Cynulliad Cenedlaethol Cymru

I call the National Assembly to order.

The first item this afternoon is questions to the First Minister, and the first question is from Jenny Rathbone.

We tackle air pollution in a number of ways. These include local air quality management, industry regulation, the planning regime and the promotion of active travel.

Thank you, First Minister. We know that air pollution kills more people than are killed in road traffic accidents, and even the UK Government admits it’s the largest environmental threat to public health in the UK. A cross-party group in the House of Commons called it a public health emergency. These air quality management areas include an area of Newport Road, where I’ve got no less than three primary schools running along it, and they are breathing in toxic levels of air at the moment. The latest plan by the Tories that was published earlier this month is no more than an options paper. There is nothing in it that even approaches a strategy. One of the options is to have clean air zones where polluting vehicles have to pay to enter them. Obviously, this would be the thing that would make the biggest impact on cutting pollution, but the Tories have passed the buck to local authorities, with shackles on. They’re not allowed to do anything along these lines until, for example, all buses have been converted from diesel to cleaner energy. I just wondered—

You do need to come to a question.

[Continues.]—what the Welsh Government interprets from this plan and what it sees as its responsibility in ensuring that communities like mine are relieved of this appalling thing.

Well, it’s important to note that some of the levers for improving air quality, such as fiscal measures relating to diesel vehicles, are non-devolved. The level of commitment to take action at a UK Government level is currently unclear, but, as evidence of our commitment to do all that we can to improve air quality at a Welsh national level, we’ve said in the UK plan that, within 12 months, we will consult on the detail of a proposal for a clean air zone framework for Wales.

Well, I commend that study, because, if you look at Germany, clean air zones have been hugely successful in their cities, reducing soot emissions from exhausts by more than 50 per cent in Berlin, for instance. But these policies require behaviour change, encouraging cycling and the like, access to city areas and free parking for cleaner vehicles, and better use of existing infrastructure, i.e. redesignating some of our routes for pedestrians and for cyclists. And, really, I do think we should have the ambition to declare Cardiff a clean air zone, so I encourage you to do that as soon as possible.

Well, of course, we are encouraging local authorities to create more cycle routes. The Active Travel (Wales) Act 2013 is evidence of that, and, of course, the proposal for a metro, which will lead to better and quicker journeys on public transport, taking people out of their cars, whilst the metro itself will of course reduce emissions from the current all-diesel rolling stock. I can say that, where future evidence demonstrates clearly that clean air zones would bring about compliance before other measures, and in the shortest possible time, we will set out how to ensure the effective implementation of such zones.

Will you therefore confirm that it’s the Welsh Government’s intention that these air quality management zones do reduce air pollution, particularly in terms of the very small particulates—the PM10s—that can go deep into the lungs and are particularly dangerous to children and young people who walk or cycle to school? And, therefore, will there be specific targets within your plans for these air quality zones?

Well, this is something that is being considered at the moment as regards air quality management zones, and it’s part of the consultation that will take place, as has been set out in the British scheme.

Professional sport brings a number of important benefits to Wales, particularly to Swansea. Of course, I know the Member will, no doubt, ask about Swansea City AFC and their successful campaign this year to stay in the Premier League. But, of course, we know that professional sport is a catalyst not just to increase participation rates in sport, but it can also give people in cities and nations a feel-good factor, and, of course, the Euros of last year were an example of how that can happen in Wales.

Can I thank the First Minister for that response? Can I highlight the importance of professional sport in promoting the identity of an area and generating wealth within the economy? I want to stress the importance of Swansea City staying in the premiership, for the economy of Swansea bay city region, for tourism in the Swansea bay city region, and for name recognition of Swansea. Will the First Minister join me in congratulating Swansea on staying in the premiership, which benefits the whole of Wales?

Yes, I will. It’s hugely important that we have a team that not just gets into the Premier League, but stays there. Also important to note, of course, the successful campaign by Newport County to stay in League 2. We all saw the scenes when the final goal was scored, a minute before the end of normal time. I can see the Member for Newport East—I’m sure the Member for Newport West as well—beaming, when I mentioned that. But, it is true to say that professional sport is a hugely important economic catalyst. We know, for example, that Swansea’s presence in the Premier League has been hugely important in creating tourism for the area, in terms of improving hotel rate occupancy and, of course, in improving spend by visitors to the city, and beyond.

First Minister, grass-roots training in football is so often crucial to future development of young players to a more professional level. Currently, however, three of our four Welsh police forces are now investigating allegations of historic child sexual abuse at this level, with the Football Association chairman, Greg Clarke, calling this the biggest crisis in football. First Minister, in north Wales, there are several accusations of an historical nature that it is felt must be investigated. Steve Walters of the Offside Trust, and, indeed, one of my own constituents, PC Mike Smith, both of whom have suffered, are leading calls for the Football Association of Wales to launch a full inquiry into this matter. Will you work with your Cabinet Secretary to support those calls and, in doing so, provide an environment where children seeking to fulfil their ambitions in the sport, to a more professional level, are able to do so safely?

We know that a safe environment is crucial for children and young people if they want to enjoy sport. We know that standards at one time were far laxer than they are now. These are matters primarily for the FAW and for the police. But it is hugely important that as much assurance as possible can be given, that any allegations in the past or, indeed, the present, are investigated fully, so as we can ensure that our children and young people continue to have a safer environment now and in the future.

I was delighted that the Assembly unanimously last week supported a Plaid Cymru amendment to the Public Health (Wales) Bill, which will mean that there will be a Government strategy to tackle obesity on the face of that Bill. And I’m grateful to Members of all parties and to the Government for supporting that. Does the First Minister agree that our clubs and professional sporting organisations, as well as grass-roots sports, will need to have an input to the creation of that strategy, in order to ensure that we have a strategy that can truly tackle the greatest problem, perhaps, facing us in terms of public health?

Well, yes, that’s right, because, although sports in the community are vital to ensure that people are active within the community, professional teams can set an example, especially to young people. They see their heroes coming to talk to them and telling them how important healthy living is. So, there is a vital role for professional clubs as regards ensuring that we do address obesity.

Swansea City and Newport County FC are both important focuses in their communities. And community morale will rise in those places as a result of those teams’ success. The problem we have sometimes with professional football clubs is that they tend now to be foreign owned. Two of the three football league clubs—[Interruption.] Well, no, it’s not going to be an EU thing. Sometimes, they do become distant from their fan base, whereas, at the same time, they are also important assets in the community. So, I wondered is there any way in which the Welsh Government can help to preserve them in their role as assets in the community.

Well, Swansea City, of course, did that successfully. Cardiff City, which was mentioned, we want to see back in the Premier League next year. Before long, I’ll have to go round Wales and mention several clubs, and wish them all success. Wrexham—yes, and all other football clubs in Wales and, indeed, any sporting clubs, playing at any level, the best of luck for next year.

But he is right that it is hugely important that fans are given the opportunity to own their clubs. Bayern Munich, if I remember rightly, is fan owned. It’s a model that is used quite regularly in Germany. And I do worry that, where there is a lack of commitment by some owners—I don’t mention Cardiff City; the ownership there has been settled for some time—but, in some clubs, the question has to be asked, are the owners properly committed to the clubs in the way that fans could be? We saw in Swansea City the resurrection of that club because of the dedication and the money of supporters who were willing to put the money in, and, as a result, of course, that club is very strongly embedded in their community.

Questions now from the party leaders. The leader of the opposition, Andrew R.T. Davies.

Thank you, Presiding Officer. Could I just welcome back the Cabinet Secretary for rural affairs, who makes a welcome return to the Chamber? I wish you well, hopefully, in getting over the recent fall that you had, Cabinet Secretary.

First Minister, you said at the end of April that Jeremy Corbyn needed to prove himself if he were to become the Prime Minister at the end of this general election. The relationship between the First Minister of Wales or Scotland or Northern Ireland and the Prime Minister is a very important relationship, and, indeed, inter-governmental relationship as well. Last week, at the campaign launch, you failed to mention his name. Last week, when the manifesto was leaked to the press, you put a press release out to say—[Interruption.] You put a press release out to say it was not your manifesto. Then, within a couple of hours’ time, it was redacted and changed. Do you believe that Jeremy Corbyn will be the Prime Minister on 9 June?

That is what I want to see. I’ve dealt with Theresa May; I see no evidence at all of strong leadership from her. She can’t answer a straight question. Leadership is about doing leaders’ debates. There are several of us who know that in this Chamber. Leadership is about going out and talking to people, rather than going to stage-managed events and stage-managed questions. That’s what true leadership is about, and there are several of us in this Chamber who have had experience of that and know that that is what leadership is about. I want to make sure that we have somebody who is willing to engage with the public, not somebody who shuts herself off from the public.

Giving a straight answer, First Minister, is most probably not your strongest card to stand on, to be fair, as anyone who’s asked you a question in this Chamber could attest to. But, in the manifesto that the Labour Party brought forward today, it talks of abolishing tuition fees, but yet your education Cabinet Secretary said last week that, actually, it’s not tuition fees that are the problem, but it is living costs. She also said, through a press spokesman, that Jeremy Corbyn would not be the Prime Minister. How on earth can you have any joined-up thinking in your Government when you have such a dislocate between the message that’s in the manifesto and the spending commitments that you’re signing up to day in, day out? Isn’t it the case that if people vote for Jeremy Corbyn on 8 June, you will have a coalition of chaos as opposed to the strong and stable leadership of Theresa May?

Well, I wonder if the leader of the Welsh Conservatives believes Theresa May to be a strong leader, given the rumours we’ve heard about his deselection, and that of the rest of his group [Laughter.] When asked on the radio whether she was supportive of him and his position, she said Andrew R.T. Davies is the leader of the Welsh Conservatives. Well, stunningly true as a fact, but hardly a great vote of confidence in him. We are proud of the manifesto that we are standing on. It offers great hope for our people. One thing we do know is that the Diamond review has put students in Wales ahead of those in England, and what we do know, of course, is that if the Tories win the general election, students will be hammered even harder. They will be forced to pay even more. So, one thing we do know is that students will never be in a position where they are better off under the Conservatives.

As per usual, you cut off the quote, and she went on to say what a good job I’m doing [Laughter.] But, if you look at what the offer is on 8 June, it is an offer from the Welsh Conservatives today to abolish Severn bridge tolls and actually deliver a shot in the arm of £100 million to the Welsh economy. A £100 million against the fiscal illiteracy that we see coming out of Labour that I noticed the First Minister has not signed up to or committed to today, yet he sat in the meeting of the national executive last week and put his hand up to spend billions of pounds that this country has not got. It is a fact that if you want to get rid of Severn bridge tolls and put £100 million into the Welsh economy, you need to vote for the Welsh Conservatives, under the strong and stable leadership of Theresa May, unlike the coalition of chaos that Jeremy Corbyn will lead.

I am generous to the leader of the Welsh Conservatives. I want him to stay as their leader—I want him to stay as their leader; Theresa May doesn’t. So I’ll offer him that. He’s right, I want him to stay, but Theresa May doesn’t, and that’s chaos for you. He stands there with the chutzpah—I think the word is—to claim that abolishing the Severn bridge tolls were his idea and his party’s idea. For how many years have we stood in this Chamber demanding the end of the Severn bridge tolls? For years, we were told by his party it was too expensive. We saw estimates of between £20 million and £120 million a year of how much it would cost, and now it’s £7 million. I welcome their conversion—I welcome their conversion—but, at the end of the day, let’s face it, the Conservatives would not have abolished the Severn bridge tolls if it wasn’t for the strong action and strong position taken by this Welsh Government.

Leader of the UKIP group, Neil Hamilton.

Diolch yn fawr, Llywydd. Sir Keir Starmer, the shadow Brexit Secretary, was in Wales a few days ago and I see from a Welsh Labour press release that he said that Conservative Brexit negotiations pose a danger to the hugely successful campaign to recruit more doctors in Wales. Can the First Secretary tell us how many extra doctors from the EU this campaign has managed to recruit?

We do know that 5.8 per cent of our medical staff are from the EU. We know that there is interest from the UK and abroad. The reality is that every single health system anywhere in the world competes in a world market. It is folly to think that, somehow, the UK can train and recruit all its own doctors within the UK. And so nobody said to me on the doorstep, nor to him, ‘What we need, you see, are fewer doctors and nurses from abroad.’ Nobody said that. So, it’s vitally important that we’re still seen as a welcoming place to get the best and the brightest to work in our health service.

I agree with that. The actual figure is seven extra doctors have been recruited this year, compared with the same figure last year—not all of whom, or indeed perhaps none of whom, will have come from the EU. Therefore, this seems to be rather irrelevant to the whole question of the Brexit negotiations. But what Sir Keir Starmer seemed to be trying to do was to instil some sort of fear in the minds of those who might be susceptible to his words, that after Brexit we are going to turn away potential doctors and nurses from the United Kingdom. I’m sure the First Minister knows, in his heart of hearts, that this is a preposterous idea and that Australia, for example, has a very strict immigration system based upon points, which are awarded in order to fill various skills gaps in their economy, and the United Kingdom will be just the same. So, why doesn’t the First Minister get on board with the Brexit negotiations and try and make a success, instead of trying to be an obstacle to progress all the time?

Can he not see that, handled badly, doctors and nurses will get the impression that the UK does not want them? It’s already there. It’s already there because the issue of mutual recognition of residency rights has not yet been dealt with. Nobody—nobody—wants to see people not be able to stay in the UK, or UK citizens unable to stay in the rest of the EU. Nobody wants that, but there is no agreement on it yet, and it’s hugely important that that is done as quickly as possible, to my mind, in advance of the substantive negotiations over Brexit. But it is hugely important that we’re able to recruit from abroad. My great fear is that we end up with a cap on immigration every year, that there is a cap in each sector, that the city gets the lion’s share in order to protect banking and finance, and we end up, because of that cap, unable to recruit doctors and nurses into Wales. That, I think, would be a foolish way of dealing with the issue.

It is inconceivable that any cap that is introduced is going to work in such a way as to prevent the NHS filling skills gaps, particularly of professional people. But—[Interruption.] But the First Minister will also know that, two years ago, the Bank of England did an in-depth study of the impact of migration upon wage levels at the lower end of the income scale—people like cleaners and care workers and waiting staff in the health service—and it concluded that unlimited immigration from the EU and other parts of the world of unskilled and semi-skilled workers reduces wages by a factor of 2 per cent in relation to a 10 per cent rise in the proportion of immigrants in those sectors. So, what’s happening here is actually that wage levels are being compressed for the people who can least afford it, whilst there is actually no danger, as a result of the Brexit negotiations, to the numbers of doctors and nurses being recruited from outside the UK.

Well, no—if there is to be a cap, a cap is a cap. You can’t say, ‘Well, the cap doesn’t exist for certain professions.’ And that is something that we need, to my mind, to avoid. We have 80,000 EU citizens in Wales, out of 3 million people, so it’s a tiny proportion of the population. I take his point that there were many who felt that wages have been depressed as a result. Part of that lies in the fact there’s been a complete failure to prosecute for minimum wage legislation—no prosecutions at all, as far as I’m aware. I have to remind him that, in his former party, they were against the minimum wage, and, as a result of that, that would have driven wages down even further than now. There is exploitation. I’ve heard stories of exploitation of EU citizens who come to Wales. That needs to be cracked down on and it needs to be prosecuted, in the same way that those who try to employ people below the minimum wage, those people who try to get around employment legislation, should be prosecuted according to the law, and the law should be strengthened to ensure that nobody is exploited in the future. That’s exactly what a Labour Government would do in Westminster.

Leader of Plaid Cymru, Leanne Wood.

Diolch, Llywydd. Last week, the successful Time to Change campaign launched a pilot scheme in nine schools to tackle mental health discrimination and stigma. If this scheme is successful, we should see more young people coming forward to seek help for problems that they might have. So, can you tell us what additional funds you’ve made available for school counsellors and for training for teachers to deal with this extra demand?

Well, every school, of course, has a school counsellor, and she will know we’ve ring-fenced funding for health and put, I think, £8.6 million a year extra into child and adolescent mental health services. And we’ve seen a massive reduction in the waiting times with regard to having an appointment within 28 days.

We’ve not seen a massive reduction in waiting times, First Minister. You can fairly say that waiting times are no worse than they were before, but you can’t say that they are improved. It’s not clear at all what those improved outcomes are from this extra spending, but what we do know is that the number of children requiring counselling is going up, and that’s a good thing, because, hopefully, that means that problems can be prevented before they become severe and require specialist help. However, we know that many schools don’t have enough counsellors or teachers with training to help those pupils who may need it. Also, we’ve seen a reduction in local authority youth workers—a staggering 40 per cent in that workforce as a decrease. This is clearly going to have an impact on whether the children experiencing the low-level mental health problems are going to be able to get the support that they need, particularly as your Government has raised the threshold for accessing specialist CAMHS. I spoke recently to someone who works with care leavers, who told me that they’re only able to refer young people who are at risk of suicide. They have no capacity in the system to work on mental health prevention. Is that situation acceptable to you, First Minister? When is there going to be an early intervention service, that’s so badly needed?

Well, as I said to her before, there is a counsellor in each secondary school in Wales. Health boards have committed to meet the 28-day target by the end of March. They’ve made great strides to reduce the numbers waiting over the last 12 to 18 months. One example: in Betsi Cadwaladr, we’ve seen the percentage of CAMHS referrals seen within 28 days go from 21 per cent in April last year to 84.5 per cent in February this year. That’s an enormous improvement in the time required to get a first appointment. So, the money that we’ve put in—the extra money we’ve put in—to CAMHS, together with the counselling that’s available in schools, is bearing fruit.

You’re giving the wrong impression, First Minister, because it’s true to say that the waiting lists are no worse than before, and, overall, you cannot say—. You cannot claim, overall, throughout Wales, that they are better. Now, children and young people with mental health difficulties go an average of 10 years—10 years—before they receive specialist help. These are the people who are likely to be the most ill, and also who cost our services the most money. It didn’t have to happen this way, that we have the kind of teenage mental health early intervention scheme—that we don’t have—that we badly need. We know, don’t we, that self-harm is the second biggest killer of teenage girls globally. Are we going to have to wait for 16-year-olds to have the vote before the mental health of our children and young people gets the proper priority that it deserves?

Well, some of us do have children, and I have a 16-year-old daughter, so I know the pressures that exist on young people, particularly through social media. That’s something that didn’t exist when I was 16, and so any bullying stayed at the school gates and didn’t tend to move beyond that. I know some of the things that are said online, and I know that, when youngsters are at their most vulnerable in terms of their confidence, they can be very deeply affected by that. But she gives the—. She didn’t listen to the figures that I gave to her. I talked about Betsi and I said, ‘Look, the percentage of CAMHS—

I’m talking about the nation.

Well, she can shout as much as she wants. She’s had three questions already, right. Again, Betsi is an example of what’s happened around Wales. In Betsi, the level of CAMHS referrals seen within 28 days has gone from 21 per cent to 84.5 per cent in February. She can’t deny that, or she’s saying that the figures are wrong. They needed to improve. We knew more money had to be put in, because of the demands on the service. That’s exactly what we did, and we are delivering for our young people.

Yes. We’re delivering on this top-six ‘Taking Wales Forward’ commitment. A phased implementation is under way, and the first increase to £30,000 was introduced in April. We have provided local authorities with £4.5 million in 2017-18 to deliver that increase.

I thank the First Minister for that response and I do commend the Welsh Government on taking very early steps to deliver on this pledge to raise the capital limit to more than double over the life of this Assembly term, to £50,000. We know very often that the only asset many of our constituents have is that home, so more than doubling it has a disproportionately great benefit on what they can pass on to their relatives at some point.

So, along with this, there is also to be a full disregard of the war disablement pension being introduced in Wales, which means that Welsh veterans no longer have to use any part of this to pay for the care they need. This is part of us honouring our covenant with those who put their lives on the line for their country. So, could I ask the First Minister if he has any idea, now, what sort of numbers we could be talking about in those who may benefit from this excellent policy?

Well, the initial increase to £30,000 will benefit around 250 people. The increase to £50,000 will benefit up to 1,000. This is out of a total of 4,000 care home residents who pay the full cost of their residential care, so a substantial percentage.

First Minister, we support the improvement in this policy, of course, particularly the part relating to the veterans’ disregard, but is this savings cap really the best that you can do for people who’ve tried very, very hard, very often at personal cost of personal sacrifices in spending, in order that they save more? Now, Jeremy Corbyn has recently said that he is not wealthy, despite earning more than £138,000 each year, and house prices in Wales are averaging £175,000 a year. So, don’t you agree that the £100,000 pledge, the cap pledged by Welsh Conservatives, probably reflects more realistically the hard work that people have put in to earning this money during the course of their lives?

