Y Cyfarfod Llawn - Y Bumed Senedd
Plenary - Fifth Senedd
20/09/2017Cynnwys
Contents
The Assembly met at 13:30 with the Llywydd (Elin Jones) in the Chair.
I call Members to order.
[R] signifies the Member has declared an interest. [W] signifies that the question was tabled in Welsh.
The first item on our agenda this afternoon is questions to the Cabinet Secretary for the Environment and Rural Affairs. And the first question, Bethan Jenkins.
Establishing an Animal Abuse Register in Wales
1. Will the Cabinet Secretary provide an update on work to establish an animal abuse register in Wales? (OAQ51033)
Diolch. The first meeting of the Royal Society for the Prevention of Cruelty to Animals Cymru’s task and finish group to consider the establishment of an animal offender register will take place on 28 September. Interim findings will be submitted to officials before Easter recess, with final findings and recommendations to follow before summer recess 2018.
Thank you for that update. You said in your response that it was the RSPCA’s task and finish group. I just wanted to confirm whether you are going to be including other organisations on this task and finish group, and taking evidence from those involved in the area who have been working—with no intention to undermine the RSPCA, but a number of groups have been lobbying for this animal abuse register. Would you include them as part of this discussion?
I see that the Welsh Government is looking into a domestic register. Are you going to discuss these two things together? Because you will recall from previous questions from me, these themes do crosscut and, therefore, I would’ve thought it would’ve been an idea for you to take joint action here, rather than working in separation.
No. The Member will be aware—. Obviously, I think you started getting this back on to the agenda with the short debate that you had, and I thought the establishment of such a register was very worthy of further attention. And then RSPCA Cymru produced a briefing document, and they made a case for it also, and they offered to lead on the establishment of a task and finish group. But, you’re quite right: it won’t just be the RSPCA. I have agreed the terms of reference for the group, around the outputs and the timeline. However, the membership hasn’t been agreed. But, you’re absolutely right: it will include other stakeholders and partners. And even on the membership of the group, I’m sure, outside of that membership, we will need to have discussions with other stakeholders and organisations as well.
The point you make around domestic abuse—absolutely. The Cabinet Secretary for Communities and Children and I have already had a meeting around this, and, as the work progresses over the next few months, we will continue to have discussions.
Cabinet Secretary, as you know, I’m also a supporter of introducing an animal abuse register, and I look forward to hearing more about its development as it happens. Of course, one of the biggest obstacles facing the register will be determining whether youth offenders will be registered, and perhaps you could tell us what the Welsh Government’s initial position is on this issue. As I’m sure you’ll agree, the register must have a constructive and not a destructive impact on youth offenders, many of whom can be vulnerable young people.
Absolutely. We haven’t got into that detail on our discussions yet. But, as I say, as we go over the next few months, I’m sure those discussions with Carl Sargeant and myself will increase.
New Controls on Fishing for Salmon and Sea Trout
2. Will the Cabinet Secretary make a statement on the proposals from Natural Resources Wales to introduce new controls on fishing for salmon and sea trout? (OAQ51045)
Diolch. It would be inappropriate for me to comment on this matter while Natural Resources Wales is consulting on proposals to introduce new controls on salmon and sea trout fishing. Their consultation closes on 14 November, after which I will consider their recommendations.
I understand why the Cabinet Secretary doesn’t want to set out clearly her views at this point in time. But I think it’s important to note that a number of fishing clubs—in my constituency, and across Wales—have expressed concerns about these proposals, particularly the proposal to have a complete ban on bait fishing, and the 100 per cent catch-and-return policy, and the impact that that will have on fishing.
Of course, it’s important to bear in mind that this isn’t just a hobby, but it is an important part of our tourism industry in large parts of Wales. Fishermen do have concerns in terms of the decline in salmon and trout numbers, and so on.
But there are far more complex factors at play than simply looking at fishing. So, can I ask that the Cabinet Secretary at least ensures that Natural Resources Wales does listen and take seriously the concerns expressed by the fishermen and their clubs?
Yes, it’s absolutely imperative that they do that. As I say, I don’t want to pre-empt anything, but I’ve certainly had discussions around this in my regular meetings with the chair and chief executive of NRW. Of course, we recognise that salmon and sea trout are very important, iconic species in Welsh rivers, and they of course benefit the Welsh economy. For instance, I think it’s about £100 million per year. So, it is absolutely vital that all views are taken into consideration.
Cabinet Secretary, as you’ve just said, angling is worth around—you took the words out of my mouth—£100 million per year to the Welsh economy. As Adam Price, the Member for Carmarthenshire has said, it’s a very important segment of all parts of Wales, particularly the rural economy. I appreciate that you’re limited in what you can say at the moment, but would you agree that the vast majority of anglers are members of clubs? They pay in the region of a couple of hundred pounds for fishing rights each year depending on the extent of the rights that they have. And whilst I understand NRW’s responsibility to manage fish stocks sustainably—of course you recognise that—would you agree with me that it’s important that the organisation does fully consult with fishing clubs, and doesn’t just consult but also listens to those clubs, because those clubs also have a key interest in the sustainability of fishing stocks themselves, which I think is often overlooked and forgotten? So, will you give me an assurance that NRW will, at the end of this consultation, put in place controls that are right, that do sustain stocks, but that are also fair to anglers and to the Welsh economy?
You’re absolutely right. In my view, any consultation needs to be meaningful, so it’s very important that NRW listen to all viewpoints. And I know they do accept that this is a very serious issue and that they need to make sure that they work very hard to get the best possible outcome going forward.
Questions Without Notice from Party Spokespeople
Questions now from the party spokespeople. The UKIP spokesperson, Neil Hamilton.
Diolch, Llywydd. The consultation period for the document ‘Taking Forward Wales’ Sustainable Management of Natural Resources’ is supposed to end on the thirtieth of this month. I know that the Cabinet Secretary has had representations from many people to say that this is a vast exercise given the breadth of the consultation that is going on and the number of issues that are often very disparate. She has been very good, I think, as Cabinet Secretary, in her period of office, in consulting and being open to all views that have an interest in all fields under her control. But I’m wondering, in view of the pressure that there has been upon organisations like the National Farmers Union, the Farmers Union of Wales and others to respond to all sorts of other consultations, and everything else which is going on with Brexit and so on, whether she feels that the time period that has been given in this instance is sufficient to get a full breadth of responses to inform whatever decisions that might otherwise be made. Is it possible to consider perhaps extending this consultation period for a little longer?
I thank the Member for the question. I did extend it, as you say, to 30 September, following representations from the farming unions and other environmental organisations. And, certainly, over the summer recess, when I’ve been attending the agricultural shows and doing visits in both agriculture and environmental settings, it was very clear, particularly over the summer as well, that the document was a large one, and they felt that to make sure they gave views that would be considered, they needed the extension. So, I did extend it to 30 September. I don’t think I’m in a position really to extend it any further, and one of the reasons—and you mentioned Brexit—is probably Brexit. I think it’s really important we get as many views as possible in around regulatory changes, around what legislation we might need, and I need to be ready to go at probably very short notice. We don’t have the luxury of time, so, no, I don’t think I can extend it.
I’m sorry to hear that, but I understand the reasons that the Cabinet Secretary has given. And I know she can’t be drawn on the substance of matters that are subject to this consultation, but there is a question of general principle that I think it would be useful to explore here. One of my constituents has written to me to say, in effect, that what we’re trying to do here is to reconcile conflicting interests, both of which are legitimate very often. And he asked the question: how does one resolve local situations where one important outdoor activity unavoidably interferes with either the environment or with another important activity, even when both are being conducted in a responsible way. This has arisen, in this particular instance, in the context of access to open water and rivers and the conflict that might exist between canoeists and anglers. What he points out is, I think, a very valid point that, instead of having one overarching right that applies everywhere without any exceptions, we need to have some kind of local decision making that respects the specific circumstances of individual instances. He says, quite reasonably, that there are places where 100 canoeists splashing and screaming at each other all day wouldn’t affect angling, but there are other places where the passage of a single canoe, which is discreet, disrupts angling for some time. Therefore, we need to have local decision making so that these individual circumstances can be taken into account.
Absolutely, and that’s something that I think we’ve been holding workshops on over the summer period and that’s certainly something that’s been raised with me. We need to collectively identify the best approach forward. So, we can certainly look at that when we have the consultation responses in and they’re being assessed.
Another important feature of this also respects the rights of landowners and farmers. Obviously, it’s in the interests of those who want to see the countryside prosper that we have access as widely as possible, and the more people who get to understand the ways of the countryside, the better it is for all those who live and work in rural communities. But extending the right to, for example, cycle on footpaths, in the same way as currently happens on bridleways, offers new challenges about the riparian land, and similarly the right to camp in open spaces as well, and how one gets there in the first place. So, I hope that the Cabinet Secretary will try to balance the interests here very carefully indeed because farming is under pressure in many ways.
I think that the pertinent word there is ‘balance’. You’re absolutely right. You mentioned canoeists and anglers, and you mentioned cycling being allowed on bridlepaths. I have to say that, in some of the discussions I’ve had over the summer, they want to see a multi-use for these paths: they want to see footpaths, cyclists and horse-riding all on the same path; others don’t want to. So, I think you’re right: it is about a balance.
I’ve had representations around camping. You’re quite right: some farmers—I went to a farm up in the Snowdonia national park over the summer, where one farmer said, ‘There are 500,000 people visiting this park per year; I want to see as many people as I can on here’. Other famers don’t feel that way inclined. It’s absolutely about getting the balance right. So, certainly when the consultation closes on 30 September, we’ll be able to review the thousands, I think, of responses—I know it’s well up in the thousands now—that we will receive.
Llefarydd Plaid Cymru, Simon Thomas.
Diolch, Llywydd. I hope the Cabinet Secretary did get a little break over the summer and, if she did, that she had some time on a beach. If she did, then she would have noticed the plastic that we have on our beaches these days. I think she had the chance, as I did, to meet the eXXpedition female sailing crew, who were sailing around the UK over the summer—or around Britain actually, not the UK, as sailing around the UK is quite difficult—sailing around Britain over the summer. They came to Cardiff and were highlighting plastic in our seas as well. If she did meet them, she will know that they were strongly in support of a deposit-return scheme. She’ll also know that the Scottish Government announced in August that they were interested in a deposit-return scheme for Scotland, and Zero Waste Scotland, for example, estimates that, in the Scottish circumstances, just on litter clearance alone, a deposit-return scheme could save between £3 million and £6 million. So, does the Cabinet Secretary now agree with me that it’s time to introduce, at the very least, a pilot deposit-return scheme here in Wales?
Unfortunately, I didn’t have the opportunity to meet the crew. I forget what happened—I think I was in another part of Wales, so I didn’t have the opportunity to meet them, but I was aware that Simon had met them. I’m sure that Simon Thomas is also aware that I spent the day with Roseanna Cunningham, the Cabinet Secretary for Environment, Climate Change and Land Reform from Scotland. She came down to Cardiff, mainly to see about our recycling, to see what she could learn from us. We did have a discussion around the DRS.
I’ve commissioned a study around a package or suite of things that I think we can do to reduce waste in packaging. I’m very keen, as you know, to get our recycling rates up. We’re now third in the world. I want to be first in the world. So, it was very helpful to hear what Scotland are doing and, as I say, I’ve commissioned this study, and once that’s been reported to me, we can decide on which aspects of it we do.
I thank the Cabinet Secretary for her consideration. I also met with Roseanna Cunningham when she was visiting Cardiff. I have to say, though, I very much, of course, support our sister party, the Scottish National Party. I don’t want them to steal a march on us here in Wales. I want us to be the first to do things like deposit return schemes and alternative ways of tackling plastic pollution. She’s right, of course, that we do very well on recycling, but the only countries that do better than us do have a deposit return scheme, I have to say. So, let’s examine one other aspect of this, because the UK Government Office for Science published an evidence review, ‘Future of the Sea: Plastic Pollution’ in July. This found that 70 per cent of all the litter in our oceans is of plastic of different kinds. We also had a report only last week that 83 per cent of tap water surveyed all around the world has been found to contain plastic fibres. So, I do think there are small policy interventions, and small nations can make those policy interventions that really change the way that we view the use of plastic, recycling of plastic and the reuse of plastic.
As well as a deposit return scheme, the Welsh Government has discussed the possibility of novel taxes here in Wales, with the new powers, and I certainly got the impression from the Cabinet Secretary before the summer—the Cabinet Secretary for finance, that is—that he was interested in how such small taxes could change behaviour and perhaps be used in an environmental way. Is this something that she is discussing with the Cabinet Secretary for finance, and particularly with a view to taxing or, in some way, levying this wasteful use of plastic?
‘Yes’ is the short answer. I think I’m meeting the Cabinet Secretary for Finance and Local Government next week, but I’m not quite sure if that’s on the agenda. But certainly, it is something that we have started to discuss. I’m very committed to reducing marine litter, and you may be aware that stakeholders have formed a marine litter task and finish group to tackle the issue of marine litter in Wales. I met with the group in Saundersfoot over the summer recess. Saundersfoot have got a brilliant scheme where they have—I forget what you call them—sort of A boards, where people can go along, take out a pair of gloves, take out a bag and can go and get litter off our beaches et cetera, which I thought was brilliant. So, I think there’s lots of good practice out there. It’s just about sharing it. I’ll be very interested to see what the task and finish group recommendations are.
I thank the Minister for that. I’ll certainly continue to urge her and the Welsh Government to introduce a deposit return scheme here in Wales. But to turn to another item of unfinished business over the summer, she’ll remember coming before the Climate Change, Environment and Rural Affairs Committee on 20 July. She was asked there around the community energy and non-domestic rates effect on hydro schemes in particular. In her reply to the committee on 7 September, she says that hydropower schemes have been disproportionately affected by the non-domestic rates revaluation. So, I’m pleased that she accepts that. She also says that she is now working and committed to finding a solution on the impact of non-domestic rates revaluation. The suggestion is that somehow the solution is to wait for a revaluation and a re-working of non-domestic rates that might happen in 2018 rather than deal with the problem that her own Government’s policies have given rise to now. Can she please give a commitment that the difficulty with hydropower schemes, which she now acknowledges, will be solved quicker than that, and that she will work with haste and speed with the Cabinet Secretary for finance to ensure that they’re not unreasonably penalised by changing business rates?
I can’t remember if I met with the British Hydropower Association before I came to committee or after, but it was certainly around that time. Again, I have shared correspondence with the Cabinet Secretary for Finance and Local Government, as has the association itself. So, I think, if I could, I will write to the Member with an update.
Conservatives’ spokesperson, Paul Davies.
Diolch, Llywydd. Cabinet Secretary, over the summer, the third annual implementation plan was published under the Wales animal health and welfare framework, and in your foreword, you state that the year ahead promises to be a challenging one, and I think that’s something that we can all certainly agree on. Now, that report highlighted that there is now scope to consider the option of banning the use of wild animals in circuses. Can you tell us why the Welsh Government has not already introduced a ban here in Wales?
We don’t have any circuses licensed in Wales. I have had at least two meetings with Lord Gardiner, the Minister with responsibility in the UK Government. We decided that we would work very closely with them around the possibility of having a joint ban. I last met with Lord Gardiner out in Brussels at an agricultural council, and I am due to have an update, I think, next month.
Well, I think it’s a real shame that, whilst Wales is advocating a ‘let’s wait for Westminster’ approach, the Scottish Government, for example, have got on with the job and already introduced a Bill, which is working its way through their legislative process.
Now, another priority highlighted in the implementation plan is in relation to welfare of animals at the time of slaughter. Following on from the UK Government’s announcement on CCTV installed in all English slaughterhouses, can you tell us what the Welsh Government is doing to ensure that a high standard of welfare for animals is kept in Wales, including at the point of slaughter, and will you now commit to seeing CCTV installed at all slaughterhouses here in Wales?
Just in relation to your first question, it’s not a matter of ‘wait and see about the UK Government’. You’ll appreciate the legislative—[Interruption.] You will appreciate that the legislative programme here is very busy, for want of a better word. I am having to make sure that I have legislation being looked at ready for post-Brexit. I thought that was the best way forward, particularly because we don’t have any circuses licensed in Wales.
In relation to your question around CCTV in slaughterhouses, there’s an incredible amount of work going on with that. You will be aware that when I came into post, my predecessor, Rebecca Evans, had had a report undertaken by an industry-led task and finish group around implementation of CCTV. Just two weeks ago, I was looking at how many CCTV cameras were installed in slaughterhouses in Wales. I have to say that the vast majority of the large slaughterhouses in Wales do have them. You will be aware that vets are present in every slaughterhouse to ensure compliance with regulations. They have the power to seize CCTV footage if they expect welfare standards are not being met. So, I think that is one reason to look at having CCTV cameras in our slaughterhouses. I’ve got a piece of work coming to me by the end of this month to look at whether we then make that mandatory or not.
Well, Cabinet Secretary, I have asked you, obviously, two specific questions now, and it seems to me that the Welsh Government is dithering on both. There is a perception, therefore, that the Welsh Government talks big on animal welfare issues but delivers very little. For example, when do you intend to review the effectiveness of the Animal Welfare (Breeding of Dogs) (Wales) Regulations 2014? When will you address the issue of the breeding, trade and keeping of exotic pets in Wales? Therefore, when will we start seeing specific action to deliver better animal welfare across Wales, including some concrete timescales on these policies?
I don’t think it’s a matter of dithering; I think it’s a matter of getting things right. You also have to realise the cost of these things. Maybe if we’d had a bit more money from your UK Tory Government, maybe we’d be able to do everything. But, the budget isn’t in—[Interruption.] You will appreciate these things. So, for instance, the cost of putting CCTV in every slaughterhouse runs into hundreds of thousands of pounds. So, you need to make sure—[Interruption.] And all the other things that you suggest. I don’t think you can say that we dither around animal health and welfare standards in Wales.
Environmental Impact Assessments
3. Will the Cabinet Secretary make a statement on the need for environmental impact assessments? (OAQ51026)
‘Environmental impact assessment’ refers to a formal process set out in regulations for assessing, consulting and coming to a decision on specific projects required by the Environmental impact assessment directive. Where EIA is not required, the environmental effects of proposals are considered by various consent regimes before development commences.
How can you call yourself the Cabinet Secretary for the environment when your Government has issued a licence to let material be dredged from outside Hinkley Point nuclear reactor and be dumped in Welsh waters just outside Cardiff? What’s worse is that an environmental impact assessment was not carried out by Wales’s environmental watchdog. No dose of radiation is acceptable for human health. So, it beggars belief that you would allow material from a nuclear—nuclear—site to be dumped in Welsh waters. So, why are you taking this huge risk? And will you now revoke the licence until a full and proper study of the potentially radioactive material has been carried out by Natural Resources Wales?
I’m unable to comment on a specific determination process that was carried out some years ago, but I can assure you that all marine licence applications are considered in line with legal requirements, which are set out in Part 4 of the Marine and Coastal Access Act 2009 and the Marine Works (Environmental Impact Assessment) Regulations 2007. The regulations provide procedures to determine the need for an EIA on the project, and I understand a valid marine licence is in place, and there are conditions that need to be complied with by the licence holder before any disposal can take place.
Looking at the environmental impact assessment of the combustion engine, both diesel and petrol, I wonder what environmental impact assessment has been done on the air quality in school playgrounds, because I had a visit today from St Teilo’s Church in Wales High School, where I’m also a governor, and that is one of the schools identified by ClientEarth as one of 1,000 schools across the UK that is suffering from really damaging levels of air pollution because of their proximity to roads. I just wondered how many of these nearly 1,000 schools are in Wales.
I can’t give you a specific answer on the number, but we do know that Welsh schoolchildren can be exposed to high levels of pollution when they’re travelling to and from schools, just as much as when they’re on the school grounds. The Member will be aware that we have begun to engage with a wide range of stakeholders to help shape work around the clean air zone framework for Wales, and that’s also being done through one of the sub-groups on my ministerial Brexit roundtable.
Swansea council states that the natural assets of the area of outstanding natural beauty provide an opportunity for economic growth and that they are important for well-being, and such benefits must not be compromised by new development that fails to safeguard or enhance the natural asset and ecosystem of the AONB. Can you tell me why the AONB isn’t a statutory consultee with an obligation to provide evidence in planning applications for land that’s directly adjacent to AONB land? This has become a material question, now, for my constituents in Gower, where the LDP anticipates the construction of 20,000 houses. Thank you.
It’s really important that any decision makers around any organisation take decisions in the full knowledge of the environmental impacts, but I will certainly be very happy to look into this and write to the Member.
Defective Cavity Wall Insulation
4. Will the Cabinet Secretary provide an update on the action being taken to monitor the progress made in cases of defective cavity wall insulation work in Wales? (OAQ51019)
Thank you. Further to my written statement of 13 June, I expect to make changes to competent person scheme requirements to help ensure insulation is not installed to unsuitable properties from 1 October 2017. For existing installations, officials will be meeting with the main guarantee provider, the Cavity Insulation Guarantee Agency, to discuss progress in resolving outstanding claims.
Thank you, Cabinet Secretary. It is clear to me that there does remain a significant number of people, many of whom are elderly and vulnerable, as you will know, who continue to face financial costs, due to the inappropriate or defective cavity wall schemes. Indeed, I’m grateful to a number of Assembly colleagues who have shared similar experiences from their constituencies with me. In recent weeks, I’ve met with more of my constituents who are facing just these problems. I welcome the update from your written statement in June, but can I ask: what is the latest position with the new pilot process under Arbed, which requires local authorities to procure independent, whole-house surveys of properties before potential schemes are evaluated and awarded funding? And do you agree that this problem requires our ongoing attention, so that we can prevent similar problems in the future, but also, and perhaps more importantly, to secure justice and recompense for those who have suffered so far?
