As we've explained, because the focus is now on multi-year planning, Welsh Government has agreed with NRW to discontinue the SLA process. Therefore, these two recommendations associated have not been accepted, and Janet, you referred to the evidence given by Prys Davies, that he said this was 

'partly because of financial pressures'.

He went on to say it’s also to do with 

'the work that we want to do in terms of embedding the corporate plan,'

which the chair, when he appeared in front, said to the committee was a seismic moment—long awaited, as people have said, but a seismic moment. And Prys Davies goes on to say,

'developing the strategic indicators, looking again at our performance framework arrangements and how we report.'

So, just to say that we'd agree with that. NRW will identify the level of resource required to enable the successful delivery of its corporate plan objectives, and my officials will test this approach through 2025 and 2026. NRW will provide the committee with an update on the development of the strategic indicators and the performance metrics later this very year, which relates to recommendation 3 of the committee's report, which has been accepted, and that ties that together in our rationale.

A significant part of the committee's report focused, understandably, on NRW's financial position, which has been picked up by many Members today, and relates to recommendations 4 to 7, all of which we have accepted. There is no doubt that NRW's budgetary position has been and continues to be challenging, but Members will be aware that this is not in a void that we're having this discussion. The budgetary pressures that face all of our public sector bodies, due to a UK-wide economic picture—and there are no organisations, including NRW, that are exempt from the extremely tough budgetary conversations and decisions that must be made.

So, as we know, in July, NRW started the formal process of consultation with the trade unions in relation to its proposed case for change programme. This came after the report, and so on and so forth, but they've embarked on that. The programme outlines the reshaping of NRW so that it can operate within its available budget. A key part of this work is focusing that resource on its statutory and regulatory functions—the ones that deal with the nature and climate emergency. These essential services, essential for nature and for people, are protected, or as protected as can possibly be done. NRW has undertaken a detailed assessment of its current activity against the priorities—those that were laid out in the corporate strategy—to assess where capacity can be scaled back to address a funding gap that is a real funding gap of £13 million for the financial year 2025-26. 

NRW's formal consultation with its trade unions closed on 13 September. It's now reviewing the feedback to determine if any changes are required, whilst still responding to its budget challenges. My officials are continuing to work with NRW to understand the impact and the ramifications of its proposal, and particularly in relation to the delivery of these front-line services and their legal and statutory obligations, on which so many Members have said to me, 'That's where the focus has got to be'. 

Included within its case for change is the proposal to cease its provision of retail and catering services at its visitor centres. This is indeed something that has received a lot of attention over the past few months, with many local users—echoed in the debate today—raising concerns over the perceived closure of the centres. Just to say from NRW's perspective, they've made clear—they've reiterated—that its visitor centres are not closing and that the sites will remain open for all those activities described—walking, biking, play areas, car parking and toilet provision.

But they are considering a raft of possible options that they've made clear for retail and catering, including opportunities for local businesses and partnership working with, for example, social and community groups—some of them are interested—who will be better placed to provide these services to keep those activities going. I'd like to see them be kept going, without a doubt. But again, given the tight budgets constraining public services that our public organisations are facing across the board, there is a real necessity—[Interruption.] Just a moment. There is a real necessity for NRW to focus on and protect the core statutory and regulatory functions. Sam, I give way.

Thank you, Cabinet Secretary. Just a quick intervention on the point around working with community groups, third sector or private sector organisations wanting to, perhaps, take on some of that work. Will you able to commit to ensure that, because of the tight timescales that are there currently, this process will not be delayed, so that we don't see a situation where, potentially, because of the tight timescales, there may be a shutting down of some things with a gap whilst some procurement process takes place—so that we don't see that taking place, that it's a smooth transition if it's required? 

I think that point has come across clearly from a lot of organisations out there who want to see a smooth transition—if they can put together cases to actually run these facilities, they don't want a gap in-between. I think that's been very clear to NRW, and certainly my officials have fed that back as well, based on some of the public concerns raised with us. So, they're very cognisant of that, Sam, but thank you for raising it.

Just to turn to the remaining recommendations in the report—because we've covered a lot of ground in the debate here today and there are a few moments remaining—they focus on specific areas of work, all of which we've accepted. In terms of biodiversity conservation, we are looking at ways to better co-ordinate our funding on that. In terms of developing a new approach to sustainable finance for nature's recovery, based on cast-iron sustainable investment principles, we are working on that. I look forward to coming in front of the committee and talking a bit more about that, because these principles would aim to increase and diversify the available funding to tackle the nature emergencies and the pressures that drive biodiversity loss. And I think it's a recognition, by the way, that we're never going to have enough taxpayer-funded money to do the scale of the challenge in front of us, so we need to look creatively at really good ethical principles behind bringing additional funding into it. 

Agricultural pollution, Llywydd, remains one of the main causes of pollution in Wales, so we do have to work together with all sectors. We're engaging with a wide variety of stakeholders regarding the complex issue of pollution from farmers. We're providing more grant funding to support farmers in this area. We are tweaking and adjusting our way forward on the river summit approach as well to focus very much on the outcomes that we want to see delivered as well. And, in fact, we had the fifth of those summits at the Royal Welsh Show, co-chaired by the First Minister. And, of course, we're undergoing at the moment the review of agricultural pollution regulations as well with the new independent chair. 

I've gone beyond my time there. Can I just close by thanking the committee for its diligent scrutiny and the Members who've spoken today? The points will have been heard not just by me and my officials, but by NRW, as they go through a difficult process of working with the trade unions, and looking at the case for change that they're putting forward, recognising the multiple imperatives of what they're trying to do, but focused on those statutory and legal requirements that they have to help us tackle the climate and nature emergencies. It's not an easy task, but there is no easy task facing any of our public bodies at the moment. Diolch, Llywydd.

The Chair, Llyr Gruffydd, to reply to the debate.

Clearly, I'd like to thank everyone who's contributed to the debate this afternoon. I won't go through everything that's been said, but, clearly, there are consistent themes emerging, as the Conservative spokesperson said.

NRW have been on an unsustainable trajectory for too long: more and more responsibilities being thrown in their direction, fewer and fewer resources to deliver those. The SLAs, the service level agreements, was an effective way of articulating to Government, to NRW, and to the wider public, 'This is what the Government expects you to deliver for this money'. Moving away from that, I think, leaves us in that limbo, in that grey area where NRW are trying to go from one cut to another, deciding exactly what their priorities are against exactly how much money they have. So, I think it's regrettable that we're unlikely to see movement in that direction soon, but, as I say, as a committee, we will be diligent in looking at whatever models are being used to fund the organisation.