Well, the pledge that the Welsh Conservatives had was not costed properly and there is a cost to how much such a policy would cost. We know that 25 per cent, roughly, of care home residents in Wales will benefit from this policy, and it’s another example of a Welsh Government keeping its promises, as we have done for the past six years.

Yes. We intend to publish our strategic approach to building prosperity for all before the summer recess.

Well, thank you for that, First Minister. I know that the Welsh Government understands the importance of manufacturing and engineering industries, their strengths within the Welsh economy. Unfortunately, the UK Government seems not to recognise the same thing, by placing steel towards the bottom of their priorities. I look forward to the Welsh Government strategy making sure that steel is at the top end. But we need to attract more manufacturing, such as Aston Martin and TVR, which the Welsh Government has actually achieved to deliver, and we need to provide more premises of a larger footprint—25,000 sq ft plus—to ensure that those factories are there for them to come into. What’s the Government doing to actually ensure there are a sufficient number of buildings that offer that large footprint to attract both inward investment in manufacturing, but also to allow current industries to expand?

Well, we do work with manufacturers and others to look at buildings as they become available. With Aston Martin, of course, it happened that the superhangar was there and that was very useful in terms of being able to attract them, and we work closely with all businesses to assess their needs in terms of future expansion. Where they seek to do that, we’ve usually been able to work with them in order to source buildings where they can expand.

First Minister, Jeremy Corbyn has set out plans for sweeping Government intervention in our industry, including taking parts of Britain’s energy industry back into public ownership alongside the railways and Royal Mail. That’s the biggest state intervention in our economy for decades. Can I ask whether you endorse Jeremy Corbyn’s approach, which I certainly believe would take Wales back to the 1970s, and do you agree with your party leader when he says that private transport operators cannot be trusted with having passengers’ best interests at heart?

Well, the energy companies—anybody who says the energy market is somehow good for consumers must be living in a different universe to the rest of us. Time and time again, Governments have recognised that the current system does not work. He talks about the 1970s—energy was cheaper in the 1970s, proportionately, and also we had major investments, such as Dinorwig, when, with the tidal lagoon, his party are prevaricating over the tidal lagoon. It would’ve been built if this had been the 1970s. He talks about the railways. The last major investment in intercity happened in 1977, with the introduction of the 125 under a Labour Government—under a Labour Government. Since then, we’ve had no major investment in the main line. We’re still waiting for electrification—where’s that gone—to Cardiff. We’re still waiting for it. We’re still waiting for electrification to Swansea. Where’s that gone? Two promises that were made by the party opposite not delivered on. We’re still waiting to see commitment to north Wales rail electrification—no sign of that yet from the Conservatives. Nobody could possibly argue that the railways, as they are presently constituted, are delivering value for money; they cost more for the taxpayer now than they did when they were nationalised, because of the way in which it was done. No, there needs to be more reality as far as the Conservatives are concerned, but above all else, they need to deliver on their promises for energy and rail, and, in that sense, they’ve been an abject failure.

Well, we certainly need new ideas when it comes to our economic strategy, because the old ideas haven’t worked, have they? I mean, we’re poorer now, relative to the rest of the UK, than when Labour first took office in 1997 at Westminster and here in the Assembly in 1999. So, can the First Minister explain what new ideas Labour has to transform our economy? And, given the fact that you’ve been in power in Wales for almost 20 years, and for a good proportion of the time in Westminster as well, what’s kept you? Where have those transformational ideas been up until now?

Where was his party when, for four years, his party actually was in charge of economic development in Wales? He conveniently forgets that, of course. [Interruption.] They don’t like hearing that, because it’s something that they’d rather forget about, but it’s conveniently forgotten about. Well, he asked new ideas. The Valleys taskforce is moving forward with new ideas for the Valleys. We’re looking at how we develop ourselves in terms of international presence, again, because we know that we have to look outside, to new countries, for investment. The air link to Qatar is a hugely important part of developing our window onto the world. We’ve seen unemployment come down to a level lower than England, Scotland and Northern Ireland, and major investment such as Aston Martin, such as General Dynamics and such as Tenneco coming to Wales.

The next challenge, of course, is to improve GVA. He is correct about that, but, certainly, as far as job creation is concerned, as far as reaching out to the world is concerned, as far as getting investment—having had the best foreign investment figures for 30 years last year—this Welsh Government is delivering.

At the heart of our approach to capital investment is a focus on maximising the resources we have available and targeting these on the areas where they can have the biggest impact in boosting the economy, supporting our communities and connecting all parts of Wales.

First Minister, it was welcome news that the finance Secretary stated a £1 billion mutual investment model will be used to fund infrastructure projects in Wales. This includes social infrastructure, like Velindre cancer care centre, and also the twenty-first century schools programme, but also the final phase of the A465 dualling, which is so vital for my own constituency. How does the Welsh Government plan to use similarly innovative approaches to invest in infrastructure and benefit the people of Wales in the future?

Well, we are continuing to face unprecedented challenges to public finances, so it is vitally important that we unlock all opportunities to boost infrastructure investment. As well as the £1 billion of capital infrastructure investment we are committed to delivering through the innovative finance model, using the mutual investment model, we are also using innovative ways of funding capital investment through the £250 million extension of the housing finance grant and the £150 million coastal risk management programme, and those schemes are in addition to the £1 billion-worth of direct capital borrowing as a result of the Wales Act 2014.

First Minister, last year’s UK budget provided a valuable boost to capital infrastructure spending in Wales and shows what can be achieved when Welsh and UK Governments work together. Do you agree with me that the projects that you mentioned, the welcome agreement on a Cardiff city deal, and today’s announcement on the scrapping of the Severn bridge tolls, shows what can be achieved and that the Welsh Government and yourself are much better off working with Theresa May than with Jeremy Corbyn?

There is some cheek in that question, and I give him credit for that, but the answer is quite simple: no, I’d rather work with Jeremy Corbyn, bluntly, if you want the answer to that question. But, secondly, yes, I think it is right that, at a time when there is no election, Welsh and UK Governments are able to work together. The city deal was an example of that. But I have to say that, when it comes to the Severn bridge tolls, we been pushing for this for years on end. Now, if an example of working together is, ‘We've made the case and, hallelujah, the UK Government is converted’, then I welcome that as well. But it does show how important it is to have a strong team here in the Welsh Government to keep on pushing at Tory Governments so that they deliver things such as the ending of the Severn bridge tolls, which we’ve called for for years.

In terms of the new three-stage process for assessing proposals for new railway stations in Wales, you are no doubt aware that some campaigners calling for the reopening of certain stations that failed to make the second stage feel aggrieved, and these include members of the Carno station action group. Now, in light of that, and in the interests of transparency, will your Government be prepared to share the results of the cost-benefit analysis in moving from stage 1 to stage 2? Diolch yn fawr.

I see no difficulty with doing that. It’s hugely important that the cost-benefit analysis is shared so that people can see what the methodology is.

Unfortunately, I can’t comment further on those proposals for change because of course there is a potential role for the Welsh Government, and that position can’t be prejudiced.

I thank the First Minister for that reply, which of course I understand. This is the opposite to the situation that we faced in Llangennech, where there’s parental opposition to the changing of the status of the school to a Welsh-medium school. There’s a feeling in the locality in Brecon that this proposal for closure has become a bit of a self-fulfilling prophecy because the council has, for many years, had a proposal to close down, and they’ve provided free transport to alternative schools for parents, so it’s not surprising that parents who want to have their children taught through the medium of Welsh are now exploring other opportunities with the result that the school rolls have been falling to unsustainable levels. I hope the First Minister will agree that I try to be on this, if on no other issue, non-partisan and helpful, so what I would like to ask the First Minister is: in addition to the acknowledged policy, which I think is the correct one, of the Minister for Lifelong Learning in relation to the situation in Llangennech—of persuasion and cajoling, bringing parents with us and going with the grain—is it not the case that where parents want to have their children taught through the medium of Welsh, you ought to make it as easy as possible for them? Therefore, requiring children to go on a bus journey of over an hour in each direction each day is not likely to bring more parents into the net of wanting to have their children taught through the medium of Welsh. So I’m wondering what, without, perhaps, commenting on this individual case, the First Minister can do to make it easier for parents in the situation that we find in Brecon to have their wishes satisfied.

Well, if I can speak generally, the leader of UKIP is correct in that, in many parts of Wales, the length of the journey time to get to a Welsh-medium school puts parents off. It’s particularly true in some parts of Wales where there is a Welsh-medium primary school but there is a substantial journey to the Welsh-medium secondary school. Monmouthshire is an example that springs to mind—Ysgol y Ffin, Ysgol y Fenni—it’s a long way to Ysgol Gyfun Gwynllyw from there, and steps must be taken to make sure that they’re able to access secondary education, particularly, more locally. Generally, local authorities have to produce their Welsh in education strategic plans. We look at those plans and, if we judge them to be inadequate, then we do not approve those plans. It is for local authorities all across Wales to show that they are providing sufficient access to Welsh-medium education in order for those plans to be effective.

The Welsh Government has an ambition to see 1 million Welsh speakers by the year 2050. Now, in order to reach that target, we need to get as many children as possible starting their education through the medium of Welsh. As you have said, it’s difficult for you to discuss this individual issue, but just as a matter of general principle, do you acknowledge that in those rural areas it costs more to get children to go to those schools? Is there any recognition of this within Government to make this possible? Because if we want to reach that target, as you said, we have to make it as easy as possible so that those parents don’t see any barriers in their way.

Well, generally, of course, the further that children have to travel to be educated, the greater the obstacle. That is true specifically of secondary schools, and that is part of the consideration we’re giving to the Welsh in education strategic plans.

As regards to the target of 1 million Welsh speakers by 2050, I won’t be in this post at that point, if I may say that, but the final document will consider the relationship between the language and economic development, and that is something that will be published this year, and, of course, the situation of education will be considered carefully as part of that whole process.

I’ve raised these issues in correspondence with the Minister around a month ago. I’ve not yet received a response, but I very much hope that I will receive a response soon. Issues of school transportation have been raised, but one thing that is problematic if you are trying to provide bilingual education in rural areas is how you actually hold events outside of school times and ensure that transport is available to arts and sports activities, and so on. So, what does the Government have to say in general in terms of that difficulty in ensuring that there is a fair option in making the choice of Welsh-medium education?

One way of ensuring that there are more activities available, for example, is to ensure that you have more Urdd branches. For example, in my area there’s one Welsh–medium secondary school and it’s in the Llynfi valley. It’s not very central to the county, but every child in the county goes there, even those that come from the Ogmore valley--they have to travel across two valleys to get there. The Urdd does hold lots of activities so that children don’t have to go to Llangynwyd every time—they can go to Bridgend or Porthcawl, which ensures that children have access to a Welsh ethos outside the school without having to travel too far.

Whilst responsibility for serving armed forces personnel lies with the UK Government, we have made clear in our programme for government our commitment to support serving personnel and their families so that they are not disadvantaged by their service.

Thank you. My further question is more about the wider armed forces community. Earlier this year, at their request, I, with Andrew R.T. Davies, met a group of women veterans, all of whom have suffered injuries on service and all of whom told us they were also dealing with mental health issues as a consequence of their service. How do you respond to the concern they expressed to us—and I’m quoting them—that ‘with more and more veterans returning from Iraq and Afghanistan it’s now taking three months to get an appointment with Veterans’ NHS Wales then three to six months to see a specialist and then they can only deal with mild to medium trauma because there are no acute services, and they’re having to travel to England for treatment for their mental health and rely on charities’?

If the Member writes to me with more detail on that, I will of course investigate. But generally, we have produced a ‘Welcome to Wales’ booklet, specifically for serving personnel and their families while living in Wales. It gives information on the support and services available in one place. They include free swimming, of course, across all 22 local authorities, a fast-track referral pathway for specialist healthcare, an enhanced flexible childcare offer, and of course access to education. We work pretty closely with organisations such as the Royal British Legion as well, to make sure that we give the veterans who have given so much what they deserve when they are living in Wales.

First Minister, the children of service personnel who have been posted overseas are in danger of receiving a patchy education. In postings where there is no official school provision, these children are sent to international schools, which may not follow a set curriculum. As a result, the children may be ahead in some areas and behind in others. What is your Government doing to ensure that children of service personnel who have attended international schools are fully assessed and receive additional support if needed?

The Supporting Service Children in Education project within the WLGA has been funded through the European social fund since 2014 to mitigate issues of mobility and deployment. That project has produced a guide for parents of service children about the Welsh education system, and for teachers on supporting service children. The latest resource to be produced by this project is the digital stories resource, which was launched at the end of last year. In addition, the MOD has operated the education support fund, although we understand that that funding will come to an end next year. The Cabinet Secretary for Education has written to the MOD, asking them to explain that position.

Our policies on sport are set in the context of ‘Taking Wales Forward’ and the Well-being of Future Generations (Wales) Act 2015. Our investment in sport, via Sport Wales, focuses on encouraging participation amongst all ages and ensuring sporting infrastructure is in place so that talented sportsmen and sportswomen reach their potential.

I thank the First Minister for that answer. I believe it is really important, for reasons I think all Members here would recognise, First Minister, that we support sport and physical activity at an elite and grass-roots level in Wales. So, I would like to return briefly to Newport County’s success, because I believe it’s very important for both levels. We had a local boy, Michael Flynn, as manager, taking over the team 11 points adrift at the bottom of the table, near the end of the season, and completely turning it around with a dramatic winner in the eighty-ninth minute of the last match of the season to retain professional football for next season in Newport, showing the importance, I think, of local input into team, and of course it is a supporter’s trust.

We will now have Premier League funding for grass roots community and sports activity around football into the future—long into the future, I hope—and at the same time, we’ve seen Newport rugby club shareholders vote for a Welsh Rugby Union takeover, which will keep regional rugby in Newport, and also nurture the game at a local grass-roots level. So, I think professional sport and grass-roots sport are looking strong in Newport at the moment, First Minister, and I wonder if you would join me in paying tribute to all of those people involved in making that a reality, and particularly the grass-roots support.

Absolutely. I saw the scenes at the end of the game, the scenes of joy, when the second goal went in against Notts County. In fact, I tweeted at the time. I’m more than happy to congratulate Newport County. I think the Dragons have a bright future as well—they need more financial stability, but that seems to be coming together. I fully recognise the importance of sporting development. The national football centre is in Newport, of course; the Football Association of Wales over the past few years has been transformed as an organisation, and now has, of course, a training facility in place where there was none before. And, of course, in terms of the importance of individual physical activity, I know how important this is, and I know, indeed, that the Member for Newport East has spent the last 18 years telling me how important it is, and I have failed to follow his advice.

We continue to take a broad range of actions to support the manufacturing sector across Wales.

Figures released last week show that UK industrial output shrank for a third month in a row, with the manufacturing sector falling by 0.6 per cent, and the UK’s trade deficit doubling to more than £10.5 billion. As a country here in Wales with a proud industrial and manufacturing past, it’s sad that the proportion of apprenticeships in manufacturing fell from 6 per cent in 2006 to a dismal 2 per cent in 2014. Those are StatsWales’s figures, in case the First Minister wants to accuse me again of misrepresenting the facts.

Does the First Minister agree with me that it is unacceptable to dither for over a year with a new economic and industrial plan for this country? What hope is there for a future in industry for Wales on a global level when we’re not providing the next generation with the skills to deliver?

Well, can I remind him that it is a key commitment of this Government that we will fund a 100,000 apprenticeship for people of all ages over the course of this Assembly term, something that we think is hugely important? He’s right to point out that manufacturing is of greater importance to the Welsh economy than it is for the UK as a whole. Some 10.8 per cent of the Welsh workforce are in manufacturing compared to 7.6 per cent for the UK. I do not accept what he says about dithering: we brought Aston Martin into Wales; we brought Qatar Airways into Wales. At the moment, the advanced materials and manufacturing sector team is currently working with 88 companies, wishing to locate or expand in Wales. So, far from dithering, we’ve been hugely active and the investment figures speak for themselves.

The Superfast Cymru scheme has, to date, facilitated the roll-out of superfast broadband access to over 46,500 homes and businesses across Powys, including, of course, Montgomeryshire, delivering average speeds of 87 Mbps and investing over £13.3 million.

Thank you, First Minister. We are now eight months away from the drop-dead date, when the Superfast Cymru project—. It does seem to have a continuing miscommunication issue with residents. I’ve been contacted, for example, by one constituent from Adfa who has complained that even though he had confirmation of superfast broadband via fibre-to-the-premises technology in February of this year—also confirmed to me in writing by the Minister—he has now been told that the situation has changed, and the technology to be used is fibre to the cabinet, and that he now is too far away from the cabinet to benefit from the upgrade. So, the situation here, I think, I hope you’ll agree, is unacceptable: one minute he’s told that he’s going to receive up to 330 MB, and then the goalpost is changed to find out that he’s not going to benefit at all. Now, back in February, there could have been other solutions that he could have taken forward through other technologies, which are no longer available. Would you agree with me that it’s important that people are given the right information in the first place?

Absolutely. Perhaps, if the Member could write to me with the details of his constituent’s problem, I will, of course, investigate.

Thank you, First Minister.

The next item is the business statement and announcement, and I call on the leader of the house, Jane Hutt.

Diolch, Llywydd. Business Committee has agreed to table a motion to suspend Standing Orders immediately after the business statement to allow tomorrow’s short debate to take place today after voting. Business for the next three weeks is as shown in the business statement and announcement found among the meeting papers available to Members electronically.

Cabinet Secretary, I recently visited my general practitioner. I had to go very early in the morning—an 8 o’clock appointment—and what I saw was unthinkable. I had to pass through a couple of surgeries, and people were waiting from 7.30 a.m. until 8 o’clock, outside in this weather, only a couple of days ago, with children—able, disabled and senior people with, of course, sickness. You have to make an appointment to see the doctor before 8 o’clock, and the surgery door never opens. That is a surprise in the twenty-first century—people waiting outside and not getting in in this weather early in the morning while the surgery staff are already inside.

So, would you kindly make a statement on GP appointments in Wales? It will definitely help many surgeries in this country and all of those stood outside without shelter at the mercy of this weather. Could not some method be devised to allow these patients to wait inside the surgeries, with the possible use of ticketing or some sort of number to be given, and they can have allotted numbers to see the nurses, or the people who are inside can give appointments for the doctors? I think it would be a great help for our sick people, young and old, to make sure that a statement is made on doctor appointments at surgeries in Wales. Thank you.

The Member raises an important question. It gives me the opportunity to say that our GPs in Wales provide a first-class service to the Welsh population. In fact, the national survey continues to show very high levels of satisfaction—over 90 per cent of patients are satisfied with GP services. To help ensure patients receive high-quality care, we’re continuing to invest new money in primary care—£42.6 million this financial year alone. Also, importantly, in terms of GP practices working together collaboratively, we’re investing in 64 primary care clusters across Wales. Of course, that all means that, in terms of access to GP services, this Welsh Government is not only investing and supporting but patients are also increasingly satisfied with those services.

Can I ask for a Government statement on the importance of universities as economic drivers, and what the Welsh Government is doing to support the university sector and to generate science parks similar to both Cambridge and Aarhus in Denmark, which have been very important in the economic success of those two areas?

Mike Hedges, the importance, as you say, of universities as economic drivers is quite clear. The higher education sector makes a substantial contribution to the economy of Wales. Universities in Wales contribute more than £3 billion a year in gross expenditure to the Welsh economy, employ over 20,000 people, have an annual turnover in excess of £1.5 billion and, of course, contribute to sustainable economic growth in many ways—through knowledge creation developing a highly skilled workforce and through engagement with local communities. Clearly, there are important examples that the university sector can learn from across the world, but I think we have real opportunities, as the Diamond review recognises, that investment in higher education can bring those benefits for the economy.

Could I ask the Cabinet Secretary for two statements from the Government? The first is quite simple—we’ve just announced, of course, that all parties in Wales are in favour of scrapping the Severn bridge tolls. I welcome that and look forward to it, but it does leave one bridge—just one bridge—in Wales that does have tolls, and that’s the Cleddau bridge. The Cleddau bridge is wholly in the hands of the Welsh Government: that is Pembrokeshire owns it at the moment, but it’s the Welsh Government’s intention to trunk the road over the Cleddau bridge—that’s been stated by the former Minister, Edwina Hart, and restated in principle by Ken Skates, too. Therefore, what are the Government’s intentions in terms of the Severn bridge—to scrap the tolls on that bridge, the only tollbridge in Wales where a bridge goes from one part of an enterprise zone to another? So, let’s ensure that Wales is free of tolls—realising the dreams of the daughters of Rebecca at last.