It certainly has my ongoing attention. I think I receive at least one piece of correspondence a week on this issue. The Member will be aware that almost all cavity wall insulations are undertaken by installers under the building regulation competent person self-certification schemes. As I’ve said, I’ll be in a position, I hope, to make that announcement from 1 October. I know that there are similar schemes being brought in by the UK Government’s ECO scheme. In terms of Arbed, we’ve just issued outcome letters to local authorities following consideration of the independent property surveys that had already been submitted. That does then enable successful local authorities to proceed to costing and designing schemes. I think that will further strengthen the quality of those schemes and further minimise problems from occurring in the future. But you’re absolutely right—we want to prevent future problems, but we do know we have some problems that we still need to ensure get justice.
In 2015, the Building Research Establishment said that we did need more data on this in Wales. We need a national study to see the extent of the problem. I think the issue here is the current properties that have undergone this, and it’s been defective. Because it’s at the heart of much of our refurbishment strategy, energy reduction, Warm Homes—it is really, really important that we get to know the scale of this challenge and put it right as soon as possible, and obviously ensure that those that are responsible meet their obligations.
Yes, I absolutely agree with the Member, and you will have heard me say in my initial answer to Dawn Bowden that my officials are due to meet again with CIGA. Those meetings are ongoing. They’ve obviously previously met them, and I think CIGA do obviously recognise the problems that are facing many of the customers that they’ve been dealing with. They’ve already taken action in a number of areas, such as the establishment of a consumer champion, for instance. They’ve developed a property care pack for householders. But I do want to assure Members that this is something that we are working very quickly on to remedy.
Of course, the Cabinet Secretary will share our opposition to the concept that the Government in London, as their Secretary of State has said already, are going to take all of the powers for agricultural payments. But would the Cabinet Secretary, in order to ensure that we do have the widest support possible in Wales to protect devolution in terms of powers, over agricultural payments, make a pledge that if those powers were to come to us that there wouldn’t be less funding provided to agricultural subsidies?
I think the Member perhaps has mistaken the question for another. This question is on deficient insulation, rather than agricultural payments.
I apologise.
So, the Minister doesn’t need to answer that question on agricultural payments, unless she can make some very creative link with cavity wall insulation. [Laughter.]
Question 5, therefore—Gareth Bennett.
Common Agricultural Policy Payments Post Brexit
Diolch, Llywydd. It’s on agricultural payments, actually.
5. Will the Cabinet Secretary make a statement on the Welsh Government’s plans for common agricultural policy payments post-Brexit? (OAQ51036)
Thank you. I’m extremely concerned the UK Government has yet to commit funding for agricultural support beyond 2022, which was promised by George Eustice before the referendum. Meanwhile, we are working with other administrations to ensure that day 1 readiness preparations will be in place, enabling payments to continue to be made.
Yes, thank you for that answer. Clearly, I understand that there is some uncertainty regarding the future, but you sound reasonably convinced that some speedy and effective form of payments can be made if the responsibility does eventually devolve to here. Would you agree with that?
I think uncertainty for the future is probably one of the biggest understatements I’ve heard this year. At the moment, there’s a black hole after 2022. We don’t know what funding we are going to receive from the UK Government. They haven’t been very clear about that. They did promise before the EU referendum that we would receive every penny that we are having currently, so we are holding them to that. You will be very aware that I work very closely with my three other counterparts across the UK. We’ve got our next quadrilateral meeting on Monday, in London. It will be the first one that Michael Gove has attended since his appointment back in June. So, these are all issues that, obviously, are ongoing, but I’ve made it very clear that I cannot see a time when we’ll be in a position not to support our farming industry, so we need to make sure that the Tory Government hold very firm in their promises to us.
When I last questioned the Cabinet Secretary on this, the UK Government had guaranteed payments to 2020. They’ve now guaranteed them until at least 2022. So, I hope that she will welcome that. And also, when she has discussions with the UK Government around the complex area of how devolution works post Brexit and what areas of agriculture should be determined here and what the UK framework that should be agreed is and what the international trade policy that should be for the UK Government is, will she, in those discussions at all times, bear in mind that the absolute priority for farmers in Wales, who aren’t so concerned, perhaps, about where power lies, is that that money continues to flow?
I wouldn’t say that farmers aren’t that concerned where powers lie. I think certainly the farmers who I’ve engaged with and the farming unions absolutely recognise that the agricultural powers belong to the people of Wales and they don’t want to see any power grab by the UK Government. You’re quite right—. I think probably—well, it was before the election that was called in June of this year, we were given assurance to 2020 and then following the election, the Treasury gave assurance to fully fund direct payments until 2022. Of course, that’s welcome, but we need far more detail around that.
So, I’ve always been very clear that we will have a Welsh agricultural policy post Brexit. However, we do accept that, in some areas, there will be UK frameworks. I’m very keen to start those conversations about the UK frameworks. Unfortunately, because we haven’t had any engagement with the UK Government for such a long time at a ministerial level, we’ve not been able to process those conversations. But certainly, on Monday, I will be raising UK frameworks in that quadrilateral meeting.
Supporting Welsh Farmers
6. What measures will the Cabinet Secretary take to support Welsh farmers in the next 12 months? (OAQ51001)
Thank you. I want to see a more efficient, profitable and sustainable agricultural sector in Wales. I am supporting our farmers to achieve this through innovative use of funding available, including the sustainable production grant, the farm business grant, the strategic initiative for agriculture, as well as through Farming Connect.
Thank you for the long answer, Minister. One measure that would certainly not support Welsh farmers would be the Welsh Government’s proposal to designate further areas of Wales as nitrate vulnerable zones. A recent survey by NFU Cymru found that nearly three quarters of farmers who responded did not have sufficient slurry storage on their farms to meet the proposed NVZ requirements and it would cost on average some £80,000 for them to do so. Will the Cabinet Secretary call a halt to these proposals, which could have a ruinous and a financially very negative effect on our farming industry in Wales?
Well, I can’t call a halt to the NVZ review because that’s a statutory requirement under the nitrates directive, so I think it needs to be viewed within that. You’ll be aware that we had a consultation on NVZ. That closed at the end of December. We received a large number of responses—I think it was over 250—many, many more than the previous time we’ve had to review it. I’m very keen to work with the farming unions and the farmers and the sector as a whole to develop solutions, and, of course, I do understand there would be a cost. However, I don’t want to pre-empt the consultation, but I will be making an announcement by the end of this year.
Farming Connect
7. Will the Cabinet Secretary make a statement on the Farming Connect business advice grant? (OAQ51024)
There is no specific Farming Connect business advice grant. However, our Farming Connect service provides a wide range of valuable support services focused on driving modernisation, increased prosperity and resilience. As we head towards Brexit and the considerable challenges this will present to farming and forestry, Farming Connect becomes an ever more important resource this Government makes available to our farmers and foresters.
Cabinet Secretary, I’ve been contacted by a constituent with concerns about the administration fees charged by consultants to conduct work under the Farming Connect business advice grant—or, if I’m incorrect, as you stated—. It seems to be that, in some cases, consultants are taking up to 20 per cent of the total grant in administration fees. Are you prepared to have a look at this and investigate it and potentially put a cap on administration fees so that as much of the funding reaches the front line and reaches the farmer as possible, rather than lining consultants’ pockets? I’d be interested to hear if this issue has been raised with you previously and I’d be happy to provide you with some examples.
I think it would be better if the Member could write to me because, as I say, there isn’t a grant that you asked me about in your original question. Farming Connect tends to signpost farmers and foresters to different schemes and grants. So, I’m really unclear as to which grant you’re referring to. So, yes, I think it would be really helpful if the Member could write to me and then, obviously, I can respond.
Floods on Agricultural Land
8. Will the Cabinet Secretary make a statement on floods on agricultural land? (OAQ51031)[W]
Thank you. My recently published natural resources policy outlines the opportunities to manage flooding by using natural flood risk management techniques in both our upland and lowland areas. In the uplands, this means taking measures to increase water storage by reducing run-off and soil sealing, and in the lowlands, slowing flow through more natural floodplains.
Thank you for that response. I did raise this with one of your predecessors three years ago: the need to do more to empower landowners, farmers, environmental groups and so on to be responsible, within specific parameters, of course, for clearing river banks themselves, for example—that they should have the powers to do that within specific circumstances. I referred at that point to a pilot scheme that the Environment Agency in England was running, and the Minister at the time agreed that he would be happy to introduce a similar pilot scheme in Wales. Can you tell us whether that pilot scheme has been put in place, and can you also explain why we are still seeing increasing examples of complaints about agricultural land finding itself under water for large parts of the year?
I’m not aware of that pilot scheme, but if it was three years ago, that doesn’t mean it’s been rolled out, if you like. But, certainly, I’m happy to look into that and write to the Member.
I too have been contacted by constituents who are very concerned about the reduced maintenance regime that’s being undertaken by Natural Resources Wales in parts of north Wales and, as a result of that reduced maintenance scheme, ditches, because they’re not being cleared, are beginning to flood-water on to agricultural land—what has been very productive agricultural land. What action are you taking to ensure that Natural Resources Wales does target its maintenance appropriately so that farmers aren’t losing out because of a lack of maintenance in their areas?
I think you raise a very important point. It’s not one that has been raised with me as a concern but I’d be very happy to discuss it at my next meeting with the NRW chair and chief executive, which I think is next week or the week after.
Sea Defences at Old Colwyn
9. What action is the Welsh Government taking to improve the sea defences at Old Colwyn? (OAQ51007)
Thank you. The Welsh Government is working closely with Conwy council on coast protection. We have supported appraisal work covering the whole Colwyn Bay waterfront and to date we’ve funded £26 million of improvements there. We are in discussion with the council on their plans for further work at Colwyn Bay.
I’m very grateful for the investment that has gone into Colwyn Bay over the years in terms of affording that particular part of the coastline with greater levels of flood protection, but we’ve seen the damage that flooding from the sea can do when we look over the Atlantic as a result of those terrible storms that have wreaked havoc in the Caribbean and in the United States of America, and I don’t want a similar situation to happen here in north Wales, in Old Colwyn. You know that the waterfront there has flood defences that protect vital parts of the north Wales transport infrastructure. They’ve gone unattended to for far too long. There have been patchwork repairs that have been done over the years and we need some action in order to bring them up to scratch. What confidence do you have that we will see a plan and that we will see some work started on significant improvements on the Old Colwyn promenade within the next two years?
Well, I think the Member questioned me on this probably at the end of last year and I think I told you then what I’m going to tell you now: we’re still waiting for Conwy council to come up with a proposal that identifies a partnership approach that they want to Old Colwyn and, indeed, to Colwyn Bay. I do know the council are having a meeting, I think next month, with partners such as Network Rail, because you mentioned the transport infrastructure alongside the A55, I think the trunk road agency and also, obviously, Welsh Government officials. So, I know they’ve been asked to prepare a report for me following that meeting.
Pollution in Welsh Rivers
10. Will the Cabinet Secretary make a statement on pollution in Welsh rivers? (OAQ51035)
Thank you. The river basin management plans, published in 2015, include detailed assessments of all Welsh water bodies and measures to improve water quality. There have been a number of significant agricultural pollution incidents in the past year, causing substantial damage, and I’ve made it clear these incidents are unacceptable.
I agree that they are unacceptable and there have been between 70 and 118 incidents of slurry pollution entering Welsh rivers annually, which makes it more than one a week. And I do appreciate that most farmers will comply with the law, but the stats suggest that some are clearly falling outside of that. A recent investigation by the Bureau of Investigative Journalism has suggested that some farms do see the fines that they incur as a result of polluting as part of the running cost of their business. If there’s any truth whatsoever in that, then those fines are clearly not working as a deterrent. And the other thing that was found through that study was that there was a persistent problem within some farms in Carmarthenshire. So, Cabinet Secretary, what I want to ask is: what action is the Welsh Government taking to ensure that the non-compliance by reoffending farms is thoroughly investigated? And I do understand quite clearly that it is Natural Resources Wales who will do that. And the other thing that was found by that investigative journalism is that some of the NRW staff are being threatened and not welcomed—in fact, quite the opposite—when doing their jobs on those farms.
Thank you, and as you pointed out, Joyce Watson, whilst I said there have been a number of significant agricultural pollution incidents, they can be attributed to a very small percentage of agricultural holdings. Continual reoffending is not acceptable and fines should, of course, act as a deterrent rather than be seen as a running cost. And I think, in some cases, fines are simply not appropriate, and requiring farmers to remedy the damage that they’ve caused, I think, is often seen as a more acceptable way of limiting reoffending. Such matters are being taken forward by the land management sub-group on diffuse pollution. I’m also seeking views, you’ll be aware, through the sustainable management consultation of our natural resources. I’ve not been made aware of any NRW staff being threatened, but, again, it’s something I’m very happy to raise with NRW at my regular monthly meetings.
I’m very glad that Joyce Watson asked that question because you and I have discussed this issue on a number of occasions. I wonder if, Minister or Cabinet Secretary, you would look at how we might improve the planning application process, in particular for super farms, to ensure that drainage and adequate slurry storage is really taken into account, because when a farm grows from 600 or 700 head of cattle to 2,000 to 2,500, the blight on the neighbouring farms is utterly unbearable. The pollution that runs into gardens, the pollution into rivers, the pollution not just, of course, from contamination of the water courses, but the pollution from the birds that flock to the grain and all the rest of it. And a super farm, if it’s well run, is an extraordinarily wonderful thing to behold. A super farm badly run is utter, utter misery for the people around it, and I really think that the Welsh Government need to toughen up on the planning. It’s a subject I’ve raised with you before and with your colleague next door to you, because I think the time is to act because there are more and more of them happening.
Yes, and certainly in our discussions I’ve made you aware that I’m very happy to look at planning policy to make sure, as you say, they are very well run, because there can be nothing worse than having the sort of pollution to which you allude.
Thank you, Cabinet Secretary.
[R] signifies the Member has declared an interest. [W] signifies that the question was tabled in Welsh.
The next item is questions to the Cabinet Secretary for Communities and Children, and the first question is from Suzy Davies.
Progress for Supporting Communities in Wales
1. Will the Cabinet Secretary provide an update on progress for supporting communities in Wales once Communities First has come to an end? (OAQ51003)
I thank the Member for her question. My officials have been supporting lead delivery bodies to deliver their transition plans for this year. A number of mitigation measures have been established to support arrangements going forward. Local authorities are engaging with partners to ensure future delivery reflects local needs.
Thank you for that answer. It sounds like work is still ongoing. I have to say, you told me shortly before recess, in a question on representations made to me on behalf of Faith in Families in Swansea West, that Swansea’s local Communities First delivery board had, and I quote, ‘detailed transition plans to make sure that locally supported projects didn’t lose out.’ I’ve now been contacted about Clase family centre in Swansea East, where Faith in Families also run services, but this time it’s by constituents themselves, and they’re very anxious because they still don’t know what the funding picture’s going to look like after March 2018. Now, six months isn’t long. Have you had any indication from all councils when those detailed transition plans will be announced?
Well, I’m really surprised by the Member’s question in terms of the detail around Faith in Families. I know that Faith in Families are running a significant media campaign around this transition period. In broad principle, the transition is going really well and we haven’t got any red-flag areas in terms of the transition process going forward. Faith in Families have been running the media campaign, as I said. However, as set out in Swansea’s local delivery board’s detailed transition plan, Faith in Families are receiving 100 per cent of their Communities First funding up to 31 March 2018—approximately £260,000. If the Member has specific questions around a particular organisation, I’d be more than happy for myself or one of my team to meet with her to clarify those issues.
From what I understand, the emphasis of the counter-poverty work that used to be carried out by Communities First will be on early years education, helping people into work and empowering communities—those will be the focuses now—which is what you refer to as the three Es: early years, employability and empowerment. I would like to understand, and I think the people in the sector also want to understand what exactly ‘empowerment’ means. What’s your interpretation of that? Importantly, how will you measure the success of this ‘empowerment’ element in attempts to reduce poverty in Wales?
Well, empowerment is certainly about local people having an involvement in the decision-making processes as we move forward, and that’s why public services boards and the future generations Act have a very close link to engagement with all communities and individuals that they have a stake in, moving forward. I think the whole principle of the three Es is an exciting one for communities. What we did realise is that Communities First hasn’t worked as well as it was designed to do in terms of lifting communities out of poverty. I think it’s done a great job of stopping communities getting poorer, but we have to have a game changer here, and the new programmes that we have in place and the support mechanisms around that, I believe, will be the experience that local communities will want to achieve, going forward.
Anti-social Behaviour
2. What discussions has the Cabinet Secretary had with housing associations in an effort to tackle anti-social behaviour? (OAQ51023)
In July 2016, I set up a Welsh Government and Police and Crime Commissioner for South Wales group, chaired by the south Wales police and crime commissioner. This group is working with housing associations across Wales to improve the approach taken to addressing anti-social behaviour.
Thank you, Minister. I’m pleased to hear that. I’ve certainly had a constituent who is exasperated at the drug-related and anti-social behaviour that’s going on that she and her young family have to witness on a regular basis. The social housing development she lives on is a mixed housing estate with single-person flats. She’s unfortunately in regular contact with the police and the local housing association. I’ve had similar cases raised with me in this regard also. I’ve heard what you’ve said, but I’d be grateful if you could give an update on those discussions and let me know what Welsh Government can do to compel social landlords to take responsibility in this regard.
Well, social landlords do take a responsibility in this field. I recognise the devastating impact that anti-social behaviour can have on individuals and communities across all of Wales. What I would say is this is a complex area that needs a multi-agency approach to deal with support for the communities, but also for the individuals causing anti-social behaviour, and we have had a strong track record on delivering on robust policies. I would ask the Member also, though, to consider his position in this, in supporting Welsh Government in asking the UK Government to increase the funding level and support for police officers across the whole length and breadth of the UK, including here in Wales and in his own constituency.
Questions Without Notice from Party Spokespeople
Questions now from the party spokespeople. Plaid Cymru spokesperson, Bethan Jenkins.
Thank you. My first question is with regard to Grenfell and I’ve asked many questions on it here in the Chamber, and you have, to be fair, sent us regular updates as requested over the summer about what you are doing in relation to Grenfell on a Wales level. On 25 August, it emerged that some private high-rise apartment buildings in Cardiff, such as those at Prospect Place, had failed cladding safety tests. You did send us that information, but I was wondering whether you could provide us with further updates on the private sector in particular, because you did tell Assembly Members before recess that it was not only you as Cabinet Secretary who was looking at this in relation to private flats, but that your Cabinet Secretary for the economy would be talking to hotels and such also. So, I’m confident that we can have a grasp of the housing within the Welsh Government’s parameters, but I want to be assured that in relation to new flats—because they’re being built all the time—and the ones that have been flagged as problematic, you are able to give us a further update here today.
I’m grateful for the Member’s question. I did, as the Member suggested, issue statements right the way through the summer when we were updated in discussions with the UK Government. I was on a multi-agency conference call with the UK yesterday on the issue, following up on actions following on from Grenfell. In Wales—I can’t find the number in my briefing, but I will write to Members wholesale in terms of identification of private buildings over seven storeys with aluminium composite material products. I think it’s seven, but I will clarify that for the Member. All local authorities have been working very well with their local agencies, so that’s private landlords, hotels, et cetera, to see where ACM may be present. The same principle applies. We are working with the private sector to make sure residents are fully informed, residents feel as safe as they possibly can, and the fire service is giving support in that mechanism as well. So, this is a difficult time, but we believe, as all of the UK—Scottish colleagues I talked to yesterday as well. We have a similar action point, taking this forward.
And on the same theme, in response to a short debate by Dawn Bowden in May in relation to electrical safety—obviously, this is pertinent here because a washing machine was involved in the situation involving the fire at Grenfell—you said that you would be commissioning research in Wales into fires caused by electricity. I want to know what’s happening with that research and who you will be engaging with it. When will that be updated to AMs? Because I know from a letter that I’ve seen to Electrical Safety First, from you on 27 July, that you said that you will, and I quote, ‘be in touch should their advice be necessary.’ I would have thought it would be integral, would it not, to get advice from an organisation like that, that specialises in electrical safety. I would urge you now, here today, Cabinet Secretary, to meet with them to hear their concerns, because they are very proactive in this field, and to come up with that piece of research that Dawn Bowden and others have called for.
I would just caution the Member, first of all, on her—. She’s correct in saying that there was an electrical device in the flat that was in Grenfell, but there is a full inquiry going on there and we have to ensure that we have all the details of that. I think the building was also compromised in other ways, but that will become clear through the inquiry. With regard to the letter that the Member raises with me, I have letters from experts in all sorts of fields every day. What is really important is that we have a co-ordinated approach, and that’s why, working with the UK, Scotland and Wales on these very issues, we are getting feedback on whether the electrical testing facilities that we have in place are adequate for the requirements that we are needing for evidencing whether that’s true. What I will do is, as I said to you earlier on, continue to update Members, in particular around electrical safety, and I will send the letter to all Members in the near future.
Thank you. Well, I would hope that if you get letters from experts, you use their expertise. I think that all I’m trying to say is that, obviously, they have that expertise to offer, and they do have an open door towards speaking to you.