As Delyth said, one clear output is the complex staffing issues faced by the organisation. We, as Members and as a committee, want to understand what the priorities of NRW are in moving forward, which will then provide a context to these redundancies—265 jobs that are being cut. So, what is to be protected, what will receive less resource, where will the emphasis be cut in terms of delivery of services? The sadness, it appears to me, is that I'm not sure if the staff themselves know what the broader plan is.

Some have been in touch with me, telling me, 'We don't know how we're going to fit in. They're saying that there'll be a possibility for you to apply for posts when this process runs its course, but I don't know but if I'm going to fit in to the priorities, because I don't know what they are'. So, there's a question there that needs to be answered.

Of course, these are challenges faced across the public sector in Wales, and we were reminded that local authorities aren't unfamiliar with similar pressures. But there is a double impact then when the local authority cuts flood resources and NRW makes significant cuts too. It's a double blow and, therefore, the impact is so much worse.

But we've heard many examples of the practical impact of these cuts, be it access plans in the Wye valley or responding to flooding in the Valleys, the impact on the SSSIs, which aren't achieving the levels that they should be achieving, and also the impact on outdoor activity. The solution in Coed y Brenin and in other areas, of course, is for NRW to commit not to close those services until alternative arrangements are in place. I'm sure that would mitigate some of our concerns.

NRW has a remit and duties that are very different to its predecessor bodies, and the Well-being of Future Generations (Wales) Act 2015 and other legislation has meant that the role that NRW plays is one that's difficult to compare to the roles of those predecessor bodies. But the question I would like to ask is: given that these cuts are happening, what is the cross-cutting role and remit? What will be the role following these cuts, and to what extent is the Government driving that vision, rather than leaving it for the board of NRW to prioritise what they feel is necessary?

I think I'm right in saying that NRW manages around 7 per cent of the surface area of Wales, so in that regard, the influence of the organisation is so far-reaching. And not just in an environmental context, but also economically, socially, culturally, educationally, in terms of public health, and so on and so forth.

A number of messages have been conveyed by Members in this debate this afternoon. The committee sent a clear message on ensuring that NRW is in a position to act and to deliver its functions effectively, and I very much hope that the Cabinet Secretary, the Government and the board of NRW are listening very carefully this afternoon.

The proposal is to note the committee's report. Does any Member object? No. The motion is therefore agreed.

Item 7 is next, that's the Welsh Conservatives debate on ophthalmology services. Sam Rowlands is moving the motion.

Diolch, Llywydd. It's a pleasure to open this debate for the Welsh Conservatives. I move the motion in the name of Darren Millar on the order paper. 

'A tidal wave of blindness'—that's a stark warning from a leading doctor on the state of eye care here in Wales. And let's not forget, that's after 25 years of a Labour-run Welsh Government. As it stands, more than 80,000 people in Wales are at the highest risk of irreversible sight loss, with eye care accounting for one in every eight patients languishing on a Welsh NHS waiting list. 

The number of ophthalmology patients waiting beyond their target date has more than doubled in the past five years, and in the last decade, referrals to ophthalmic services have increased by over 50 per cent. But the workforce, of course, has not matched this increase, putting immense strain on health services and on people who are working so hard on the front lines.

It's estimated that 69,000 people in Wales have some form of diabetic retinopathy, with a consultant ophthalmologist in Swansea saying,

'we're filling up clinics faster than we can staff them'.

The RNIB said that demand for eye care services is expected to rise by as much as 40 per cent over the next 20 years, putting even more pressure on a service that's already creaking under the immense strain of lengthy waiting lists and outdated infrastructure.

Members, the numbers are staggering, but it's the personal stories that I'm sure we all hear of in our inboxes and on phone calls that are tragic. Too often, discussions in this place can feel theoretical, removed from the reality of people's lives, but let's not forget that it's decisions made by Ministers in this place that have a harsh effect on the people we are elected to represent. 

A person got in touch with me just this week saying that they're on a list for a cataract operation at a hospital in north Wales. They've been told that the wait for the surgery is two and a half years. That two and a half years can have a massive impact on a person's life. It changes them, not just in that two and a half years, but changes them forever; it means they can get blind when they don't have to, they can lose their sight.

But it's not just about eyesight. The lack of action, we know, on the very treatable gradual loss of sight in so many circumstances sadly has a huge impact on other important areas of our lives. If these issues aren't dealt with quickly, there can be a significant mental health impact on those who are suffering, and their families, of course, and a risk of increased loneliness as people find it more difficult to access spaces that they could go to in the past. We're aware of the physical health impacts due to an increase in trips and falls when people's eyes aren't properly supported, and, of course, there's economic impact for those unable to continue with their work. It just goes to show that a focus on proper eye health care is so important.

Within all this, let's not forget that this loss of sight, many times, is treatable, but people are losing their sight because they're waiting too long on these lists, which is ultimately the responsibility of Labour Ministers in this place. This situation is at a crisis point—let's make no mistake about this. But I'm not convinced that the Labour Party here in Wales understand the importance of the crisis that we're facing here today. 

We read in an interview in today's Western Mail that the Cabinet Secretary was specifically asked, if there was a patient in Swansea waiting for a cataract surgery, why shouldn't they be allowed to get that surgery done in Shropshire, where they would be seen months, or, let's be honest, even years quicker. And for some reason, that question didn't meet with a hugely positive response from the Cabinet Secretary. It seems like there's a reeling back from a commitment we only heard just a week or so ago about colleagues in England working more closely cross-border, rather than embracing the cross-border support that we know is really important. It seems crazy to me. I can't figure this out. Why wouldn't we want to have people in Wales seen more quickly if the opportunity is there to do so?

It's not just about cross-border between Wales and England; there are opportunities being missed in work with other sectors, whether it's charities, the private sector, or others working at the coal face.

I recently visited Specsavers in north Wales, in Broughton, who are working to treat people with eye problems. And at a national level, they want to be able to support, with the training and development of optometrists, as they have done in other parts of the UK. It's organisations like this that can help take the strain off the NHS, and make sure that people are seen as quickly as possible instead of waiting, literally, for years. I've spent time with the RNIB in Llandudno over the summer recess. I had the privilege of walking round the town with a representative from RNIB wearing a set of goggles that enabled me to see things as they saw things around the town. It helped me appreciate the experience that they have. And they're desperate to play an important role in supporting people in the prevention of sight loss.

So, in short, in my view, the Labour Party’s attitude needs to change, to embrace patient choice and the support of others. So, we're calling on the Welsh Government to adopt measures in order to tackle the deep-seated issues that impact eye healthcare in Wales. And to start, Welsh Government should accept the recommendations of the national clinical strategy for ophthalmology and make the investment needed in order to prevent the collapse of eye care services across Wales.