The second statement I’d like from Government is a little more complex. It relates to a planning application for a cabin holiday park in Beddgelert. Now, I don’t expect the Government to make a statement on the particular planning application, but the campsite in Beddgelert is to be done away with, and there’s a planning application for holiday cabins in its place, which includes hot tubs and all sorts of other things, as well as a shop and a centre and such things.

The plan underpinning this is part of something that’s emerged from the old Forestry Commission and, therefore, I want a statement from the Government on the role of Natural Resources Wales in this application. As I understand it, NRW, as the successor body to the Forestry Commission, has a 20 per cent stake in this scheme, and if it does proceed and is successful in terms of its planning application, then NRW will receive £48,000 per annum in rent for 16 holiday cabins, which is £3,000 per cabin. Of course, the problem here is that NRW is also a regulator for the site, and NRW as a regulator hasn’t raised any objections on the development. Therefore, you have a governmental body that is regulating and is also responsible as an investor. I’d like to hear from the Welsh Government how exactly they expect NRW to balance that position and to ensure that everything is done properly to ensure that local people can be assured that they’re doing their proper work in safeguarding the local environment.

Diolch, Simon Thomas. Indeed, it is a breakthrough that the Welsh Labour Government and, indeed, yourselves have been calling for the Severn tolls to be removed and now we have the Tories actually responding to our calls here from the Welsh Government and from parties in this Chamber. It is very important, therefore, we look at how this can progress, but your point about Cleddau bridge is well made and I’m sure that the Cabinet Secretary for Economy and Infrastructure will want to update you on that.

I think your second question does draw attention to a whole range of issues, which touch on the role, powers and responsibilities of NRW, but I think you have put it on the record now in terms of this application, which does cross over issues relating to tourism, forestry and planning, which, of course, Welsh Ministers have to reserve comment on. But you’ve put it on record.

Could I call for two statements: firstly, on an issue I and others first raised with you 14 years ago, and possibly earlier in the First Assembly when I wasn’t here, and that’s deaf school pupils in Wales? In this UK Deaf Awareness Week 2017, the latest Welsh Government-published figures have shown that deaf school pupils in Wales are underachieving at every key stage with the National Deaf Children’s Society Cymru saying that these pupils face being left behind without urgent action, and the figures suggesting that the attainment gap having temporarily fallen has widened again at GCSE level.

Having launched the ‘Close the Gap’ petition following a poor set of results four years ago, the National Deaf Children’s Society has said the latest figures are unacceptable. Well, deafness is neither a learning disability nor a learning difficulty and there’s no reason why these pupils should be underachieving unless and only because they’re not accessing the appropriate support. As we called for 14 years ago, that means raising deaf awareness, improving acoustics in the classroom and ensuring that deaf children and their families are supported from the start. I hope the Welsh Government will respond with a statement on this very serious issue, having given it deep and serious consideration, and consider how we might now move forward.

Secondly, and finally, could I call for a statement from the health secretary on rare conditions in Wales, once he’s read the spring 2017 edition of Vasculitis UK’s magazine, and an article within it entitled, ‘What’s up with Wales?’? This article, entitled ‘What’s up with Wales?’ says:

‘We, at Vasculitis UK, have a really good relationship with all the leading medical vasculitis professionals in England…. However, in Wales, it is a different situation.’

Having been given a diagnosis and a treatment plan by a leading world expert in England,

‘The advice of the experts “over the border” seems to be resented and ignored’

when we come back to Wales.

‘There are various natural problems in Wales for people with rare diseases…. There seems to be a last century attitude in Wales’

and

‘There seems also to be a general culture of hierarchy and closed ranks.’

Now, even if that’s not 100 per cent accurate, the fact that these people hold those views, based on their experience of treatment in Wales, and put that into a UK magazine, must merit attention, and I hope that will justify a statement accordingly.

I’m grateful that Mark Isherwood has kept faith, as he has, with these very important issues, which he raised with me, I’m sure, not just 14 years ago. It’s an issue not just for health Ministers and their responsibilities, but also for education Ministers and their responsibilities as well. Our national mission is to raise standards and to continue to improve the attainment of all learners, and of course deaf children’s attainment levels are crucial. We do aim to achieve this through the range of educational reforms that are currently under way. Our ambitious additional learning needs Bill, if passed, will completely overhaul the system for supporting pupils with additional learning needs, including learners with hearing impairments. And a £20 million package of funding will support the implementation of the Bill and our wider plans, including developing the workforce. But I do recall again—and I’m sure that the Cabinet Secretary for Education will be able to update us on this—the ways in which we ensured that, in our capital investment programme, twenty-first century schools, we were particularly looking at these issues when we were developing that ambitious programme, to ensure that we could take this on board in terms of the ways in which those buildings could assist. And that’s very much part of raising deaf awareness for policy makers, as well as for those who are delivering the services.

On your second point in terms of rare conditions, well, certainly, I have, over the years, met with groups, as you will have done here, and indeed professionals who are delivering in terms of addressing the needs of people with rare conditions. And I don’t recognise that statement that was made, but I know that the Cabinet Secretary will be taking very serious consideration of how we are progressing in terms of meeting those needs.

Some six weeks ago, Julie Morgan and I wrote to the Cabinet Secretary for the environment and planning about the threat to the most vibrant live music venue in Cardiff, which is at Womanby Street, because of the threat of planning applications for a hotel and some residential units as well. I’m delighted to see that the Cabinet Secretary for the environment and planning is now back with us after the really life-changing injury she suffered as a result of an accident. But, now that she’s back, I wondered if the Government could provide us with a statement as to whether it’s able to introduce new planning guidelines to ensure that it is absolutely clear to any developers that the agent of change in any development has to be met by the person who’s making the application, because under the current planning laws, the whole of Womanby Street could be put out of business if these applicants are successful, and they could then insist that the live music venue has to pay for soundproofing et cetera, which, in any case, is unlikely to be effective because people on the street will cause noise whether they’re inside or outside a venue. Nearly 1,000 jobs are at risk here, as well as many millions of pounds from music tourism. So, I wondered if we could envisage an early statement on how we can change the law to ensure that any new development has to make it clear that they’re going to have to pay for the costs of any mitigation that results from a new development.

I thank Jenny Rathbone for raising this very important issue again—this important campaign that Julie Morgan also raised with you. Lesley Griffiths is back in business, certainly wanting to meet with you to discuss this issue. She is certainly very concerned to make sure that the principle of making agents of change responsible for managing the impacts of new developments is made very explicit in any future revision to ‘Planning Policy Wales’. It’s already there, it’s already contained within ‘Planning Policy Wales’, but it clearly needs to be more explicit. And I think that the Cabinet Secretary for Environment and Rural Affairs is ready to meet with you to discuss how that can be taken forward.

I was very pleased, a few days ago, to see the Welsh Government noting Llangefni station as one that could be reopened in future. This emerges directly from the work that my predecessor, Ieuan Wyn Jones, did as Minister for transport, in commissioning a feasibility study on the potential of reopening the line from Gaerwen, through Llangefni, to Amlwch—something that I know would bring huge economic benefits to Anglesey. I know that Ieuan and I would be more than happy to discuss this issue further with Government. But would it be possible to have a statement from the Cabinet Secretary for transport on the additional work that needs to be done now in order to transform this exciting idea into a reality?

Well, the Cabinet Secretary, as you have acknowledged, recently announced the prioritisation of 12 new railway stations across Wales. That decision was made, assessing a number of proposals against the well-being goals, set out in the Well-being of Future Generations (Wales) Act 2015. And, clearly, now, it is about working with local authorities, partners, and all those who can progress proposals for those stations, including the station in your constituency, with a view to future consideration. So, I know the Cabinet Secretary will want to update the Assembly on this matter.

Can I call for two statements, please, one in relation to the regulation of drones and light aircraft? I’ve received a number of complaints recently from residents in my own constituency about the use of drones in residential areas, hovering over people’s back gardens, filming local residents, and invading their privacy. And, indeed, in addition to that, there have been some complaints about the use of light aircraft on beaches that are right adjacent to the rail infrastructure, and indeed the trunk road network. And, of course, if any of those microlights, et cetera, had an accident, then that could cause a serious problem on those particular pieces of infrastructure. So, I would appreciate a statement from an appropriate Cabinet Secretary about the way that we can best regulate these, while still allowing people to use them for leisure purposes.

Can I also call for a statement on access to GPs? I know that my colleague Mohammad Asghar has also raised this as an issue, but the National Pensioners Convention Wales produced a report recently on access to GP services in Wales, and it found that there were significant problems with accessing some appointments in some surgeries. And that was largely due to the inconsistency around appointment arrangements. It reported that, while some surgeries were offering same-day appointments only, others were allowing people to book in advance, and offering a more flexible approach, which seemed to be much better for patients, in terms of their patient experiences. So, I do think it’s about time that we had a statement on GP access, and how to improve that overall, and I would appreciate it if one could be scheduled.

I think, on the importance of access to GPs, I’ve already commented on that in response to an earlier question. But I think the changes to the GP contract for 2017-18 are important, in terms of the ways in which it can provide for new, enhanced services, and also to take forward the quality and outcomes framework, which is where we need to see the consistency in terms of delivery. And, you know, that’s going to free up more capacity for GPs, and also access to practice nurses, which we must of course remember is equally important in terms of the primary care team and the services provided. And also it means patients can be seen by the most appropriate professional for their needs. So, these are issues that, of course, in terms of GP services, we are addressing.

Your first question, I will obviously take back and identify which Cabinet Secretary is appropriate to answer your important question—indeed, if we have powers at all in terms of the use of drones and the impact in terms of the invasion, if you like, of private space, and the use of them as well.

Could we find time for a statement on the detrimental impact on Welsh Government policies of well-being and promoting prosperity, of cuts—existing cuts and possible future cuts—to disability benefits in the south Wales Valleys and throughout Wales? A £30-a-week cut to some new claimants of the employment and support allowance came into effect last month, so disabled people put in a work-related activity group will now receive £73 a week. I’ll just repeat that: £73 a week. I wouldn’t be able to live on that, and also to cope with the additional challenges and costs that people with disabilities have. The Prime Minister, Theresa May, says this lower rate of support will, in her words,

‘encourage disabled people to find work.’

Yet, over 30 authoritative disability charities have said the cuts do not incentivise work at all, but they do make life harder for disabled people who face extra costs of living, and they mean some people will be unable to afford basic necessities. Last week, the Prime Minister refused to rule out further cuts to allowances for people with disabilities, so if things are bad now, we can only imagine how things might be if a Conservative Government is elected for the next five years. So, can we have a statement to shine a light on the effects of these punitive attacks on people with disabilities, and the consequences for the people we represent and the communities they live in?

I’m very grateful that Huw Irranca-Davies has brought this to our attention in the Chamber today, and I have to say that, certainly in my constituency capacity, I’m being approached by people who are now suffering directly as a result of the further cuts to welfare benefits, particularly affecting disabled people from 1 April—people who are struggling and who are losing access to Motability, for example, and then having contradictory expectations that, of course, cannot be delivered, and all reducing their income levels. We remain deeply concerned about the UK Government’s changes for employment and support allowance claimants assigned to the work-related activity group, which started from April this year. It will see new claimants receive approximately £29 per week less than existing claimants, and we’ve got to remember it’s how the cuts on new claimants—. And the Department for Work and Pensions estimate that 500,000 families in Great Britain will be affected in the longer term. We estimate that around 35,000 affected claimants will be in Wales, and especially in the local authority areas in the south Wales Valleys, particularly those affected by higher ESA rates than for Wales as a whole. As a Welsh Government, we are taking action to help people to manage the effects of the UK Government’s welfare benefit changes, and we will continue to analyse the impacts of such cuts and monitor those impacts. Putting more money into our advice services, credit unions and the support services is crucial, but I think it would be very helpful for us to bring this to the wider discussion statement by the Cabinet Secretary; it would be very helpful to this Chamber and to the Assembly.

Three brief areas, if I may, leader of the house. Firstly, can I support Mark Isherwood’s earlier call for a statement on support given by the Welsh Government for rare diseases in Wales? I think you mentioned vasculitis, an area of concern close to my heart. Many of these sufferers of rarer diseases do often feel left out. It’s natural for large diseases—cancer, heart disease—to get a lion’s share of funding, but over time I think it is important that we do send a signal to sufferers of rare diseases that they are being thought about and policy is being formed around them, too. So, if I can ask for that.

Secondly, I think it’s six months now since the health Cabinet Secretary made a statement—it was either written or oral—to this Chamber on giving the go-ahead for the specialist and critical care centre at Llanfrechfa Grange Hospital in Cwmbran. I think 2022 was the date given for completion for that project. Could we have an update on whether or not that is on course and what the latest is on that, because there are concerns by health officials within health establishments? So, I would be grateful for that.

Finally, I drove along the Heads of the Valleys road near Gilwern on the weekend, and it’s good to see that coming along. That’s a fantastic piece of road, and there are many economic potential benefits around there. I can see the Member for Blaenau Gwent nodding vigorously at that. However, just down the road from the A465, Heads of the Valleys, you’ve got the A40 that links Abergavenny to Raglan and to Monmouth in my constituency, which is an ageing concrete road surface causing a lot of hassle for commuters and also a lot of hassle for people living in adjacent areas. So, if we’re going to have this fantastic piece of road kit up at the Heads of the Valleys, it doesn’t make any sense to have a poorer piece of road infrastructure feeding into it. So, I wonder if we could have a statement from the Cabinet Secretary for transport on how he intends to build on the development of the Heads of the Valleys and make sure that the surrounding road network is also built up to standard.

Well, Nick Ramsay, the Cabinet Secretary for Health, Well-being and Sport is sitting here listening to your first two questions, one of which I did respond to in terms of rare diseases and also the priority we give to that, but also to the state of play in terms of the critical care centre. Yes, it’s wonderful that you have a stretch of the Heads of the Valleys road with more funding coming through innovative finance to complete it, as was raised by Vikki Howells earlier on today, but also seeing the sign, which you will have seen, saying ‘Funded by the European Union’, strikes me that that road would not be built without us being a member of the European Union, and with Welsh Government funding as well. So, that has made a huge impact in terms of the Welsh economy and access to your constituency. And then, of course, Nick Ramsay, you mentioned the roads that come off the A465. That is a matter of work and partnership together with your local authority.

I thank the leader of the house. The next item is the motion to temporarily suspend Standing Orders 12.73 and 11.16 to allow the short debate scheduled for 17 May to be debated as the last item of business today. I call on a member of the Business Committee to move the motion.

Move.

The proposal is to suspend Standing Orders. Does any Member object? The motion is therefore agreed in accordance with Standing Order 12.36.

The next item is a statement by the Cabinet Secretary for Health, Well-being and Sport on end-of-life care. I call on the Cabinet Secretary, Vaughan Gething.

Thank you, Presiding Officer. On 27 March this year, I published the updated ‘Palliative and End of Life Care Delivery Plan’. This plan reaffirms our commitment to ensuring people have a healthy, realistic approach to dying, and are able to plan appropriately for the event. We want people to be able to end their days in the location of their choice, be that home, hospital or hospice, and we want them to have access to high-quality care wherever they live and die, whatever their underlying disease or disability.

This plan covers all aspects of palliative and end-of-life care, delivered by both primary and secondary sectors, and involves specialist palliative care services delivered by the NHS and third sector providers. This care also involves recognition of the needs of those experiencing bereavement. It builds on the success of the first plan. It’s been updated to reflect the latest strategic and legislative change and has strengthened children and young people and research sections.

We know that care at the end of life has improved greatly since the publication of the first end-of-life care delivery plan in 2013. Consultants in palliative medicine are now available on call 24/7 across Wales to provide advice and support to other professionals, and to visit patients where required, enhancing the service provided by clinical nurse specialists at weekends. And support is now in place for clinical nurse specialist teams to work seven days a week in acute and community settings. This has provided front-line staff with valuable support at weekends, enabling patients who present at hospital with end-of-life care needs to avoid hospital admission where appropriate and allow patients with complex needs to remain at home.

Funding has also been provided to improve access to hospice-at-home provision, and we have introduced primary care palliative registers so that all general practices have a register of all patients with supportive or palliative care needs. In collaboration with Tŷ Hafan children’s hospice, we’ve established a 24-hour out-of-hours telephone advice service for paediatric palliative care, which is now available across Wales.

Dying is, of course, an inevitable event. While I fully appreciate it is not a subject that many people are comfortable talking about, it is vital that people let their loved ones know how they wish to end their days when the time comes. Planning for the end of life through open conversations can result in a better death and certainly help the grieving process for those left behind.

Last week, I attended the Byw Nawr conference and was pleased to officially launch the new website for advance care planning. Today, people find most of their information online and it will be invaluable to have that resource at their fingertips on the internet. We have also provided £150,000 to train staff in advanced communication skills and end-of-life care. This has enabled colleagues to begin and manage serious illness conversations with patients, families and carers. The end-of-life care implementation board, though, provides strong leadership and oversees the delivery of the plan. As is the case with all of our major health conditions, the board receives £1 million annually to support their identified priorities.

As part of the budget agreement with Plaid Cymru, the Welsh Government allocated an additional £1 million for this year, to further enhance end-of-life care provision. The board has provisionally identified that this funding will be used to pursue a Compassionate Communities approach to end-of-life care, for telemedicine, to further roll out the serious illness conversations training to support the development of an all-Wales advance care planning record, and to take forward research priorities and support GP clusters in Wales.

The Welsh Government also provides approximately £6.4 million in funding to support specialist palliative care services provided by hospices and health boards throughout Wales. This significant investment is a reflection of the importance that this Welsh Government places upon end-of-life care. It’s vital that individuals receive the best possible care in the location of their choice at the end of their days.

Direct feedback from patients and their families about specialist palliative care services in Wales has shown that, over the past year, these services make an enormous difference to people’s quality of life in their closing days. During 2015-16, 93 per cent of the responses to the iWantGreatCare patients’ evaluation of their experience of specialist palliative care were positive. The average Welsh score was 9.5 out of 10 across all domains. This would not be possible, of course, without the dedication and professionalism of our workforce. So, I do want to take a moment at this stage to acknowledge the work of our clinicians, nurses and other staff who provide care for people at the end of their lives. There can be fewer jobs more emotionally demanding, yet more necessary. I am sure that Members across the Chamber will join me in recognising and thanking our staff for their work.

But, dying is a social matter. How well we care for people who are dying reflects on how we care as a society. Advances in modern medicine and treatment have resulted in a growing population living longer with incurable diseases. It is vital that good end-of-life and palliative care is made available across Wales. The updated palliative and end-of-life care delivery plan was developed through effective partnership working. That continued co-operation between the Welsh Government, the implementation board, the national health service, professional bodies and the third sector is key to delivering outcomes at a greater pace and with greater impact. We should all recognise that the challenges ahead are many and significant, but we can look forward to the future with a sense of shared direction and confidence.

This week is Dying Matters Awareness Week 2017, placing the importance of talking about dying, death and bereavement firmly on the Welsh and UK agendas—something I very much welcome, as chair of both the cross-party group on hospices and palliative care and the cross-party group on funerals and bereavement. With an estimated 32,000 people dying in Wales each year, that’s affecting somewhere between 160,000 and a third of a million people directly in Wales each year, many vulnerable to serious additional problems—suicide, loneliness, social isolation, anxiety, depression and social problems from stigma to job loss.

But the majority of end-of-life care in Wales is provided by hospices across a range of settings, including in-patient units and hospice-at-home services. There are lessons that the NHS could learn from hospices and especially about the integration of care services in the home community hospital and hospice. I’ve been asking successive health Ministers and our health Secretary here for many years to ensure that NHS Wales starts asking our wonderful community hospice movement how it can help them deliver more for the resources available—in modern, parlance, designing, delivering and co-producing services with them—and too many still feel that that’s not the case. I wonder if you could respond to that point.

Hospices Cymru, as you’ll be aware, are receiving Welsh Government funding on a ring-fenced basis through health authorities over a three-year period. But that period finishes in 2018. Can you provide assurance to them whether that funding will continue to be ring-fenced when the existing funding expires, because they need to know for their forward planning? If not, can you indicate when you might be able to provide that assurance, or at least information?

At 16 per cent to 20 per cent, hospices in Wales still receive far less Government funding—that’s Welsh Government and Welsh NHS funding—than their English and Scottish counterparts. They also highlight a postcode lottery of hospice services, with a disparity of care available between different parts of Wales. When will the Welsh Government finally, in the context of my previous question, recognise that, by discussing, designing and delivering with them on a more balanced funding basis, it’s win-win for everybody, and the means of delivering in a strict budgetary environment?