I wanted to move on to housing. I’ve been talking about social housing quite a lot recently. I wanted to ask a question in relation to updating homes that are currently in private hands, but are going into disrepair. It’s something that we could be utilising much more to increase our stock on a local level. I know that you have the Houses into Homes scheme, loans for people to update their properties, and that local councils have empty dwelling management orders in relation to taking those properties in in a cohesive way. I’m wondering if you could give us an update on those particular schemes, and tell us how many private homes have, therefore, been taken over in this way or updated from the loan structures, so that we can add to the stock that we need here in Wales to build those homes, and to try and take away from some of the eyesores on our streets, which are animating people’s everyday lives, because they see them in disrepair, every day, and we really need to get those houses into proper homes, so that people in our communities can utilise them to the best effect.
Of course, the Member is right to raise this issue. We’ve had great success with the Houses into Homes scheme, where the money recirculates back into the system and purchases more homes. I would encourage local authorities to use the management orders, where properties are empty and becoming a blight on their community, to enforce that. We also introduced a council tax scheme around second homes, where that can be used also as an additional levy to raise cash, to stimulate people to thinking about what are they going to do with that property. I will update the Members with the numbers—I don’t have them to hand, but I will ensure the Member is made aware of them—the current position we find ourselves in.
The Conservative spokesperson, Mark Isherwood.
Diolch, Llywydd. We heard at Citizens Advice Flintshire’s annual general meeting this summer that the Welsh Government was moving to the commissioning of advice services. I wonder whether you could say a little bit more about that, and confirm how you will ensure that organisations operating in Wales providing critical work—not only the larger ones, but the smaller ones—in terms of crisis intervention and support are protected against the larger organisations operating in England and elsewhere in the UK, who, on a pure cost basis, are likely to undercut organisations in Wales.
I’m very conscious of the difficulty that some smaller organisations have in commissioning, but we will look very specifically around the criteria expected on that, about having local connections, and making sure that they can deliver good, quality services.
I would like to give confidence to the Member around reassuring him, and others, about the funding mechanism in place. But, of course, budgets are extremely tight at the moment, and the budget process is coming up, of course. Where services are affordable, we will deliver them, and I hope that we can give confidence to some of the smaller organisations that the criteria around that will not disadvantage them.
Thank you. Well, in the context of both the budget process and the Bevan Foundation latest ‘state of Wales’ briefing, published at the end of July, which said Wales has the third highest poverty rate in the UK, behind only London and the west midlands, with ‘little change in the headline rate’, how do you respond to the Public Policy Institute for Wales August report, ‘Participatory Budgeting: An Evidence Review’? They highlighted Porto Alegre in Brazil as the birthplace of participatory budgeting, saying the process there
‘has fundamentally changed the relationship between citizen and state, improved the functioning of government and led to improved public services and infrastructure.’
But, in Wales to date, the use of participatory budgeting
‘has been more modest, and the impact has, as a result, been smaller.’
And they recommend that, in Wales,
‘the focus in the short term might usefully be on laying the foundations’
of participatory budgeting in future budgets, alongside the use of other forms of engagement or consultation that signal an intention to promote greater public awareness of, and involvement in, the Welsh Government’s spending decisions. What consideration will you be giving to their findings?
Well, I find their comments, as always, very interesting. What I would suggest is that the Welsh Government has been very proactive in this space. By legislating the Well-being of Future Generations (Wales) Act 2015, we’ve put a duty on public bodies to have engagement with communities and interested parties. So, I would disagree with the fact Wales is behind the curve here; actually, we’ve legislated prior to any other country doing that.
I think more the issue is that Porto Alegre, which piloted this, is clearly ahead of the curve, and has quantifiable outcomes that can be looked at. And what this is is part of a broader agenda, which I hope you might look at and embrace.
My final question is to move to housing in the context of communities. As you know, Community Housing Cymru signed a compact with the Welsh Government and the Welsh Local Government Association last December, underpinned by a commitment for housing associations to work in partnership to maximise housing delivery for the local area. What reciprocal responsibility lies with local authorities to work with housing associations to ensure that their resources also maximise social housing delivery for the local area?
Well, the compact changed last year, so it includes now the Welsh Local Government Association. So, local authorities are very keen to ensure that they work with housing associations even where stock retention has remained in some local authorities, like where the Member lives. So, there is operational work between the authority, registered social landlords that work in the area, and Government. That’s what the compact was all about, and it’s extended to a tripartite agreement now.
UKIP spokesperson, Gareth Bennett.
Diolch, Llywydd. Good afternoon, Minister, and welcome back to the Chamber. Yesterday, one of your backbench Members, Hefin David, raised the issue of the remediation of brownfield sites. Now, I realise that brownfield sites can be problematic to develop, but there are some brownfield sites that can be prepared for housing relatively cheaply. So, I wondered what involvement your department has currently with the development of brownfield sites for housing.
I work very closely with my Cabinet colleagues, in particular, Ken Skates and Lesley Griffiths, on the issue of bringing housing opportunities forward. Brownfield sites is one of those areas we have discussions about, as with all other land opportunities that my colleagues around the Cabinet table can bring to the table, including the health sector.
You’ve mentioned this before. When I did Minister’s questions with you for the first time in April, you mentioned your ongoing discussions with Ken Skates’s department and the possible use of Welsh Government land for brownfield housing development, and you suggested at that time that there were—at least, I took the suggestion to be that there were—many redundant NHS buildings that could be used in that capacity. So, do you have any more details on how this process is ongoing, and how close you are to developing any of these possible sites?
I’ve had several offers of land from Ken Skates, the Minister for infrastructure, and we are working through those on the affordability of delivery now, and looking at other partners. I will be announcing shortly a decision on the innovative housing schemes, which will include new opportunities for developments across Wales, which I believe are quite exciting, and the sector is looking forward to that.
Thanks. Oddly, my next question was on your £20 million innovation scheme, which you’ve now mentioned yourself. Obviously, your announcement is coming shortly. Is there anything you can give us here today regarding that scheme?
Well, I think there’s a huge opportunity. I saw some of the submissions that came through; the closing date was Friday of last week. Some are very innovative about power house-type homes—build a home that produces electricity, so there’s no energy bills to the consumer but added value to the grid. Some of it’s about modular units for the under 35s. So, there is a whole host of opportunities there, but I will make a statement to the Chamber once I’ve decided what the allocation should be.
Modern Slavery
3. What measures will the Cabinet Secretary take to combat modern slavery in the next 12 months? (OAQ51004)
Thank you. We are committed to continuing working with police and crime commissioners and other partners in continuing to tackle slavery here in Wales.
Thank you for that answer, Minister. Modern slavery in Wales is on the rise. In 2015, there were 134 referrals of potential victims of slavery. This showed an increase of over 91 per cent on the previous year. However, the real figure is likely to be much higher due to the secrecy and the tight control that the perpetrators have on their victims. Cabinet Secretary, what further measures does the Welsh Government intend to take to increase awareness of modern slavery and to ensure local authorities, public bodies, and voluntary organisations are able to recognise the signs that someone could be a victim of modern slavery in Wales?
Let’s look at the Member’s question carefully, and, actually, we could consider this to be somewhat of a success here in Wales, where we are identifying the issues around slavery and capturing the slave drivers and prosecuting them, and that’s absolutely the thing we should do. That’s why there’s been, I believe, an increase in identification of this. We are the only country in the UK to appoint an anti-slavery co-ordinator, and we were the first in the UK to do that. I would encourage other parts of the UK to actively seek to appoint an anti-slavery co-ordinator because, as a country, we can deliver on this much better. The Member is right about making sure that key agencies, key workers, can identify early on where people are thought to be enslaved and that our intelligence agencies and support phone numbers are available for individuals to report that, if they are to be identified by individuals.
Until very recent times, slave labour was virtually unknown in the UK. Is it therefore true to say, Cabinet Secretary, that slave labour is the direct result of uncontrolled mass immigration? The sexual exploitation of women and children has dramatically increased over the last two decades—almost all controlled by immigrant gangs, exploiting immigrant workers. Does the Cabinet Secretary not agree that virtually non-existent border controls, brought about by free movement of people, has hugely exacerbated this truly evil manifestation in our country?
Well, I can’t think of a word that the Member uttered there that I agree with him on. The fact of the matter is that this hasn’t been a hidden crime—slavery has been around for hundreds of years, and it was the British empire that started a lot of this off in the first place, and we should be the ones now stopping the whole issue of this. That’s why we have appointed an anti-slavery co-ordinator. I don’t think that mass immigration, as the Member talked about, has anything to do with the slavery we see today. In fact, I don’t even acknowledge the Member’s views in the fact that we have uncontrolled mass immigration; the Member is wrong to suggest that.
Welsh Government’s Childcare Pilot Scheme
4. Will the Cabinet Secretary provide an update on the Welsh Government’s childcare pilot scheme? (OAQ51034)
Thank you for your question. All seven early implementer local authorities are open for applications and already children in Wales in these pilot areas are receiving free childcare. Applications are already being processed for additionality to these pilot schemes.
I thank you for your answer, Cabinet Secretary, and I’m pleased to see that a number of the families will be from the Gwynedd area, included within that pilot. I do think that piloting the childcare offer is the right approach. We’ve all seen that some local authorities and other providers in England are having huge problems with rolling out their project. So, do you agree with me that the problems that have already been encountered by parents and providers in England underlined the importance of actually piloting this in the first place?
Of course, and we’ve taken the steady approach, but we have hundreds of young children in our childcare settings across Wales today and we should be really encouraged by the fact that we’ve had very few problems identified currently. I dare say we will encounter problems, but not on the scale that the English model started off with. I do understand that the problems in England were challenging because of the big-bang approach. We haven’t taken that approach, and I’m confident that we are doing this the right way.
Minister, when you were giving your evidence to committee some months ago, and then the education Secretary came in just after you, there seemed to be a little bit of confusion as to exactly how the money would flow around the system to provide this provision when it is universally rolled out from the pilot scheme. How are you taking this across Government because, from my understanding of the evidence you gave, you were looking at the school setting to make some of the provision? Obviously, without additional money being made available, that is going to be very challenging for many schools to provide that provision. So, have you identified the budget lines where this money is going to come from and, indeed, can you confirm today where that money will be in the future?
Part of the pilot scheme process is about learning about how this money will flow. Out of the six models, seven local authorities want a joint pilot scheme. There are all different models of delivery: some are purely school settings and some are school and private settings. So, we are understanding what works best for parents, and, ultimately, that’s what we’re seeking to clarify: what is it that works for families across Wales?
I wouldn’t worry about the finances of this. This will be delivered. We are working with HMRC. Actually, the Member may be helpful to us as well. I will contact the Member in terms of dealings with HMRC. We do have a piece of legislation that we are likely to introduce to ensure that we can use the data package that HMRC are using for families in Wales, to deliver the package as we move forward. It would be of great help if the Member could be supportive in that process.
You’ll know—and I’m sure you’ll sigh when I raise this again—my concerns about the lack of a workforce strategy for childcare workers. We know it was in draft form three years ago, and despite promises to the contrary, we still haven’t seen a strategy in place, and I’ve registered my concerns now that that’s been rolled into the new employability programme, which doesn’t go live until 2019. But in the meantime, of course, the pilots are running and we’re all for that, and the clock is ticking in terms of rolling the scheme out fully and nationally. So, my question is: how can you be sure that without a strong workforce strategy in place that not only do you have sufficient numbers of childcare workers to be able to deliver the fully rolled out childcare offer, but also that those workers are sufficiently qualified and that they are the best childcare workers that we could possibly have?
Well, I pay tribute to all the childcare workers across Wales. They do a fantastic job, and I should declare an interest as my wife is one. I would say that they are the best in terms of delivery of services. Can I say the Member is right to raise the issue again? We recognise that rolling this programme out on a measured basis gives us the opportunity for the sector to be developed as well, and we are working with the sector in order for the right people, the right development of skills, to deliver the childcare pledge. The caring sector not just in childcare, but in adult social services as well, is something that the Minister and I have had several discussions on, about how we develop that, and Julie James, the Minister responsible for the employability programme, will have more details as we move forward.
Homelessness in Ynys Môn
5. Will the Cabinet Secretary make a statement on homelessness in Ynys Môn? (OAQ51027) [W]
Our focus on prevention is having a positive impact in both Ynys Môn and the rest of Wales. In total, we have prevented 10,300 households from becoming homeless. We are continuing to support services in Ynys Môn to support those who are homeless, rough sleeping or at risk of homelessness.
Thank you. This month, I met with staff and managers of some of the organisations and charities that do excellent work on Anglesey in tackling and dealing with homelessness, including The Wallich and Digartref Môn, and Gorwel, also. Unfortunately, being asked to do more and more with reducing resources means that they are now reaching a point where it is entirely impossible to achieve, and the threat of a cut to the Supporting People fund from the Welsh Government risks undoing and undermining much of the good work that is and has been done in Anglesey and other parts of Wales. Does the Minister recognise that fact and accept that if the Welsh Government doesn’t maintain the financial support for these organisations they will be making a grave error and putting pressure on some of the most vulnerable people in our society?
Well, I agree with the Member’s concerns about how the Supporting People budget helps many homeless people not just in his own constituency, but right across Wales. But there is no guarantee as this point in the budget stages that I can protect Supporting People or other elements of funding in my budget. It’s a very difficult financial settlement we find ourselves in, and I will have to make that decision as we move forward to 3 October, but I’m sure I have listened very carefully to those concerned, of the significant lobby that’s out there in the Supporting People field.
I endorse that point. The Welsh Government has said it’s not possible to make comparisons of numbers of eligible households between 2015-16 and 2016-17 because of issues of data quality of the 2015-16 figures, and of course changes to the returns for 2016-17 with the new legislation. We hope figures of suitable or sufficient data quality will be available soon. However, in the five preceding years, the number of homeless households on Anglesey fell from 125 to 45. It also fell in places like Gwynedd, Wrexham and Torfaen, but they increased in places like Neath Port Talbot, from 140 to 195, and Flintshire, from 55 to 95. What consideration have you given to establishing why we’re getting these different patterns in different parts of Wales, irrespective of the political colour of the councils at the time?
Yes, and the Member is right on what he raises around the data collection. What I’ve asked the team to do is look at, specifically, all areas to have some sort of consistency about interpretation and measurement and how that looks. It may be that it is about interpretation of what that looks like to individual reporting. I fear that we have to have more consistency around data and therefore are able to put investments in the appropriate places where that data has spiked or is increasing.
Cabinet Secretary, winter’s fast approaching and there’s going to be many people in Llandudno and along the north Wales coast and elsewhere who are going to be forced to rough-sleep this winter because they’ve literally got nowhere else to go. What measures have you put in place already to ensure that these people are helped into safe, secure, warm accommodation—and long-term accommodation—before winter actually sets in this year?
I’ve asked all authorities to prepare a cold weather plan for homelessness and rough sleeping to ensure that there are facilities available for trigger points within the winter period. I would also ask the Member to also consider her party’s position on where we are now: about to introduce the ending of the right to buy, which protects social housing stock in Wales. Therefore, it would be really good if the Member could consider supporting that Bill as opposed to objecting with her Conservative friends.
Incentives to Build More Homes
6. Will the Cabinet Secretary outline how he intends to increase incentives in the private sector to build more homes in Wales? (OAQ51043) [W]
I thank the Member for her question. Through Help to Buy Wales, the House Builders Engagement Programme and the Wales property development fund, we work closely with the sector to make Wales an attractive place for private developers to build. I will be making an announcement tomorrow about additional support for home builders and small and medium-sized enterprises.
Well, that’s very good news, and I just hope that, in responding tomorrow, you will take on board the points made by the Federation of Master Builders, who have suggested that there is a lack of available small sites and a shortage of finance, which precludes small and medium-sized businesses from increasing their delivery of new homes. I just wondered, on top of your announcement tomorrow, whether you have been working with your other Cabinet Secretaries to make sure that there is an all-departmental approach to what is, I think, a very serious problem.
Lesley Griffiths and I meet the Home Builders Federation on a regular basis. We’ve got a meeting very shortly. The Member will have to wait for the details of the scheme, but I hope, when she reads the announcement, she will be encouraged by the content.
I commend Eluned Morgan’s point about the need for more SME builders, as a crucial sector that, in previous decades, provided for a lot of growth. One thing you could do is copy the scheme in England whereby local authorities have their Treasury grant increased by the value of the increase in council tax that comes with new house building. That would be a great incentive.
I think what would be really useful to the Welsh Government is to have a lift of the borrowing cap on local authorities, which would allow local authorities and others to invest with SMEs to build more properties for our communities, but it’s just a Treasury rule that needs addressing.
Public Spaces Protection Orders
7. Will the Cabinet Secretary make a statement on the use of public spaces protection orders to ensure community safety? (OAQ51017)
I thank the Member for her question. The use of PSP orders is a matter for local authorities, who must consult with their local police force and community representatives.
That’s a bit brave. Okay. With the introduction of public spaces protection orders going forward, you’ll be aware of the media outcry, actually, in Conway, with the previous cabinet, I might add, where it has been proven that enforcement officers—external ones—have been very overzealous in terms of targeting my constituents and visitors. Now, with the public spaces protection orders going forward, we’re being told that this is a remedy. How are you going to be working, Cabinet Secretary, with the UK Government and our chief constables across Wales to perhaps look at making PCSOs in uniform more involved in these kinds of environmental crimes, going forward. I have raised it before with you and with your predecessor—about how we can perhaps have a more uniform approach in terms of enforcement across Wales, and, certainly, I do believe that Conwy County Borough Council isn’t the only one where there are issues regarding the enforcement of FPNs and those kinds of environmental crimes.
I think the Member is right to raise the issue. Public spaces protection orders were established under sections 59 to 65 of the Anti-social Behaviour, Crime and Policing Act 2014. They are a matter for local authorities and the police. I would also encourage support from the Member in regard to the devolution of policing. Therefore, we would be able to manage all of these issues from the Welsh Government, as opposed to asking her colleagues to try and help us with trying to change for the better our communities, with the support of the police and PCSOs.
A Sustainable Fostering Service
8. Will the Cabinet Secretary make a statement on plans to deliver a sustainable fostering service in Wales? (OAQ51010)
Thank you for a very important question. We recognise the vital role foster carers in Wales play in looking after children in care. As part of our Improving Outcomes for Children programme, we are working with partners to deliver a fostering in Wales network.
Thank you for that answer. Further to that, you will be aware that Action for Children has recently claimed that foster care in Wales is in crisis. Figures show that 88 per cent of adults say that they are unlikely to ever consider fostering a child or young adult. So, I would ask: what further action is the Welsh Government planning in order to increase the numbers of foster carers, and do you agree that we need to move to an all-Wales standard, such as in terms of foster carer payments, with a view to reducing competition between providers and geographic areas of Wales?
I’ve got a working group looking at this. As well as the fostering in Wales framework, our work around promoting stable placements includes a review of special guardianship orders, investment in a new model of adoption support through the National Adoption Service, and a task and finish group on children’s residential care. I think this is one of the areas that I don’t think should be political in any way, where we have the interests of young people at heart. If the Member has any positive contributions to make, I would be very happy to receive them and feed them into the working group as we move forward.
It’s not just the service that’s in crisis; some of the foster carers and the children that they care for are in crisis. Cabinet Secretary, what assurances can you give us that looked-after children will be able to access emergency support services, such as child and adolescent mental health services, if they are placed in foster placements that are outside the local authority that is responsible for their care order? I have a number of very unfortunate cases that bear witness that this is not happening, and I think we absolutely must change it.
I would urge the Member to write to me specifically with those cases. I will take them up personally to ensure that we look at them with detailed analysis. Look, these young people who find themselves in a fostering placement or childcare setting are extremely vulnerable, and we should be doing more than what we do currently to make sure that these young people are safe and have resilience moving forward. I would welcome the Member’s letter when I receive that.
Refugee Children
9. What assessment has the Cabinet Secretary made of local support services available to unaccompanied refugee children? (OAQ51046)
I thank the Member for his question. This year, I have provided £410,000 to help local authorities build capacity and expertise to support the arrival of unaccompanied asylum children in Wales.
I’m grateful for the Cabinet Secretary’s response. I have passed him the details of Adam Bakhtiari, who is 17 years old, originally from Iran, living in my constituency, and is facing a very difficult situation if he were to be forced to move back to Iran for reasons that we don’t have time to go into here. But, in his case, he wasn’t given the support that one might’ve expected that he would’ve received. He couldn’t speak English, for example, and he had been placed in a situation where he couldn’t communicate. So, would the Cabinet Secretary look again, to see whether the support that he has referred to is actually reaching the right places and the right children, such as Adam, who deserve all support?
I think the Member is right to raise that, and I will ask my team who deal with this particular part of the department to give me reassurances about the finances and how they are distributed and used, particularly regarding the young gentleman that you raise with me. If the Member wishes to write to me with more detail, I’ll give that some more measured thought around my response to that.
Cabinet Secretary, will you join me in congratulating faith communities across Wales on the work that they have done in helping to welcome asylum seekers, including refugees and unaccompanied refugee children, here into Wales, and supporting them in terms of integrating them into our society and lowering community tensions?
I think faith communities play an important role in terms of making sure that we continue to keep a welcome in Wales, and I’m certainly happy to endorse the Member’s comments and thank them personally for the work that they’re doing in our communities.
Domestic Abuse
10. Will the Cabinet Secretary provide an update on the Welsh Government’s strategy for tackling domestic abuse? (OAQ51029)
I thank the Member for her question. Our national strategy sets out the actions we are taking to support victims of domestic abuse. A delivery framework to support the strategy will be published shortly and we are also developing a communications framework, a survivor engagement framework and a model for sustainable funding of provision.