We're also calling for Ministers here to set targets and deadlines for improving waiting list backlogs, and to publish a timetable for development and roll-outs of a electronic patient record and referral system for a truly modern health service. And we believe this can be done by working across sectors and by working across Governments, giving people choice to ensure people in Wales do not suffer unnecessarily on waiting lists. It's a big job, there's no doubt about it. But it has start somewhere, and it has to start now. Anything less would be a sad, unnecessary and continued failure of people in Wales. I encourage all Members to support our motion. Diolch yn fawr iawn.

I have selected the two amendments to the motion, and I call on the Cabinet Secretary to formally move amendment 1, tabled in the name of Jane Hutt.

Formally.

Moved. Mabon ap Gwynfor.

Thank you, Llywydd, and I thank Sam Rowlands for bringing forward this timely debate, and we will be supporting it. Because as the wording of the motion suggests, ophthalmology services are on the brink, and there is no time to lose in order to rectify the situation. Indeed, the fact that the former president of the Royal College of Ophthalmologists Wales Committee has described the new national strategy as

'the last chance we have to plan a viable future for eyecare in Wales',

and that the current president has warned that there is a

 'tidal wave...of blindness'

facing us underlines this urgency. And when looking at the state of eye care in our health service, then there is no surprise at all that they have come to this conclusion. Around one in every eight people who are on a waiting list are there because of ophthalmology needs. This is, therefore, the speciality with the most intense pressure within the health service. As a result, less than half of the patients at the highest risk of going blind are receiving their treatment within the extended target date. 

The situation is particularly fragile in the Betsi Cadwaladr Health Board area, where only 44 per cent of these patients are receiving their treatment within this extended period. The waiting list of 42,809 is higher than in any other place in Wales. And I see that in my casework and my inbox on a weekly basis. And as the RNIB's research clearly shows, the pressure on ophthalmology services will only increase over the coming decades, with an increase in cases of glaucoma, macular degeneration and cataracts an inevitable result of the fact that our population is ageing.

But as is common across many parts of the health sector, the same old pernicious paradox is undermining our preparedness for the challenges ahead, namely that while the demand on health services continues to increase, the capacity of the workforce is shrinking, which is evident in terms of staff numbers and the lack of action on the all-Wales digital referral systems.

I'm very grateful for you taking an intervention. As you'll know, the Stanley Eye Unit is based in Abergele Hospital, which is in my constituency. That hospital is going to have the opportunity to expand its capacity of services in the future, because much of the orthopaedic activity from there is currently being transferred to Llandudno hospital. Would you join me in encouraging the Betsi Cadwaladr University Health Board to help clear its backlog by investing in the Stanley Eye Unit to make sure that it has the capacity to deliver these extra operations that people so desperately need? And will you also join me in encouraging the NHS more widely to use its resources more efficiently by encouraging it to do both eyes, if people need cataract operations, at the same time, rather than in separate appointments, which seems to me to be a nonsense?

The Member for Clwyd West makes a very important point. Stanley hospital does provide excellent services, and of course I would agree with the need to expand that provision and ensure that more is done. There is a broader question there in terms of health provision and the lack of investment in the infrastructure that we have in Wales in terms of services. So, I do support those comments.

It's also worth remembering that effective and prompt eye treatment is key for the preventive agenda, especially in the early detection of other health conditions, such as diabetes. 

What is particularly disappointing about all of this, of course, is the fact that Wales was the first country in the UK to develop specific targets for the highest category of blindness risk, and as we mentioned during our debate last week, we as a party are still encouraging clear targets as a basis for effective governance. Once again, however, we must face the reality of the Government not being able to marry their good intentions with positive results.

It is therefore essential that this new national strategy represents a turning point in the Government's efforts to address the significant threat to ophthalmology provision in Wales. In this regard, we encourage the Government to act on any recommendations regarding clear targets and benchmarks, and the provision of resources that are proportionate to the needs of patients and staff, in accordance with the point made by Darren Millar.

As around two out of every three people in Wales who suffer from sight loss are women, and that women, particularly those from less privileged backgrounds, are more likely to face barriers when seeking treatment, we are also calling for appropriate emphasis in the action plan to address this, which is a reflection of the wider gender inequalities in our health system, which Delyth Jewell spoke of earlier. This should go hand in hand with the broader work of improving the state of the workforce, and we would be grateful for an update in the Minister's response regarding the Health Education and Improvement Wales plan to increase CPD opportunities for staff in this area.

The First Minister has consistently stated over the last few weeks her intention to lead a Government that has a relentless focus on delivery. So, prove that that ambition is more than just words by supporting this motion. Thank you.

What strikes me in this Welsh Conservative motion today is the sheer number of people who are at risk of sight loss and how many people are waiting beyond the target and how many of them are waiting beyond the target date for an appointment. And the figures, set out in our motion today and which Sam Rowlands set out in his opening comments I think are pretty shocking. What also strikes me, as detailed in our motion as well, is that the increased demand is expected to be 40 per cent over the next two years. Now, that should, should it not, set alarm bells to the Government that they need to take this issue seriously and that this should be a top priority for the Welsh Government to address.

Now, we know that under this Government here we've got the longest waiting times in the UK, but what our motion sets out today is that the biggest increase in the number of patient pathways waiting over a year was actually in ophthalmology, at the same time as the workforce in this specific area has seen a 2 per cent drop in its workforce, alongside a 50 per cent increase in referrals in the past decade. Now, the Cabinet Secretary—I know he's new to post—may stand up and tell us that the Government's got a plan and are committed to driving down waiting lists, but the sad thing is that we have heard this previously from past health Ministers. In 2001 the electronic patient record and referral system was launched, but guess what? It's still not operational in Wales. Now, the Health and Social Care Committee publishes a termly monitoring report, and that report tracks waiting times against the Welsh Government's own targets—a really valuable document and one that is made publicly available as well. Now, the latest report conducted in the summer shows us that the biggest increase over the last six months in the number of patient pathways waiting over 53 weeks was in ophthalmology—have I said that right? Ophthalmology. It has the highest number of patient pathways waiting, and also the highest number of patient pathways waiting over 53 weeks.

Now, the monitoring report also goes on to give some commentary as well. It says that the Welsh Government have tried introducing some measures, alongside health boards, to address the high ophthalmology waits, such as the eye care measures that were introduced in 2019, where patients are assigned a health risk factor to prioritise those at greatest risk of irreversible sight loss. But the report also states that less than half—48.6 per cent, actually—of high-risk patients are seen within their clinically safe target date, indicating that there's a need for better implementation and awareness. So, I don't really think that that is good enough at all. Now, when the Cabinet Secretary does respond to the debate today, I would like him to address the issue around resource—the resource being allocated to address the shortage here—and also how effective he thinks the community clinics have been in reducing waiting times and providing fast and effective care.