The end-of-life implementation board, as you indicate, has been allocated an extra £1 million in 2017-18, and one of the provisional areas identified for that is developing a Compassionate Communities approach to end-of-life care. Two and a half months ago, I attended the Marie Curie lecture on a Compassionate Communities approach to end-of-life care, highlighting the need to provide people near the end of their lives with the support they need to remain in their communities by applying health promotion and community development principles and providing support to those who are dying and those who are bereaved. How, therefore, do you respond, not just in terms of a provisional part of £1 million for one year, but to the call by Marie Curie for Wales to become a compassionate nation, following the lines of a Compassionate Communities model that has successfully been developed in numerous towns and communities around the world, including, they say, Frome in Somerset? It’s not about more money; it’s about using the existing money wisely to improve outcomes and lives.

How do you respond to the calls by Age Cymru on end-of-life care for the Welsh Government to provide direction on effective collaboration between local health boards and local authorities to ensure equal access for older people to hospice care, and for the Welsh Government to carry out robust monitoring of the implementation, delivery and outcomes of its palliative end-of-life care delivery plan to determine whether it is delivering real improvements in palliative care and end-of-life care for older people in Wales? How would you respond to Macmillan’s calls for people approaching the end of their life and who would benefit from the support of palliative care services to be identified so that early discussions might be started about their care, for people’s preferred place of death to be recorded early and for health and social care services to be co-ordinated—

Are you coming to a conclusion, please?

[Continues.]—to ensure that people are able to be cared for and die well in the place of their choice?

Are you coming to a conclusion, please?

It is my final question, so thank you for allowing this. Hospices Cymru support the ‘Ambitions for Palliative and End of Life Care: A national framework for local action 2015-2020’ document, drawn up by the palliative and end-of-life care partnership in England across all the sectors, and this has ambitions for each person to be seen as an individual, to have fair access to care, the co-ordination of care and much more. How do you respond to their call for this model to become more integrated into the Wales end-of-life care delivery plan so that we may all learn from each other and benefit together?

Thank you for the series of questions, which I’m aware that the Member has raised on a number of occasions in the past. He is consistently interested in this area, as I’m sure everyone realises. Of course, it was dying matters week last week, that was when I attended the Byw Nawr conference and spoke to them about the work that they’ve done, recognising the work they’ve done in promoting this as a more national and natural conversation to have. There’s more work to be done with them, but more work, frankly, to be done amongst all of us in the communities that we represent.

I certainly don’t underplay the contribution of the hospice movement and the variety of hospices around the country, which were the main focus of the comments and questions that were made. And, in fact, most Members in this Chamber will know of a local hospice where their constituents attend, if not having hospices within constituencies or regions, and I have regularly visited a number of hospices in this role, but also I have two within my own constituency. So, I understand perfectly well the role that they play in engaging with clinicians, in engaging with the public in designing and delivering care around a person that better meets their needs. One of the real significant steps forward in the lifetime of the last plan, which is going to be carried forward in the next one, is actually promoting the Hospice at Home movement so that people don’t need to go into a hospice, necessarily, but providing that hospice care at home, and there are real strides forward that have been made. In fact, in the way that the care is commissioned, it’s a regular part of what health boards do, and that will stay with us, but hospices are very much part of the design and the delivery of this plan, and I don’t necessarily share the Member’s rather pessimistic approach and assessment of the contribution of the hospice movement, both to designing this strategy, being part of how it’s delivered, but also understanding the successful nature of its impact on palliative and end-of-life care.

In terms of the financial matters raised, well, as I’ve indicated, the £1 million goes for each of the major conditions plans, of which this is one. It has £1 million allocated recurrently, and I indicated in my contribution the significant amount, the £6.4 million, that is spent recurrently in this area. I am well aware of the issues in Frome that he mentions, about the Compassionate Communities approach, and much learning has been taken, both by Government officials, the health service, and the third sector, in seeing what’s happened within that particular community, and it’s something for us to build upon here in Wales. And I look forward to having the ongoing conversation that I will have with the end-of-life care board and all of its members and supporters, on how we develop not just compassionate communities but, ultimately, for us to be a more compassionate nation.

I’ll end with your point about outcomes and delivery, because part of the strength of the delivery plan approach that we take is that we take an issue of major significance, we bring together people from Government, from the health service, and the third sector, and individual clinicians who are leaders in their field as well. And there is a constructive and helpful tension there that is created, both about understanding and agreeing on priorities, and those priorities then being carried forward. And the reporting mechanism that takes place is an open and an honest one, and there are times where each of the delivery plans and their associated delivery boards recognise that we haven’t made all the progress we would otherwise want to. I expect exactly the same process here: to have an honest reporting coming in about what we have and have not done, and then how we reset our priorities looking forward to the future.

May I thank the Cabinet Secretary for his statement, and for all of the work staff and volunteers in the health service and the third sector do in providing end-of-life care and palliative care across Wales? I don’t think there’s much new, truth be told, in today’s statement—although it’s always useful to have an update—so may I refer, perhaps, to what should happen in the mind of one of the organisations involved in the area, namely Age Cymru? I will just list some of the requirements that they have set out.

They want palliative and end-of-life care to be an entirely central part of care planning for those with chronic and long-term conditions. They want better co-ordination between local authorities and heath boards, in order to give equal opportunity for everyone in our older population to have access to hospice care. They want end-of-life care commissioned by local health boards to include comprehensive care for people in care homes. They want every institution and professional worker to have the necessary training and ensure continuity of training throughout their working lives. They want the orders that you do not attempt resuscitation or to cease to provide food or drink not to be put in place without full consultation with family or other carers. Finally, they want an assurance of very careful monitoring on the implementation and delivery of end-of-life care plans so that it does deliver better care. So, although we are in a situation where some steps have been put in place by Government, there is clearly more to be done in the eyes of those involved in this area.

So, three questions emerge from that. One: do you disagree with any of those recommendations, and, if you don’t, when can we be given assurance that those will have been implemented? Secondly, the annual report mentions improvements in palliative care for children—and, naturally, that’s something that we welcome—but there are far too many children who can’t spend their last days in their own homes. Would you agree that there is some work to be done in that area? Do you acknowledge that we need to strengthen services to support the siblings of those who have suffered bereavement? Finally, minority ethnic groups are particularly identified by Marie Curie as an area where services need to improve. So, what does the Government intend to do about that specifically?

Thank you for the series of questions and comments. In terms of the priorities that Age Cymru identify, many of those are already covered in the work that I’ve outlined that the board is taking forward. Part of the strength of the work that we’re doing is having that genuine cross-section of people with a direct interest in the area setting an agreed list of priorities. The difficulty otherwise is that we potentially get different bids made during the year and not having a properly organised approach to improvement, but I think that the list that you’ve identified—as I say, they’re covered in the contribution I’ve already made in terms of the opening of this debate, but also in the priorities that the board has set for itself in the year ahead.

In terms of the second particular issue you raised, about paediatric palliative care, there was a concern about whether this was properly taken account of in moving forward. I met a group of paediatric palliative care clinicians, and it was a very constructive conversation. I think they’ve moved forward, and they’re in a much better place now about understanding and accepting that their issues are properly taken account of, and there was a definite step forward in this iteration of the plans. So, there is progress that’s been made.

But in this and in every other area—almost every area on which I attend this Chamber to speak—there is always more to be done, and always more that we could do. There’s got to be an essential honesty about that as well. That includes bereavement support, again identified in my opening contribution as an area for improvement for the family that is left behind. That’s part of our challenge. It’s also why we’re having a national conversation about this, and why we should take the opportunity to use time in this Chamber to continue to do that. If we don’t normalise the conversation in this place about the importance of it then we’re unlikely to have a national conversation that takes place in a wider part of our society, so that it is a normal conversation that takes place about what we want.

It’s also why the advance care plans website has been launched, and actually having people having that conversation at a time when they can make choices—a much more active choice—about what they would want is a really important thing to do, because lots of people know they’re coming to end-of-life care. All those people that are on end-of-life care registers and receiving palliative care in primary care—there should be efforts made to improve and increase the numbers of people that have actually gone forward and had an advance care plan drawn up that they’ve actively contributed to. We made real progress last year and improved the numbers of people that have a plan like that, but we understand there’s only just over a third of people who are on a primary care register who now have an advance care plan in place. So, significant progress last year, yes, but lots more to do to get people into a place where they can receive the care that they want at the end of their life.

Finally, on your point about black and Asian origin communities in Wales, there is a real challenge here about the sort of care they want to receive. Some of this is about the differing nature of family support that exists in some of those communities, and the way they feel about looking after a relative. Some of it also is the work that Marie Curie themselves had done. I attended the launch of the work, both at the consultation start of it, and then at the final report stage. They recognise that, actually, the hospice movement, as well as the health service, needs to do more to promote the opportunities that exist for end-of-life care and for people to make different choices. There’s something about the health service and the hospice that provide a lot of that care to be more proactive in going out to a number of those communities who don’t take part and don’t take up palliative care in the way that other communities do, to say, ‘This is an option’. I’m pleased to see that they recognise that they had a problem and they want to do something about it, and I’m certainly interested to see that that does take place and, over the time of this plan, maybe seeing more people in different communities around Wales having access to palliative care and making active choices about their end of days.

I declare an interest in this subject as I am the vice-president of George Thomas Hospice Care, based in the grounds of Whitchurch hospital in Cardiff North. This delivers specialist palliative care for Cardiff to allow people to live in their homes and maintain their independence for as long as possible. I think it is an example of good partnership working between the voluntary sector and the statutory sector, between the Welsh Government and the local authority. And, also, I think we would all want to pay tribute to the long-standing investment of the voluntary sector in the hospice movement from which this grew.

I think that this plan is a very important plan, the palliative and end-of-life care delivery plan, and a crucial plan, and I'd like to pay tribute to Professor Ilora, Baroness Finlay, who has been so instrumental in this plan and who is standing down as the national clinical lead for end-of-life care in July. I've worked for many years with Ilora, and I think she's made a tremendous contribution to this area of work.

One of the issues that I'm very concerned about, which the Cabinet Secretary, I believe, did refer to in his introduction, was the really crucial issue of people, when they are very ill, being moved into hospital for treatment when, basically, it would be better if they were to stay at home if the support services there could be given for them to remain at home. And this does happen with many seriously ill people who have been receiving this support, but, when the situation becomes much worse, they then go into hospital. So, it's how we manage to keep people in that situation at home. And I’ve had several examples of that in my own constituency, where, actually, on a weekend, someone who was very near the end of their life was taken into a hospital A&E because the on-call doctor was so concerned about their condition, whereas I think, with a bit more collaboration and working together, they could have remained at home with a bit of increased support. So, I think that is one of the crucial areas, and I wonder if the Cabinet Secretary could say a bit more about that.

I welcome the point made that we need a review of the capacity of existing bereavement services, as I think these are a vital part of planning for end-of-life care. And, in George Thomas Hospice Care, the consultant has described to me about how they are providing pre-bereavement counselling for children who have a parent, or a grandparent, maybe, or perhaps a sibling, who is dying, and she says that this absolutely helps enormously if you do it before the loved person dies and that that does mean you tend to need less frequent follow-up sessions afterwards. So, I wondered if the Cabinet Secretary had any views about that and whether this was something that was happening to any extent throughout Wales.

And then, of course, there is the whole issue of children's services for the small, but very important, group of children who do need palliative care, and I'm sure he is aware of the work of the Together for Short Lives body, which has put forward several proposals.

And then the final point I wanted to make was in terms of advance planning. We have to take account now of the number of people diagnosed with a dementia who will need end-of-life care, and we are having a debate on that later on in the afternoon, about dementia. But, in George Thomas Hospice Care, 75 per cent of their patients have cancer, and, up until now, the next group that they were working with were people with heart disease. But now the next-biggest group is people who have dementia, and I think that that is something that we've really got to take into consideration in planning for palliative care, if people do have a dementia. And I note that—I think it was Macmillan who have said that we need to do a lot of pre-planning with older people, and I think we've just got to take into account the fact that a large number of people have dementia.

And then I just want to say that I do agree with all the issues about, you know, trying to learn perhaps from the Compassionate Communities movement. We do need the big conversation, and we do need to move on to make death much more a part of life.

Thank you. I just want start by agreeing with you on your point about people with dementia and to reinforce the value of having advance care planning so people can make choices when they're in a position to do so, and to actively decide what they would want, rather than leaving it for other people to second-guess what they might have wanted at a different time in their life. And, actually, supporting people with dementia is particularly difficult. I know we'll discuss this later on today, but the process of going through and losing someone, and losing the personality they might have had, or parts of it, and then to lose them physically as well—it is a particularly challenging time for the individual who is going through that and their families as well.

I think I’ve already mentioned the progress on paediatric care, but what I haven’t mentioned, though, is the additional work we’ve had done on the transition between paediatric and adult services. It can be a really difficult time for the individual young person as well as their family, and this can be particularly difficult when relationships are built up through the paediatric service, and how that’s actually transferred on. But we’ve got a particular post within Wales, which is a first, based at the Children’s Hospital for Wales, and that particularly looks at the transition from paediatric palliative medicine into adult.

I recognise the point that you make about bereavement support pre death, about having that conversation earlier, and that’s recognised—the earlier the conversation, the better prepared people are for the bereavement. On your point about George Thomas hospice, you’re right: individual and community investment in creating that movement and then sustaining it as well is a hugely important part of what keeps the hospice movement special and well funded. I also want in particular to recognise the points you make about Ilora Finlay, the clinical lead for Wales, who is much respected right across the UK as a clinician. If you want to sum up Ilora’s view on end-of-life and palliative care, I think it would be fair to say that she says that Wales has much to be proud of, but also much more to do. I think it’s a fair reflection on where we are.

The final point I want to make is on the point you make about maintaining support for people in their last months and year of life. We know that too many of those people have unnecessary hospital admissions, and so it is something that is part of the focus for improvement. The latest figures show that there are 65,000 admissions of people in their last year of life—65,000 admissions into hospital. Not every one of those will be inappropriate, but we recognise that a number are, and with different support that person could be appropriately cared for in their own home. So, that’s a large part of the focus for improvement in the year ahead. So, I think the points are well made, and hopefully next year we’ll be able to report back on progress that has been made for people across the country.

Thank you for your statement, Cabinet Secretary. The sad fact is that while everyone will eventually die, we don’t all die well. Because of the latter, it is essential that we have excellent end-of-life care.

I welcome the Welsh Government’s palliative and end-of-life care plan, and the commitment to improve the care given to those approaching the end of their lives, and those they leave behind. If current trends continue, the number of people dying in Wales will increase by 9 per cent. We know that around 6,200 people who die each year do not get the palliative care they need, but these figures come from Marie Curie, and they’re not coming from the NHS, and therefore don’t feed into the workforce planning.

We need an all-round approach to palliative care, as often the whole family are involved. Therefore it is essential that staff are properly trained to deal with sensitive situations such as this, and it’s pleasing to see that £150,000 is provided to train staff in advanced communication skills and end-of-life care. Although this is a good start in recognising the specialist skills needed, could you provide more information on how many staff you anticipate this will train, and what areas will be covered in Wales? Some may be more than others, due to logistic situations.

Funding to provide access to hospice-at-home provision is welcome, along with palliative care registers for all GPs who have a register of all patients with supportive palliative care needs. Could you also tell me how these registers are compiled? Because there are some people, obviously, without families, who go unnoticed, who become ill, and they’re reluctant to visit their GPs. I wonder how we can reach these people who sometimes—very often, actually—die at home and are discovered days or weeks later. Can we do more to ensure people like this are included?

Also, to bring back something Rhun had said, a Marie Curie report has highlighted, as I indeed highlighted in the last statement, additional barriers faced by bereaved LGBT and BME communities, beyond the universal pain experienced after losing a partner. Despite this, there are no specific actions outlined in the delivery plan aimed at addressing these issues. Cabinet Secretary, do you agree with me that, if we are to improve the end-of-life care for BME and LGBT communities, we must address the shortcomings in this plan?

In England, the NHS conducts a survey of the bereaved called VOICES, and this shows the level of care and support given to families at the end of their loved ones’ lives. We don’t conduct any such survey in Wales. If we are going to ensure that everyone who needs specialist palliative care gets it, and we’re going to ensure that an individual’s needs, priorities and preferences for end-of-life care can be identified, documented, reviewed, respected and acted upon, then we must conduct a survey of the bereaved also in Wales. I see there is no provision for this in the statement.

Rather than relying on data collected through the iWantGreatCare programme, which many patients are unaware of, does your Government have plans to introduce a comprehensive survey of bereaved families in Wales? The website launch of ‘Byw Nawr’ is welcome and is definitely the way forward. However, we must not depend on the statement that nowadays most people find most of their information online. Although this is true, there are many people without access to online services and, therefore, we need to be inclusive.

So, it’s important that this plan is inclusive and beneficial to all. I note that consultants in palliative care are now available on call 24/7. Can you tell me how people will become aware of this service? The work with Tŷ Hafan children’s hospice and a 24 hours out-of-hours telephone call service for paediatric palliative care is essential and is very, very welcome.

I thank all hospital staff involved in this extremely sensitive area, whilst also acknowledging the dedication of families to their loved ones. I recognise the positive ongoing work and the commitment shown by the Welsh Government and the Cabinet Secretary in this statement. However, I look forward to working with you positively and constructively to further improve the services in palliative care. Thank you.

Thank you for the series of questions and comments. On the point about serious illness conversations, I’ll happily provide an update for Members about how many staff have undergone the training in the last year and how many more we expect to have that training over the next year and more as a result of the additional resource we are putting into it.

On your point about the survey of bereaved families and/or patients, I’d be happy to consider whether there is a better way forward from the iWantGreatCare survey, but at this point in time, no-one has suggested to me, and it’s not been an ask from the board, that we need to have a different means of understanding feedback directly from people involved in the care and people who are involved in receiving care as well. I would have expected, if there was a real call for that and there was an inadequacy, that that would have come through the board, both from clinicians who are still champions for their patients, as well as from the campaigning third sector as well. So, if there is real evidence there’s a need to do something different, then I’m open minded about it, but I would need to be persuaded that we don’t currently have an adequate way of understanding the quality and the impact of the care that is provided.

On the same note, on the point you made about the organisation of palliative care, we’ve got more people available at different times in the day now as well. We’ve got a service that is available throughout the week. I’d need to be persuaded that there is a different way in which that should be accessed. Part of the challenge, of course, and one of the points you made earlier, is what happens to those people who die alone in their own homes. Those evens, fortunately, are few and far between.

There is a broader challenge about how we as a society engage within our own communities, with our neighbours, and with our loved ones. Because, actually, if family members are not engaging directly with those people, it’s very difficult to then say it’s somebody else’s problem, whether it’s the Government or the health service. There’s a challenge about how people engage in services. The great majority of people are engaging in health services towards the end of their life. It’s relatively unusual to have a sudden end to someone’s life. It normally comes when people expect that is what is going to happen.

It’s really about how we support people involved in caring for people at the end of their life—those are people in families, friends, and of course professionals in health and care services. That’s how the primary care register is drawn up and maintained. It is exactly that: people involved in care making sure they’re ready and available to make sure we can properly target the resources we do have to properly support the professional and the individual.

The final thing I’ll say, on your point about the engagement, or otherwise, of the third sector and individuals, and engagement with the Government about the survey evidence that exists, is: we actually know, from all the different fields of engagement, that the hospice movement and third sector organisations are part of the organisation that designs and delivers these plans. They’re part of the delivery board. They talk regularly to their health service organisations and individual commissioners as well. That’s part of the strength of the way in which we design and deliver our delivery plans. I want to see that maintained. If people do have real evidence there’s an inadequate source of information, I’ll consider it. But, really, we don’t want to undermine the strength of the board in the process. We do know there’s very real challenge delivered through that, and I think we’re all the better for it.

In welcoming the statement from the Cabinet Secretary, can I put on record my acknowledgment of the huge changes and investment that have been made over the last four or five years in Wales that have substantially changed the discussion we have about these issues, as well as some of the co-operative working that we’ve already heard about in the statement? I welcome that.

However, I want to ask him a more fundamental and different question. Because as his statement points out, we are extending life through medical intervention, but, I feel, not always asking a more fundamental question, which is: is this needed or necessary, or does the patient really want it? We demand and expect dignity in life, and in end-of-life care. It is time to discuss whether we should not have the same dignity and rights extended to those who wish to end their lives at a time of their choosing, whether they’re facing a terminal illness or a debilitating condition such as dementia.