Thank you, Cabinet Secretary. The statistics on domestic violence are shocking. In Wales and England, on average, two women are killed by their partner or ex-partner every week. Domestic abuse-related crime is 10 per cent of the total crime—a figure that is increasing—yet it remains the violent crime least likely to be reported to the police. Whilst prosecution rates are rising year on year, reoffending rates remain too high. It’s estimated that four in 10 survivors of domestic abuse are repeat victims. The introduction of a domestic violence offenders register would shift the onus on to the perpetrators. This would allow the police to hold information on perpetrators, prioritise resources based on risk and, most importantly, better protect survivors. With this in mind, will the Cabinet Secretary explore the establishment of a Welsh domestic violence register?
I personally am supportive of the Member’s principles behind this. I have written to Sarah Newton MP, Parliamentary Under-Secretary of State for Crime, Safeguarding and Vulnerability, to ascertain her views on a campaign for a register of perpetrators. I will consider the issue in light of her response around that. I’ve also sought some legal advice around the competency of the Assembly as to whether we can create a register or not, but I am exploring all options and I will write to the Member with more details when I receive them.
Cabinet Secretary, I’m pleased that Jayne Bryant has raised this very important issue. I’ve had the privilege over a number of years as an Assembly Member to visit Women’s Aid groups across Wales and, obviously, in my own constituency, in Abergavenny, where I also visited a safe house, and I realise the important work they do, not just for the victims, but for the families, for children involved as well. I’m sure you’ll agree, though, Cabinet Secretary, it’s not just about strategy, important though that is; it’s about concrete action on the ground as well. So, how are you consulting fully with domestic violence charities to keep up-to-date with the issues that are affecting them from week to week, month to month, year to year, to make sure that the strategy and its goals that you and your Government are implementing are actually delivering real results on the ground that will assist victims of domestic violence and their families?
The Member is right to raise this issue. I’m very keen to ensure that we get a real response from real people when we are developing a strategy. That’s why I have survivors on my advisory panel, to tell me about their real-life experiences, to make sure we can deliver on those. I’m working currently with many of the sector individuals regarding sustainable funding models and service agreements, to look again at what services are required on the ground, not just driven by policy of the Government, but actually what people are saying they need in their communities, and I look forward to making those announcements and changes in the near future.
Thank you, Cabinet Secretary.
[R] signifies the Member has declared an interest. [W] signifies that the question was tabled in Welsh.
As it is the start of a new term, I have accepted four topical questions on our agenda this afternoon, and therefore I probably won’t be in a position to call all of those who’ve requested a supplementary question unless the questions are unusually brief during this session. Therefore the first question is from David Rees.
The Welsh Steel Sector
What discussions has the Welsh Government had regarding the impact on the Welsh steel sector of the joint venture between Tata Steel and ThyssenKrupp AG? (TAQ0044)
Both I and the First Minister have spoken with Tata Steel UK CEO Bimlendra Jha about the announcement of the joint venture.
Well, thank you for that answer, Cabinet Secretary—very brief and very short.
Now, that announcement of a joint venture clearly has been something in the background, and many concerns have been expressed by steelworkers in my constituency and across Wales regarding the future of steel making here in Wales. Only 18 months ago we saw the threat of closure in the Port Talbot works. Beyond that we saw the threat of selling off the steel industry in south Wales, only to find that, eventually, they recognised that the plan, or ‘the bridge’, as it was known, actually did work, and therefore made the steel industry viable, and all those were removed.
But once again we face some uncertainty because of this announcement. I understand the unions have given a cautious welcome, but there are some issues, particularly in the detail, and we need to give confidence to the steelworkers in Wales who have dedicated themselves and committed themselves to improving steel making here in Wales. So, in that respect, can you tell me what discussions you have been having with Tata to ensure that the agreement to invest the £1 billion in steel making is going to be honoured by a new venture, because legally there’s a different entity now in place, or will be in place, particularly as that was at the cost of pensions to many workers?
What actions are you taking as a Welsh Government to ensure that the proposed advanced steel research centre that was being discussed will continue at Swansea University, and not perhaps be hived off for research in other parts of the EU? What assurances have you received for a sustainable future for steel making here in Wales, to ensure that the Port Talbot works is not short term, but is actually continued to be long term, and the jobs are long term? And what actions are you taking with the UK Government who, to be blunt, to this date have been very ineffective—my word is ‘useless’—because historically they’ve done nothing? But you need now to work with them to make sure they buy into steel making here in Wales.
Can I thank Dai Rees for his question and for the interest a number of Members have shown in this subject, not just today, but over many months and indeed years? I’d like to begin in responding to Dai Rees’s questions by putting on record my appreciation to the loyal, dedicated and skilled workers employed by Tata across Wales. They have shown incredible patience and loyalty. They have sacrificed in terms of their pension in reaching the point that we are at today, and they deserve to be shown equal respect and credit by Tata as an employer as they move towards the joint venture.
As I said, I’ve already spoken with the CEO of Tata Steel UK, and I’ve sought and been given a number of assurances. I would agree with the trade unions in the statement that they have issued that today’s announcement is to be welcomed cautiously. This paves the way for Europe’s second-biggest steel business to be formed, which could bring many benefits to the UK—benefits that could align and should align with the sector deal approach being taken forward as part of the UK industrial strategy. Last week, or last month, I met with the Secretary of State in the Department for Business, Energy and Industrial Strategy to discuss, amongst other things, the steel industry and the sector deal and how we needed to ensure that research development and innovation was at the heart of the sector deal approach for steel. I’ve been given assurance over the assets that exist across Wales and the UK—that there will be no closures; that the announcement paves the way to a sustainable and competitive future for the steel industry in Wales. But I will be seeking further discussions, not only with Tata but also ThyssenKrupp to ensure that the interests of Welsh workers are at the very heart of the joint venture.
I can assure the Member that our investment, our interest in the advanced steel innovation centre continues, and that project will be taken forward. I think one of the strengths of the research and development base in Tata Steel’s Wales operations is that it’s linked so strongly to higher education institutions in Wales, that it’s embedded within the higher education institution estate, and so that project will be taken forward.
The most important thing for steel making in the UK is that it is competitive so that it can be sustainable. Of course, the Member rightly raises the role that the UK Government can play in this regard, specifically concerning energy and the disparity between energy prices here and elsewhere. Action is still required in this regard. It is something that has been raised at an official level and at a political level with the UK Government and we still await a satisfactory response. Talks will be ongoing and I am in no doubt that discussions will be ongoing at the UK steel council, involving not just Tata Steel but other steel manufacturers in Wales, to press for a fair deal on energy.
My officials have also been engaged with officials at BEIS in recent days concerning this matter. We’ll be working jointly together in the interests of UK steel operations to ensure that those commitments that were made for the steel plants are honoured. Of course, the primary commitment concerns the blast furnaces at Port Talbot and the £1 billion pledge, which we expect to be honoured. But there are other conditions that will be honoured regardless of the joint venture’s details, concerning the £13 million that we’ve made available to Tata Steel UK. Those conditions include conditions on minimum employment periods of five years for workers, and they will be honoured by the joint venture.
Thank you very much. I particularly thank you for that last answer, Cabinet Secretary, because the five-year condition, of course, is something that you spoke a lot about when there was a possibility of sale for the site. When it comes to a five-year commitment, though, have you had any sense yet of what type of jobs the merged outfit is going to be prepared to commit to, and when will you find out what types of jobs are likely to be affected? Because the long-term sustainability is the crux here, rather than a simple five-year conditionality? One was supposed to lead to the other. The types of jobs that are going to be lost in Port Talbot—we need to know what types of jobs they are in order for us to be able to scrutinise further any plans that they may have on that.
The Welsh Government in the past has pledged to retrain people who have lost their jobs already. I imagine you may want to say something about that in the future as well. Is there anything that can be done on the back of this that will help accelerate interest in the enterprise zone in Port Talbot? And is there any influence that you can bring to bear that may—how can I put this—maximise the number of relevant jobs that can be brought to the new prison that we’ll be discussing this afternoon, if in fact it does come to the area?
And then I just wanted a little bit of reassurance myself on the steel science centre, because obviously this is a focal anchor project of the Swansea bay city deal. It was based on Tata itself, actually—comments that they had made about carbon-positive products and new construction material. I think we need to know whether ThyssenKrupp is also interested in this new way ahead before we can be completely satisfied that the science centre is sustainable.
I thank Suzy Davies for her questions and assure her that steel-making jobs are our priority, not just for Port Talbot but for other sites across Wales. I’ll be seeking specific assurance over jobs within the procurement departments as well within the Welsh assets. In terms of other jobs that have been speculated over elsewhere, I think the unions have made clear that the vast majority of human resources and IT jobs exist outside of the UK and therefore the impact of any reduction in that regard will not have major implications for steel sites within Wales, but I am seeking assurance specifically, as I say, over procurement jobs, and over the steel-making jobs likewise.
In terms of research and development, particularly as we transition to a low-carbon economy, I’m confident that the Welsh sites are in prime position to take advantage of initiatives and support from Welsh Government and from the UK Government, should it be forthcoming within the sector deal. There is no doubt in my mind that the steel innovation centre, which forms a critical part of the Swansea bay city deal, will go ahead with the original aspiration unchanged, delivering through a partnership approach a new form of innovation, research and development that can drive an economy of the future. I have every confidence that that will continue to be a major part of the city deal and will go on to become a major success. Indeed, the investment will be considered by the investment board this week. I was also assured by the CEO of Tata Steel UK that he will continue to fight as hard as he can for Welsh interests within the joint venture. That includes Welsh interests insofar as jobs are concerned and insofar as research and development is concerned. He identified the fact that research and development is strongly embedded within higher education institutions within Wales as a major reason why it’s in such a strong position.
Thank you, Cabinet Secretary. The second question—Bethan Jenkins.
The Kris Wade Case
Will the Cabinet Secretary outline the lessons that have been learnt from the Kris Wade scandal at the ABMU Health Board? (TAQ0043)
There are important, wide-ranging lessons to be learned from this case by the whole of the national health service here in Wales, including Abertawe Bro Morgannwg University Local Health Board. I’ve asked Healthcare Inspectorate Wales to undertake an independent review to provide further reassurance and ensure that lessons are learned. I set this out in my recent statement, and will keep Assembly Members up to date.
Thank you for that response. It’s quite hard to know where to start in relation to this issue—an internal report that is fundamentally flawed, and what a former consultant at ABMU said was created by middle-grade managers as a bolt-on to their day job. That, in itself, is a damning indictment of this report. You say today that it’s an independent review. What I read in the written statement was that it was to be an assessment of this review. So, I would like clarification that it is going to be a truly independent review. And yesterday, the First Minister said, and I quote:
‘It is absolutely crucial that the investigation is independent. It’s not for me then to tell Healthcare Inspectorate Wales what they should and shouldn’t do’.
Yet, the outline of a limited remit is in your statement last week. So, I want to know, if this is the remit, will you commit to changing it? Because we need to look at the case as a whole, including the mistakes made by ABMU in the initial handling of allegations against Kris Wade: his employment, the failure to get a Criminal Records Bureau check, the failure to dismiss him, possible nepotism, and the very real possibility that if ABMU had acted sooner, the murder of Christine James might have been prevented. These are questions that we really need to get to grips with, as well as the potential conflict of interest that exists now with the interim chief executive of the health board.
I want to understand as well, without being disrespectful, how did it take so long for you to give this to Healthcare Inspectorate Wales? I am led to understand that this report was ready in January, and we only had a written statement last week. Why did you decide on Healthcare Inspectorate Wales rather than an independent review, as has happened in other cases, so I can understand that process, and how will it happen so that people can give evidence to it, so that those who were allegedly asked to give evidence in the last internal investigation can give evidence and those who are directly affected by this scandal can be involved in the process? I met with the husband of Christine James, the lady who was murdered by Kris Wade, yesterday—Stuart James—and he had to put on the television and find out via the television that this report even existed. That is, frankly, unacceptable. We cannot have a situation where people have to watch the media for them to find out what’s happening in relation to a person who has done something fundamentally awful to a member of his family. So, I’ll finish with this, and he doesn’t want to do any media interviews, but this is what he told me:
‘It should be remembered that this murder has had significant life-changing effects, both upon Christine James’s family, who are left behind, and also those individuals who are mistreated in the care environment where they should have been at their safest. It is not about numbers, cost, political prizes. It is about getting to the truth and ensuring that those responsible for the failings are brought to account and that they themselves understand what those failings are.’
I plead with you, Cabinet Secretary: there are managers and people who have made decisions who are still in their roles or who have had payouts from that health board who simply should not have had them, based on the way that they’ve operated in this health board, and I will not, as far as I am an Assembly Member, let these people down. Victims have been let down. We have seen scandals in the past by care homes, by celebrities in the British system, and we cannot let this happen under our watch. So, please, please make sure that this independent inquiry works for the sake of all those involved.
I take the view that the independent review remit is sufficiently broad for HIW to do their job. They are genuinely an independent inspectorate, and the challenge is to ensure that they provide a review that does provide reassurance in looking at what happened. There’s also a challenge for all of us in understanding, not just what happened at the time, but where we are now as well. And some of this is about the assurance we provide for our system moving forward. Health Inspectorate Wales is the appropriate body to undertake this investigation. I know you made a number of comments about linking the conduct complained of during the employment and the subsequent murder. It’s worth reminding ourselves that the three issues complained of were referred to the police and it was the criminal justice system that investigated and decided not to pursue any further action. I think there are genuine questions for us to understand about what happened at the time and whether that will that be the same approach taken now.
On the point about the link between the three serious issues complained of during his time in employment and the murder, I think politicians of any shade should hesitate before seeking to draw a direct link between the employment and the murder. I think it is important to understand, following the review, whether there is any real evidence that the behaviour complained of had any part to play in the subsequent murder. I do understand why there are such high emotions around this by people directly affected and the families, both of the alleged victims, the three people who had raised complaints about Kris Wade during his conduct as an employee, as well as the family of Christine James. So, I take this seriously, and I do await the report from HIW and the review they’re undertaking and I don’t seek to limit their ability to talk to people in undertaking a proper and robust review of what’s happened. I’ve said I’ll keep Members updated. If there’s more for me or the Government to do, once that review is provided, then I’ll be completely transparent with Members about decisions that I take and further next steps if they’re required.
Cabinet Secretary, the findings of ABMU’s internal report on Kris Wade stated that they did not robustly pursue complaints and stated, in effect, that there was a culture in some areas of basing actions on, I quote, ‘the believability of patients’ is absolutely shocking. I note, and fully supported the calls of the BMA and other opposition parties that there should be an independent inquiry. I am glad that the First Minister stated his support for this yesterday. We want the health board to uphold the highest of standards. The public cannot be assured that it will do this if we simply let it to investigate itself. Consequently, Cabinet Secretary, can you update us on what discussions you have had with Healthcare Inspectorate Wales to expedite an independent inquiry? Thank you.
Thank you for the comments and questions. The health board review, the internal review, I know has regularly been referred to as being flawed. It’s not a whitewash. When you look at and read the report they recognise there were failings in the way they went about their business, both through the initial employment of Kris Wade and through dealing with the complaints that were made about his conduct as an employee of the health board. And I think it’s really important to recognise that we expect health boards to investigate themselves, and to understand, where something has gone wrong, including when it’s gone seriously wrong, they still have a responsibility to investigate that conduct and to try for themselves to understand lessons to be learned, in addition to the ability to have an independent review. I think the fact that they’ve been prepared to say to themselves that they recognise that there were failings, they recognise that the initial complaints were not robustly investigated, that the approach focused too much on the believability of the complainants, rather than actually trying to find the truth—those are things that none of us should try and pretend are not in that report and are not serious issues in the here and now as to how we expect future concerns to be properly and robustly dealt with. In addition to those health boards needing to investigate themselves, I set out in this case, as I said earlier in response to the question and in the written statement, that HIW will undertake their own independent review, they will report and I will ensure that Members are fully up to date, including, of course, making available the report that they do provide.
Last week, Cabinet Secretary, I met with the chair of ABMU and the senior officer who was one of the seekers of that report to seek reassurances that if this situation arose today, it would be identified quicker and we wouldn’t be having the same failures that happened before. Whilst the Member for South Wales West keeps harping on about lessons learnt, it is important to my constituents that lessons are learnt again, because they need the confidence that the systems are in place. Now, they assured me that they were in place, but will you ensure that HIW not just assess their assessment, but they’re actually comfortable and confident that the systems that have been identified are in place so that this cannot happen again, and that that will be part of the remit?
I think that is covered in the remit. We expect the assurance to be provided by HIW about current practice, to look at the identified and recognised failings and assure that those are things we have designed out of our system—as an example, the challenge about not properly checking the criminal records check. It’s one thing to say, ‘Well, would that person have passed a records check even if it had been done at the time, at the point of initial employment?’, and, actually, it’s likely they would have done, but the challenge is, in any event: how do you actually remove the risk? And we now have a process across the national health service where shared services undertake that, so people should not be able to get into our national health service in the same way and avoid a criminal records check, for example. So, I recognise the point that you make, robustly as well, that there does need to be proper reassurance that Members can place faith and reliance, because it matters not just to Members within the Abertawe Bro Morgannwg university health board area; this is an issue for the whole service to take lessons and learning from and to properly reassure the public about the way I expect our health service to behave.
Thank you, Cabinet Secretary. The next question is from Angela Burns.
Avastin
Will the Cabinet Secretary make a statement on the All-Wales Medicines Strategy Group’s decision not to make Avastin, a potentially life-prolonging cancer drug, routinely available on the Welsh NHS? (TAQ0041)
The All Wales Medicines Strategy Group, the AWMSG, has appraised Avastin to treat recurrent or advanced cervical cancer. The AWMSG recommended against its routine use as the evidence for clinical cost-effectiveness was insufficient.
Thank you for that very disappointing answer, I have to say. The All Wales Medicines Strategy Group does estimate that each year around 50 cervical cancer patients in Wales will receive a terminal diagnosis who could require Avastin treatment. But given your endorsement of their recommendation, I find it very hard to understand the process going forward for these patients. Cervical cancer patients will now have to attempt to access this via the independent patient funding request route, which is often an untimely and uncertain process, and I do accept, Cabinet Secretary, that you’ve made great strides to try to solve some of the problems there. But, nonetheless, in 2016 the IPFR annual report stated that an average of just 50 per cent of all cancer drug requests were accepted, so by this estimation potentially half of all of those with advanced stage cervical cancer will not get access to a potentially life-prolonging drug.
What assurances can you give that all cervical cancer patients who need Avastin will be able to access it in a timely manner via IPFR, especially when you remember that time is a luxury that these patients can ill afford? And could you please explain to me why it is the case that the Scottish Medicines Consortium and England’s cancer drugs fund both approved Avastin as a drug routinely accessible within their respective health services, whilst the All Wales Medicines Strategy Group did not? Why is your Government putting female cancer patients in Wales at a distinct disadvantage to English and Scottish patients in the same situation? And finally, Cabinet Secretary, what efforts has your Government made to ensure greater consistency in how clinicians across Wales’s seven health boards will interpret the clinical exceptionality clause when submitting applications via the IPFR? These women are in desperate need, it’s a dreadful disease, it buys them a little time, and they have as much right as their sisters across any of the borders north or to the east of us.
This is a good example of where there are emotionally charged, and understandably so, questions for our national health service to address, and to be properly sensitive and yet robust about our evidence base for actually making choices. And it’s a good example of whether we make choices on an evidence base, about how we use our precious and finite resources, or whether we make choices on a campaign-led basis. The honest truth is that we have an expert group that has reviewed the evidence on a clinical and cost-effectiveness basis, and they have given us their recommendation. If I simply say that I will overturn that in the absence of evidence that it is the right thing to do for the whole service, then I don’t think I’m meeting the responsibilities that I have and I take seriously as Cabinet Secretary for health for the people of Wales.
And, when we look at Scotland, they made a different choice on the evidence presented to them. It’s not for me to try and explain their system. When you speak about England, though, the cancer drugs fund has got a notice of removal around Avastin. So, this is not going to be routinely available at the end of this month in the English system, because NICE do not appraise Avastin as something that’s clinically cost effective for routine use. So, if the evidence changes, and if the price changes along with that, then of course we can look at that again.
We’ve just been through a significant review on the independent patient funding request process, to look again at these questions of how any form of health intervention is looked at to be clinically effective and cost-effective as well. And nobody disagrees that we need that twin approach to how we make decisions for our service. And that is where we need to be. Otherwise, we have a system that will not be affordable and not make good value for precious and significant public funds put in to our health service. The IPFR group review, we said it would be completed by the end of September, all clinicians up to speed and up to date. I have previously committed to providing information to Members on the new way in which that reform process will be working, and I stand by the commitments that I made, to be transparent about information, and to make sure Members are regularly updated on the current and future practice.
This is one of those situations that’s likely to get more and more common, I guess, as treatments that prolong life, rather than cure cancer, get developed, but with a potential for major cost implications. Now, we’ve had concerns, which you know well about, about IPFR and exceptionality, and I certainly look forward to seeing how changes recently announced will improve access. But we’re also concerned about whether the current appraisal processes reflect the changing way that medicines are developed and used in clinical practice. Do you think that the current system is sustainable, or will public concerns—whether those concerns are justified or not—lead to you making changes, do you think?
I’ve not had any serious or significant thought to undo either the NICE appraisal process for us to withdraw from that, or, indeed, to change the way the AWMSG undertake their appraisal process. We have particular different ways to look at orphan and ultra-orphan medications, recognising the rarity of those conditions. And these are incredibly difficult choices. I recognise these are incredibly charged for individuals who have conditions, and are looking for the health service to help prolong their life. I do understand that, and it’s why I recognise these are sensitive and emotionally charged choices to make.