I was pleased that Sam Rowlands mentioned the issue of cross-border; it's particularly important in my own constituency. But I know myself that there is capacity in Shropshire. There's capacity there, but that cannot be used. Why? Because NHS Wales is not prepared to pay for those services. As Welsh Conservatives, we want to see a Welsh Government accept the recommendations of the national clinical strategy for ophthalmology and commit to making the necessary investment to prevent the wholesale collapse of eyecare services across Wales. But also, I think that what is really disappointing is that the Government have deleted our entire motion today. That motion sets out a factual position and then goes on to address what the Government needs to do, and it's disappointing that the Government wasn't able to support our motion as it was.

Our eyes and vision are precious. Urgent treatment for so many eye conditions is essential, including glaucoma, diabetic retinopathy and wet age-related macular degeneration. However, non-urgent eye conditions, such as cataracts, if untreated, can have a significant impact on a person's life, on their ability to do their job and remain independent if not dealt with in a timely manner. Whilst waiting times for surgery are reducing, as the Welsh Government amendment states, they are not where everyone wants them to be.

There have been huge medical improvements in both ophthalmic and optometry services, however a sustainable solution is needed if demands for eye services are to be met in the future, which will only increase with an ageing population. I worked in an ophthalmic department quite a few years ago now, when a cataract extraction was done under general anaesthetic and you could expect to be an in-patient for around 10 days. Now, the surgery is done under local anaesthetic, takes about 30 minutes, and you're back home later that day. Eye care has and must continue to evolve. One area where this has occurred is in primary care, where the Welsh Government has invested significant funding in optometry services. This has enabled health boards to ensure that patients are seen at the right time, by the right person and in the right place, whether that be a specialist secondary service or in a primary care setting. 

Historically, optometrists undertook eye tests and contact lens assessments only. Now, they provide a number of treatments and services, freeing up specialist care, and they have far more clinical responsibility. The professional workforce has ensured that they have upskilled, with higher qualifications being achieved. The transformation of the delivery of services in eye care has been delivered at pace, and must continue to do so into the future. I am pleased that the new Cabinet Secretary for Health and Social Care is currently considering a national clinical strategy.

Digital technology also plays a very important role, and I think it's fair to say that ophthalmology was behind the curve, and investment is vital in this area if progress is to be made and maintained. Importantly, Wales is the only country in the UK that has a low vision service. This is a service providing advice, support and aids to help people maintain their independence and quality of life. All of these reforms and expansion of different eye services are important and the reform of pathways and a reduction in waiting times must continue to be a priority for our health boards. Diolch.

This debate has really highlighted a number of stats and figures about the impact of not treating eye care across Wales, but I want to go on a slightly different tack this afternoon. I want to talk about a service that, actually, if we don’t get on top of this, will be under huge pressure, and that’s our guide dogs across Wales. We all know that if people who are suffering with sight loss don’t get timely treatment, or people lose their sight, they require a guide dog to go about their daily life, and I don’t think we talk about that enough in this Chamber. We’re talking a lot about statistics and the people who actually need the help, but, actually, if we don’t sort this out, there’s going to be a lot of pressure to get more guide dogs coming into the country. A recent survey reported that 2 million people living across the United Kingdom live with sight loss, and, with these figures, a lot of those people rely, as I said, on guide dogs to go about their daily lives safely. The role of these dogs extends far beyond what people think they do. They enhance people’s quality of life, they foster a sense of freedom for those individuals, and they enable them to engage with society, something I think we should all champion in this Chamber.

One of the most striking statistics is that guide dog owners are 80 per cent more likely to leave their homes for social activities compared to those without a guide dog. This increase in social interaction is critical. It not only combats loneliness, which also costs the Government money, but it also promotes mental health and well-being and that’s very, very important at a time in Wales when a lot of people are suffering with loneliness and isolation and issues with their mental health. We need to make sure that everybody across society, even if they have sight loss, has access to get out of their home and engage with society. Just imagine the difference that a loyal guide dog can make, allowing somebody to walk confidently into a cafe, attend a concert, or simply just enjoy a stroll around the park.

In Wales, Guide Dogs Cymru have been instrumental in providing these services. They currently support a huge number of guide dog partnerships across this country and this number is steadily growing, reflecting the increased demand for assistance among those with visual impairments. And what we’re saying in this debate is that we need to address these services to make sure it doesn’t put more pressure on Guide Dogs Cymru. Each year the charity trains approximately 20 new guide dogs, ensuring that more individuals can benefit from this invaluable service. Guide dogs are trained to navigate a variety of environments, from the busy city streets here in Cardiff to the public transport, when it turns up. And they also learn to avoid obstacles and help their owners make safe decisions. This training not only prepares them for the challenges of the outside world but instils confidence in their handlers, and it does state in statistics that 93 per cent of guide dog users report feeling safer while out and about with their dogs. It is essential that we continue to support the work of Guide Dogs Cymru and similar organisations. They rely heavily on donations and volunteers to carry out the vital mission that they carry out. Every contribution, no matter how small, helps to train a guide dog and support those who need them the most. So, I would encourage everybody today to support this motion that we have put forward, because, if we do not support this motion and the eye health of the population of Wales gets worse, charities like Guide Dogs Cymru will need an awful lot more support to help those vulnerable people right across Wales who need a dog to go about their daily lives.

It’s a pleasure to take part in this debate tonight, on a subject of great importance, which constituents raise with increasing regularity. Firstly, I’d like to make it clear that my constituents have received excellent ophthalmology treatment, and I have received no complaints regarding their clinical treatment, but the astronomical waiting times are having devastating consequences, and need to be addressed as a matter of urgency. Some of the personal testimonies I’ve heard from constituents waiting for ophthalmology treatments have been deeply distressing, and, in north Wales, Betsi Cadwaladr University Health Board has by far the worst waiting times in Wales for ophthalmology services, with close to 43,000 people assessed as health risk factor R1 waiting for an appointment. That means that over a quarter of all of those in Wales on the waiting list are within a health board that serves just 22 per cent of Wales’s population. As my colleague Darren Millar mentioned, Abergele’s Stanley eye unit—. And people from my constituency are generally referred to that hospital, which provides roughly 40,000 appointments every year, but the hospital is in urgent need of investment to increase capacity. I've met with constituents who have been referred to Abergele Hospital's eye clinic by their local optician and told they have to wait over two years for treatment. Ophthalmology patients in Denbighshire and Conwy are disproportionately elderly, and often have to undertake caring responsibilities for their partner. So, it's frankly unacceptable that, in a developed nation, an elderly woman and sole carer of her terminally-ill partner should have to endure over two years of misery living with cataracts before she receives treatment. It is, quite simply, an affront to human dignity, and it must be addressed as a priority by this Government.