Now, currently, this is not a legal position. It’s been challenged regularly by brave individuals who go to the courts in the position of end-of-life terminal disease themselves, to challenge this position. The most recent brave person to do that is Noel Conway, who has just been given the right to challenge to the Court of Appeal. But I acknowledge that the courts have consistently said—and I tend to agree with them—that this is not a matter for the courts, but a matter for Parliament, and a matter for Parliament to decide. So, I wondered, with the election of a new Parliament, and a new Government, whether the Welsh Government does intend to have this conversation with that Westminster Government, because although the powers are not here, they affect each and every one of us in the decisions we’ll be taking about our lives and the lives of our friends and family.

Can I leave him with a quotation from Atul Gawande, who is a Reith lecturer and who wrote a very, very good book on this whole process of dying called ‘Being Mortal’? What he says is this: ‘For many, such talk’—and by ‘such talk’ he means the sort of thing that I’ve just suggested—‘however carefully framed’—I hope I framed it carefully—

‘raises the specter of a society readying itself to sacrifice its sick and aged. But what if the sick and aged are already being sacrificed...and what if there are better approaches, right in front of our eyes, waiting to be recognized?’

Does the Cabinet Secretary recognise that there are some approaches that should be discussed also?

Thank you for the recognition of progress made and the recognition that’s been made by different parties working through the last Assembly and into this one, and by different people outside this place as well. I think that’s very welcome.

In terms of the broader point you raise, I think that’s going beyond the conversation we want to have about making choices about how we want to die. There is part of it, though, that is still about where we extend life in medical interventions. There’s a challenge here about ‘do not attempt to resuscitate’ notices, and what people would and wouldn’t like. There’s something there again about going back to advanced care planning, and understanding what we want, as opposed to leaving it to a medic to intervene, because the challenge for the medic will be—or whoever the healthcare professional is; there’s been a recent Nursing and Midwifery Council decision on this that I found difficult—about what point should someone attempt CPR or otherwise. Most healthcare professionals will feel that they’re duty-bound to attempt CPR. Now, I think there’s a real challenge there, because there will be times when actually that is probably the wrong thing to do. But the challenge is how you have that conversation that takes account of the professional duties and the ethical duties that individual healthcare professionals have, and also their ability to be a regulated and registered professional as well. So, this is not an easy area—and that goes into the individual conscience choices that you raise about what we would choose to do for ourselves. As well as the gentleman you refer to, I knew Debbie Purdy and her challenge as well about her ability to make choices for herself. I think part of this is that, when we talk about what Parliament decides to do, there isn’t a Government view on this. This is a matter for individuals to decide what they choose to do—how, where, why and whether the law should or should not be changed to make it easier for people to end their life at a time of their choosing. Personally, I find it quite difficult to see people going to different countries to end their life at a time of their choosing. If I were in that position, I’m not sure what I would do, but that’s why it is an individual conscious choice, and I think that’s the right thing for it to be. But, in doing that, I think we all need to take account of the ability of an individual to make their choice for themselves, at a time of their choosing, obviously with the safeguard of the capacity to do so. But, equally, we do have to consider the hazard that we potentially put in the way of healthcare professionals. It’s a difficult and a finely balanced debate, I think, for all of us to have, and almost all of us will come to slightly different conclusions. But I think, absolutely, in the area of where we are now, we need to have a more regular conversation about dying, what it means to us, what matters to us, and what matters to those that are left behind.

I, too, very much welcome this statement today, allowing us to focus on these very important services that matter so much to people and their families across Wales. And like many others, I’m familiar with my local services in Newport, and the St David’s foundation, and I know that they have very impressively grown and expanded their services and presence, not just in Newport, but surrounding parts of Wales over many years, and do provide real commitment and quality of service.

I would like to raise a few matters with the Cabinet Secretary—first of all, specialist prescribing by pharmacists in hospices, and their role with community pharmacists, because I am familiar with the view that they can provide a great enhancement of end-of-life services, entirely in line with prudent healthcare, and entirely in line with allowing people to return to their homes in a timely manner. And high-quality prescribing I think is absolutely central to this area of health provision. So, I would like to ask the Cabinet Secretary what perhaps expanding role he sees for those specialist prescribing pharmacists in taking strategy and policy forward. Also, core funding for hospice services in the community—because, again, I guess many Members are familiar with the pressure that these services operate under, the expanding demand that, obviously, will accelerate with the ageing population that we will have, salary pressures within the services that they provide, nursing and otherwise, and, of course, some of the increasing role that these services will be fulfilling in the future. So, I would be interested in to what extent the delivery plan will prioritise addressing those core funding pressures, because, I think we haven’t seen an increase in that core funding for these services over quite a period of time.

Two other matters briefly, Dirprwy Lywydd—

Yes, you’re out of time—quickly.

Very quickly, then. First of all, there’s the taboo that is involved in discussing these matters. Obviously, today is a way of addressing how we overcome that taboo by the very nature of the statement, and the debate and the delivery plan. But it does seem to me that there was a time when death was much more a family and community experience, you know when bodies were in the home, as it were, and when people took matters into their own hands in terms of how they dealt with death. And it’s very much, I think, been removed from that setting and been professionalised. And it has created a taboo, and we do need to make sure that conversations take place if people are going to think ahead, plan ahead, and ensure that they’re ready for that inevitable end of life. So, I think we do need a cultural change, and I think this is recognised in what the Cabinet Secretary has said, and we need to make sure that that takes place.

No, I’m going to stop you now—

Just on black and ethnic minority services—

Very quickly, because you’ve had three—

Very, very quickly, Dirprwy Lywydd—only to say that we do have an example through Marie Curie of how we can provide an enhancement of service and a greater access. And I think we do need to roll that out, that sort of approach, throughout our communities in Wales.

Thank you. Cabinet Secretary.

I’ll try to be brief, Deputy Presiding Officer. I recognise the points made around the role of specialist prescribing. I recognise the challenges on core funding. It would not be honest of me to say that I can deliver a significant amount of extra core funding. We’re all aware of the pressures on every public service at a time of reducing budgets, and the extra money going into the healthcare budget comes at a real cost to other parts of the service. So, I won’t make promises that I can’t deliver in this or another area. I do recognise the points you make about black and ethnic minority communities, and the progress Marie Curie have made. I think there is a challenge there for the rest of the hospice movement and, indeed, the health service to understand those particular challenges and make better provision.

And finally, this is the point about having a statement, having this conversation—it is still a taboo subject. We need to get back to a point where it is a much more normal conversation. So, I do look forward to having this conversation again with Members, both within and outside the Chamber, about how we’re trying to renormalise a conversation about the most inevitable event. Birth and death are the two inevitable things about our life, and we don’t spend anything like enough time talking about it, discussing it, and then we can all have as good a death as possible.

Thank you very much for that.

Item 4 on our agenda is the statement by the Cabinet Secretary for Education on educational leadership, and I call on Kirsty Williams to introduce the statement.

Thank you very much, Deputy Presiding Officer. When reflecting on the many excellent schools that I have had the privilege to visit over the last year, it is clear to me that each benefits from high-quality leadership. Our challenge, as noted by the Organisation for Economic Cooperation and Development, is to ensure a whole-system approach to leadership, and to make it a prime driver of our education reforms. To succeed, every school needs inspirational leaders, and I believe the establishment of our national academy for educational leadership is an important step forward. Set alongside new professional standards, reforming initial teacher education and curriculum reform, it is part of a coherent and collaborative approach to leadership development.

Since announcing the establishment of the shadow academy board last November, I have been greatly encouraged by the progress that has been made in a short space of time. The shadow board, led by Ann Keane, have proven themselves to be professional, enthusiastic and committed to this task. To be the best, Deputy Presiding Officer, we must learn from the best, and, therefore, I am pleased that they have considered international examples of leadership development, from some of the best-performing education systems in the world, such as Canada, Singapore and New Zealand. And they are clear: we must build on international evidence to form a made-in-Wales approach. The board have made a number of recommendations around defining the vision, the values and the function of the academy, along with governance and its organisational structure.

In focusing on the leadership of learning, supporting the four purposes of our new curriculum, the academy has set out a vision to be: inclusive and collaborative, enabling equitable access to opportunities, owned by the sector, and central to developing a culture-led collaborative leadership; inspiring and motivational, promoting great leadership development now and for the future, linking coherently to the national reform agenda; capacity building, enabling leadership to thrive, and empowering leaders, and ensuring our future supply of leaders; and having quality and impact, making clear the role of leadership, and the difference this makes for our system, and underpinning that with research and a strong evidence base.

The board has reached a unanimous consensus that the academy should be a company limited by guarantee. This would enable a flexible governance structure, which can better accommodate sector representation, would have a legal form favoured by the Charity Commission, and could employ staff in its own name. I have therefore instructed officials to start scoping the timescale and resources needed to establish the academy, in spring 2018, as a company limited by guarantee. I expect this to be a small and agile organisation, with a small strategic board, and led by a chief executive. We will continue to consult on the full role and remit of the academy, and test the timescales for next steps. There will be a series of regional roadshows next month, and I would encourage stakeholders to attend and learn more, and to give their feedback.

It is my intention, based on the advice of the shadow board, that the academy will broker and quality assure a range of programmes, have a role in ensuring provision across regions, support leadership at all levels, and work with others to identify and support current and future leaders. I have said many times in this Chamber, and outside, that the quality of our education system cannot exceed the quality of our teachers. Over the next five years, we are committed to developing a national approach to career-long professional learning that builds capacity from initial teacher education and is embedded in evidence-based research within a self-improving school system.

My vision for professional learning is one where actively engaging in professional learning is a primary responsibility of every individual, and its purpose is to develop individual and collective expertise to raise standards for all of our learners. That impact will be seen in the embedding of the four curriculum purposes into the learning and experience of all our learners. We will do this through approaches that are collaborative, coherent and innovative, as well as research led.

The proposed new professional teaching standards will bring together standards for teaching and leadership to reflect better career pathways from entry into the profession and onwards and in a way that provides clarity of expectations. This includes both those who choose to focus solely on their classroom practice and those who choose to move into more formal leadership roles, up to and including headship. These proposed standards are based on five areas of practice: pedagogy, collaboration, innovation, professional learning and leadership. The proposed new standards will have leadership as one of the five areas of practice for all teachers. The importance of effective leadership at all levels is essential if we want to improve the quality of teaching and improve learner outcomes.

Progress has also been made in respect of current provision. In relation to headship, we have worked with consortia and we have enhanced the national professional qualification for headship. A current cohort of practitioners is going through this programme and I will seek their views on what further improvements we will need to make. While I recognise that in some areas recruiting headteachers is not without issue, I am not prepared to compromise on the quality of entrants to headship in Wales. I believe we need to set the bar high for those we entrust with the leadership of our schools. So, whilst I recognise that the NPQH needs to develop, I am clear that we should maintain the requirement and keep it as a threshold for entry into headship.

We have also been improving a range of leadership programmes for heads and middle leaders to ensure that we have an enhanced and coherent offer across Wales. From September 2017, we will have a range of common programmes, and, again, I will update the Chamber at a later date.

The establishment of a national academy of educational leadership, alongside new professional leadership standards aligned to professional teaching standards, will ensure that leaders at all levels are well supported to develop and inspire colleagues and to work collaboratively to embed the new curriculum. Taken together, these reforms will drive forward our national mission to raise standards, reduce the attainment gap and ensure an education system that is a source of national pride and national confidence.

Can I thank the Cabinet Secretary for giving us sight of this statement before she made it in the Chamber this afternoon? The Cabinet Secretary will be aware that the national academy for leadership was something that we very much supported when she announced it in November last year. If there is any criticism, it’s about the pace, really, of delivering against that announcement, because, of course, you’ve alluded today to the fact that this thing won’t actually be in place until the spring of 2018. That doesn’t sound like the sort of pace that we need in order to address some of the real challenges that we’ve got in delivering high-quality leadership in the Welsh education system.

Just yesterday, we heard some of your senior officials telling an Assembly committee that some leaders in Welsh schools were guilty of gaming the examinations system—not allowing young people, potentially, to reach those higher grades and trying to bank lower grades. I think that epitomises a system, really, that isn’t allowing everybody to fulfil their potential. I know you’ve got some concerns about that, and I’d be grateful if you could, perhaps, comment on that in response to everything I’ve got to say.

Of course, we’ve got some excellent leadership. You’ve referred to the fact that you’ve visited many schools already and seen that leadership—I’ve got some excellent leadership in my own constituency. Then, of course, there are examples of poor leadership across Wales as well. One thing you didn’t refer to in your statement was trying to port some of the good leadership that we’ve got in our university and further education sectors into our schools, and whether there might be some role for the national leadership academy in helping to facilitate that. I know, again, we’ve had some exchanges on this in the past, but our further education colleges in particular, I think, show how you can run pretty significant large organisations that have already got a certain amount of collaboration with our secondary schools, and there’s no reason—I can’t see any reason—why some of that leadership ought not to be rubbing off, particularly onto our secondary schools. Of course, as well, we’ve got some very good collaboration now in terms of federal models—federations of schools—around Wales. But I wonder whether clustering schools together with strong leadership is another potential way forward and whether, again, the national leadership academy will be able to have some input into that.

I note that you said that the shadow board and the academy will be brokering and quality assuring a range of programmes in the future. I just wonder how that sits in terms of the existing arrangements. Obviously, we’ve got the Education Workforce Council, we’ve got Estyn and others, all with an interest in this field. It would seem to me that there needs to be some sort of collaborative approach.

You’ve mentioned the fact that we’re going to have a board, and you want it to be a small board, but there are obviously lots of stakeholders who will have an interest in making sure that that board works correctly. We’ve seen Welsh Government establishing boards in the past for things and it’s gone horribly wrong. RIFW springs to mind, for example. So, we obviously need to make sure that this board is of the right shape and size, but also that it can be held accountable for its actions, both to the Welsh Government and, indeed, to the National Assembly and the sector as a whole. So, how do you see those sorts of arrangements working to make sure that the governance of this new board is actually going to be right?

Can I also ask you, Cabinet Secretary, about how you’re going to measure success? Obviously, we see snapshots on an annual basis with the Estyn annual report of their take on performance across Wales. We see a snapshot every time there’s an inspection that is completed. We’ve seen snapshots with the OECD’s reports as well into the Welsh education system. But how are you actually practically going to measure the success of this academy? Is it going to be improved outcomes for pupils, for learners, or is it going to be the fact that people have attended courses? Because I can’t see anywhere in the statement today precisely how you’re going to be able to measure that.

You’ve mentioned some of the recruitment challenges that we’ve got, and I recognise those too, certainly in some parts of Wales. Welsh-medium schools, in particular, faced some challenges in recruiting new heads in the past, as have some of our specialist schools and our faith schools as well. So, I wonder whether you’re going to have a particular focus on some of that specialist provision where we’ve got these weaknesses in terms of being able to identify new heads, and how you expect this national academy to be able to plug some of those gaps. Thanks.

Can I thank Darren Millar for his in principle support for the academy and a strong focus on leadership? Members will be aware that lack of support for leadership was a key component of the OECD report into the state of Welsh education in 2014, and it’s an area where not a lot of progress has been made. So, like you, Darren, I’m very anxious that progress is made as quickly as possible and, as always, we’re trying to get the balance right between pace and ensuring that what we’re doing is of value and will succeed.

So, we’re certainly not sitting back and waiting for the spring of next year when we would expect the company to be up and running. That’s why I highlighted changes we’re already making, for instance, to the NPQH, which needed to be strengthened, in my view, and how we’ve been able to persuade the consortia to better work together to streamline their offer. One of the challenges in the past has been that the offer available for professional learning at all levels has been very dependent on which consortia you happen to be working in. From September of this year, we will have a more unified offer that provides equity for teachers right the way across our nation and will be of a similar standard regardless of where you are. So, we’re not sitting back waiting for the spring; we’re getting on and we’ll have new offers available from September of this year.

Darren raises the issue of early entry, which was the subject of much debate at yesterday’s Public Accounts Committee. You will be aware that I too have raised concerns both inside and outside this Chamber around the practice of early entry. Let me be clear—I welcome the opportunity to be clear once again: each decision about early entry into a formal examination should be done on the basis of what is right for that individual student, and I am concerned that that is not what is being done in some of our schools. There is evidence to suggest, anecdotally, that some students are entered early, bank their C grades, which works towards the school’s accountability measures, when really, given the opportunity to sit that exam again, or indeed sit that exam a year later, that child could have gone on to get a B or an A or an A*.

We are doing two things about this, Darren. One, we are having some qualitative research done with regard to the patterns of early entry, which is being done by Qualifications Wales; consortia have written to all schools to express my concern and to reinforce my approach to early entry; and I am committed to reviewing high-stakes accountability, which is often the driver for decisions that are being made regarding early entry. We have to have a smarter way of looking at whether a school is successful or not, and not one that has unintended consequences that potentially we are seeing here with regard to the use of early entry.

Darren, it’s a good point about FE and HE. There are already leadership programmes in place for both of those sectors. We have been remiss in the school sector about not having this provision earlier, and FE and HE have been part of the discussions. We look to work with them closely to see what lessons can be learnt. My ultimate vision for the academy is that the academy will provide leadership opportunities for everybody who is engaged in education in Wales—from our nursery sector, from our school sector, FE sector, HE sector, regional consortia, local education authorities and, dare I say it, even the education department of Welsh Government as well. If our education system is to be a success, we need leaders at all levels, and nobody is immune from being able to engage in professional learning that will make them better at that job, and that goes for my department also.

Federation does provide an opportunity to address some of the challenges of leadership and recruitment and retention, and that is being increasingly used across the sector. It is a particular issue potentially in rural schools, where being able to recruit headteachers to small, isolated rural schools can potentially be problematical, and therefore create a question mark over the future viability of the schools. Therefore, you’ll be aware of the introduction of the rural schools fund, which has particular guidance attached to it to look at supporting federation, both hard and soft.

With regard to the make-up of the board, I expect it to be small, and I expect it to be led by a chief executive and a chair that has all the auspices of public appointments. But to reassure you, both the Education Workforce Council and Estyn have been involved in the shadow board. EWC is a formal member of the shadow board and Estyn is an observer at the shadow board. So, we’re taking into consideration those people’s views as we develop the programme. What will success look like? Well, we haven’t got to that stage yet of actually having targets or success measures, but success will be improved outcomes for our learners and Wales being the place to pursue an educational career, whether that be as a schoolteacher or a school leader, because you will want to come here because you will be developed into your role, you will be supported in your role and you will be working in a successful education system.

May I thank the Cabinet Secretary for her statement and echo her thanks to the shadow board for their work too?

You make reference in your statement that over the next five years you’re committed to developing a national approach for career-long professional development. I know you’ve made reference to this in the past, and this will be good news for those who have been providing evidence recently to the Children, Young People and Education Committee on CPD, who feel, perhaps, that the coherence and the co-ordinated package aren’t currently in place. But you do say, and I will pick up on the issue of timing, that that will happen over a period of five years, and whilst I accept that the creation of a new body, or the company limited by guarantee that you refer to, is going to take some time, are we ambitious enough in trying to reach the point that we are trying to reach in a period of five years? Perhaps you could respond to that point.

I would agree most strongly that we do need to improve career paths, as you say and that you acknowledge in your statement, but there is a dilemma, of course, because much of the evidence that we hear talks of teachers, and the best teachers, being promoted out of the classroom. Therefore, the challenge, I suppose, is striking that balance between ensuring that the best do have opportunities to move beyond the classroom in their careers, but also that we don’t lose the best teachers who become headteachers who don’t teach, or go to the consortia, or the local authority, or Estyn and so on and so forth. So, we need to ensure that that pipeline of talent is maintained. There is a risk, perhaps, that looking at this in isolation may be happening. I’m sure that isn’t the case, but I would like some assurances from the Cabinet Secretary that she is eager to strike that balance, but also I’d like to know how you are striking that balance between ensuring opportunities without necessarily losing the best talents from our classrooms.

You refer to the NPQH in your statement. I’ve raised some concerns about this provision in the past and the situation that did exist where there was a failure in actually accessing courses, where there were fewer places than there were vacant headship positions, and that wasn’t sustainable. I understand, as you say in your statement, that the situation has improved, but I would like to know, for example, whether the Welsh Government has looked at how many people have completed that qualification and have then gone on to take a headship. I would like some assurances that you have evaluated these courses as they currently exist, because the feedback I get from a number of teachers, and those who have completed this qualification, is that they haven’t necessarily learnt any new skills, but they are simply recording what they are currently doing. Now, I understand that there is some value in reflective learning, but I do feel that there is a perception among the profession that the NPQH doesn’t provide the best possible value for them in their career development. And if you want to retain the NPQH, as you say in your statement—and I have no problem with that, necessarily—then what I want to be sure of is that the NPQH is as meaningful and as valuable as possible, and has the best possible impact for the time investment of the sector and the individuals in terms of completing that particular qualification.