I’m open to other people having a view on how we could look at a different way to have a generally evidence-led process. I certainly wouldn’t say, ‘It’s this far, and no further, and no change ever, ever, ever.’ But, actually, we have a process that is robust, that is respected and accepted by clinicians across the country, and I would need to be persuaded that there is a better way to do that. If there’s evidence available to do that, I’ll happily ensure that it’s looked at, but, again, as politicians, we need to recognise our role and responsibilities within the system, and I won’t put myself in the place of these independent experts who are making choices, based on their expertise, for the good of our whole system. There’s something here about the things that we could and should do as politicians, and equally to recognise that, sometimes, we have to be responsible and not get involved in a campaign that looks like it might be the right thing to do from an emotional point of view, but, actually, we’ll fundamentally undermine parts of the rest of our service for those who need it if we make choices that we know are not sustainable and not based on clinical effectiveness.
Cabinet Secretary, I know that you are aware of my concerns about access to medicines generally, and I’m grateful to you for meeting with me previously to discuss Avastin. And I do understand the difficulties, but I think we also have to recognise that it’s very difficult for people to understand that something can be made available in Scotland, and in England, and not in Wales. I have raised with you previously my concerns about the All Wales Medicines Strategy Group, and the transparency involved, and also the levels of engagement with the drugs manufacturers, which does appear to vary between the different countries in the UK.
So, I would like to ask whether this is something you will take another look at, to check that the AWMSG has done absolutely everything possible to engage with the manufacturer—in this instance, Roche. But you also mentioned price. I would be grateful if you could advise whether there have been any discussions between AWMSG and Roche about obtaining a suitable patient access scheme that would bring down the cost, and enable this to be made available to patients in Wales.
I’m happy to respond to those points now, actually, because in terms of the AWMSG and their transparency, they actually undertake their review meetings in public. People can and do attend. For example, the recent decision where they did not recommend that we take forward PrEP on an all-Wales consistent basis, and we announced a trial, that meeting took place in public and the decisions are published. They are made publicly available. So, this isn’t a committee that meets in secret and keeps its decisions secret either. In terms of this particular issue, on price, yes, there was engagement. Roche offered a patient access scheme, a reduction on the headline price, and it was on that basis that Avastin was then appraised. So, there was engagement through the appraisal process, and equally, after the AWMSG indicated their initial decision, their likely decision, they were given the opportunity to come back and to use the appeal mechanisms that we have, and to date, they’ve chosen not to do so. That’s a choice for them, but they were told at an early stage what the likely choice was going to be. They were given the opportunity to appeal before the choice came to me, after that, but they’ve chosen not to, and that’s a matter for them.
The position in England where the cancer drugs fund has recommended removal, there is a notice of removal, so from October this will not be available in the English system. That’s partly because NICE recommended to the system in England that the evidence wasn’t there that it was clinically effective and cost-effective at the same time. So, in that sense, there’s a consistent approach now being taken. The cancer drugs fund distorted the picture by actually providing medication, providing hope to people, yes, but every independent and objective review said that it was poor value for money, and I think ethically challenged, frankly, and I think ethically outrageous to provide medications that were not effective that gave people the hope and the impression that they would be. We need to stick to a genuine evidence-led system, where we give people realistic points about the efficacy of the treatments available, and we make them available on a much more consistent basis, and that will be the focus of this Government. It’s why, for example, we’ve introduced the new treatment fund.
Thank you, Cabinet Secretary. And the final topical question from Adam Price.
The Rights of Sub-state Governments
In light of events in Catalonia, what discussions has the First Minister had with the UK Government as part of the UK-EU Brexit negotiations regarding the rights of sub-state governments to act autonomously without being restricted by the state government? (TAQ0042)
Llywydd, the Joint Ministerial Committee on European Negotiations has been established as the forum where devolved Governments can seek to influence UK-EU Brexit negotiations. I represent the Welsh Government on that JMC. Events in Catalonia, to which this question refers, have not been discussed at a meeting of the committee.
At the heart of this question, of course, is the fundamental right of nations to self-determination, which is indeed enshrined in the UN charter, and as the tectonic plates are shifting around us in these islands, in the European mainland, and across the world, it is increasingly under threat from a sort of irredentist power grab from the central state, as they themselves feel their supremacy challenged. I’ve heard the Cabinet Secretary refer to the almost neo-colonialist attitudes you hear at the joint ministerial council when Brexit is discussed. This question is, of course, as he alludes, inspired by the terrible events that we’re seeing in Catalonia, and Members will be troubled to hear that in the last few hours the Guardia Civil, the Spanish state police, have raided the Generalitat, the headquarters of the Catalan Government. The Catalan President has declared that Catalan autonomy is effectively now suspended by the Spanish state.
Can I urge the Cabinet Secretary to do what the Scottish Government has done, to send a message of solidarity to the Catalan people and the Catalan Government, as they stand there now in front of the Generalitat, declaiming, ‘No tinc por’?
Does dim ofn.
We are not afraid. Let’s say with them that we’re not afraid either. We stand with them, and with the people of Kurdistan that are also people being threatened by a referendum that will be prevented by the Iraqi state Government on Monday as well. We stand in solidarity with all peoples of the world that ask only for this: the right to choose their own future.
Llywydd, the Member very passionately puts his view of the situation, as he’s absolutely entitled to do, and has drawn our attention to the concerning reports of the developing situation in Catalunya. The Welsh Government is absolutely clear: we believe in democratic principles and think that they should be respected. Democratic politics is the basis for resolving constitutional issues. What I’m not able to do is to act as though the Welsh Government had responsibility for the conduct of relationships with other European states or indeed with states elsewhere in the world. That is not a responsibility devolved to us and we mustn’t put ourselves in the position that makes it appear as though we think that would be the case.
The European Union’s own external action service website states that the EU believes that democracy is the only political system that can fully realise all human rights. Would it not be a useful exercise for the Welsh Government to encourage the United Kingdom Government to remind Spain, as a member state of the European Union, that it should live up to the principles that the European Union’s external action service said are embedded in the founding treaties, reinforced by the charter of fundamental rights, and that are fully declared as a result of the Lisbon treaty incorporating that charter into European law? A Government, like the Government of Spain, that is afraid of the votes of its own people at the ballot box is a precarious institution indeed, and this Assembly, of all institutions, ought to stand up for the rights of small peoples or small nations to self-determination, if that is what they wish. Like the Cabinet Secretary, I believe in the United Kingdom, but if the people of Wales were to vote for political independence, that is a right that should be expected and Catalonia deserves nothing less than that.
The Member helpfully draws attention to the statements that exist within the European Union and elsewhere, and that is reflected entirely in what I said that, as a Welsh Government, we believe in the respect of democratic principles and democratic politics as the way to resolve constitutional and other disputes. But the Member is also right to say that these are responsibilities of the UK Government. That Government will hear what other parties and other elected politicians say and it’s right that people use this forum to make those views known. The Welsh Government has to respect the responsibilities that have been devolved to us and that’s what I intend to do.
I’m very disappointed to hear the response of the Cabinet Secretary. I know that he has a sense of history and I suspect that what he’s telling us doesn’t sit comfortably on his shoulders, given the relationship between Wales and Catalunya and the wider relationship between the progressive peoples of Wales and Catalunya, going back over 75 years. All we’re asking for from the Welsh Government is no more than what FC Barcelona has stated themselves:
‘to democracy, to freedom of speech, and to self-determination’,
and to condemn
‘any act that may impede the free exercise of these rights.’
If a football club in the capital city of Catalunya can say that, then I think that the Welsh Government can say it—just standing in solidarity with a similar devolved Government that, at this moment, is having its offices raided, its members harassed and whose Parliament is being challenged by a central Spanish state. I know that I’ve had support for an open letter to go to the Presiding Officer of the Catalan Parliament from many Members here. I intend to send that this evening. I hope that other Members will take the opportunity, finally, to support that as I think we should at least stand, as a Parliament, shoulder to shoulder with other Parliaments, to simply say that you have the right to ask your people what their future should be.
I entirely agree with the Member about the long history of close relationships between Wales and Catalunya and between organisations that operate here in Wales and operate in Catalunya. The First Minister himself met representatives from Catalunya within the last couple of years. Nothing that I’ve said this afternoon should be read as detracting from our concern at the reports that are emanating from Catalunya or our support for the resolution of disputes by proper democratic, political means. And it is uncomfortable. The Member is right to say that sometimes it is uncomfortable, but the position I feel like I have to defend and depart from him slightly—. He said that the Parliament here could make its views known. That is certainly possible, but I’m being asked to make the Government’s position known, and I’m a member of a Government where, with our Scottish counterparts, we are involved in a very deep dispute with the UK Government in which the UK Government is seeking to trespass into responsibilities that have been devolved to this institution. And, if there is a principle about people respecting where responsibilities lie, I’m just not going to cross a line in which I put myself in a position of appearing to say things as though I had responsibilities, or the Welsh Government had responsibilities, for the conduct of relationships with other European Union states, when we plainly do not.
I thank the Cabinet Secretary.
The next item, therefore, is the 90-second statements. Dawn Bowden.
Diolch, Llywydd. It’s been 30 years since Wales witnessed one of the greatest sporting achievements, when Merthyr Tydfil Football Club beat the mighty FC Atalanta from Italy in the UEFA Cup Winners’ Cup. That September evening in 1987 was a memorable night for the club when they beat Atalanta 2-1 at Penydarren Park, and we should remember that, to this day, Atalanta remain a club in the Serie A league. So, while young Welsh fans may dream about Gareth Bale and Hal Robson-Kanu, it was Kevin Rogers and Ceri Williams who delivered the goals for Merthyr in front of over 8,000 fans at Penydarren Park. And still, today, the echoes of that great night and that fantastic victory in European football can still be heard over the decades. There’s now a film about the occasion, ‘The Martyrs Of 87’, which provides a new opportunity to enjoy that great night.
Those of you who follow football will know that that the club did subsequently hit hard times but, thankfully, returned as Merthyr Town FC, and, if you pay a visit to the LoadLok Penydarren stadium today, you will find a ground with great facilities that is fit to support young footballers for many years to come. So, can I place on record my best wishes to the current manager, Gavin Williams, and the playing squad for the remainder of this season? Thirty years may have passed, but that night of glory against Atalanta is not forgotten.
Llyr Gruffydd.
The twenty-second of September 1934 was a Saturday. Some miners at the Gresford Colliery had swapped shifts so that they’d be able to go and watch Wrexham play football that afternoon. But, of course, they were never to make the match as an explosion 2,000 ft underground ripped open the Dennis shaft in the early hours of that morning.
The disaster claimed 266 lives, all local colliers, whose families rushed to the colliery pithead. Only six men, on a break, escaped from that shift. Volunteer rescuers, armed with only nose clips and canaries against deadly carbon monoxide gas, went down to try and save any survivors. Three of the rescue brigade from the nearby Llay colliery also perished. The families waited in vain until Sunday night, when it became apparent that nobody was coming up from that Dennis shaft alive. Popular reaction was immense and immediate: £566,000 was raised for widows and the children of those lost—the equivalent of around £30 million today. The surviving miners were effectively abandoned by the pit owners and had to sign on the dole at a time of mass unemployment.
The Gresford Colliery is now closed, the tip its only visible reminder of a pit that employed 2,200 workers. But a lasting memorial to the 266 lives lost stands outside the Gresford colliery club, and this statement is also testimony to their sacrifice and the sacrifice made by countless Welsh miners over the years. The bodies of those caught in the explosion remain entombed deep underground, but they will never be forgotten.
The next item is a debate on the Health, Social Care and Sport Committee’s report on medical recruitment and I call on the Chair of the committee to move the motion. Dai Lloyd.
Motion NDM6502 Dai Lloyd
To propose that the National Assembly for Wales:
Notes the report of the Health, Social Care and Sport Committee on the inquiry into medical recruitment, which was laid in the Table Office on 29 June 2017.
Motion moved.
Thank you very much, Llywydd. I’m very pleased to open this debate today on the Health, Social Care and Sport Committee’s report on medical recruitment. As background, earlier this year we debated the committee’s first major report of the fifth Assembly, which focused on winter preparedness for 2016-17. As part of that inquiry, we heard a strong and consistent message that sufficient service capacity and enough staff are vital components in any effective healthcare system. We therefore agreed that, over the course of this Assembly, we would review the sustainability of the health and social care workforce. Our inquiry into medical recruitment in Wales is the first part of this broader review.
The Deputy Presiding Officer (Ann Jones) took the Chair.
This work started back in the summer of 2016 when we carried out an initial broad piece of evidence-gathering to help understand the key workforce issues across the health and social care sector. This was designed to help inform our approach to looking at workforce issues throughout the fifth Assembly. We heard from a wide range of organisations and individuals across the spectrum of involvement in training, education, and recruitment.
Last autumn, we launched the inquiry into medical recruitment and ran a further written consultation exercise. Our terms of reference included a focus on the capacity of the medical workforce to meet future population needs, the implications of Brexit for the medical workforce, and the factors that influence the recruitment and retention of doctors. We also looked at the extent to which recruitment processes are joined-up, deliver value for money, and ensure a sustainable medical workforce.
We had an excellent response to our consultation exercise, and we’re grateful to everyone who took the time to write to us and present evidence to us in one of our formal meetings. During the formal evidence sessions, we heard evidence from a specially convened panel of trainee doctors from across Wales, from both general practice and a number of different hospital specialties. I would like to take this opportunity to further thank all those who took part.
The evidence we heard helped us come to some very clear conclusions and enabled us to make robust recommendations to the Cabinet Secretary. As Chair of the committee, I was very pleased that so many people who contributed to the inquiry were able to attend the launch of our report back in June of this year, and I think it is safe to say that the report has been very well received.
Our report covers a wide range of issues and we have made a total of 16 recommendations to the Welsh Government. We hope that they will contribute towards delivering the long-term solutions that are needed. These are the areas of particular concern to us: first of all, the low number of Welsh domiciled students securing places at Welsh medical schools—recommendations 2, 4 and 5; the need to increase the number of undergraduate medical education and training places in Wales, mentioned in recommendations 4, 5 and 7; then the need for better engagement with schools to increase the number of Welsh domiciled students applying to medical school, outlined in recommendation 3 in the report; and, finally, the implications of Brexit for medical recruitment mentioned in recommendations 15 and 16.
Our first recommendation relates to the establishment of Health Education and Improvement Wales, the new single body for the commissioning, planning, and development of education and training for the NHS workforce in Wales. We asked for a clear action plan and we noted with interest the Cabinet Secretary’s written statement, issued shortly after our report was launched, which provides an update on the approach to HEIW’s establishment. I’m also aware that the establishment Order and the first set of regulations were laid before the Assembly last week, and I look forward to hearing more from the Cabinet Secretary about a clear action plan and future timeline.
As I said earlier, we are concerned about the low and declining numbers of Welsh-domiciled students applying to medical schools across the UK. Despite some improvement during the 2017 application round, the number of applications from Welsh domiciled students is still considerably lower than other parts of the United Kingdom. Also of particular concern is the low number of Welsh domiciled students securing places at Welsh medical schools. This is especially concerning in light of the evidence we heard that there is a tendency for students, once qualified, to remain in the area where they studied initially. I note that the Cabinet Secretary has partially accepted our recommendations that relate to these concerns, namely recommendations 2, 4 and 5. While I, and my fellow members of the committee, appreciate that admission criteria are a matter for individual medical schools, I am glad that he has agreed to continue to work with those schools with the aim of increasing the number of Welsh-domiciled students applying.
We said we believe there is a clear case for enhancing and increasing medical school capacity within Wales if we are to address the current recruitment and retention issues, and that this must include agreeing a clear plan to develop more opportunities for undergraduate medical training in key pressure areas and in north Wales in particular, receiving evidence in favour of establishing a medical school in Bangor from many witnesses, and this was outlined in recommendations 4, 5 and 7.
Again, I note that the Cabinet Secretary has partially accepted recommendations 4 and 5, and fully accepted recommendation 7, which relate to our concerns on these matters. The Cabinet Secretary’s written statement of 18 July illustrated the recognition that there is a case for an increased level of medical education to take place in north Wales, whilst setting out his position that this does not mean a new medical school should be established, in his opinion. I know the Cabinet Secretary has committed to a number of strands of work that will take this matter forward, and I hope his contribution this afternoon includes an update on the progress being made.
We also heard about the importance of engaging with schools at a much earlier stage than current practice suggests. There is a clear need to take the message out to schools across Wales that medicine is a career that pupils can aspire to, and that it is a realistic and achievable aspiration for students from all communities. We recommended that the Welsh Government should work with the deanery, and, shortly, HEIW, and medical schools in Wales, to develop a programme of support and advice on admissions and interviews for pupils in Wales, mentioned in recommendation 3. I note that the Cabinet Secretary’s response makes reference to the 2016 summer work experience schemes run by both Cardiff and Swansea medical schools, and I welcome the fact that this approach will continue.
I would also like to mention the concerns that we heard about the potential and very uncertain consequences of the United Kingdom leaving the European Union on health and social care staffing, including medical recruitment. We heard strong arguments from a range of stakeholders for an early and clear resolution on the ability of EU nationals to be able to work within the UK. We recommended that the Welsh Government should continue its dialogue with the UK Government to emphasise the importance of quickly clarifying the ability of EU nationals to continue working in the UK, and also commence working in the UK in the future, and that’s mentioned in recommendations 15 and 16. I’m pleased that the Cabinet Secretary has accepted these recommendations and I welcome the Cabinet Secretary’s statement that the Welsh Government is clear that it wants to enable people from the EU and the rest of the world to train and work within our NHS after the United Kingdom exits the EU. That concludes my opening statement and I look forward to the debate. Thank you.
I’m very pleased, as a member of this committee, to have a chance to speak in support of this report, and I’d like to put on record my thanks to all those who came to give evidence before us, and to the clerking teams that support us so ably.
Medical recruitment and workforce planning are two of the most important issues affecting our NHS going forward, and we need to ensure that we find the right balance to ensure that the future—or future Assembly Members, actually, here, are not going to have to try to solve this problem in the future.
This report ties in very closely with the cross-party parliamentary review into health and social care, which we discussed yesterday and which is still an ongoing piece of work, but when I was sitting in that committee there were two specific elements that really struck me most forcefully, and those are the two I would like to concentrate my contribution on.
The first is the whole issue of workforce planning. I think that we have to recognise that we cannot rely on our NHS to be a medical-based model, run solely by doctors and nurses, because, with the best will in the world, we simply cannot fill the gaps that we have. We need to be far more effective at bringing in and incorporating and integrating, as valuable members with equal presence within the NHS, allied healthcare professionals of all types. We need to bring in the third sector. We need to embrace care home operators more into the NHS, because otherwise we simply will not get the people, and the people within to stay within the NHS that we need. We’ve got to just broaden our base and not simply concentrate on the very obvious gaps that we see within some surgical specialities, some GP practices and within some elements of nursing. When we looked at the workforce planning, which we only did a very small part of, because it is so complicated, it really struck me that we simply don’t spend enough time on that. If we plan today for what might happen in five years’ time, then we’ve got a sporting chance of actually putting in place the people that we need in five years’ time. So, we know that some health boards, for example, are going to see a dramatic drop-off in key areas because staff are ageing; they’re going to retire, and there’s going to be a gap. If we constantly rely on filling that gap as we get to that crisis, we’re never, ever going to get ahead of ourselves.
So, I would like to talk to recommendation 10, and I would like to urge the Welsh Government—. Because, although you accepted it, you talk about identifying priority areas for investment, you talk about talking to medical and dental commissioning and non-medical commissioning proposals. But have you talked about other organisations such as allied health workers, and have you talked to other engaged bodies such as local authorities? Because, of course, for us to do workforce planning in the NHS, we need to know that we have the social workers, which is a local authority function, for example. I just feel that the impression I came away with, as a committee member, was that this was a very, very big task, there wasn’t cohesion, there wasn’t a coherent strategy at all, there wasn’t a real idea of capacity building at lower levels for the future, and there simply just wasn’t enough forward planning. I would like to have reassurance that somebody somewhere is really getting to grips with this issue.
The other point that I would like to discuss and concentrate some of my remarks on is how we get more Welsh students to study in Wales and remain in Wales. I notice that the Government has partially accepted our recommendations, and I know that Dai Lloyd has already commented on this, but I was quite disappointed in one of your responses. Actually, it was the response to recommendation 2, Cabinet Secretary—but it does speak to all of these recommendations—when you said that admission criteria is ultimately a matter for medical schools, and elsewhere there’s a marginal implication that there’s not an awful lot that the Welsh Government can do because these medical schools are universities within their own right. I simply don’t agree with you. You do have the leverage. For example, widening access, as an element of funding, could be used to lever in more Welsh-domiciled students. Using part of our Welsh baccalaureate as a criteria for being able to take a medical degree could be another lever. There are levers at your disposal, and I think, to be frank, that just sort of stepping back and saying, ‘Well, you know, it is up to Swansea; it is up to Cardiff how they do it. They are independent universities; they can say what the criteria for eligibility are’ is actually letting you and us and them off the hook. I think we’ve got to be far more robust. You do have the power; you simply need to be creative and exercise it.
This inquiry was worth while, and I thank the Chair and my fellow Members and the clerks and the research team. We started from a point where we knew there was a problem, of course, that medical recruitment was a barrier to the NHS delivering its functions, but what we have now, I think, is a valuable document—a very comprehensive document—asking why, and what we can do to try and overcome some of those barriers. It’s also worth noting that at a time when we know that there is more and more pressure on NHS funding, we’re not necessarily asking for things that are going to cost more. In the long term I would argue that savings could be made by sorting out recruitment problems within the health service. Certainly, ensuring that we provide sufficient numbers of staff and rely less on agency staff would bring savings in its wake, so we’re not necessarily asking for further investment in the longer term.