Elderly ophthalmology patients are also regularly being referred to clinics outside of north Wales, which is not an acceptable or sustainable solution for the majority of patients who are elderly and find travelling challenging. There needs to be sufficient investment and thus capacity in their area.

Another aspect of eye health that adds to the importance of swift treatment is that many conditions that affect the eyes are degenerative and continue to worsen if untreated. I've spoken to many constituents living with macular degeneration who are slowly losing their vision while sitting on a waiting list. The RNIB have highlighted that over 80,000 in Wales are the highest risk of irreversible sight loss as they are waiting too long for appointments. I think we can all appreciate how terrifying the prospect of losing our vision would be, and I think we—well, the Welsh Government—need to have some empathy with individuals facing that reality.

The demand on ophthalmology services is also increasing, with a projected 40 per cent rise in demand over the next 20 years. Yet we have seen no plans put forward by the Welsh Government to prepare for this demand. The number of ophthalmology patients waiting beyond their target date has more than doubled in the past five years, and there is little sign that we are moving in the right direction. We are, as the former president of the Royal College of Ophthalmologists in Wales said, facing a 'tidal wave of blindness' across the whole country if provision is not improved and waiting times are not brought down. The Welsh Government must evaluate its priorities and recognise the urgency of the situation and implement a plan to rapidly bring down the waiting times and invest in services across Wales to increase capacity with demand. Thank you very much.

I call on the Cabinet Secretary for Health and Social Care, Jeremy Miles.

Thank you, Dirprwy Lywydd. I welcome the opportunity to respond to this debate and to explain how we're working with the health service to reduce waiting times and to enhance access to eye care in the community and in our hospitals. I also look forward to hearing Julie Morgan's short debate later this afternoon. It will be a further opportunity to discuss how public services support blind and partially sighted people to live full lives in a world that is designed for sighted people.

Under the health service the majority of people will be seen by primary care services. If they need eye care, an optometrist will see them. The health service provides eye care in a timely manner and of a high quality to people throughout Wales. Some will need further treatment in hospital. I want to emphasise from the outset that, although progress has been made to reduce long waiting times for eye care, there is still work to be done in order to deal with the backlog that built up during the pandemic. Between 2023 and 2024, the demand for specialist eye care services in hospitals has increased by around 13 per cent, and that is mainly as a result of the long-term impacts of the pandemic.

Although those services are operational again at the same level as they were before the pandemic, there is a backlog of people who have waited too long, and the increasing waiting list for eye services in hospital reflects the general health of the population. The number of people waiting longer than two years has, however, reduced by 44 per cent since the high-water mark in March 2022. But, for too many people who are referred to hospital, the waiting times are still too long. We must go further and quicker.

In 2019, as we heard during the debate, Wales was the first nation in the UK to introduce new targets for hospital-based eye care to prioritise those facing the greatest risk of sight loss.

We are the only UK nation to even have this target. It's a clinical measure, crucial for the many people who require timely follow-up care. It enables the NHS to identify both new and follow-up patients and prioritise those at greatest risk of sight loss. We've done this at a time when new referrals for treatment have increased considerably in the midst of the toughest financial climate since the start of devolution, while we continue to see regular waves of COVID infections.

Whilst we acknowledge that the latest all-Wales performance figures are not at all where we would want them to be, we are seeing improvements in health boards that have proactively introduced the new optometry pathways. We know, as many Members in the Chamber have said in the debate already, that the demand for eye care services is set to increase at a significant rate over the next 10 years, as our population continues to age. This will continue to challenge timely access to specialist eye care services if we continue to do the same thing. We have long recognised that eye care services need to be delivered differently; we no longer need to just manage these services in hospital.

On the question of resource, which Russell George asked me to address, as part of our work to reduce waiting times and increase access to specialist services, we have committed an additional £30 million every year to move more eye care out of hospitals into primary care optometry services in the community. This not only reduces the demand and increases the capacity in hospital services, but ensures that professionals are seeing the right patients at the right time, and, crucially, in the right place, with care being delivered much closer to home. Primary care optometry pathways in Wales, which use optometrists with additional postgraduate qualifications, are considered to be the most progressive in the UK. It enables optometrists to manage, monitor and treat more people in the community. We have a highly skilled eye care workforce in primary care, which has been, in fact, underused for many years. But they are equipped to meet the challenges of eye healthcare in our ageing population.

The additional optometry clinical pathways have started to have an effect on access for people with acute eye problems in the first instance, with more than 2,000 episodes per month now being seen by independent prescribing optometrists in the community. We absolutely recognise that the transformation reform work that has been undertaken in optometry to improve access has to be replicated in hospital eye care services. In September 2021, we commissioned an independent external review of eye care services in Wales. Since then, we have tasked the NHS executive to work with the ophthalmology clinical and the wider eye care community to determine how the report's recommendations can be turned into practical solutions. As part of this process, we've worked with the Getting It Right First Time team, which has developed individual health board plans to improve the efficiency and productivity of cataract and glaucoma pathways.

Dirprwy Lywydd, cutting waiting times and ensuring that people have timely access to care to save sight is crucially important to us. I'll be hosting a ministerial summit later this month to discuss the new clinical strategy for ophthalmology, which has been developed between the NHS executive and the national ophthalmology clinical implementation network. I want to build on the transformative work that we've developed in primary eye care services, and I'll be working with my colleagues in Government and across the NHS to achieve that.

I call on Altaf Hussain to reply to the debate.

Thank you very much, Deputy Presiding Officer. I'm delighted to be the last speaker and talk about what I heard from all of you speakers, who were great. You have so much clinical knowledge that I won't talk about any clinical input in this debate.

I want to thank my colleagues, especially Sam Rowlands, for tabling such an important, timely debate, and to everyone who took part in the deliberations this afternoon. Tackling the tidal wave of blindness is vital not only for the health of our citizens, but the health of our nation. Thank you, Mabon, for supporting our motion, and I'm thankful to Lesley Griffiths, who raised, really, the issue of retinopathy, which we need to consider. I'm thankful to James, who talked about permanent blindness—why you need to have the guide dogs—and it is a debate for itself, really. What we are talking about here is the blindness that can be restored, so that the patient goes back into the world where he can see the light through light.