To conclude, and perhaps to play devil’s advocate—and I have broken the golden rule by using Google Translate to find the proper translation for ‘devil’s advocate’—but I could ask what the point is of creating better leaders if the burden on those leaders is actually stifling when it comes to carrying out that role. Because a major part of the challenge facing us in creating leaders is giving them the time to lead in an effective manner, but also giving them the time to learn how to lead properly in order to secure continuous improvement within the profession.

Now, I’m looking at the academy’s vision as you’ve outlined it, and the four bullet points: inclusive and collaborative; inspiring and motivating; building capacity; quality. Now, there’s nothing new there, if I can be honest about this, and I’m sure that you would acknowledge that. I accept that I’m taking it out of context—it would be good if we could see the whole of the work presented to you by the shadow board in terms of the recommendations and any work underpinning those. But if you’re if the profession, you’re a manager, you’re a teacher and you are also a learner in terms of CPD. You can be a SENCo; you can be part of a pioneer school and looking at the development of a new curriculum. Those are the main challenges or the main barriers to effective leadership: you simply don’t have the time to get to grips with that role. Almost 90 per cent fail to manage their workload within their working hours according to a recent survey by the EWC. So, there are some questions, I think, in terms of providing the time to deliver this agenda effectively, particularly, as you mentioned earlier, in smaller schools where you don’t have a team where you can delegate responsibilities to them. The agenda—you touched upon this in an earlier response—in terms of smaller schools, most often rural, and leadership go hand in hand. I would like to hear more as to how they overlap, too.

Thank you to Llyr for his questions. With regard to the professional learning offer, I simply don’t think that, in the past, we have been able to offer our teaching profession the professional learning opportunities that are truly useful to them. There’s a balance to be struck between a national approach, making sure that every teacher, regardless of where they are in Wales, has access to a suite of professional learning opportunities that reflect national priorities, whether that be around introducing the digital competence framework, for instance, or behaviour management, or new curriculum changes, but also recognising that, for each teacher, their own professional learning needs and expectations are going to be very different.

We have to move away from the old-fashioned professional learning that we’ve done in the past, where we require teachers to come, usually to Cardiff, and listen to a sage on a stage for the day and go back and simply do that in that school. That simply is not inspiring for professionals themselves, nor does it have an impact in the classroom. So, we have to ensure that there are national overarching professional learning opportunities, but also to be responsive to the individual needs of individual teachers. Professional learning can happen in lots and lots of ways, and our job is to ensure, as a national Government, that that is available to everybody, it’s properly funded, and what is available is of good quality.

Llyr, you’re absolutely right. One of the challenges that we’ve got is that, if you’ve got a bright, sparky young teacher, that person is whipped up through the ranks and often taken out of the classroom. It’s not true in all cases, but sometimes the professional qualities and talents you have that make you a fantastic classroom teacher aren’t necessarily the leadership qualities that are needed to run a school. So, we have to recognise and we have to provide career progression for those people who want to remain in the classroom. Their career opportunities and their earning potential shouldn’t be stifled because that’s where they excel. That’s where we need them to be, and, of course, the devolution of pay and conditions gives us a perfect opportunity to look at these things in the round.

The national professional qualification for headship, it does need to be—we do need to improve it and we’re in that process. We certainly take feedback from those people who have gone through. But there are two things that we do need to address: (1) why is it that, if somebody goes through the NPQH process, they then don’t go on to apply for a headship position? I know a very talented teacher in my own constituency and we had this very conversation. She said to me, ‘Are you kidding? I’ve seen what my headteacher has to do and I quite like my life, thank you very much’, which brings us on to the very real question that you talked about: workload. We often talk about workload for teachers, but workload for heads can often be extreme.

So, what we’re doing on workload for heads, we have got a piece of research going on at the moment where we’re actually looking at what headteachers spend their time doing and what we can do to alleviate some of that. I want my headteachers—our headteachers, sorry; that was very proprietorial of me, ‘my headteachers’—I want our headteachers to be concentrating on teaching and learning and curriculum development. I do not want to be worried like I was for one headteacher who spends most of her time worrying about how she’s going to get the doors open in the morning, because the school building that she’s working in is falling down around her ears. She should not be worrying about that; she should be worrying about teaching and learning. I don’t want the headteacher who I met recently spending time looking at how she can save an extra 10p on the paper order or the toilet roll order; she needs to be thinking about teaching and learning. We can delegate those tasks to other people. So, just like we could be looking at federation, we also need to be looking at business managers actually taking some of those tasks off headteachers and giving them to people who’ve got the skills to do that and the time to do that, so that headteachers can concentrate on what we want them to concentrate on, which is raising standards and providing great educational experiences for their young people.

The other issue is about having a benchmark for headship, and having some assurance about the qualifications and the readiness for headship, but let me be clear: what the academy will also be about is simply not getting somebody through an NPQH that they have quality assured; it’s also about creating the mentorship and the support that is ongoing. And one of the things we do do to new heads especially is, ‘Congratulations, here’s your new headship, off you go’, and we leave them alone. That is a terrifying prospect—a terrifying prospect—for those professionals. So, what the leadership academy is about is nurturing people’s careers throughout the entire journey and not simply saying, when you get to be the headteacher, 'That’s it, now you’re on your own, good luck with that’, but providing new mentoring and partnership arrangements, so supporting headteachers to do that.

Thank you for your statement, Cabinet Secretary. From my own experience in secondary schools, I know the importance of leadership in ensuring that our schools thrive, that the staff feel engaged and supported, and that pupils achieve the success that we want from them.

I have three short questions on your statement today. We all know about the pressures on school budgets. It’s not just about offering staff opportunities to train and develop, but also about ensuring there are sufficient resources in the system so staff may be released and training prioritised. How will you work with partners to ensure resources are sufficient so that staff can actually be released?

Secondly, I’d also like to know more about how the Cabinet Secretary will ensure the portability of this training and development, so that Welsh school leaders who have benefited can find their development recognised outside of Wales. I would hope school leaders in Wales would be recognised amongst the very best—how would the Welsh Government envisage wider recognition of this progressing?

Finally, the Cabinet Secretary mentions the excellent leadership she’d witnessed in Welsh schools, and I know we’re visiting Craig yr Hesg in Glyncoch together just next week to see one such example. How will the Welsh Government ensure that the brilliant practice taking place every day in Welsh schools is at the core of the new leadership offer?

Thank you, Vikki. One of the things that the OECD told us was (1) yes, we have to do more about leadership, but, secondly, we have to get better at recognising success and celebrating success. I think, sometimes, there’s something intrinsic in the Welsh psyche—if we were Americans, we’d be shouting from the rooftops, but there’s something intrinsic about us as Welsh people not to want to be boastful or to be too brash. That’s why we are looking at a number of ways in which we can, indeed, celebrate success and recognition. Most recently, we’ve launched the first ever Wales teaching awards, and a very uplifting experience it was too. We’re actively looking at Welsh Government scholarships for headteachers and educational professionals to gain the opportunity to study further, and have them held up as Welsh scholars. We’re looking at ways in which we can go on to enhance the reputation of training in Wales, but, ultimately, a lot of this will come down to the quality of our initial teacher education, and the provision by the academy. I want people to aspire to come to a Welsh institution to train to be a teacher, because they are the best institutions that deliver that training.

Time is a real issue, and constrictions in budgets do make time for professional learning a real challenge. That’s why we’ve got to be much more creative about how we provide professional learning opportunities not in the very old-fashioned way. There is so much to be gained simply by department-to-department working. One of the real challenges we’ve got in schools is not that that school is better than that school over there in another county; it’s actually in-school variation. We can have high-performing departments in one area and a low-performing department in another area. Actually getting the school itself to work together to raise standards internally is a potential professional learning opportunity that I would like to see happen more.

But this has to be taken as a whole package. The academy of leadership on its own will not succeed without our reforms to initial teacher education, without our professional standards. So, it’s very important that we look at all of this in the picture, and this is about, as I said, creating an education system that is a source of national pride, confidence, and holds the profession up to be the high-status profession we would all want it to be.

Thank you for your statement, Cabinet Secretary. If the academy’s responsible for brokering and quality-assuring leadership programmes, it’s obviously going to need to employ staff, I don’t dispute that, but the question I want to ask, though, is what size the academy is likely to be—how many people are likely to be on the board and how many employees will it need? How will the board of the academy be held to account for the performance of the academy? Will we wind up with a similar situation as with health boards, where, despite repeated failings, no-one on the health board appears to be held properly to account?

You also state that you are continuing to consult on the full role and remit of the academy. Can you give any indication as to when the academy’s full role and remit will be finalised and the details announced? My hope is that the academy will ensure that the provision of training is offered evenly across Wales, and I would ask you to confirm whether that will be the case. The Cabinet Secretary states that the Welsh Government has also been improving a range of leadership programmes for heads and middle leaders, but can the Cabinet Secretary please clarify whether the programmes brokered by the academy will replace or sit side by side with those already in existence? If it’s the latter, will the Cabinet Secretary please explain how the new programmes will be co-ordinated with existing ones? I support the Cabinet Secretary’s objective to improve leadership in schools and to give school leaders the support they need, but there is a lack of detail in this statement, and I look forward to hearing that detail in due course. I genuinely hope this academy will succeed, but we’ll see what happens. Thank you.

Can I thank Michelle for her optimistic outlook on the future of school leadership in Wales? What I should have done in answer to, perhaps, some of the questions from Darren and Llyr Gruffydd, and, indeed, to Michelle—I’m sure Ann Keane, who is chairing the shadow board, would be very happy to meet with spokespeople, or indeed other Assembly Members who have an interest in this area, for people to gain a deeper understanding of the thought processes. I’m fortunate that I get to meet Ann on a regular basis, but I’m sure she won’t mind if I extend that opportunity to Assembly Members, if they would like to engage with her on that. It is my anticipation that the existing programmes will come into the academy, but, some of these questions that Michelle raised, we simply haven’t got to the answers yet. That is the focus of ongoing work.

As I said in my statement, we have roadshows organised for next month, and the establishment of an internal Welsh Government project board to take the project forward. By July, I expect work to begin to set up the academy, including the articles of association, the terms of reference, board members, and transition from the shadow board to the new board. Once the company limited by guarantee is established, priority will be given then to the public appointment for a CEO and chair, and I want that to be under the terms of Nolan and public appointments, and then, from the spring, the shadow board will morph into the new organisation. Some of the details that Michelle has asked for, Deputy Presiding Officer, have not yet been agreed, and, like I have done today, I am more than willing to come back to the Chamber to update the Chamber as those decisions are taken by me.

Thank you very much. We have three more speakers, and can I just remind everybody that we have had one spokesperson from every party now, so can I just ask for a short preamble and short questions and shorter answers? Thank you. So, Lee Waters.

Diolch, Dirprwy Lywydd. Cabinet Secretary, I’d like to warmly support the passion you have for nurturing leadership as a way of achieving excellence in standards. Can I just ask a couple of questions about how you see this sitting within the existing landscape of initiatives, bearing in mind that we are meant to be doing fewer things and keeping things simple? So, how, in particular, do you see this fitting in with the consortia and with local education authorities, because I think there’s a danger we have a cluttered landscape? Secondly, we have an emphasis on school-to-school support for raising school standards, and there is, as you know, excellence already in leadership all across Wales. So, how do we see existing leaders supporting emerging leaders? And, finally, you mentioned in your statement that you said:

‘The quality of the education system cannot exceed the quality of our teachers.’

As you know, half of the school workforce are learning support assistants, and I do feel that they are a neglected part of the workforce. So, how do you see that workforce being captured within the spirit of the academy?

Deputy Presiding Officer, you want me to give short answers, but those are big questions—big, big questions. On higher-level teaching assistants, you’re quite right. They are a crucial part of our workforce, and we have seen the development of higher-level teaching assistants over the last Assembly term and we want to accelerate the number of teaching assistants that can access those training opportunities to raise their qualifications, and, as I said in an answer earlier, ultimately, whilst the academy initially will look at school leaders and potential leaders, we want the academy to look at leadership at all levels, including teaching assistants. With regard to school-to-school working, it’s absolutely crucial, as part of the self-improving system, that we provide those opportunities for people to see what good looks like.

Sometimes, when you go to a school, it’s not because people want to get up and do a bad job in the morning, but actually they simply do not know what good looks like. Actually, giving them the opportunity to see what excellent leadership and what great teaching looks like is absolutely crucial. As part of our work on school-to-school working, that’s what we are focusing on: to give people the opportunity to mentor, to work together, to spend time in other schools, in people’s classrooms, to use the excellent practice that we already have, and to be much more sophisticated in how we do some of our professional learning. I said earlier about improving it; if you go to the Fern partnership, their professional learning is developed by live coaching. So, the classrooms are set up so that the teacher can be observed from a different room. With an earpiece in, they’re actively getting advice on professional learning as they’re delivering that lesson—you know, ‘Try this’, ‘Have you thought about this?’ So, we’re investing in that kind of support and professional learning—much better than what we used to have in the past.

On LEAs and consortia, that’s why we don’t want the academy to provide this themselves, because that will just be another player. Their job will be to broker and to ensure that the consortia, who will take a lead on this, are applying this. But we don’t want them to provide it themselves, because that would just add to the confusion of what is already, in my opinion, quite a crowded field.

Thank you for the statement, Cabinet Secretary. I’m pleased that something very similar to the Welsh Conservatives’ policy has found its way into your own policy. Could I ask you whether you agree that education leaders have a crucial role in improving the place of the Welsh language in the culture of our schools and colleges? I’m not talking here about the curriculum, but the culture. And how will this be reflected in the vision, values and functions of the academy?

Well, I don’t know about a Tory policy finding its way into my agenda. I can assure the Member that this was a commitment in the Welsh Liberal Democrat manifesto a year ago, and that’s one of the reasons why I’m determined to take it forward.

I think this issue about values is absolutely fundamental. One of the things that makes me proud to be the education Secretary in Wales is because of the values that underpin our education system—values of equity, of opportunity; ones that are consistent with wanting everybody to have a fair crack and the ability to get on in life, not to be excluded because you don’t live in the right place or because your parents can’t afford the tuition, when you’re 11 years old, for you to pass an exam to get into a grammar school. The values that we see, espoused by the academy, are values of the Welsh education system, and they’re values that I’m proud of.

Finally, Rhianon Passmore.

Diolch, Llywydd. Cabinet Secretary, I am rising today to welcome this statement on education leadership. Wales has a proud heritage of high-quality teachers and school leadership. However, the announcement of the establishment of the current shadow academy board last November was widely welcomed. It is indeed heartening to hear that the shadow board has made a proficient start, and I welcome very much the fact that we’re looking at best practice from around the globe, including Canada, Singapore and New Zealand. Too often, time and energy is dissipated in attempting to reinvent the wheel when other education systems have already found creative solutions to shared problems. As the plan for the leadership academy evolves, can I ask whether the series of regional roadshows will include Islwyn? Additionally, how will these roadshows be advertised to stakeholders, and how will busy professionals, as has already been mentioned, be encouraged to attend and participate?

I would like, today, to acknowledge the work of your predecessor, Huw Lewis, who stated, when he announced the Welsh Government’s new leadership strategy, that

‘We know that school and college leadership is second only to classroom teaching as an influence on pupil learning—and this will be paramount over the coming years.’

Cabinet Secretary, from your statement, I note that you signpost, from September 2017, that we will have a range of common programmes available for professionals. Do you have an estimate of how many of our school leaders will be able to access these programmes, and what guarantees, at this early stage, can we receive of consistent access across Wales?

The roadshows will commence on 12 June. I don’t know whether the roadshow will include your own constituency, but I’m happy to provide details. Details of the roadshow will be given out via all the platforms that the Welsh Government has at its disposal, including ‘Dysg’ and including the new ‘Education Wales’ Facebook page. I would encourage Members—if they want to keep up to date with all things ‘Education Wales’—that they can like the new Facebook page. But I will write to the Member about more details for that.

The whole point of having the academy is to ensure there is equity of provision across the nation that is of the same quality for all our professionals, regardless of where they are. And the Member is absolutely right; if we want to have a first-class education system, we have to have first-class leaders. We have many in Wales, but not enough, if we’re honest, and we need to do more, and the prime purpose of this academy is to provide us with the leadership that we will need to ensure, as I say, that our national mission is fulfilled: that we have an education system that is a source of national pride and, more importantly for parents, national confidence.

Thank you very much, Cabinet Secretary.

Item 5 on the agenda is a statement by the Cabinet Secretary for Health, Well-being and Sport on the dementia action plan. I call on the Cabinet Secretary for Health, Well-being and Sport, Vaughan Gething.

Thank you, Deputy Presiding Officer. This statement today is timely, as we are currently in Dementia Awareness Week. I hope everyone is using this week to take action to raise awareness and offer both help and understanding to those who need it.

In October last year, on World Mental Health Day, I was pleased to launch the second delivery plan in support of our 10-year mental health strategy, ‘Together for Mental Health’. A key action within the delivery plan is the development of a dementia strategic action plan. This responds to a key commitment within our programme for government, to make Wales a dementia-friendly nation. We’ve come a long way in realising our commitment to create a dementia-friendly nation, but we recognise there is still more to do. As part of this, we’ve moved forward on developing a new dementia strategic action plan, as promised in ‘Taking Wales Forward’. So, I was pleased to launch the public 12-week consultation at Oldwell Court in Cardiff in January this year.

We should never forget that more people are living longer, and that is something to be celebrated. But, as life expectancy improves, we know more people will develop dementia. And dementia is one of the biggest healthcare challenges our generation faces. It is estimated that between 40,000 and 50,000 people in Wales are currently living with dementia. The impact of dementia in society is much wider when we consider carers and family members. Last year, we announced a number of priority areas on dementia and the steps we would take to address them, including providing more than £8 million of additional funding over the last two years to develop dementia services across Wales. This included work on dementia risk reduction, increasing public awareness, actions to improve diagnosis rates and ensuring support is available to people affected by dementia. And these messages have been built upon throughout our draft action plan. But, to ensure the plan is appropriate, it is crucial that we hear from people living with or affected by dementia, whether in a personal or a professional capacity, so that we understand what matters most to people. We must have a clear way forward to support people with dementia and the people close to them.

The views and experiences shared with us have been instrumental in creating the draft plan. A number of engagement events across Wales took place to hear from people living with dementia, family members, carers, health professionals, voluntary organisations and other people with an interest. This has been undertaken in partnership both with the Alzheimer’s Society and the Dementia Engagement and Empowerment Project, otherwise known as DEEP. Over 1,200 people personally affected by dementia took part throughout the consultation period, and our thanks go to those who have contributed to this work.

As I’ve previously said, no two people with dementia, or the people who support them, will have identical needs. Overwhelming feedback from the engagement undertaken is that people want support and services to be delivered with a rights-based approach, that that support should flexible to the different needs at different stages of living with the condition, and that action demonstrates a whole-pathway approach. Now, the plan supports this approach and contains a number of themes that require further action over the next five years. The themes were informed by feedback from the responses to the ‘Together for Mental Health’ delivery plan consultation in 2016, where dementia was cited, and the engagement with stakeholders undertaken prior to the formal consultation period, as well as from reviewing other relevant dementia strategies. The themes include: raising awareness of how to help people reduce their risk of developing dementia, or delay its onset; raising awareness and understanding of dementia through the expansion of dementia friends and dementia supportive communities and organisations; ensuring dementia is recognised appropriately and sensitively and that people have timely access to assessment and diagnosis; early support and treatment for people with dementia, their carers and families, following diagnosis; and the availability of increased support, whether in a person’s home, in hospital, or in a care home. 

The formal consultation closed on 3 April and we received 119 responses from a variety of stakeholders including the older person’s commissioner, a number of the royal colleges, and key stakeholders such as Care Council for Wales, the Welsh Local Government Association, the Alzheimer’s Society and DEEP. These responses, and feedback from the stakeholder events, are currently being analysed to inform the final report.

Respondents provided suggestions on how the final plan could be improved, and those suggestions included: strengthening the rights-based approach through the whole document; further emphasis of a cross-Government approach to include transport, housing and planning, as well as health and social care aspects; highlighting the importance of allied medical professions in supporting people with dementia and their families or carers; further emphasis and specific actions in relation to supporting people with protected characteristics; more focus on younger-onset dementia, palliative care, peer support and community-led approaches; more support for carers, including adding clear measures for respite provision; and more awareness of support already available, including promoting further the national dementia support helpline. Of course, many respondents also wanted to see a more ambitious diagnosis target. I recognise the importance of this and I’ve agreed that this matter will be kept under review. 