I will look at some of the most crucial recommendations as I see them. First of all, increasing the number of Welsh-domiciled students studying medicine in Wales. I don’t need to explain why this is important, I’m sure, but too few students from Wales are now applying to study medicine and too many of those fail to secure places to study in Wales. We must increase the percentage of students under the current regime who are domiciled in Wales, because, quite simply, they are the most likely to remain here to work once they have qualified. And we must, surely, remember that the main purpose of training doctors in Wales is to provide staff for the NHS in Wales. But we must also increase the number of training places. We could make increases in Cardiff and Swansea, and I very much hope that we do make those increases in Cardiff and Swansea.
But there are opportunities to innovate here too, and recommendation 5 clearly calls for a medical education centre in Bangor. There are so many reasons for that: linguistically, geographically, economically even, in terms of increasing opportunities for students from north Wales to study in their own areas, and also in terms of developing expertise in providing rural healthcare and to do that bilingually. It would provide firmer foundations for the health provision for the residents of that area, making it easier to recruit doctors who want to be involved in lecturing or research work. So, you can imagine my disappointment when the Cabinet Secretary said in July that there was no case for having a medical school in Bangor and that placing students in north Wales was the way forward.
First of all, the committee isn’t asking for a medical school. I, through Plaid Cymru—and I make this clear—am not asking for a full medical school. It may come in due time, of course, but that is something that would take years. But, with collaboration between the Government, the deanery and its successor, Bangor University, Cardiff University and Swansea and some over the border—why not—there is no barrier to taking the first steps towards providing a full course for undergraduates based in Bangor and to move towards that, if not to achieve that tomorrow, but certainly to move towards that immediately. My concern—and I’m sure that many will share this concern—is that if the Government can be so heedless of the thorough work done by the committee and the clear evidence that we’ve received on the need for this, what confidence can we have in the Government to innovate and to be ambitious in relation to the rest of the recommendations?
Yma, mae gennym alwad gyda thystiolaeth dda yn sail iddi dros sefydlu canolfan addysg feddygol newydd ym Mangor. Wrth gwrs bydd yna rwystrau, ond ni fydd y rhwystrau hynny’n cael eu goresgyn cyhyd â bod y Llywodraeth hon yn ymddangos yn amharod i wthio ffiniau’r hyn sy’n bosibl. Yn yr adroddiad hwn, mae gennym ddarlun sy’n peri llawer o bryder—gadewch i ni fod yn onest—o ble rydym gyda hyfforddiant a recriwtio meddygol yng Nghymru. Ond nid yw’r pwyllgor yn dod i’r casgliad wedyn na ellir goresgyn y problemau hynny. Rydym yn cynnig atebion—amherffaith, yn ddiau—ond rydym yn eu gweld fel her. O ran arfogi ein GIG yn y dyfodol gyda digon o feddygon, o ran mynd i’r afael â nifer y swyddi gwag meddygol sydd gennym ledled Cymru, a sut i ennyn brwdfrydedd disgyblion, grymuso ein pobl ifanc i anelu at fod yn feddygon sy’n gweithio yn eu cymunedau ar hyd a lled Cymru, a’u helpu i allu astudio yma os ydynt yn dymuno gwneud hynny, mae angen i gleifion yng Nghymru wybod bod y gwaith yn cael ei wneud. Mae angen i ni weld hynny gan Lywodraeth Cymru. Mae angen i ni ei weld yn fuan.
I welcome the opportunity to speak on the report. I’m a member of the committee, and I found this a very important, stimulating report. The Chair already mentioned in his introduction the panel of trainee doctors that we had. I felt that we really did get to grips with some of the key issues that doctors, trainees and students have to address. I particularly enjoyed the visit at the beginning of the report, where we went to Cardiff University and we saw the way that the students learn through practising their medicine on models as a first step. I thought that was a very good introduction to the report.
I just wanted to refer to some of the recommendations in the report. I think it’s pleasing that most of the recommendations are accepted and that there are a few that are partially accepted. Obviously, two of the partially accepted recommendations were about the need for more medical education in north Wales, which Rhun has just referred to. I think it’s obviously good that the Government has accepted the need for an increased level of medical education in north Wales and proposes to do this by collaboration between Cardiff, Swansea and Bangor, albeit saying that there is no case for a new medical school to be established in north Wales. I think it’s particularly important that Health Education and Improvement Wales is being set up, and I hope also that we will get a bit of an update from the Cabinet Secretary when he replies to this debate.
I think the issue of the number of Welsh applicants to Welsh medical schools is one of the key issues that we addressed in our report, and I think we heard endless examples of people who are doctors now who tried to get in to Cardiff University medical school, for example, couldn’t get in there, and went and trained in England and, in some cases, they did come back, the people who were giving us evidence, but we all know that if you train somewhere, you’re more likely to stay there, and I think there is evidence about that.
Certainly, when we interviewed the staff of the medical schools, there certainly appeared to be a great willingness to look at this issue, and the actual figures are improving. I think we were told that 61 per cent of Welsh students who applied to Cardiff University for this year have been offered a place, which is a definite improvement, but we’ve still got the issue that’s been raised that the number of students in Wales applying to go to medical school is much less, as a percentage, than other parts of the UK. So, we do need to do a lot to encourage and to do all the work in schools that has been referred to and make schoolchildren feel that they can be doctors. Because I think that did come out of the evidence as well, that, in many schools, there is maybe a bit of a lack of aspiration, and I think that is something that we feel the medical schools and universities should be working on with the schools.
We had great evidence about how what we have to offer here in Wales is an attraction to trainee doctors and to work in Wales, because of the work-life balance and other lifestyle issues, but it was also raised with us very strongly that there is an issue about rurality and how you attract doctors to actually work in very rural areas. And we did get evidence of projects and pilots that have been done to work particularly in rural areas, and I think that would be something that I wonder whether the Cabinet Secretary, when he responds, could talk about—how we could do more of that.
And then, I’d just like to quickly finish on the Brexit issue. We know that, currently, 7 per cent of the doctors working in Wales come from the EU and that there were 1,354 EU nationals directly employed in the NHS in Wales. But in terms of the doctors, I think we also have to acknowledge that there is a huge number of doctors coming here who have been trained in non-EU countries; in particular, India, which is the biggest group of doctors. I’d like to end, really, by paying tribute to BAPIO, which is the British Association of Physicians of Indian Origin, who have worked very hard to bring Indian doctors here. Very recently, I met them when they’d just come back, and they seemed to have the initiative and the determination to ensure that we do try to keep the non-EU doctors as well coming here to Wales. Thank you.
I’d like to thank our Chair of the health committee, and also thank all of the other members on the committee and the people who gave evidence for us to proceed. Problems with recruitment and retention of front-line staff, clinicians in particular, have been well documented in recent years, and we must ensure that we tackle this issue robustly. Staff shortages have led to increased workloads, which have become unmanageable for many front-line staff. Unmanageable workloads have affected staff morale, led to an increase in stress-related illnesses and forced many clinicians to leave the field altogether.
Nowhere is this more evident than in general practice. Some GPs have seen their case loads double in recent years, with practices unable to recruit GPs. A GP seeing over 100 patients during a consultation is not unheard of, so these unmanageable workloads have to be addressed to stop people leaving this profession.
The Royal College of General Practitioners state that we need to recruit an additional 400 GPs over the next four years, and I’d like to discuss how we are going to do this. Above all, we must incentivise clinicians to stay in Wales. We must also ensure young people from all backgrounds are encouraged to train as clinicians. According to the Royal College of Physicians, there is a distinct lack of research undertaken to understand the drivers for recruitment and retention, and decisions on future medical recruitment strategies are not based on robust evidence, so it’s therefore imperative that we do collect as much evidence as is possible to deal with future recruitment campaigns.
But we mustn’t focus solely on front-line staff, because the NHS is Wales’s biggest employer, with around 72,000 people working in it. Collaboration and communication of all departments is a must to ensure its future running. There are just under 6,000 hospital clinicians and 2,000 GPs working in the NHS in Wales. So, without the vast numbers of nurses, scientific and therapeutic and technical staff, patients could not be treated. Without the administration and support staff, our hospitals and GPs wouldn’t function. So, we cannot recruit more clinicians without ensuring that there are sufficient staff to make the appointments, conduct the diagnostic tests, transport patients and nurse patients back to health. The Welsh Government cannot simply divert funds into recruiting more front-line staff. They need to ensure that there are sufficient staff across the whole of the NHS to cope with the increasing demands and changing in demands on the services.
Two weeks ago I was visiting a hospital within my region—the cardiac unit—and one of the nurses was really working non-stop. She stated, without really complaining, that at short notice a member of staff had not turned up, and another nurse was doubling back to do a second duty, as this, they explained to me, was easier than filling in a form for an agency nurse, and on a cardiac unit it was imperative that this complement of staff was at its most. Also, what came out was that our nursing staff sometimes have great difficulty in parking their car when they go to do a night shift or an early evening shift, finishing late at night, and as they cannot park near the hospital, it is a risk for them to travel towards their car.
Also, as has been mentioned before, we must train more Welsh-speaking prospective GPs, and encourage them to take part and be in places, in rural areas in north Wales, which are predominantly Welsh speaking. So, we must do more to recruit Welsh-domiciled students, even if that means lowering the entry qualification, because some people are not getting into, say, Cardiff University, for example, but they are going to London, and we’ve lost the opportunity of recruiting those people.
So I look forward to working with everyone concerned on this issue. Thank you.
Can I start with a word of thanks to the Cabinet Secretary for his readiness to make himself available from time to time to discuss issues in relation to NHS services? I personally appreciate the opportunity to have those conversations with you. I’m not a member of the Health committee but, in common with many other Assembly Members, obviously have pressures on GP recruitment in particular in my constituency. I have a practice that has recently closed its list and asked patients to reregister with other practices, and others are under very, very real pressure of a similar nature. Many have adopted innovative ways of practising, multidisciplinary ways of practising, which we should encourage practices to adopt generally, although often they have been adopted as a result of shortages. There are initiatives amongst practices locally and at the health board level to recruit GPs and some of those are succeeding, but they are long term, if you like, in their effects.
The comments I want to make, really, relate to the Welsh Government’s initiatives in this respect, in particular the Train, Work, Live recruitment initiative, under which GP trainees get a substantial incentive to continue to work in their local area for a year after their training ends. That’s obviously of significant benefit to those areas that have been targeted for that support, mainly in west Wales and in north Wales, and I don’t for one second begrudge residents of those parts of Wales the support that they will be getting for recruitment initiatives there.
But, really, it’s a plea to the Government to keep the effects of that on other parts of Wales, where there are also great pressures on recruitment, often for reasons, as Julie Morgan said, of rurality in constituencies like mine, which are not predominantly rural but have pockets of rurality that suffer from similar challenges as those parts of Wales that are predominantly rural.
The risk, of course, is that the scheme may operate not just as a draw to those parts of Wales but create a sort of competitive disadvantage, if I can put it like that, to those other parts of Wales that still suffer from significant recruitment pressures. So, I hope the Government will keep that incentive scheme under review and look in particular at perhaps perverse consequences that may arise in other parts of Wales that suffer similar pressures on their recruitment.
I’m going to focus on the recommendation relating to north Wales, as you would expect. During the last week of the last term, we had a short statement from the Welsh Government stating that it did not support the case for the creation of a medical school in Bangor because it is a long process and because it is a very costly one. Now, perhaps it is going to be a long process, but that, in itself, isn’t a reason for not doing something—because it’s going to take a long time. As far as I see it, that isn’t a reason.
I’m going to challenge the statement that it’s costly as well. At present, health boards spend very significant sums on agency staff, including locum doctors, to do important work, because of recruitment problems. In May 2017, 141 medical posts in Betsi Cadwaladr health board were empty or vacant. This represents 37 per cent of all posts empty in NHS Wales, and they’re the figures of the Welsh NHS Confederation. The lack of staff creates significant costs, significantly higher costs than the relatively low cost of establishing a medical school in the north. The initial investment would pay for itself very soon, and there’s no need for capital investment, even, in Bangor.
I’ve asked if I could see a copy of the business case for establishing a medical school in the north. I don’t know whether there is a business case or if there is an intention to publish a business case. That would be beneficial, so that everyone could see the logic behind the decision, because I am struggling to find that logic at present.
The Government’s statement states that we need more medical education in north Wales, following the recommendation of the committee, and that’s excellent and something to be welcomed. Now, there is a requirement for the universities and medical schools in Bangor, Swansea and Cardiff to work together. But what I would like to know is what the purpose of this collaboration is. What’s the end goal of that collaboration? What’s the aim and objective of it? We in Plaid Cymru suggest an objective of training 40 doctors in Bangor—that is, training from the very initial day when they start their training—and we see that as a very important step on the journey for a medical school in the north.
This report is particularly timely for my constituents in Caerphilly: Bargoed Hall surgery closes its doors next week due to the ending of the practice by the GP there. I’ve had many communications with constituents over the summer, but particularly useful has been communication with the health board, and I have to praise the Aneurin Bevan Local Health Board for what has been improved communication with me with regard to this issue, and I’ve been able to, therefore, give my constituents as much information as I can give them as we had it, and that information has been emerging as we’ve been able to get it. Patients have been moved to a surgery in Bryntirion nearby, but it has not been without difficulties, and we’re still in an emerging situation. I’d therefore also like to thank the Cabinet Secretary for visiting Bryntirion Surgery with me to discuss some of these issues, and also thank the committee for the depth and breadth of evidence that they’ve gathered, which will go some way to helping resolve or prevent these issues from occurring in my constituency and other constituencies in Wales in the future.
I’d particularly like to make reference to page 49 of the report. There’s some very stark evidence there with regard to GP recruitment and the feelings that new GPs may have. Paragraph 164 says:
‘While Dr Heidi Phillips, representing GP Survival, told us that, according to a survey of Swansea medical students, general practice was not seen as an attractive option because: “…they see what we see, which is a 10-minute revolving door, starting at 8.30 a.m. through to 6.30 p.m., with no protected time for education, no protected time for the expansion of other interests, and no protected time even for administration. It’s relentless. When you look at the other side of it, you see the GPs—our role models—who, from the evidence I submitted, are burnt out, exhausted, demotivated and demoralised”.’
Of course, that is no advert for anyone wishing, then, to go into GP practice. But the report is constructive, and says, at paragraph 168:
‘Developing new models of care will be a key part of tackling these workload and sustainability issues: we believe the pace, visibility and focus of this development needs to be stepped up, which will need strong and structured direction and leadership.’
Key in that paragraph is ‘new models of care’, because what the health board have suggested, in order to attract GPs to Bryntirion Surgery—which needs new GPs as Bargoed Hall closes—is they’re going to have to introduce a new model of primary care. The real difficulty is: how do you explain to the public in Bargoed what a new model of primary care actually means? What it means is Bryntirion having pharmacists, having mental health care professionals and having nurses who are able to deliver standards of care comparable to GPs and ease the pressure on GPs. That is significant, but really key will be explaining that to patients who expect to see a GP. New models of primary care can take that pressure off GPs and ease the problem, but I’m yet to see that explained in a very convincing way.
The report also mentions locum doctors to fill GP vacancies, and when the Cabinet Secretary visited Bryntirion Surgery, he heard from the full-time GP there who said that locum doctors are all very well, but they leave behind a trail of admin work that the permanent GPs then have to pick up, and in addition to that, locum doctors are very expensive. So, it doesn’t really resolve the problem, it just puts a sticking plaster on it.
I’ve also been contacted by Dr Paul Edwards, through Allan Rogers—Allan Rogers used to be the MP for the Rhondda, he’s in his eighties now and still very active in politics—he wants to help solve this problem. He saw my video on Facebook with regard to Bryntirion Surgery and he put me in touch with Dr Paul Edwards who’s working with Guy Lacey, the principal of Coleg Gwent. They’re looking at ways in which the rich, untapped source of talent in the northern Valleys can be recruited to become GPs in the future. Many people growing up in areas of relative deprivation would make good doctors, but because of cultural issues of aspiration in education they’re not encouraged to apply for medical schools. Dr Paul Edwards signed his email to me: Dr Paul Edwards BSc, BM (Hons), PhD, Membership of the Royal Colleges of Surgeons of Great Britain and Ireland, Fellowship of the Royal Colleges of Surgeons, consultant surgeon, honorary senior lecturer, grade C and two Ds at A-level. So, this is a clear opportunity to recruit our future GPs from the areas of the northern Valleys that I always talk about. I’m therefore pleased to see that the report makes recommendations on this subject, and I sincerely hope the Welsh Government commits to working with all relevant stakeholders and experts to ensure that this potentially transformative change can be brought about.
Thank you. I now call on the Cabinet Secretary for Health, Well-being and Sport, Vaughan Gething.
Thank you, Deputy Presiding Officer. I want to thank Members, not just the committee members for their report, but Members for the debate today, and the range of recommendations that we’ve had an opportunity to discuss, and their contribution to helping us deliver a sustainable workforce for NHS Wales.
I recognise, as the committee do too, that there are UK-wide challenges in recruiting and retaining doctors in some specialities, and in particular the point that Dai Lloyd highlighted in his opening remarks: the additional risk created by both Brexit uncertainty and our eventual path out of the European Union. It’s worth again highlighting the view of this Government: we welcome the fact that European Union nationals are here in Wales as doctors and other healthcare professionals, but more than that, as members of the communities that each of us is privileged to represent up and down our country. And, again, to take on board Julie Morgan’s point, there are many doctors that we rely upon to help deliver our services from other parts of the world. And back to your really good example of a really engaged medical workforce who want to carry on being proud of where they and their families are from, but also are incredibly passionate and proud about our national health service, and go out and sell Wales to other parts of the world incredibly effectively.
Of course, the purpose of this committee report was to consider recruitment issues in terms of the medical workforce. Inevitably, there is a significant focus on medical education, but also comments today, and in the report, about other healthcare professionals as well. I want to start by coming back to the statement that I made on 18 July about medical education and training in north Wales. I recognise that the committee did not come out with an explicit recommendation for a new medical school in Bangor, but certainly they were clear that they want to see more medical education and training take place in north Wales, and the recommendation about a centre in Bangor. In my statement, let’s remind ourselves, I recognised the need for increased medical education to take place in north Wales. That is still my view. That is not a fig leaf; that is not something to get through a debate; that is where this Government is. I now confirm my view that a collaborative approach, looking at Cardiff, Swansea and Bangor universities working more closely together, can deliver the increase that we wish to see in medical education and training taking place in north Wales. It’s also worth me saying that all of those parties have confirmed their willingness to make real progress with that work. Those discussions are ongoing, and the detailed arrangements that will need to be put in place, and the challenges that we face, and again—
Rhun ap Iorwerth and Mark Isherwood rose—
I restate my commitment to providing a further response back to Members this year on that work—[Interruption.]
Who are you giving way to?
Well, I saw Rhun. I’ll take one, and then I might take another.
Will you confirm that you will look at going down the route of accepting undergraduates from year 1 right the way through, which I am told without any shadow of a doubt is possible in Bangor, through a collaborative approach between Cardiff, Swansea, Bangor, whoever might want to get involved?
We need to look at what is possible. I don’t want to rule anything in or out at this point. I need to see what is possible, and equally not just what is possible, but what will provide us with the greatest return for the service. I’ll take a brief intervention and then I’ll make some more progress.
How do you respond to the statement made to those AMs in north Wales who were able to attend a meeting with the north Wales medical committee last week that they would want that collaboration—this is the GPs medical committee—to include the neighbouring universities in north-west England, which have also provided student doctors and doctors to the region in the past?
Well, I think we need to be careful about what we’re trying to do and achieve. We want to understand how we can provide more people with the opportunity to train and undertake part or all of their medical education and training in north Wales. There is a different point though, I think, about how we have a more grown-up set of relationships with colleagues in north-west England, and recognise the fact that many Welsh-domiciled students go to north-west England to undertake medical education and training, not because they don’t have opportunities—that may be partly to do with why some people go—but because there are lots of people who opt to leave home and to go further away. That’s part of understanding not just the path that students take, but we need to be better at keeping people within Wales and giving them opportunities to stay here, but also at what we do about recovering those people and bringing them back to Wales. There’s a particular issue here about returning and repatriating Welsh language skills within healthcare professions as well.
I said before that the worst possible outcome would be to invest in additional places in any part of Wales, and then for there to be no increase in the number of graduates that we retain within Wales. So, it’s looking at all parts of it: how many people go into medical education and training within Wales, and also what do we do to keep people when they finish that education and training as well? So, that, in essence, is about much more than medical student numbers and where they are within the system; it’s ensuring we have a genuinely sustainable medical workforce in Wales and all aspects of education and training in the pipeline need to be considered and operate effectively.
This goes back to some of the comments that I’m pleased that people have picked up on, including Hefin David’s regular reference—and can I commend you for it—in referring back to the northern Valleys, but there is a broader point about how we ensure that children do aspire to become doctors: the debate that we have about the health service and people’s understanding that actually you’re in the firing line in many respects if you go into the health service, and the way we talk about the service more generally. There are people who would otherwise have chosen to go into medicine who are choosing different options. That’s a challenge for all of us, wherever we sit politically, about seeing those people have those opportunities regardless of where they live.
There is that point about greater awareness of not just medical roles, but all roles within the national health service. And the consistency of opportunities across Wales for young people to have work experience opportunities to introduce them to healthcare, not just from an employment perspective, but both from an employment perspective and a patient’s perspective too. Because we do recognise that actual work experience opportunities, as they currently exist, have not been as equally distributed as we’d want them to be and, of course, lots of people already in and around the service are more likely to have those opportunities. So, we need to make a proactive effort to ensure those opportunities are more widely spread.