So, if we set aside the human cost—indeed, the human tragedy—and look at this in a purely economic light, tackling ophthalmology waiting times and preventing irreversible sight loss will help to reduce the strain on public finances. Accepting the recommendations of the national clinical strategy for ophthalmology and committing to making the investment necessary to prevent the wholesale collapse of eye care services across Wales will help to prevent avoidable disabilities and the need for state support. But, we can't ignore the human cost, and while we have to appeal to the bean counters at the Welsh Treasury, we also have to show that Wales is a kind, compassionate nation that puts the needs of the citizen above all else.

As colleagues have pointed out, we are failing in that duty. The Welsh Government would have us believe that they are finally getting to grips with ophthalmology waiting times and simply ignore the fact that they have been running things for the last 25 years. When I was first elected to the National Assembly for the brief period between 2015 and 2016, I remember pointing out then that people were going blind on waiting lists, yet nothing changed. Nearly a decade later, waits have gone in totally the wrong direction, and if we don't tackle this issue now, things will only get darker. 

Reports out last week point out that half of the world's population will be short-sighted in the next quarter of a century. As Sam pointed out in opening this debate, the personal cost of these waits is horrendous, and he spoke of experience at first-hand of the challenges faced by those with sight loss and how we have a duty to ensure that we not only help them overcome these challenges, but ensure that we do everything in our power to end preventable sight loss.

Russell George, Chair of the health committee, stated that the committee has found that the biggest increase over the last six months in the number of patient pathways waiting over one year was in ophthalmology. It also held the highest number of patient pathways waiting. Russell said that ophthalmology needed a spotlight placed upon it, and I could not agree more.

Gareth Davies highlighted the fact that north Wales has by far the worst waiting times in Wales for ophthalmology services. He talked about the need to expand the services at Abergele Hospital's Stanley eye unit, which Darren also mentioned, which deals with around 40,000 scheduled appointments every year. We are supposed to have a national health service. Your treatment and waiting times should be the same whether you live in Porthcawl or anywhere in north Wales. We must act now to tackle preventable sight loss and stop forcing people to live in the dark when we have the ability to experience the light.

I was in Kashmir over the summer, and there we have mobile clinics visiting communities, as is prevalent in Australia and other far east countries, picking up those with preventable sight loss and providing treatment. If they can do that in the Himalayan foothills, why can't we do so here in Wales? Therefore, I urge you all to support our motion and to reject the Government's amendments. Diolch yn fawr.

The proposal is to agree the motion without amendment. Does any Member object? [Objection.] Yes, there is objection. I will defer voting under this item until voting time.

And that brings us to voting time. Unless three Members wish for the bell to be rung, I will proceed directly to voting time.

We will only be voting on item 7 today. First, I call for a vote on the motion without amendment, tabled in the name of Darren Millar. If the proposal is not agreed, we will vote on the amendment tabled to the motion. Open the vote. Close the vote. In favour 22, no abstentions, 23 against. Therefore, the motion is not agreed.

I call for a vote on amendment 1, tabled in the name of Jane Hutt. Open the vote. Close the vote. In favour 23, no abstentions, 22 against. Therefore, amendment 1 is agreed.

I now call for a vote on the motion as amended.

Open the vote. Close the vote. In favour 23, no abstentions, 22 against. Therefore, the motion as amended is agreed.

And that concludes our voting today. If Members are leaving the Chamber, please do so quietly, before we move on to the short debate.

We move on now to the debate, and I call on Julie Morgan.

Diolch, Dirprwy Lywydd. I'd first like to thank Guide Dogs Cymru and the Royal National Institute of Blind People for their expertise in this subject, and to welcome members of Guide Dogs Cymru and some of my constituents to the public gallery, who have come down here to be here for the debate. I would like to give one minute each, Dirprwy Lywydd, to Sioned Williams, Carolyn Thomas, Cefin Campbell and Mark Isherwood.

Every single person in Wales should get the chance to live the life they choose. There should be no barriers, no matter what your age, sex, gender, ethnicity, disability or sexuality. You should be free to live your life as you wish. But it has become increasingly apparent that blind and partially sighted people are facing barriers in living their lives, and this should absolutely not be the case. These barriers can include things that can be easily fixed or prevented if disability groups are consulted with when decisions are made—things that sighted people don't even think about.

I'd like to focus on a couple of different areas during this debate today. The first is how blind and partially sighted people navigate transport and our streets, and the second is access to employment. According to the RNIB, there are around 112,000 people living with sight loss in Wales, and this is expected to double by 2050. Four thousand two hundred people are registered as blind or partially sighted in Wales, but the world around us is not always the safest or the easiest place for blind and partially sighted people. Every day, sighted people take for granted that they can see what is happening around us, being able to see what bus is coming, being able to see a cyclist approaching, or being able to differentiate between the pavement and the road. Now, just take a minute and imagine that you are blind and you have to do all those things, and this is where charities such as Guide Dogs come in. They are the leading providers of training and support for blind and partially sighted people to gain the skills they need to move around independently. They're also passionate about removing barriers so blind and partially sighted people have the confidence and support to live the life they choose. And while doing research for this debate, it has become clear that moving around our streets safely and without fear is something that blind and partially sighted people have particular trouble with.

Now, pavement parking is one issue. Eighty-one per cent of people with sight loss said that reducing obstacles on pavements was important to improving their quality of life, and this is something that blind and partially sighted people battle with every day because local authorities do not have the powers they need to deal with the issues. Ninety-five per cent of people with sight loss have been forced to walk onto the roads because vehicles are parked on pavements. Four out of five blind or partially sighted people have reported that this is a weekly occurrence, and, of course, this is a problem for everybody, including people with young children and prams and people in wheelchairs. Many of us are able to see the dangers, like cars and cyclists coming towards us, but that is not the experience for everyone. I am pleased that the Welsh Government has been looking into banning pavement parking but I think it needs to be done as soon as possible.

It's great that, in Wales and Cardiff, we've seen a significant shift towards active travel, but there have been some consequences for blind and partially sighted people. However, I do want to put on the record that Guide Dogs are not against active travel in any way. They see it as very positive, a very positive move, and that it should be celebrated. However, they have raised concerns about the way some of the designs are being implemented, which is putting people with a vision impairment in danger. This should not be the case. Guide Dogs recently commissioned a piece of research with University College London on the challenges that some active travel infrastructure for blind and partially sighted people bring. The findings show the different designs of bus stops, including floating island bus stops and shared bus stop borders, are highly dangerous for people who are blind and partially sighted. The design means that bus users have to cross cycle lanes in order to get to the bus stop or to get onto the bus. The curved side pavements are often narrow, and there's always the risk of a bicyclist coming along the cycle lane. I've had several testimonials from constituents who find these styles of bus stops very dangerous, and I'd like just to read out one of those now.