The findings from the consultation will be incorporated appropriately into the final plan, and will be accompanied by a detailed action plan that includes measurable actions and targets to be achieved within the lifetime of the plan. Following a wealth of notable practice being provided within the consultation responses, we will also be publishing a compendium document that highlights practice examples across the pathway so we can learn from what is already happening. It is only by working together we can build a truly dementia-friendly Wales and combat other problems, such as loneliness and isolation. The public consultation has already helped us to learn from people’s experiences and expertise to develop what I’m confident will be a robust, evidence-based action plan.

But I don’t want it to end there. I want to see the third sector taking a more active role in the way services are shaped and delivered in the coming years, which should be a great example of prudent health and care principles in action. I want us to tackle the stigma attached to dementia and take away the fear that many may have through a lack of knowledge and information. We know from our consultation that there are a wealth of community projects spanning the country that look to raise awareness and understanding of dementia and that will help to reduce stigma. I want to see more communities in Wales becoming dementia friendly and provide help and support to all those who need it.

It is my hope, therefore, that at the three-year point of review, I, or my counterpart—whoever is providing the report—can stand up as I am here today and broadcast the progress and changes that we have made towards making Wales a genuinely dementia-friendly nation. I trust that Members from all parties will recognise the work undertaken to produce such a comprehensive document that reflects the voices of many people across Wales. We certainly will be listening to contributions made in today’s statement, ahead of our publishing the final plan in the summer. I want that final plan to be ambitious but achievable, and that we can continue to work in partnership in the future.

Thank you very much for your statement, Cabinet Secretary. I think Welsh Conservatives would be keen to support plans drawn up or even led by those who live with dementia, either first hand or as family members, friends or carers, and, as you say, other voluntary organisations and those who have an interest who took part in the consultation. We certainly support the rights-led approach, but I did want to press you, first of all, on the balance of the delivery mechanisms that have been referred to in the draft plan.

Now, most of the proposed key actions seem to be the responsibility of health boards, and in terms of direct medical intervention, I can see why that would be the case—diagnosis professionals, psychological and pharmaceutical support, and care for an individual, perhaps within a nursing home or another medical setting where they might be receiving assistance across a number of co-morbidities, shall we say. But with better diagnosis, there is greater scope, I think, for non-medical support, particularly early on. I think an over-emphasis on the health board, if you like, might almost be, for some people, like giving in to the fact that they’re going to need medical care. Even though that might be true later on, it certainly isn’t necessarily true early on. I’m wondering whether the early part of the support pathways that you refer to in here could be less about health board leadership and more about individuals and other partners who might be better at the whole, sort of, emotional, family support approach to things, rather than looking to the LHB for the lead all the time. I heard what you said about the third sector and I support what you say in that, actually, but the idea of co-production goes beyond even the third sector and we should be looking, perhaps, a little bit more to community structures, which include family, of course, or friends, to help with those early stages following diagnosis.

I wonder if you can tell me a little bit as well about what a future dementia support worker is going to look like. I appreciate we already have some working in a number of sectors at the moment, but the plan refers to specialist intervention for those who have dementia through alcohol or those with early onset dementia. Are we going to be talking about the same individual dementia support worker, or are we talking now about a range of dementia support workers for an individual? I’m guessing the answer to that is flexibility in responding directly to the needs of given individuals, but I’d appreciate a bit of steer on whether we’re going to need more dementia support workers, whether they will need different skills and, once again, whether they will necessarily come from within the health sector.

Clearly, a lot of work has gone into awareness raising in the general population, and I certainly welcome that, although I’m not entirely clear who is going to retain responsibility for that. But just as importantly, a lot of work seems to have gone into dementia awareness and training within the health and social services sector particularly. I’ve got two questions on the back of that.

The first is that general awareness training at population level means that a lot of us are more aware than we were before, but I think still very few of us will have the confidence or the knowledge to broach the subject with a neighbour or somebody we see regularly in the shop or the pub—somebody who’s outside our immediate family but still within our community—because not everybody is picked up through professional routes, particularly if they live alone. I’m wondering whether this plan is the place to help us, generally—you know, members of the public—be part of helping, certainly in early-stage dementia. Then the flip side of that is how more detailed training can reach public-facing activities outside the public sector—so, hospitality, retail, public transport—so that the rights you were talking about are actually capable of being fulfilled. I know there’s some fantastic examples of voluntary approaches to this, and we spoke about Tesco having its slow shopping day, for example. I think there’s more space for that.

Then, finally, the draft plan—and I think I’m quoting your speech here—says more support for carers, including ‘clear measures for respite provision’ for carers. I agree, but this is an area of policy where the words ‘rights based’ are, sort of, in many cases, simply just words, and identifying needs under the social services Act doesn’t always translate into actual support for carers—that’s an observation, it’s not a criticism. So, my question on that is: what are your thoughts on how we might all work, actually, to help deliver on rights for carers in terms of respite, and that’s cross sector and, as far as Welsh Government is concerned, cross portfolio? Thank you.

Thank you for that series of questions. Of course, to be very clear, we’ve got national manifesto commitments on improving respite care for carers. You can expect us to make progress on that in the course of this Government. On your general point about awareness generally, which I think is a completely fair one, across the public—. It’s something about what is a generally dementia-friendly community, it isn’t just about a handful of individuals or just about public services, it is about public-facing interactions, and that does include individuals and companies as well as public services. That’s recognised in what we try to achieve in having generally dementia-friendly communities.

You asked a particular point about what a future care worker or a specialist support worker looks like and, of course, that will be something for us to develop in understanding the needs of individuals and how we can understand how we actually commission and provide that, whether it’s through the statutory sector or the voluntary sector. Examples are, for example, an understanding that is being developed through work undertaken in Wales of people, for example, who have alcohol-related dementia and what we can do to support those people in a particular and specific field as well. So, there is specific work that we are undertaking to try and understand what that could and should look like.

Then, of course, we come back to the broader question of how we commission that support and how it is then practically provided. And here I think this goes back to your opening salvo of questions about the role for the NHS and who’s going to be responsible for delivering the actions we set out in the plan. Well, of course, from a Government point of view, if we set out that it must be the third sector who undertake a range of activities, it’s difficult for individuals in this place, or even the public, to hold us to account for what the third sector do and don’t do of their own volition. There is something about us understanding the balance in the action plan, what will set out what the Government, or organisations in Government, could reasonably expect to take responsibility for will do. But it also comes back to the point that this has been drawn up as part of the pre-consultation within the sector and with individuals. So, much of what you will see in here directly comes from those organisations and individuals that said, ‘This is what we want to see’. I think that’s a good thing. It does show that we have really listened to what people have had to say, but they recognise, too, that there is this balance in non-medical support that is to be provided, and getting that right in the future.

So, it’s about the commissioning and the understanding of needs in the first place. Again, you see that process taking place within the architecture drawn up by the social services and well-being Act, but you will see that as we go on to deliver this. As I said in my speech, there is a cross-Government approach that is needed to do that, but also an approach to outside Government, to local government, to the third sector, and, of course, as you rightly mentioned, individuals and communities.

It’s good to be able to note that it is Dementia Awareness Week, and I congratulate everyone involved with activities this week. It was nice to see our friends from the Alzheimer’s Society Wales here in the Assembly today, and there are events happening across Wales—I had an e-mail this afternoon drawing my attention to an event in Llangefni town hall between 10 a.m. and 4 p.m. on Thursday. This is great—people are talking about dementia, but raising awareness about dementia is not all we need. More people are coming to understand and are being involved with people with dementia, but what we need is to raise awareness more of the deficiencies there are in the care for patients with dementia and in the sustenance for their families and their carers.

I would like to pay tribute here to Beti George who has done so much to draw my attention to these issues. Beti shared her story in terms of caring for her partner, David Parry-Jones, in a very emotional programme on the BBC recently—‘Lost for Words’. Very sadly, Beti lost David last month, and I know that we all here sympathise with Beti. But we have to all commit not to slacken our determination to have a strategy that genuinely tries to create a Wales that is proud to say, ‘Yes, we’re doing all that we can for dementia sufferers and their families’.

Rydym ar lwybr a allai ein harwain at fod yn genedl sy'n deall dementia—o ddifrif—sy’n gallu dweud ein bod ni bob amser yn gofalu hyd eithaf ein gallu am y rhai â dementia, ac yn rhoi cymorth i'w gofalwyr a'u teuluoedd. Mae gennym strategaeth sy'n cael ei chreu, a strategaeth a allai, fel y dywedais, fod yn rhywbeth sydd wirioneddol yn caniatáu i Gymru roi ei stamp ar y mater hwn sy’n rhan mor boenus o fywydau cymaint o bobl. Ond mae'n golygu, wrth gwrs, ymateb i'r ymgynghoriad, fel y gwnaethom yn y Pwyllgor Iechyd, Gofal Cymdeithasol a Chwaraeon. Rydym wedi ystyried ein bod ni, drwy'r gwaith yr ydym wedi’i wneud, yn rhanddeiliad allweddol yn y gwaith o greu’r strategaeth honno yr ydym ni i gyd ei hangen.

Tri chwestiwn: fe ddywedasoch y bydd canfyddiadau'r ymgynghoriad yn cael eu hymgorffori yn y cynllun terfynol. A yw hyn yn golygu eich bod yn derbyn bod y gostyngiad yn nifer y nosweithiau o ofal seibiant angen ei atal a’i wrthdroi? Oherwydd mae hynny'n rhywbeth sydd wedi dod drwodd yn glir iawn, yn sicr i ni fel pwyllgor, wrth ymateb i'r ddogfen ymgynghori gychwynnol.

Rydych chi hefyd wedi tynnu sylw at bwysigrwydd y trydydd sector, ond mae hyn yn rhywbeth sy’n cael ei ddweud dro ar ôl tro. Nid yw'r trefniadau ariannu yma yn arbennig o ffafriol i gynllunio gwasanaeth hirdymor a chadw'r staff gorau. Felly, pa newidiadau y byddwch chi’n disgwyl i awdurdodau lleol eu gwneud wrth gomisiynu gwasanaethau fel y gellir cynllunio ar gyfer y tymor hir?

Ac yn olaf, mae mater penodol iawn, ac un sydd o ddiddordeb i mi—rydym ni’n gwybod y gall dysgu iaith arall helpu i atal dementia. Pa gamau y mae'r Llywodraeth yn eu cymryd i sicrhau bod pobl yn deall hyn ac yn cael cyfle i ddysgu iaith arall—gallai fod yn Gymraeg neu fe allai fod yn iaith arall?

Thank you. To be honest, I don’t think we’re going to cover in the strategy the opportunity to learn an alternative language specifically, but there is a range of activities that we understand people can undertake to help to reduce their risk of actually acquiring dementia or to delay the onset of it, and that is absolutely part of the work that we’re undertaking. We’ll continue to work with communities and individuals to promote awareness of that, and, hopefully, to encourage people to take ownership of the choices that they could and should make for themselves.

I’m really clear that we will take account of the consultation, we’ll take account of the report that the committee has provided and we’ll take account of what is said in today’s debate. As in any consultation, we’ll have a range of ideas that we could and should take account of and do something with. There will also be parts that we simply can’t, but there’s got to be some honesty in actually saying, ‘This is a meaningful exercise’. I think that Members and, indeed, stakeholders will see how they’ve had an influence on the final plan when it’s published.

Again, I hear what’s said, both by yourself and Suzy Davies, on respite for carers, and I’m really clear that this is a commitment that the Government has itself about improving the availability of respite care.

On your point about longer-term commissioning of services, there needs to be some honesty about this amongst people in this Chamber, regardless of our party background. When local authorities have annual budgets to plan for and to manage, when we don’t know the scale of the cuts that we face and what that means in terms of budget planning for ourselves, let alone other actors and agents within the country, it’s very difficult to then say, ‘We require someone else to plan on a much longer-term basis’.

The unavoidable truth is that the situation is dynamic, because we don’t know what we are going to get within this place to then divide up to then pass on to actors and agents outside here, but having a strategy and a shape for what we want to achieve should help that in framing how those commissioning decisions are made, where they’re made individually by local authorities, of whatever political leadership—this is a challenge across the country; it’s not just for your party, mine or any other—it’s all parties and independents that are running local government in Wales at this point in time. It’s also a challenge for health boards in working with their partners as well in trying to decide and determine how they properly meet the action plan and the focus and the attention that we will have with it. So, there’s an honest point there, even though I think that everyone in this Chamber would want to be able to see these services planned on a much longer-term basis, consistent with the strategy and to have real and achievable outcome measures. We’ll do what we could and should do in designing a strategy to help with the best use of those resources.

It was wonderful today to attend Dementia Awareness Week—an event outside the Senedd. Thank you for your statement, Cabinet Secretary. The goal of making Wales a dementia-friendly nation is one that we all share. Dementia is now the leading cause of death in Wales, and the number of people affected by dementia is expected to rise by around 40 per cent in the next decade.

It is important that we adopt a whole approach, which involves listening to people with dementia regarding their needs and the views of family members, professionals and carers. It is therefore pleasing that there has been much collaboration with the Alzheimer’s Society and the dementia engagement and empowerment project team. Only by collating information, which must be ongoing, can we reach people with such individual needs.

Regarding the draft dementia strategy itself, I have a few questions relating to the high-level performance measures. You have set the target of ensuring two thirds of dementia sufferers have a formal diagnosis. Can you tell me when we may be able to see if this target is realistic and if, indeed, we are going to be on track to reach this target?

The strategy sets a target for the percentage of NHS staff who come into contact with the public also being trained in dementia care. The target is for three quarters of the workforce by 2019, and I’d like to ask when we can expect to see 100 per cent of NHS staff trained in the appropriate level of dementia care.

The Welsh Government rightly want to see a reduction in the percentage of people with dementia who are prescribed anti-psychotic medication. However, you haven’t indicated a target for that reduction, and, granted, there may be a few cases whereby this is necessary, but all the experts agree that we should not be using these medicines to treat dementia. So, Cabinet Secretary, will you be using guidance to ensure that anti-psychotics are only used when strictly necessary?

You have previously highlighted that dementia can strike at any age and, indeed, the role that alcohol can play. We need to better educate the public about the risks of alcohol-related dementia and brain damage. So, Cabinet Secretary, what plans do you have to increase public awareness about the fact that alcohol misuse can lead to dementia? Finally, Cabinet Secretary, what plans do you have to improve access to substance misuse clinics, so that we can hopefully prevent more people from developing alcohol-related dementia in future?

Dementia is one of the biggest health challenges facing our nation, and it is, therefore, vital that we get this strategy right. I look forward to seeing and working with you, Cabinet Secretary, to share our shared aim of a dementia-friendly nation. Thank you.

Thank you for the comments and questions. I’ll start with your point about the diagnosis target. The draft indicates that it’s for the life of the plan. I indicated in my opening remarks that it’s something I’m prepared to keep under review, because I do know that a number of actors and stakeholders wanted there to be a more ambitious target, but I’m determined that we have a stretching but an honest target. I don’t think it would be helpful to set an aspirational target that can’t be achieved in the life of the plan. I want something that is real and achievable, but as I say, stretching, and recognises the need for further improvement. That helps me to deal with your point about the number of staff trained. We’ve set the target already that we think is stretching. What I won’t do today, to get me through a debate, is just pick out of the air a figure of ‘100 per cent of staff’ or ‘the maximum number of staff are, therefore, trained’. But, again, it is something for us to review and to consider as the plan carries on, and as we actually make real progress throughout the life of this plan towards achieving our aims and objectives.

The same goes for anti-psychotic drugs. We are confident that there needs to be a change and a challenge in the way that prescribing behaviour takes place. Each individual clinician has a responsibility for the judgment that they exercise and the care that they provide for an individual within their context. We want clarity on the ability to reduce the inappropriate prescribing of anti-psychotic drugs. But I’m not going to indicate today that there are any particular targets that will be set. That is part of what we need to consider in drawing up and coming to a final conclusion in the action plan. Again, I said that today is, at least in part, a listening exercise to Members about what we’ll actually have in the final plan, to think about whether a target will be helpful—will it get us to a point where we want to be—and then how we can appropriately measure the progress that we do or don’t make on getting different decisions made by practising clinicians.

Then, your final point about substance misuse prevention and recovery. You’ll know that Rebecca Evans leads on substance misuse policy and action for the Government. We’ve maintained investment in this area despite the reductions in the overall budget. That in itself is a marker of the reality that we recognise that this is a really important area, not just in terms of dementia reduction. I go back the points made at the front of this debate about the rise in dementia that we know that we face as a country. Some of that is related to age, but much of it is related to behaviour as well. All of us know that we make choices for ourselves that have a potential consequence. We know from the Caerphilly study, undertaken over a significant period of time on people living in the same sort of communities in Wales, that making different choices on the key behaviours and determinants of healthier outcomes—on smoking, alcohol, diet and exercise—have a significant impact, not just on obesity as we discovered earlier, and will come up later today when I hope that we will pass the Public Health (Wales) Bill, but equally in a whole range of other areas. There’s a significant impact from the choices that we make. Making different choices will be better for us in the here and now and not just for our future. It is one of our big challenges as a nation: whether we can collectively determine that we will make healthier choices for ourselves and for generations to come.

Can I thank the Cabinet Secretary for his statement? I’m really pleased that we are getting this opportunity in Dementia Awareness Week to again listen to the views of Members. I also welcome the fact that the Welsh Government is taking time to consider what has been a very well-responded-to consultation. I think it is absolutely the right approach to get this strategy right, although I would add that I think it is essential that what we come out with at the end of this process is a strategy that is sufficiently ambitious to meet the scale of the challenge we face in Wales with dementia.

I very much welcome what you’ve said about the strong emphasis on a rights-based approach, which I believe has come from the excellent input of the dementia engagement and empowerment project, and I do take this opportunity to pay tribute to those people who are living with dementia who I know have really transformed the work of Welsh Government on this issue.

I do have a few specific questions. The first is on diagnosis rates, and I heard what you were saying, but I make no apologies for repeating the point that 50 per cent would not be enough for a disease like cancer, and it shouldn’t be enough for people with dementia. I understand what you’re saying about the need to be realistic, but I would like to see the work that you are doing in keeping this under review aimed at a more ambitious diagnosis target. I’d also be interested to know in your response today to what extent diagnosis rates have come up as an issue in this consultation, because I know it was in the health committee’s response, it was certainly in my response on behalf of the cross-party group, and I’m guessing it was in a vast majority of the responses, that people want that ambition to be there for a better diagnosis rate target.

The issue of support workers has been mentioned by several people. My specific concern, as it has been throughout, is that we’re going to need more of them than the plan is proposing. So, I’d be interested to know how your thinking is evolving on that, because the 32 that are set out currently is not going to be enough, and I’d be interested to know whether you are re-evaluating that.

You will be aware—and I’m grateful to you for coming to the cross-party group to talk to us and to talk to people living with dementia—that palliative care and end-of-life care was a very important issue that came out of that meeting, and I’m pleased that that’s been picked up in the statement. I’d be grateful for an update on how your thinking is evolving on that.

I’m also grateful to you for picking up on the issues that I raised following the cross-party group on the Gypsy/Traveller community, and your acknowledgement that there hadn’t been enough work done to identify the needs of that community in relation to dementia. So, I would like to ask how that work has come on, because I know that you were looking to do more consultation with that community.

And just finally to say that today I’ve been up at Big Pit in my constituency, attending the launch of the new dementia-friendly underground tour, and I’m sure you’d want to join me in congratulating Big Pit and National Museum Wales on an excellent and groundbreaking initiative. But can I ask you, Cabinet Secretary, what you see the role of Government now being to actually make sure that all that good practice that we are seeing, resulting from really hard work in different communities in Wales—and there is a tremendous amount of good work going on out there—is actually being rolled out across Wales by Welsh Government? Thank you.

Thank you for the series of comments and questions. I’m pleased to hear you recognise we should get it right this year, and with sufficient ambition that is exactly what we’re attempting to deliver.

I just want to deal with your point about the end-of-life care and the link to that. In the previous statement, we did have a question from Julie Morgan about end-of-life care and the link in terms of the need to have improvement in end-of-life care for people living with dementia as well. And the points about advance care planning: you need to have that conversation at an early enough stage so that people make active choices, as opposed to having choices made for them, and people have to imagine what someone might have wanted or would have wanted. That’s a very difficult position for people to be placed into.

And I recognise the points you have made consistently about support workers, about understanding the need, about understanding the areas in which they can be used and about the resource. We’ve already committed a significant resource up to now, but the different choices that we will choose to make, having had a strategic decision about the action plan, then making sure resources accompany it to deliver on the aims and objectives.