I’m happy to recognise the changes that have been made to admissions processes in both Cardiff and Swansea medical schools and the improvements in the number of Welsh-domiciled students accepted. Admissions data shows that 80 per cent of Welsh-domiciled students were offered a place to study in Swansea. In last year’s intake they took up that place and they say there are 88 Welsh-domiciled students in Cardiff, and that’s the highest number for six years. So, progress has been made, but I certainly recognise there’s more that needs to be done. Part of this is ensuring that our own young students and young people are familiar with the selection process and have the opportunity to practise those skills, so that if they get the opportunity for an interview, they’re in the best place to actually perform well and be offered a place. That’s about positive and constructive feedback, but doing this all on a proactive basis to encourage the applications in the first place.
Because we do need to demonstrate the wider benefit of studying in Wales and that the student experience here is sufficiently positive to encourage individuals to stay and continue working within Wales. That means ensuring there are sufficient opportunities in postgraduate training for people to pursue their careers, including, of course, through the medium of Welsh. That means training in Wales must offer many choices and benefits. But being a compact nation, the experience should be gained in both urban and rural medicine, to provide the opportunities to discover the diversity that accompanies each setting. This does go into some of the work that Julie Morgan referenced, including, in particular, rural opportunities as a positive plus for people who want to just come into and stay within our system. Now, all parts of that jig-saw need to work together if we’re going to capitalise on any additional places that may be established, and I’m already working with the Cabinet Secretary for Education on these issues. As I’ve said, I’ve given my commitment to return specifically to the subject of north Wales this year.
I do welcome the committee’s recognition of and support for the Train, Work, Live campaign. Again, 91 per cent of GP training posts were filled last year, an increase from 75 per cent the previous year, and the increases are in those parts of Wales where the new financial incentive scheme was introduced. I am happy to confirm to Jeremy Miles that we will review the impact of the incentive scheme to make sure we’re genuinely helping to bring more people into our system, rather than shifting numbers around by simply creating different problems in different parts of the country. That also brings me to Hefin’s point about local healthcare. There’s something about the language we use about who is speaking to who about what people can expect. I think often in the health service we use a certain language that actually doesn’t mean much to the public and we exclude them with the language that we use, but also the understanding of what it will mean for them when they still want a service to be provided.
I recognise I need to finish, but I want to point out the Train, Work, Live campaign will continue and there’ll be a particular focus on psychiatry training to address the low fill rates we’ve seen there as well. So, all our efforts, including the establishment of HEIW, which I will return to again in the future, will be about how we improve recruitment and retention across our workforce, and I really do welcome a very constructive report and debate from Members and the committee today.
Thank you very much. I now call Dai Lloyd to reply to the debate.
Thank you, Deputy Presiding Officer. May I thank the Cabinet Secretary and other Members for their excellent contributions this afternoon to this very mature debate on a report that is a very thorough one?
Now, I’d like to reiterate the importance of recruitment and retention as key issues in the future of the health service, because we need to teach and train sufficient numbers in the first instance and also we have to keep them in the system. There is a challenge, as Hefin David suggested. I’m the first doctor in my family and it was a significant challenge for someone like me, out in a rural area, to go to medical school in the first instance. We need to make it much easier for people, wherever you come from, to go to medical school.
May I thank Angela and Rhun and Julie for their contributions, as well as, of course, Caroline, Jeremy and Sian Gwenllian with regard to Bangor medical school, and also Hefin David? One matter, as there was a lot of emphasis on GPs and vacancies and the pressure on family medicine, one issue that I didn’t mention initially was the importance—. Even if we teach every GP that graduates from the medical schools that we have at present, we’re not training sufficient numbers at present even if we could retain every one of them in the system. We’re not training enough of them at present. We need to increase the number that we’re training and that’s why we’re calling for a medical school in Bangor.
The other point to make is that after training, once graduated, it’s important to retain doctors in the health service wherever they are. That is at the heart of the matter, that it is our young doctors who graduated two or three years ago who are working in our hospitals, who are the junior doctors, who are the future GPs, who are the specialists of the future, and at present they feel under significant pressure. That’s down to the way that they’re treated, very often, by managers within the health service, because these young medics have to fight for time off away from their jobs to study, to research; they have to battle to sit exams and battle for vacations, even, with constant pressure to fill vacancies in the rota, the on-call rota, and those posts are very busy already. We’ve heard about the pressure from Caroline Jones and others.
As well as that workload and the way that they’re treated—having to battle for everything—there’s also a duty to tell the truth when things go wrong, but when doctors complain to their managers about deficiencies in the service, when things happen that shouldn’t happen—becoming a whistleblower, that is—then those doctors are also in danger of being prosecuted themselves. Now, that is unacceptable. It undermines the morale of doctors who are totally committed, and when facing such pressure and such a lack of support from their managers, it’s little wonder that young doctors are leaving to work in other places, and they don’t get the opportunity to become local GPs or specialists, locally; they’ve left because of the way that they’re treated.
So, we need to increase the number of doctors that we’re training and we need to retain them, and that’s the major challenge facing us. A lack of doctors and nurses brings great pressure on the remaining staff, as we’ve already heard. And, yes, we do need to train more doctors. We’re not training enough here in Wales at present to meet the need. Even, as I said, if we could retain every single one of them that we’re training, we’re not training enough. And, yes, we do need another medical school in Bangor. We were having these debates 20 years ago when we were part of the process of establishing a new medical school in Swansea. One of the first steps that this Assembly took was to agree to that idea that one medical school for Wales wasn’t nearly enough, and I remember those early debates and the early steps taken to establish that medical school in Swansea, and we’re repeating history again, here: the same steps, the same debates. But I’m sure that there will come a medical school, ultimately, in Bangor. I also have a message for the managers in the health service to work much harder and with greater confidence to retain and to look after and to care for our young doctors, so that they remain in the health service here in Wales. We need to retain the brightest and most talented here in this nation. Thank you.
Thank you very much. The proposal is to agree to note the committee’s report. Does any Member object? No. Therefore, the motion is agreed in accordance with Standing Order 12.36.
Motion agreed in accordance with Standing Order 12.36.
The following amendments have been selected: amendment 1 in the name of Jane Hutt and amendment 2 in the name of Rhun ap Iorwerth.
We now move on to the Welsh Conservative debate on community health councils, and I call on Mark Isherwood to move the motion.
Motion NDM6505 Paul Davies
To propose that the National Assembly for Wales:
1. Notes the Welsh Government’s White Paper—’Services fit for the future’—which seeks to abolish Community Health Councils in Wales.
2. Recognises the important role Community Health Councils have played in delivering independent public service accountability and providing a strong voice for patients in Wales.
3. Believes that the White Paper proposals will weaken the voice of patients and communities and reduce scrutiny of the Welsh Government and Health Boards.
4. Calls on the Welsh Government to:
a) extend the consultation period on the White Paper, following its failure to properly engage with Community Health Councils, patients and the Welsh public; and
b) work more constructively with Community Health Councils on future proposals for a new people’s voice body.
Motion moved.
The Welsh Government’s White Paper consultation document, ‘Services fit for the future’, claims to focus on the principles of enabling and empowering organisations, staff and citizens. However, it also proposes to replace our regional community health councils, which are independent and therefore able to challenge and scrutinise the NHS on behalf of patients, with what it describes as a new national citizen voice body, thereby threatening yet further top-down, centralised control.
We therefore view with real concern the Welsh Government’s amendment to this motion, which seeks to delete reference to the widespread and evidence-based concerns raised with us. In consequence of these, our motion recognises the important role that community health councils have played in delivering independent public service accountability and providing a strong voice for patients in Wales, and believes that the White Paper proposals will weaken the voice of patients and communities and reduce scrutiny of the Welsh Government and health boards.
The White Paper states that the new arrangements will be based in some respects on the Scottish Health Council and working across health and social care. However, as today’s Plaid Cymru amendment, which we will be supporting, notes:
‘a single national community health council in Scotland was regarded as not sufficiently independent of government by the Scottish Parliament’s Health and Sport Committee.’
In fact, when the director and the chair of the Scottish Health Council attended the Scottish Parliament’s Health and Sport Committee in January, the committee’s convenor stated, ‘I think you are a toothless hamster. I don’t see where you’re adding value’, and that campaigners feel distant from decision making. The committee collectively found that it was clear the Scottish Health Council does not, in its current guise, present itself as a body independent of Government. Some might say that this is what attracts the Welsh Government to this model. After all, they removed the right for an independent review from the NHS complaints procedure in 2011, leaving complaints to be investigated solely by the body complained against, followed by the right to request a review by the Public Services Ombudsman for Wales, who then reported a 50 per cent increase in complaints about the NHS in Wales over the following five years.
In a positive and pioneering step, community health councils, or CHCs, were established in 1974 under a Conservative Government with a statutory duty to represent the local community’s positive interest, which included acting as patient advocates in complaints involving the NHS. They became a whirlwind of activity and achievement. After 26 years acting as the only statutory NHS patient-led watchdogs, Labour abolished all CHCs in England on 1 December 2003. As Andy Burnham, a subsequent Labour health Secretary in England, stated some years later, ‘The abolition of community health councils was not the Government’s finest moment. It seems we failed to come up with something to replace CHCs that did the job well.’ And, as Lord Justice Francis stated in the Francis report on serious failings in care at Mid Staffordshire NHS Foundation Trust before 2009, quote:
‘Community Health Councils…were almost invariably compared favourably in the evidence with the structures which succeeded them’
in England. It is now quite clear that what replaced them—two attempts at reorganisation in 10 years—failed to produce an improved voice for patients and the public, but achieved the opposite.
Labour replaced CHCs in England with public patient forums and then local involvement networks, which were criticised on the basis that they were constrained by a lack of real power, often criticised for not being representative of their local populations, and hampered by cases of internal disputes and a lack of awareness of their work. A Conservative-led Government replaced this with Healthwatch in 2012, comprising independent social enterprises responsible for representing patients across England and dealing with local concerns. The UK Government bit the bullet after the Mid Staffs scandal and commissioned the independent Keogh report, which resulted in 11 English trusts being put into special measures. But it was the north Wales community health council that then wrote to the previous Welsh Government health Minister after it obtained hospital mortality statistics showing that all three main hospitals in north Wales had higher than expected death rates. After that Minister stated the decisions to close the community hospitals at Flint, Llangollen, Blaenau Ffestiniog and Prestatyn were supported by the community health council, the community health council also wrote to him expressing concerns about the robustness of the information provided by Betsi Cadwaladr university health board, which they had used to inform their decision-making process. Community health councils’ acting independently and inconveniently in this way sets the context for the Welsh Government’s failure now to include them in their proposals.
We’re advised that, two years ago, the Welsh Government directly or indirectly appointed the chief executive of the board of community health councils in Wales who made the CHC submission to the preceding Green Paper, ‘Our Health, Our Health Service’. No doubt the Welsh Government will deny that, but that, nonetheless, is what we’ve been advised. We further understand that the White Paper is basically what he said, that the CHCs themselves never saw the paper until it was submitted, and that this chief executive was subsequently suspended and then dismissed—all matters of public record now.
Up until the night before the White Paper was published, the CHCs themselves were told by the Welsh Government that they would not be affected. Successive reports have criticised a single CHC, Abertawe Bro Morgannwg, which was chaired by the former Labour Merthyr Tydfil council deputy leader. But, gradually, those criticisms were extended—wrongly—to all CHCs across Wales.
Despite an ever-increasing shift of resources to the central board of CHCs in Wales, CHCs themselves have sought to get on with their provision of complaints and advocacy services, visiting and monitoring, scrutiny and challenge, and engagement. In 2015-16, Healthcare Inspectorate Wales conducted just one hospital inspection in Betsi Cadwaladr university health board settings, compared to 600 hospital ward visits by north Wales community health council. Whereas every ward is inspected every six months by north Wales community health council, inspections by Healthcare Inspectorate Wales are, on average, only every seven to 10 years. All this is at risk.
Commenting in late July on the Welsh Government’s consultation, the Consultation Institute stated
‘worryingly, there are unanswered questions about the proposed process for public involvement on service change’,
that there are
‘important questions that need to be properly considered’
and that they were therefore organising their own ‘special Roundtable’ in Cardiff.
However, on 1 September, they stated that they had encountered a problem they ‘had never seen before’, with the Welsh Government uniquely stating
‘that to attend such a third-party event would compromise the integrity of the consultation’
and suggesting
‘that it would be wrong for NHS Managers and other public bodies to attend anything that was chargeable.’
In reality, the respected Consultation Institute is an independent, best practice, not-for-profit body.
Facebook posts then revealed that the organisation hired by this Welsh Government to lead on public engagement had only begun their search for venues three weeks before the consultation ends. One post includes the phrase ‘tight turnaround’. In another, the employee seems to suggest the scrapping of CHCs is inevitable, despite the consultation phase still being ongoing. Only yesterday, the organiser issued an e-mail requesting support from its members where events were still low on participant numbers—just nine days before the consultation ends. Further, CHC members and staff are explicitly excluded from attending.
Another e-mail yesterday stated that older people in north Wales obtain help when they need it from the Bangor and Wrexham offices of the CHC, but very often they approach one of the 72 individual CHC members who reside in north Wales. These unpaid, but skilled volunteers, who are the eyes and ears of the public, have also been instrumental in alerting the health board management and Assembly Members to major issues such as the mental health and infection control failings we have experienced. There are 700,000 patients residing in the area served by Betsi Cadwaladr, which translates into just one CHC representative for every 10,000 people.
The White Paper references the Organisation for Economic Co-operation and Development report published last year. The White Paper suggests that CHCs should be closed, but the OECD did not say at any point that CHCs should be closed down. The OECD advised that they should evolve. Professor Marcus Longley, also referenced, did not say in his report that CHCs should close down, but evolve, and based his advice on the presumption that they would continue.
CHCs across Wales agree that a new body is needed with a remit over health and social care, but have expressed serious concerns about these Welsh Government proposals. They have therefore confirmed that they support the calls on the Welsh Government in our motion to extend the consultation period on the White Paper, following its failure to properly engage with community health councils, patients, and the Welsh public, and to work more constructively with community health councils on future proposals for a new people’s voice body. For goodness’ sake, listen to them.
I have selected the two amendments to the motion, and I call on the Cabinet Secretary for Health, Well-being and Sport to move formally amendment 1, tabled in the name of Jane Hutt.
Amendment 1—Jane Hutt
Delete all after ‘Services fit for the future’ and add, ‘which sets out a range of proposals to strengthen quality and governance in health and care services in Wales’.
Amendment 1 moved.
Formally.
Thank you. And I call on Rhun ap Iorwerth to move amendment 2, tabled in his name. Rhun.
Amendment 2—Rhun ap Iorwerth
Add as new point at end of motion:
Notes that a single national community health council in Scotland was regarded as not sufficiently independent of government by the Scottish Parliament’s Health and Sport Committee.
Amendment 2 moved.
Diolch, Dirprwy Lywydd, and Plaid Cymru is pleased to support this motion today. We are not happy with the proposals that the Government is indeed trying to rush through with little scrutiny, it seems, and what could only be described as a sham consultation, and, yes, we too have noticed the scramble to arrange focus groups close to the consultation deadline—indicative, I think, of how this is being handled, with the consultation being regarded almost as an oversight.
Now, last week, that quick appeal was made on a personal Facebook account by an individual who had been charged with running a number of focus groups, we are told, to discuss the matter, admitting that it was, as we heard, a ‘tight turnaround’, and it certainly was. The consultation period is nearly over. Somebody did suggest that CHCs could be invited to those focus groups, but a reply stated that, as the White Paper proposes their abolition, they may not be too keen to take part. Now, individuals, certainly, who sit on community health councils have got in touch with the organisers of these focus groups and have been told, in no uncertain terms, that they are not to represent the views of community health councils in those focus group meetings, and to be there as ordinary citizens and nothing else. This is not the way that consultations should take place, and the Government has been found out. But a flawed consultation isn’t the sole reason for our concerns; we simply don’t agree with the proposals.
The first objection: the proposals to remove the independence of our community health councils. Now, the Scottish Parliament’s Health and Sport Committee noted this was the effect of similar proposals in Scotland. Now, we’re all for learning from Scotland where it fits, and they have, without doubt, got a lot of things right, but learning also involves learning from mistakes. We can look at a whole host of countries and the way that they tackle issues similar to ones that we need to tackle here in Wales. But it’s not just looking at what they’ve done in Scotland or anywhere else that is important, but looking at the effects of actions that have been taken, and I think making such a body like a community health council too close to Government goes against everything that we have known about how to make such bodies effective, and Scotland have found that out after their experience with changes to governance and the oversight of health in Scotland. Hence, our amendments that we urge you to support today, and I’m grateful to the party opposite for indicating that they will be supporting that amendment today.
Another objection: the notion that because Healthcare Inspectorate Wales do inspections we don’t need another body going into hospitals. Dare I remind the Minister that it wasn’t so long ago that HIW was heavily criticised by a committee in this Assembly, and indeed it failed to spot the poor care that was going on in the Princess of Wales Hospital? Having duplication of inspection is a good thing, and adds an additional layer of protection. And, no, CHCs aren’t an inspectorate, but they know, from far more visits to hospitals, it must be said, than are conducted by HIW, what goes on in our hospitals, and crucially there is a different kind of oversight. CHCs offer a particularly important element: they measure the patient experience. And if we are to provide a better experience for our patients, ensuring that hospitals provide for them what they need and deserve and require, then we will not be succeeding in giving Wales the kind of NHS that it needs.
Now, we’re not arguing for the preservation of CHCs as they are. I haven’t heard anybody from any CHC arguing that, forever and a day, community health councils should remain. What we are arguing for is the maintaining of their function in being an effective voice for patients in Wales. What we have in this White Paper are proposals that take away the voice of the patient. These proposals do not give patients in Wales the security, the support and the voice that they need. So, I’m afraid it’s back to the drawing board.
The Welsh Government consultation document entitled ‘Services fit for the future’ set out a number of proposals with the declared aim of strengthening the voice of citizens in health and social care. However, in the view of many people, the proposal regarding community health councils will not provide an effective and independent voice for patients in Wales. The consultation proposes to abolish community health councils in their current form and establish a new body, based, in some respect, on the Scottish Health Council. This all-Wales body would work across health and social care.
Community health councils represent the public’s interest in the way services are planned and provided. There are seven community health councils in Wales—one in each of the local health board areas, and responsible to the same local population. The role is to listen to what individuals and the community have to say about health services with regards to the quality, quantity, access to and appropriateness of the services provided for them. They then act as the public voice in letting the managers of the health services know what people want and how things can be improved. In my view, abolishing community health councils and setting up an all-Wales body on the Scottish model will seriously weaken accountability and public influence. It will break the vital link between local people having a say over the services provided by their local health boards. Community health councils provide an accessible outlet for patients, service users and the public to engage with their health services. This is particularly important for vulnerable patients. Community health councils are able to represent the interests of such patients when they are unable to do so themselves.
Removing this established and independent avenue for engagement and scrutiny runs the risk of silencing communities’ concerns on the delivery of local services. This is an essential component for the improvement of future services within the NHS in Wales. Abolishing the CHCs is also likely to exacerbate the inability of health boards to settle complaints within the existing 30-working days target. At present, nearly half of the complaints to Aneurin Bevan health board are outstanding after 30 working days. My concerns are in no way alleviated by the example set by the Scottish Health Council, which the Welsh Government seems to think is the model we should follow. The Health and Sport Committee of the Scottish Parliament voiced its concern earlier this year. This committee is chaired by Neil Findlay, a Labour Party Member of the Scottish Parliament. They said they were clear that the Scottish Health Council did not, in its current guise, represent itself as a body independent of Government.
Concerns were also expressed that SHC’s function was not clear to the public or to the health boards. They appeared to lack any formal role on direct engagement with patients and the public who may be impacted by proposed service changes. Indeed, one representative of the Scottish Health Council, when asked about local protests against service changes, told the committee it was not their role to campaign on behalf of local groups. No wonder the committee concluded that the SHC was a ‘toothless hamster’. I believe we must retain community health councils with increased powers and responsibilities as the best way of meeting the Welsh Government’s aims set out in this consultation. Deputy Presiding Officer, this Government in Wales are not very happy to make changes to the NHS, but they are quite happy to make changes to the NHS’s eyes and ears of the public, and want to change it, which is not acceptable. Thank you very much.
Can I welcome the White Paper, which addresses the issue of how we should engage better with citizens in terms of service delivery? I think it’s clear that the more we work with service users, the more likely it is that we are going to get a better and successful model of service delivery. The recent experience, for example, of the Gellinudd Recovery Centre, where patients have a say in everything from policy to the decorations, has led to not just a better service, but also to predicted savings of £300,000 to the NHS. So, one of the areas that’s being suggested in this White Paper that is ripe for reform is that body of community health councils, which are embedded in local communities around Wales. That’s clearly where we have all focused our attention today.
I think the community health councils themselves would be the first to put up their hands and agree that there is a need for reform. An obvious point is the fact that, at the moment, they have the right to speak on behalf of the public in relation to health but not in relation to social care. It’s clear that we want to see better integration, and so there’s an example of where something needs to change. I think if we are honest, we would have to admit that, in general and certainly in some areas, members of the public have no idea that community health councils exist to speak on their behalf. I had not heard of them before I was elected to this Chamber last year. So, if we are going to have a patient voice organisation—
That’s a lack of curiosity.