‘I'm a regular user of buses to and from Cardiff city centre. Catching the bus in Cardiff is difficult as several different buses leave from the same bus stop, so I therefore must ask fellow passengers or passers-by which bus has pulled in. If nobody's around, I must walk across the cycle lane to ask the driver his destination. If the bus is the wrong number, I must walk back across the cycle lane to the pavement. On one occasion, I was halfway back to the pavement when a cyclist zoomed past me. Luckily Jason, my guide dog, stopped abruptly, but the close call left me very frightened and anxious and I was concerned not only about my safety but his. I felt shaken up and disorientated when I was getting myself back to the pavement.’

This is one of the many examples I've received and, sadly, the story is the same for most. In the past few weeks alone, Guide Dogs have heard of several incidents on Castle Street in Cardiff, and one guide dog owner was actually knocked over by a cyclist. The installation of continuous pavements on some high streets is also causing problems. Continuous pavements are where the road is brought to the level of the pavement to allow level crossing. However, tactile paving is not always installed on the pavement either side of the road, so there's no way for blind and partially sighted people to know they're crossing road. One constituent gave an example of Cowbridge Road in Canton, where this does occur, but I know that there are many of these pavements across the city. It is imperative that when our streets are being designed or changed, the experience of disabled people in using these features is considered, because there is usually a practical way of dealing with this, but because we don't consult enough, we don't get those words in early on. 

And, of course, it applies as well to segregated cycle pathways. The only segregation is often a white line down the middle of the path, and if you're blind or partially sighted you don't know you're also sharing your space with cyclists, and it's very common for people to find themselves on the wrong side. This can be very dangerous for both the pedestrians and the cyclists. I'm very passionate about active travel, and I'm so pleased that the Welsh Government has done so much about active travel, as are the disability charities. But the infrastructure must be done correctly, so that disabled people are not disadvantaged or put in danger when trying to navigate it.

And I think I've spoken here in the Chamber before about the challenges that guide dog owners face when getting taxis, and I specifically raised the experience of my constituent Ryan, and his guide dog Jamie, when, first of all, a taxi driver refused to pick them up and then later on that day, a taxi driver asked Ryan to pay more because he had Jamie with him. And guide dog owners are often refused access to shops and other premises because they have a guide dog with them, and this can be debilitating and humiliating. These practices are completely illegal and an offence under the Equality Act 2010.

I do believe that there is not enough awareness of and training under the Equality Act, and what it means in practice. Guide dogs are not pets or accessories; they are professionally trained mobility aids. They are classed in the same way as wheelchairs or any other aid, but 80 per cent of guide dog owners have been refused access to a business or service because of their guide dog, and I know we have people in the gallery today who have experienced that. 

A lack of knowledge of the Equality Act also seeps into blind and partially sighted people's ability to access employment. According to the RNIB, there were 20,000 people with sight loss in Wales within the working age bracket of 18 to 64, and shockingly, only one in four registered blind and partially sighted people of working age are in employment, and that's the same as it was in 1991, so it hasn't gone up at all. 

Job seeking can be particularly stressful for people who are blind or partially sighted, as the whole process is geared up for those who are sighted—from the way that jobs are advertised online, having to disclose an impairment or disability during the application process and not knowing how the employer will react, to dealing with interviews where there is no way to read body language or non-verbal cues. 

And then, when people get the job, employers often have limited knowledge or understanding of how a person with sight loss would do their job, or which adjustments are available. This includes employers who are signed up to the Disability Confidence scheme. Under the Equality Act, employers have a legal duty to make reasonable adjustments for the staff. However, research undertaken by RNIB has found that 23 per cent of employers said they were not willing to make adaptations to employ someone with a visual impairment, despite legal obligations to do so. This is why one third of the people who are not in work said the biggest barrier to them getting a job was the attitude of employers towards their disability.

This should not be happening. We want blind and partially sighted people to live fulfilling lives. We need greater awareness and education in every area of the Equality Act and how to implement it, and we need to ensure that there's a simpler process for people to take action if organisations do not comply with the law. We need to ensure that statutory guidance for every aspect of our street design is fully inclusive. And above all, we need to utilise the lived experience and knowledge of disabled people.

We need to do better. I think we have achieved a lot. Disabled people themselves are able to ensure that we know what they need, and I think it's up to us now to make sure that we do incorporate that in all our thinking. And I know that we are capable of doing that in Wales. Diolch.

Can I ask all four speakers to keep to their time please, because we have got just literally that time left? Carolyn Thomas. 

I would like to thank Julie Morgan for tabling this important short debate. I am a frequent rail user and often see Transport for Wales companions wearing a blue tabard helping passengers with disabilities use the rail service. I would like to mention how valued it is having staff on platforms to help passengers on and off the trains, and with information. They also radio ahead to the arrival station.

It was raised with me at an event in the Senedd by the Guide Dogs for the Blind Association that there are issues with gaps between the train and platform. I know that the new trains being introduced by Transport for Wales are level boarding, so that will be completely seamless, getting on and off. However, in places where they have older stock, there can sometimes be significant gaps still, and I've had reports of guide dogs falling down those gaps. It's also important to make sure that platforms have adequate tactile servicing, so that blind and partially sighted people know when they are approaching danger, such as the platform edge and stairs, but also where the train is expected to stop and the doors open. These are simple things that can be done to make the world of difference. Thank you.

Thank you, Julie, for bringing forward this important debate, and thank you for the opportunity to contribute.

While marvelling at the Paralympic Games this summer, I was reminded of my latest foray into the sporting arena—a hotly contested game between my office and Llanelli's visually impaired bowls club, down at the Selwyn Samuel Centre in Llanelli. Now, to paraphrase that famous line of sporting commentary, 'Our boys took one hell of a beating' and left me reeling from a masterful performance from the home team.

Now, defeat aside, it was a brilliant morning, with 15 or so club members present of all ages and all types of visual impairment. It really did strike me how crucial sports can be in bringing people together, offering not only a sporting activity, but crucially, that opportunity to socialise, share experiences and forge friendships, and to prove that any disability or visual impairment doesn't have to be a barrier to getting involved in sport.

So, we are looking for a rematch—revenge, hopefully—but can I just thank the bowls club for the wonderful welcome we had? And it just shows how marvellous a job they are doing, and let's hope Welsh Government and third sector bodies can support this kind of activity, moving forward. Diolch.

It's now 21 years since I first attended a Guide Dogs Cymru event here, highlighting the need to make shared streets and outdoor public places more accessible for people living with a vision impairment. More recently, their campaign for safer streets has also emphasised that although active travel measures should never put pedestrians at risk, many cycle routes have been installed on footways without any clear delineation between the cycle and pedestrian footways, and it called on the Welsh Government to introduce much more robust checks before funding is allocated to new active travel routes.