Again, I recognise that you’ve been very consistent about diagnosis rates. It was a significant issue in the consultation. I tried to recognise that in my opening statement. It is important, again, that we have an ambitious and a stretching target, but one that is actually realistic. I want to see a real rate of improvement take place and I don’t want there to be excuses about not achieving a target. We have to have something that really can challenge, but really be delivered. It’s something that’s not just about the diagnosis taking place and the additional support and training that people need to make the diagnosis, but also about making sure that support is in place once that diagnosis has been made as well. I know that was an issue that was raised in the meeting with the cross-party group that I attended.

And finally, two points. I think the engagement with the Dementia Engagement and Empowerment Project has been a really important exercise, both before the consultation launch—the pre-consultation—and during the consultation as well. It’s really important, if we’re going to talk about co-production and the citizen being an equal partner in their healthcare, that that has meaning for the way we design policy as well. So, it isn’t just about having professional advocates speaking on behalf of people with dementia. People living directly with dementia themselves have been an important part of the design and delivery up to this point and they will be thereafter in the delivery of services.

And finally, I recognise the need to roll out good practice. That’s why we’ll have a compendium document to go with this to understand what is already taking place and where good practice exists, so that other people can look at how and why that’s being created. There is always a challenge in seeing whether good practice really does travel and can be introduced on a more system-wide basis. How often does good practice really relate to a set of circumstances in a locality and a group of inspiring individuals who coalesce by accident and by chance, rather than by actually designing the way the whole system should work? But to understand what that looks like so there’s a better prospect for that to actually take place.

Finally, to congratulate Big Pit on the dementia-friendly tour. I’d have loved to have been there with you this morning on the tour. I had one of my best days out at the national museum at Big Pit with my father-in-law. It’s a fantastic experience, and making sure that there is now a dementia-friendly tour is a big step forward.

Just a few quick points because most of them have been covered. Going on the risk reduction, I think the six points and ‘Together for a Dementia Friendly Wales’ are absolutely crucial, and I wondered what more the Cabinet Secretary could do to publicise those steps. I think, obviously, the very important one of trying new things—Rhun ap Iorwerth brought forward the idea of learning a language, the Welsh language—and I wanted to highlight, which I think I’ve mentioned in this Chamber before, singing for people with dementia and the Forget-me-Not Chorus, which covers Cardiff, the Vale and Newport and which is such an inspiring activity that involves people with dementia and, of course, their carers as well. So, I wondered if there were any plans to encourage and support activities like that, which are outside the health and social care sector completely. I believe that is done in conjunction with the Welsh National Opera, that particular activity.

I’m very glad to see he’s put such an emphasis on raising awareness. I think it’s very important that awareness is raised not only for the individuals and for public bodies, but also private companies. I’m sure many of us has seen what British Gas is doing in relation to this, which is trying very hard to become a dementia-friendly organisation. It’s been overwhelmed with offers from staff to be dementia champions. I think they had aimed for 15 and had 50 immediately. Now their engineers are having training, which means that when they go into people’s homes they are aware of all the issues related to dementia. I think there’s a huge job to do there, beyond the places we’ve got our natural levers with in the public sector. I don’t know if he had any plans to look at that.

The end-of-life care you’ve covered in your response to Lynne Neagle, but I wanted to reiterate my support for what Lynne Neagle said about the particular needs of the Gypsy and Traveller community. They do have a very early death rate compared to the rest of the public, and I really think that addressing the particular needs in relation to the dementia strategy are very important.

Thank you. It was remiss of me not to respond to Lynne Neagle’s point about the Gypsy/Traveller community. It is worth taking account of and thinking about how to take that forward—a recognised need that is not well covered. At a previous event of the cross-party group on Gypsies and Travellers I particularly recognised, with the research that was published, that there are still continuing deficits in our ability to provide adequate health and care provision with that particular community. Only some of that is about the cultural barriers that exist. Much of it is actually about the willingness of services to engage properly and effectively. I’m pleased you highlighted the example of British Gas. Other companies have been mentioned today, where awareness raising is taking place directly with staff, and about people understanding for themselves, and, within that large staff group, people will be directly affected. And there is often a generous response when the issue is discussed and debated within groups of people. Our challenge will be how successful we’ll be about getting more and more organisations to undertake that sort of approach.

I recognise that time has gone on and I want to try and be brief in answering the rest of your points. I am pleased that, earlier, you mentioned the point about trying something different. For some people, doing something different, like singing, is an important part of that, but it goes on to the second point of doing something to jog and retain memory and, often, music is an important part of triggering and retaining memory. And those other memories too, like the Sporting Memories that Lesley Griffiths was promoting earlier in the year as well—a really important example of understanding what has given meaning to someone’s life and enjoyment, as well. So, there are lots and lots of different areas that we want to try and promote, and, again, thinking about that good practice, where it exists. Often, much of that is easy to do and doesn’t require a great amount of money; it does require some time and understanding.

Thank you, Cabinet Secretary.

The next item on our agenda is the debate on Stage 4 of the Public Health (Wales) Bill. I call on the Minister for Social Services and Public Health to move the motion—Rebecca Evans.

Thank you, Presiding Officer. I formally move the motion. I am delighted to introduce the fourth and final stage of the Public Health (Wales) Bill before the Assembly today.

This Bill has had a long journey to reach this point, through various stages of consultation and further refinement. Today marks the culmination of that journey. I’d like to begin by thanking the Chairs and members of the Health, Social Care and Sport Committee, the Constitutional and Legislative Affairs Committee, and the Finance Committee, for their diligent scrutiny of the Bill. Similarly, I’d like to thank the wide range of stakeholders who’ve engaged positively throughout the process across each of the areas that the Bill covers. The Bill before the Assembly today continues Wales’s strong tradition of using legislation as an important part of our efforts to improve and protect health, alongside our tailored public health services, programmes, policies and campaigns. It will make a real and positive difference to our communities in a number of ways.

We’ve worked over many years to protect the population from the harms of smoking, particularly our children and young people. The Bill will break important new ground by extending the smoke-free requirements, for the very first time, to certain open spaces. This, together with the Bill’s other provisions on tobacco and nicotine products, will further embed the significant progress we’ve made in this area. People who choose to have special procedures, including body piercing and tattooing, will be better protected against the potential risks of infection, through the new licensing system. Communities across Wales will benefit from the changes to the way pharmaceutical services and access to toilets for use by the public are planned, and from the health impact assessments that will be carried out by public bodies.

Members will be aware that this Bill has already benefitted from full scrutiny in the fourth Assembly and, as a result, comprised a comprehensive suite of measures for further improving and protecting health and well-being in Wales. Nevertheless, the work of this Assembly has led to a number of material changes that have significantly strengthened the Bill. As a direct result of this work, children up to the age of 18 will now be protected from the harms that can be caused by intimate piercing. The smoke-free requirements in open spaces will be extended to cover outdoor childcare settings, further protecting children from the harm of smoking and preventing it from being seen as a normal, everyday activity. And, importantly, the Bill now gives a clear legislative focus to Government action to address the priority public health issue of obesity through the national strategy that will now be prepared.

I’m grateful to Members for the collaborative way in which they’ve engaged with the issues and worked with the Government to improve the Bill in these important ways. Of course, while today marks the end of the Bill’s journey through the Assembly, if passed, it will also signal the start of a critical new phase. I look forward to implementing the various elements of the Bill to realise the many benefits it seeks to achieve for people in Wales, and to the ongoing engagement of the Assembly in that work.

Before I close, I would like to put on record my very sincere thanks to all of the officials who’ve supported the work on the Bill so carefully and so diligently as it’s made its way through the Assembly. Presiding Officer, I commend the Bill to the Assembly.

I rise on behalf of the Welsh Conservatives group, in the absence of my colleague Angela Burns, simply to say that we’re very pleased to be able to support the Public Health (Wales) Bill this afternoon, as it makes its final passage through the National Assembly. It’s in much better shape than the previous incarnation of the Bill, which, of course, sought to introduce unnecessary restrictions on e-cigarettes, and I was very pleased that the Welsh Government saw sense on that matter and withdrew the proposed restrictions on those from the revised Bill that it presented before the Assembly last year.

We’re very pleased to see the additional restrictions on smoking of tobacco. As you know, we’ve engaged in some very useful discussions on possible further extensions to those areas where smoking will be prohibited in the future, particularly around bus shelters and in other settings where young children can often find themselves. We’re very pleased also to see the progress that is being made in terms of planning public conveniences in local areas, and I very much hope that we will see some significant improvements in ensuring that there aren’t the sort of closures that we’ve seen of public conveniences as a result of the requirement to produce local strategies.

And, of course, there was the very important amendment that was passed at Stage 3, with the support of all parties last week, in terms of the need for a national obesity strategy. I think it was a very strong and powerful argument that persuaded everybody in this Chamber to recognise the importance of obesity to public health and the need for a national programme of action to address that if we’re going to achieve better health outcomes in the future. So, we were very pleased indeed to support that amendment.

On pharmacy services, we know that there can very often be long and protracted discussions that take place in local communities where there are proposed changes, at the moment, to local pharmacy services, even simple things like relocations. So, I think that the new regulations and the new provisions in this Bill will help to improve just that. So, I want to say, on the whole, we absolutely support the principles of this Bill. We look forward to holding you to account as a Government for implementing the Bill once it becomes law and after it has received Royal Assent, and we will continue to work with you to improve the public health of the people of Wales.

We will be supporting this Bill today. Don’t get me wrong: I am not suggesting that all Bills should go through a similar journey to that of the Public Health (Wales) Bill through the Assembly, but I do think that the fact that the Bill, to all intents and purposes, went through this Assembly twice—it does show the work done by all parties, including Government and the opposition parties, and this is now a strong Bill before us for Stage 4 consideration today.

I am particularly pleased of the Plaid Cymru amendment that was unanimously supported last week, which will make it a requirement of Welsh Government to draw up a national obesity strategy—the biggest public health problem facing us as a nation, I’m sure. I’m grateful for the Minister’s willingness to collaborate on this issue. The challenge now, of course, is to draw up a strategy that can be truly transformative in terms of the health of our nation.

This isn’t a perfect Bill. We on these benches were very eager to strengthen the Bill in relation to the air that we breathe. We didn’t receive support for those amendments. Having said that, the British Lung Foundation is pleased that the pressure that we put on in this area has led to some movement from Government. But I do have to say that we again heard from the First Minister today that his Government is willing to await the Westminster Government’s strategy in terms of tackling air pollution before drawing up a plan for Wales. He wasn’t even willing to respond to the request from Simon Thomas to set specific targets. However, Plaid Cymru, of course, will continue to press for a comprehensive strategy in order to improve air quality and reduce the dangers of pollution, and I look forward to continuing the discussions with the Government in this area.

But, today, we will support this Bill, which in its entirety is a Bill that we believe can be an important tool in safeguarding the public, safeguarding public health, and encouraging a healthier Wales for future years.

I call on the Minister for Social Services and Public Health to reply to the debate.

I’d like to thank both spokespeople for their comments today and for their support for the Bill, and look forward to implementation of the Bill now, because I do think it has real potential in terms of improving the public health of the people of Wales, and I look forward to collaborating with and engaging with Members across the Assembly in terms of the implementation phase, which we’ll move to next. Thank you.

The proposal is to agree the motion. Does any Member object? The motion is therefore agreed in accordance with Standing Order 12.36.

The next item on the agenda, therefore, is the short debate, and I now move to the short debate, and I call on Dawn Bowden to speak on the topic that she has chosen, and I ask everybody else to leave the Chamber quietly.

Os gwnaiff yr holl Aelodau sy'n gadael y Siambr wneud hynny’n dawel—mae gennym fusnes pwysig i’w glywed o hyd. Dawn Bowden.

Diolch, Llywydd. I’m very pleased to have the opportunity to bring forward this debate today, as in recent months I’ve been able to meet with representatives of Electrical Safety First and talk to them about the statistics that they have provided, particularly in relation to fires caused due to the lack of care with electrical appliances and devices. And I’m also pleased to give Mike Hedges a minute of my time for him to contribute to this debate.

It is, perhaps, timely that this opportunity has come up for me to speak now on this subject, when my own mother has recently been the victim of a house fire, which has led to her having to move out of her home, probably for several months. The fire was almost certainly caused by either faulty wiring or electrical equipment. She was out walking her dog at the time the fire started, but fortunately she was only away for about 20 minutes, so, when she came back, she was able to get help quickly and before the fire had taken hold of the whole house. Despite that early action, the fire and smoke damage was significant, and the whole house has to be renovated.

In Wales, statistics show a steady decrease in the number of primary fires between 2010 and 2015, but saw an increase in the year up to 2016. Fires from white goods seem to be at a generally consistent level for the same period, and there has been a noticeable, consistent decline, as we would probably expect, in chimney fires. But we have not seen an overall decrease in accidental fires. The answer to why this might be could lie in the title of this debate: electrical fires in today’s technological age.

I’m sure that your households, like mine and many others these days, contain a plethora of mobile communication devices. In your homes, you will all have Assembly phones and Assembly iPads, and no doubt many of you will also have personal mobile phones and tablets of some sort. And, as most families no longer rely on one fixed landline phone in the house, it’s quite likely that each member of the family will also have their own mobile phone and portable computer device. And, if you have former smokers in the house, you probably have e-cigarette devices as well. Each of these devices, or each of these units, are reliant upon mobile chargers, which inevitably increase the risk of fires, simply because of the sheer numbers of them that we have, but these devices do also carry their very own specific risks.

By the very nature of the devices, we don’t tend to use them when we are asleep, so most of us charge them up overnight, and this, of course, means that we don’t notice if they start heating up. And how many people leave devices resting on something potentially flammable, like a cushion or a soft chair, when charging them? Indeed, some people are so attached to their mobile phones that they charge them under their pillows. And, because we have so many devices, we also purchase spare chargers. Manufacturers’ replacement chargers are often seen as expensive, and the availability of cheap alternatives purchased off the internet are often a tempting alternative. And I believe this is an issue that Mike Hedges wants to touch on in his contribution later, so I’ll leave it to him to elaborate on the inherent dangers that this presents.

So, what can we do to improve electrical safety? Interestingly, we have regulations that require private landlords to carry out annual safety checks on gas fittings and appliances, but no similar regime exists for electrical equipment. This could be a starting point. In the last Assembly, there was recognition by the Welsh Government that regulation would be beneficial from a fire safety perspective, but to date this remains an outstanding action. Such a precautionary regime would certainly serve to significantly reduce the risk to tenants while at a relatively low cost to landlords—around £100 to £150 for any designated test period—and would also protect their property investment.

It is, of course, an assumption that the increase in the use of mobile devices and chargers accounts for the increasing number of accidental fires, but the records kept by a number of fire authorities, bizarrely, don’t actually categorise this type of cause, whilst most still record fires for chimneys, which are now relatively rare. This is something that the Welsh Government could encourage fire authorities to change so that, at a minimum, we could get a handle on the extent of the problem.

Finally, Llywydd, whilst some form of regulation in the private rented sector will not provide protection to home owners, who, I have no doubt, will also forget the risks that go along with electrical equipment, particularly mobile devices, we can all look to familiarise ourselves with the potential dangers and be more responsible in terms of how we use electrical equipment and, just as importantly, what type of electrical equipment we buy. Since my discussions with Electrical Safety First, I’ve certainly changed my behaviour in relation to how I use electrical equipment and that which I buy.

In conclusion, Llywydd, what I’m hoping for in bringing forward this debate is a discussion on reviewed consideration of introducing a regulatory regime for electrical testing in the private rented sector; further research, including changes to the information recorded by fire authorities into the causes of fires; and a general public awareness-raising campaign supported by the Welsh Government on electrical fire prevention. Let’s act now to reduce unnecessary but everyday fire risks in our homes caused by ignorance around electrical safety. Thank you.

Firstly, I would like to thank Dawn Bowden for giving me a minute in this debate. I want to cover two things: hair straighteners and chargers. Examples of fires from hair straighteners are: a woman had to be rescued from her burning home after a pair of hair straighteners were left switched on on her wooden floor and started a blaze. She had to be rescued by firefighters. Two young boys were rescued from a bedroom in a house in Pinner, north London, by firefighters after a fire was started by hair straighteners. Many people use hair straighteners. I don’t, by the way, but many people do. I don’t think the Cabinet Secretary does either, but I may be wrong. [Laughter.] Many people do. They get up to very high temperatures and they are potentially dangerous. Although neither of those led to death, if we don’t deal with it, they will eventually.

And chargers. The availability of cheap generic options online, according to fire safety experts, is highly dangerous. Chargers on auction sites can cost less than £1 and the proper ones by the manufacturer over £15. Is it any surprise people buy the cheaper ones? But what a charger does, effectively, is bring the amount of electricity—the voltage—down to the voltage needed to charge the batteries. What happens is that, if they’re generic, they may not actually work effectively, and they can lead to heat being generated. The charity Electrical Safety First found that half had been wired in a substandard component, and none met the safety requirements of the Electrical Equipment (Safety) Regulations 1994. Unless something is done, we’re going to have fires and people are going to die.

Thank you very much. I now call on the Cabinet Secretary for Communities and Children, Carl Sargeant.

Thank you, Deputy Llywydd. I thank the Member for raising this important issue here today. She is quite right to point out a growing and serious risk. My best wishes to your mum, as well, in terms of her home being refurbished.

Although fires and fire casualties are falling significantly, Llywydd—by around half since responsibility was devolved in 2005—we and the fire service are very proud of that, but there is no room for complacency. We’ve heard details of that today. In particular, dwelling fires from nearly all known causes have reduced, but electrical fires show a steady and sustained rise over the past 15 years or so. They are now the second commonest source of house fire after cookers.

In response, our fire services provide extensive help and advice on preventing electrical fires. For instance, over the past two years, they’ve distributed nearly 6,500 pieces of electrical safety equipment to households in need free of charge and funded by Welsh Government.

However, as we’ve heard, that hasn’t been enough to counter the worrying and sustained increase in electrical fires. Trends on this scale probably reflect underlying social change. It’s vital that we understand those changes if we are to respond effectively. And Dawn is right; the amount of chargers in properties, and gaming machines, et cetera, in these properties, has grown significantly over these years. The reasons may seem obvious, as the Member points out—all the amount of portable devices, mobile phones, tablets, laptops, e-cigarettes, cameras and so on—and recharging these is perfectly safe if it's done properly with a suitable charger. But people may be tempted to cut corners and they might use the same charger for very different devices, or a replacement charger that might be cheap but isn't safe, like Mike Hedges alluded to. Or they might overload their electric circuits by using multi-plug adapters to charge several devices at once.

A lot of the focus, Llywydd, here has been on counterfeit or unbranded electrical goods, and I recognise the safety risks that they can pose. And I welcome the work of groups like Electrical Safety First, whose campaign to raise awareness of those risks is well known. But fake products are not the only problem; they may not even be the main problem. We've heard all about the legitimate, branded products, from tumble dryers to tablets, which have recently had to be recalled because of fire risks also. What's more, fire safety is at least as much about changing behaviour as it is about product design, and I wouldn't recommend anybody going to sleep with a phone charger under their pillow; it can lead to very warm ears at the very least. Almost all products are safe if they're used properly, Llywydd, but none of them, legitimate or counterfeit, is safe if misused, or, if they're not repaired when faulty, it's important not to overlook that message.

So, the answer isn't as straightforward, and it isn't helped by the weakness in the data we have. The UK-wide system that the fire service uses to record fires and causes hasn't been kept up to date with the social and technological changes that we’ve seen, and I will look at that in detail. For instance, we know from the system exactly how many house fires started from trouser presses or welding equipment, but we don't know how many started from phone chargers or e-cigarettes, and that's certainly a sign of the times. We will continue to press for improvements in that system. To cut through this, we have started to commission some in-depth research into the problem, involving both our fire services and Electoral Safety First. It will aim to identify the causes of recent trends and the best way of tackling them, and I will keep Members informed of those details.

In the meantime, there are some simple steps that people can take to stay safe. I'd urge people to seek out and follow the advice that they get from the fire service or Electrical Safety First, and those who are particularly vulnerable or at risk should get a full home safety check from the fire service. This covers a wide range of risks, including electrical fires, and includes free safety equipment for those who need it also. Llywydd, it's a really important debate that Dawn Bowden has raised today, and it could happen to anybody and anywhere. In closing, I'd like to reiterate my thanks to Dawn for raising the issue, and I can assure her and the Assembly that we, and our colleagues in the fire service, are aiming to tackle it as swiftly and as effectively as possible. Thank you.

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