Working with Wales Council of the Blind, Vision Support and RNIB Cymru, they've also given evidence to the cross-party group on disability, highlighting the paucity of habilitation training and support for vision-impaired children and young people. Only early involvement of blind and partially sighted people in the design and delivery of services will enable them to live the life they choose.

Thank you, Julie Morgan, for bringing forward this important debate in the Senedd.

I'd like to draw attention particularly to the situation of young people who are blind or partially sighted, because we in Wales have prided ourselves, haven't we, on leading the way when it comes to children's rights, and the Welsh Government is bound, of course, to give due regard to the United Nations Convention on the Rights of the Child. Article 23 says that

'a child with a disability has the right to live a full and decent life with dignity and, as far as possible, independence and to play an active part in the community.' 

But we know, and as you've outlined, really, many young people with sight impairments are not being supported to live as autonomously and independently and freely as they're entitled to, as they have the right to do.

Article 26 of the UN Convention on the Rights of Persons with Disabilities also enshrines this right, and it was a programme of government commitment to incorporate the UNCRPD into Welsh law. So, can I ask the Cabinet Secretary to let us know where we are with that important work? As chair of the cross-party group on human rights and a member of the Equality and Social Justice Committee, I've heard concerning evidence that Welsh Government is not resourcing or prioritising that work sufficiently. Diolch.

I call on the Cabinet Secretary for Health and Social Care to reply to the debate. Jeremy Miles.

Thank you, Dirprwy Lywydd, and thank you to Julie Morgan for bringing forward this debate today. It's an important issue, as we've heard, that touches the lives of so many people across Wales. It's also very timely, following the earlier debate on improving health services, so that people don't lose their sight because of treatable conditions.

Losing eyesight can have a deep effect on the well-being of a person. The 'Time to Focus' report, which was launched by the charity, Fight for Sight, vividly illustrates the personal impact and the wider costs of sight loss. It reveals that seven out of 10 people feel like some area of their life is limited by their eye condition, and almost a quarter think their sight loss has a negative impact on their personal relationships; one in five said it limits their ability to develop those relationships. This shows us that there are far-reaching consequences from both a quality-of-life perspective and also a financial perspective, particularly for people of working age with sight loss.

The RNIB estimates nearly one in five people will experience permanent sight loss in their lifetime, with one in three experiencing some sight loss in their lifetime. In Wales, an estimated 3.5 per cent of the population are living with sight loss that impacts their daily lives. I want to assure Members that we are committed to making Wales a more inclusive country for people with sight loss. Central to this is developing accessible, responsive and citizen-centred services that meet the needs of blind and partially sighted people in Wales. It's essential that barriers are removed in all aspects of life to enable blind and partially sighted people to fully participate, in the way that Julie Morgan was setting out in her contribution.

Our commitment is embodied in the low-vision service, where more than 8,000 assessments are performed every year by optometrists and dispensing opticians on our high streets. Wales is the only UK nation to provide this service in primary care, close to people's homes, and often within people's homes, which supports people who are sight impaired or severely sight impaired. The service provides low-vision aids to people who need them, signposts to other services, and provides information about daily living and eye conditions, aimed at maintaining a person's independence.

I am, however, aware of the concerns expressed by RNIB regarding the number of visual rehabilitation specialists who support visually impaired adults. It is vitally important that blind and partially sighted people can access rehabilitation services. We've been working with the Wales Council of the Blind to explore solutions to this. As we've heard already, active travel is a key enabler to ensure blind and partially sighted people can live the life they choose. The Cabinet Secretary for Transport and North Wales recently met with RNIB to discuss how we can make streets and public transport safe and accessible for blind and partially sighted people in Wales.

Under the Equality Act, as Julie Morgan pointed out, public authorities have a duty to make reasonable adjustments to the built environment, to ensure the design of new infrastructure is accessible to all. In our guidance, we ask local authorities to ensure that under-represented groups are involved throughout the design process for active travel infrastructure. The active travel board is re-establishing the inclusive active travel group on which the RNIB is fully involved.

Practical matters, such as pavement parking, can, as we've heard, act as a significant, and, of course, a physical barrier to people who are blind and partially sighted. Most journeys start with walking or wheeling, even if that's just the journey from your front door to the car. Pavements and footpaths are an essential infrastructure for people making journeys to local amenities, public transport and more, and it's important that people are considerate when parking their cars. Obstructing pavements and paths so that pedestrians have no option but to enter the carriageway to continue their journey is clearly dangerous, and a particular issue for the most vulnerable in our communities, and we are engaged and working with local authorities to explore how we can support them to tackle this problem.

Bus services are also important for enabling blind and partially sighted people to live their lives freely and independently. The Department for Transport is introducing new accessible information regulations for bus operators that will apply across Great Britain. We fully support these changes, which will provide consistent audible and visible information for bus passengers, and we will work with stakeholders to ensure that these are complied with in Wales. We are looking at a range of options to make bus travel across Wales easier and more accessible by simplifying fares and the ticketing system, including combined bus and rail tickets. Our White Paper 'One Network, One Timetable, One Ticket' sets out our vision for transforming bus services in Wales. We are looking at a range of reforms, including the franchising of bus services, which will allow local authorities to create new municipal bus companies. Our mandatory concessionary bus pass scheme for people aged 60 and over and disabled people already enables free travel on local bus services and some rail services.

Rail services themselves are a lifeline for blind or partially sighted people and we’ve made an £800 million investment in new trains, which will have facilities to support everyone in accessing the railway. We agree that stations should be accessible, with all platforms fitted with tactile paving, and we are transforming station facilities on the core Valleys lines, including installing tactile paving, improved audio passenger information systems and, crucially, step-free access.

The rail network in Wales beyond the core Valleys lines is the responsibility of the UK Government and we will work constructively with it to improve station facilities. Transport for Wales offers passengers an assisted travel service to support them throughout their journey, from helping with luggage, reserving a space for assistance dogs, guidance around stations and support in making connecting services.

As I mentioned earlier this afternoon, the Welsh Government has reformed primary care ophthalmic services to improve access to eye health services. As part of the reform, health boards must conduct an eye health needs assessment every three years to ascertain the needs of the public when delivering eye services in both primary and secondary care. Central to this exercise are the needs of blind and partially sighted people. Taken together, the needs assessment, combined with delivery on a cluster footprint, will ensure that local population needs, and in particular the needs of blind and partially sighted people, will be fully considered and delivered against.

In closing, Dirprwy Lywydd, I would like to emphasise how much I welcome this debate. From a Welsh Government perspective, we remain unequivocally committed in our efforts centred on ensuring that blind and partially sighted people can live the life they choose.

Thank you all. That brings today's proceedings to a close.