I don’t think it’s a lack of curiosity. I have been an elected politician for a very long time, and I have got to tell you that I had never heard of them. So, I don’t think that I am atypical. I think that you guys are the atypical people. I think that what’s important—[Interruption.] Well, go and do a straw poll of the people just walking down the street, and I can tell you that I would be very surprised—. I held a meeting recently with about 150 people who were pretty angry with what was going on in their local community, and they had no idea that the community health councils exist. I’m not saying that this is about—. I’m saying that they need resources, sometimes, to allow them to get out there and to speak to the public. So, they do need help in terms of communicating with the public. I don’t think that their transparency and their accountability to the public, and their ability to stand up for the public in relation to the health service, is as clear as it perhaps could be. I think they should be properly resourced, so that the public are aware of them, and that it’s a channel for them to have their say.
In principle, I think that we do need a forum for local patients’ voice and an independent complaints advocacy service. My fear is that if we don’t have a mechanism to file complaints, I believe that in this day and age, what we are likely to see is a free-for-all on social media, where patients could be whipped into a frenzy and where individual health workers could be vilified. That’s the situation that I think we have got to avoid at all costs. But, I think there are elements of the work that CHCs currently undertake that, in a new structure—or in an enhanced role for community health councils—should be made with the designs and needs of Welsh patients in mind. I think the formal relationship with local health boards is something that must be built on, and it’s difficult to envisage how a national approach to a citizens’ voice advocacy service could work locally. I have examples where CHCs in my area are co-designing services with the health board, supporting service change, and working with people through communicating changes to service delivery.
The ability of CHCs to intervene as people are receiving their treatment is also invaluable, and I think it makes sense that we’ve got to try and change services for the better, even while patients are undergoing treatment, and a retrospective approach, whilst valuable, is likely to undermine individual patient confidence. Just because Government and health boards think geographically, in terms of lines on maps, it doesn’t mean that patients do, and we must take the stress of understanding health configurations away from patients, and that’s particularly important when we’re talking about sharing services with England.
I think it’s extremely useful for CHCs, if they are dissatisfied with the response of the health board, to be able to refer that decision to Welsh Government Ministers, and I think we’ve all learned by now that it is not possible, or correct, for us to duck and avoid political responsibility. I think this is simply a part of a genuine consultation process—I certainly hope that it is. My understanding is that CHCs are not looking for more time to consult on this issue, and whilst we should look to other parts of the UK for best practice, it’s important to note that the Scottish model, as Rhun referred to, has also received criticism. So, I hope that by working together, the Welsh Government, the individual health boards and the existing CHCs can design an organisation that supports patients and the delivery of excellent health and care services that the people of Wales can and should expect.
I’ve got to say, Eluned Morgan, I listen closely to your arguments, and you have very many sensible things to say, but that wasn’t one of them. I’m a bit concerned about your argument that just because people aren’t aware of community health councils, they shouldn’t exist. If you use—
I didn’t say that.
Well, you said something that could be confused as saying that.
I actually said they should be better resourced.
Are you taking an intervention from the Member?
No, not yet. I’m not.
No, sorry; you can’t shout out.
You actually said that you hadn’t heard of community health councils and that was an argument for them not to be there. Well, on those grounds, I think many of my constituents have never heard of the Welsh Assembly, but I don’t use that as an argument to abolish myself—well, not yet, anyway, but I suppose there’s still time.
Look, no-one—well, very few people at any rate are saying that the current community health council structure is perfect or that it shouldn’t be changed. Far from it; it should be changed. I think we all accept that. Community health councils, as Eluned Morgan did say later, accept that as well, but they need to be changed for the better. I just don’t think there’s been a full appreciation on the part of the Government of the value-added the CHCs have brought to the NHS in Wales since their inception. Nor has there been an adequate consultation process with members of CHCs on the relative merits and disadvantages of their abolition. Now, as has been said, they have the statutory rights under law to hold health boards to account. Crucially, of course, volunteers visit and monitor hospital services and speak to patients and staff in hospitals. Yes, in many cases, volunteers, not experts, to be sure, but volunteers who bring enthusiasm, dedication, a fresh viewpoint, and who can peel back the layers of the bureaucratic onion and see to the core of issues that bureaucrats often won’t see.
Now, there is no doubt at all that the new model, whatever form that takes, should without doubt retain all that is good about the current structure. The organisation should have teeth—many Assembly Members here today have spoken about the need for that. It should be independent. It should be able to hold a health board to account. It should be non-political as far as possible, transparent, and ensure that people can be heard.
What are we in danger of losing? Well, I would say nothing less than the day-to-day oversight of the NHS from a patient’s point of view, and the importance of that should not be underestimated. How many times do we stand on this Chamber and grandstand, for want of a better word, about the importance of the citizen being at the centre of the decision-making process, whether that be in relation to the health service or the care system, as has also been mentioned in today’s debate, schools, or whatever sphere it may be? Co-production, which is one of Mark Isherwood’s buzzwords and a current buzzword across the political spectrum—yes, it seems to me that the key tenets of co-production are being cast aside, shredded, when it comes to devising this new system of monitoring the NHS and holding it to account locally.
I recently met with Aneurin Bevan community health council, my local health council, who explained to me some of the areas that they get involved in. Often, these areas, I would concede, are in many ways secondary in the wider scheme of things—secondary, at least, to the managers’ concerns, who are busy overseeing at the top layer, and with managing some major budgets. But they’re areas that, to patients, are extremely important, and actually can be resolved pretty easily with a bit of organisation, once a clear focus is brought to bear on them. For instance, the Aneurin Bevan CHC visits to local wards highlighted that there seemed to be a problem with low linen pillow supplies, particularly on weekends and bank holidays. This was actually pretty easily sorted out, but without CHCs there, there would have been no patient voice, no clear focus on that issue. Patients could still be lying in beds on weekends or bank holidays without the sheets that they wanted, and yet it was sorted out, thanks to the intervention of the community health council.
Now, I accept that the UK Parliament’s solution in England has had some serious problems, and probably should itself be left well alone. But it is quite frankly bizarre that the Welsh Government should be contemplating moving to the Scottish model of patient representation at the very time—the very time—that that model is coming under such heavy criticism north of the border. Many AMs have referred to the description of it as a toothless hamster. If the Welsh Government doesn’t want to listen to this Assembly on the issue of CHCs, then at least listen to the experience of the Scottish Government, which is now learning the lessons of rushing into a change that was not appropriate and is not fit for purpose.
So, in conclusion, Deputy Presiding Officer, as we contemplate the twentieth anniversary of devolution to Wales, and the creation of this place, surely the greatest benefit of this process—not the event, as was originally alluded to, but this process—surely should be the ability to take our own local decisions over key areas of peoples’ lives, and that should allow us, even at this late stage, to reconsider the proposed changes to community health councils in Wales and come up with an alternative that, yes, embraces change, but at the same time retains the core principle that lay behind the establishment of those CHCs in the first place—putting the patient truly at the centre of the process and at the centre of the NHS. Not bureaucrats, not health boards, not dogmatic ways of thinking—let’s put the patient at the centre.
I’m pleased to contribute to this debate because I do think that the community health councils do important work. I have spoken to both in my region, Hywel Dda and Powys, and part of Betsi is also within the region that I represent. I hope to express in this debate some sort of development on the community health councils, which builds upon the good things that they do: the ability to oversee, and the reliance on volunteers, which is both a strength and a weakness simultaneously in the current regime. But I also want to reflect on the fact that the community health councils have been in place since 1974 and haven’t developed a great deal since then. There are some very old-fashioned aspects to the way that they work. There has to be improvement and they have to be modernised.
I do want to focus on one thing specifically, which is a weakness in the Government’s paper at the moment, particularly in speaking to the residents of Powys—. There is no mention and no consideration given to the cross-border issues, with patients from Powys serviced in English hospitals, but can be overseen by the community health council in Powys. Therefore I want to ensure, and I hope that the Minister, in replying to the debate, can give an assurance, that the Government does wish to retain that patient voice in health services that are located in England but which provide services for patients from Wales.
As I discussed these issues with community health councils, I have seen a desire from them to develop, and they are developing an alternative model. They have responded to this consultation with their own ideas, and I very much hope that the Government will listen to them. There has been some discussion today on the basis that the consultation and the proposals of the consultation are to be implemented as they stand. I hope that this will be a true consultation and that the Government will listen to what the community health councils themselves have to say, because they do have an alternative model.
Now, placing health and social care together is something that is to be welcomed. Ensuring a patient voice is something that we should welcome. The question is: how do we achieve that?
First of all, any new pattern has to be entirely independent of Government—that is something that we should all stand firm on. And being independent does mean being independent in terms of structure, in terms of legal status, and in terms of appointments to the councils or to any new body that is established to replace them.
I don’t sense that the councils themselves are opposed to the concept of a national body. They haven’t told me that. What they have said is that what’s important is that the local voice and regional representation is maintained. So, there is a possibility here to have a national body that could merge some aspects, which may bring forward savings, if you like, in terms of bureaucracy, employment and staffing and so on, but also ensure that the community health councils’ structures are in place to reflect local needs and the local voice. Now, that’s not exactly what the Government is proposing, of course. That is some sort of compromise and a discussion that needs to happen. But I am open to listening to such ideas and to see what happens.
I do think, whatever does happen, it’s exceptionally important that local people have the right to go onto wards, to undertake visits where health and care is provided, and that that is strengthened, that there is sufficient support for laypeople to understand that situation, because I do think that it’s important that their status is enhanced when they visit wards or placements, and that they are treated with respect by professionals, and that support and training is available for them.
The final thing I want to say is that we must take this opportunity to enhance the membership of community health councils. Eluned says that she wasn’t aware of them and I accept her comments, of course, but I have been aware of them for some decades now, I have to be honest. Some of the people I was aware of 20 years ago are still on the local community health council, and I’m not quite sure if that is necessarily how these should develop in order to be entirely representative of the communities that they represent and representative of the people who now use our health and care services.
Thanks to the Conservatives for bringing today’s debate forward on an important subject. We’ve heard a lot already about the flaws in the Welsh Government’s consultation process, so I won’t dwell on that, but rather on the changes that they propose in their White Paper.
Now, ‘Services fit for the future’, the White Paper, recognises the need for what it calls a strong citizen voice in how health and social care is planned and provided. They also want to improve the legal framework for the inspection and regulation of health services and they want to establish a new independent body for patient voice and regulation and inspection.
Unfortunately, this so-called citizen voice is not described in any detail in the White Paper. There is nothing about how the members will be recruited. There is nothing about resourcing of the new organisation. The only thing we can see clearly is that citizen voice is designed to replace the existing system built around community health councils, or CHCs.
The White Paper uses the current buzz phrase of co-production. However, it doesn’t really go into much detail regarding what this so-called co-production will actually consist of. If we go back to the Welsh Government’s own social services Act of 2014, the codes of practice in this Act do actually give us detailed guidance as to how to achieve co-produced well-being. This includes promoting user-led organisations that add social value. Well, the CHCs with their membership containing a strong element of volunteers surely represent a good example of a user-led organisation. The notion of co-production should surely be encompassing bodies like the CHCs, rather than being used as a vague form of words that is utilised to help get rid of them.
So, why does the Welsh Government want to ditch the CHCs? Well, Co-operatives and Mutuals Wales, an important third sector organisation, believe that the Welsh Government has a problem with the extent to which the health boards propose sometimes substantial changes, which are then challenged by the CHCs. Although the proposed Government changes are somewhat vague, it is widely believed that under the new system the new body would crucially lose many of the powers of the CHCs. It is not clear if the new organisation would have any rights at health board meetings, for instance. It is also widely suspected that it would not have the power enjoyed by the CHCs, which we’ve been told about today, to enter and inspect premises for spot checks. These powers are crucial in gaining an understanding of how the NHS actually works in one local area. Any new body, if it is to have a meaningful role, must be allowed to visit and inspect NHS premises, speak to patients there, and afterwards be able to contact the patients and former patients once again in order to help establish whether improvements have been made as a result of that body’s intervention.
We need to remember that the model of community health councils scrutinising the work of the NHS came in after the Ely Hospital scandal in Cardiff in the early 1970s. The system adopted throughout the UK at that time came about after a scandal, in other words, which afflicted our own local area. If we are to avoid future scandals—and let’s not forget we’re still in the throes of recovering from the Tawel Fan scandal—then we need to stick to certain clear principles of operation and scrutiny.
Decisions should be taken as close to the people who use the services as possible. Local priorities should be established according to local needs. There should be clear lines of accountability, and volunteers need to be the lifeblood of the scrutiny organisation. Volunteers will have different skills and contribute in different ways. Any new body must be free to determine how it recruits its own volunteers. We are left entirely in the dark from the Welsh Government’s White Paper as to how far these principles are going to be upheld in the new model. We, therefore, in UKIP support the Conservative motion today and urge the Welsh Government to consult further, and more openly, before adopting any new model. We also support Plaid Cymru’s amendment.
A worrying aspect of devolution is that we now have four separate models of user scrutiny of the NHS in the four different regions of the UK. Although enthusiasts for devolution might argue that this is a welcome expression of different regions going their own way, I would argue to the contrary that we have a national health service, not a regional one, and that it should operate broadly in the same way across the UK. The way in which patients are treated and the way in which users can scrutinise the work of the NHS should not differ markedly across the different regions, or we will gradually lose any sense of it being a national service at all. Thank you.
I’m pleased to have the opportunity to contribute to this debate.
Rwy’n falch o gymryd rhan yn y ddadl y prynhawn yma. Rwy’n mynd i ganolbwyntio fy sylwadau ar y rôl bwysig y mae cynghorau iechyd cymuned yn ei chwarae, ond rwy’n awyddus iawn i siarad am CIC Powys yn arbennig. Mae’n rhaid i mi ddweud, fel AC etholaeth, fy mod i mewn cysylltiad rheolaidd â chadeirydd fy nghyngor iechyd cymuned lleol, ac roedd yn dda cael cyfarfod hefyd â llawer o aelodau’r CIC yn sioe Aberriw y mis diwethaf lle cawsom drafodaeth dda am y Papur Gwyn. Nawr, yn ystod cwestiynau i’r Prif Weinidog ddoe, nodais y pryder nad oedd y Papur Gwyn yn cynnwys unrhyw gydnabyddiaeth o gymhlethdodau penodol gwasanaethau trawsffiniol, ar wahân, wrth gwrs, i’r materion eraill yn ymwneud â’r rôl graffu bwysig y mae CICau yn ei chwarae. Nawr, oni bai bod y newidiadau hyn yn cael eu hadlewyrchu, mae yna ofn gwirioneddol y bydd llais y claf a chraffu ar wasanaethau iechyd ar gyfer pobl Powys—nad anghofier eu bod i raddau helaeth, wrth gwrs, yn defnyddio gwasanaethau o dros y ffin yn Lloegr—yn gwanhau’n ddifrifol.
Ddoe, roeddwn yn falch fod y Prif Weinidog wedi cadarnhau y byddai Llywodraeth Cymru yn edrych yn ofalus ar yr ymatebion i’r ymgynghoriad gan gyngor iechyd cymuned Powys ac yn sicrhau y byddai consensws yn cael ei gyrraedd. Roedd hynny i’w groesawu. Ond mae’n hanfodol, yn sicr yn fy marn i, ein bod yn cynnal sefyllfa lle mae gan gynghorau iechyd cymuned hawliau statudol i weithredu fel eiriolwyr effeithiol ac annibynnol ar ran cleifion mewn lleoliadau trawsffiniol yn arbennig. Mae hyn yn bwysicach byth i fy etholwyr oherwydd y newidiadau sy’n digwydd yn Swydd Amwythig mewn perthynas â rhaglen Future Fit y GIG. Rwy’n gobeithio bod Ysgrifennydd y Cabinet yn gwrando ar y pwynt nesaf hwn, fod cyngor iechyd cymuned Powys yn cynrychioli llygaid a chlustiau cleifion o dros 60 o fyrddau a phwyllgorau darparwyr gwasanaeth sy’n darparu gwasanaethau iechyd gwerth cyfanswm o dros £120 miliwn, gan gynnwys £22 miliwn gan Ymddiriedolaeth GIG Ysbytai Amwythig a Thelford yn unig. Ar hyn o bryd, nid oes unrhyw eglurder yn y Papur Gwyn ynglŷn â phwy fuasai’n cyflawni’r rôl graffu bwysig ar ran cleifion yn absenoldeb cynghorau iechyd cymuned.
Mae eraill wedi crybwyll profiad model yr Alban ar gyfer cynrychioli cleifion yno, felly nid af i mewn i hynny a siarad am fochdewion diddannedd ac yn y blaen, ond oni bai bod cynghorau iechyd cymuned yn cael rôl statudol, mae yna ofn na fydd ganddynt unrhyw ddannedd i fod yn eiriolwyr cryf dros gleifion, gan adael cleifion i weiddi o’r cyrion, wrth gwrs, yn hytrach na bod yn rhan annatod o’r broses o wneud penderfyniadau. Wrth gwrs, fe wrandewais ar Eluned Morgan. Yr hyn y buaswn yn ei ddweud yw bod llawer o fy etholwyr yn gwybod am y cynghorau iechyd cymuned am eu bod wedi’u cyfeirio; mae fy swyddfa’n derbyn atgyfeiriadau gan CICau ar gyfer mathau penodol o waith achos. Ac yn aml, mae fy swyddfa yn cyfeirio etholwyr at y cyngor iechyd cymuned, felly os nad ydynt yn ymwybodol o’r CIC, fe fyddant yn fuan erbyn iddynt adael fy swyddfa.
Y pwynt olaf y buaswn yn ei wneud yw ein bod yn aml—mae pawb ohonom yn gwybod hyn fel ACau—yn aml iawn pan fydd sefydliad yn wynebu cael ei ddiddymu, fod y sefydliad hwnnw’n ymgyrchu’n drwm tuag atom ni. Ond yr hyn y buaswn yn ei ddweud, wrth siarad am fy nghyngor iechyd cymuned fy hun, yw mai’r hyn y maent yn ei ddweud yw eu bod yn derbyn newid. Mae hynny wedi’i dderbyn ac wedi’i ddeall, ac nid oes unrhyw deimlad na ddylai fod unrhyw newid yn digwydd o gwbl. Felly, buaswn yn dweud heddiw fy mod wedi fy nghalonogi fod Aelodau o nifer o bleidiau gwleidyddol yn cefnogi cynnig y Ceidwadwyr heddiw. Rwy’n gobeithio y bydd pob Aelod yn gwneud hynny, gan fy mod yn credu ei bod yn bwysig i lais y dinesydd gael ei gryfhau yn hytrach na’i wanhau.
Thank you, and I call on the Cabinet Secretary for Health, Well-being and Sport, Vaughan Gething.
I’d like to thank Members for their contributions and the opportunity to respond to today’s debate. It’s worth reflecting that the White Paper that is mentioned in passing actually sets out a series of wide-ranging proposals to take forward health and care services in Wales, because we do aim to put people at the centre of all that we do, and to enable organisations to work better together across boundaries.
We had some of this conversation yesterday, of course, in the parliamentary review debate. This is a consistent part of this Government’s approach: the citizen, the person is at the centre of the way that health and care services work, are planned and delivered. There is wide agreement that health and care systems here in Wales need to work differently to deliver those services and the kinds of outcomes that people across Wales all want to see. That’s why the White Paper looks at a whole system approach and proposes a package of measures to support closer integration. They include proposals on the composition of health boards, which is a crucial factor in the way organisations are run and how decisions are made; important new ideas of quality and candour to underpin a culture of planning, collaboration, openness and transparency; areas where health and social care could align much more effectively, such as in setting high-level common standards in complaints handling—something that the ombudsman has called for in the past; continuous engagement and decision making on service change, not as a one-off event but as a continual process to engage the public; and, of course, regulation and inspection, including the alignment and independence of the existing inspectorate. And importantly, of course, measures to strengthen the citizen voice are an essential element in achieving this. That is what the Government wants to do—to strengthen, not weaken, the voice of the citizen.
As with all things, we need to look at what to build on, what has worked well and to understand what has not worked well, and learn from experiences elsewhere. As Members will be aware, there’s been a long history of calls to reform community health councils. References have been made to Professor Marcus Longley’s review in 2012, and that made recommendations to improve our current system, as well as highlighting the need to think differently about the future. It not just recommended that, but we have implemented as far as possible what we can do from the Longley review within our current system.
The interim report of the parliamentary review, published in July, that we debated yesterday, indicated that the voice of the public in Wales could be strengthened by reforming the current arrangements. And again, that is what the Government proposes to do, and it’s interesting that the debate is positing that the Government simply wants to remove organisations and remove the citizen’s voice, which is exactly what we’re not proposing to do; we propose a different way and a reform of the process. Members in every part have said that they recognise a case for reform is made, because much has changed since CHCs were introduced in the 1970s and we should not pretend that we can continue to run with the same system as we recognise the changes that we all wish to see made across health and care.
Increasingly, of course, health and care services are being integrated. So, any body in place to represent the voice of the citizen should be set up to recognise and respond to that change. We can’t have a new citizen voice going across health and social care without having primary legislation to achieve that. So, there is a need to fundamentally reform the way that the citizen voice body works. That’s why the White Paper’s underlying aims are to develop proposals that are fit for the future and to genuinely take account of that increasing integration we see now and we expect to see in the future.
The CHC reform proposals are part of a package that I’ve described, which I believe, if enacted, will improve quality and place the citizen at the centre of health and social care planning and delivery.
Will you take an intervention?
I will, yes.
I just want to talk about the fit for the future paper in its generality. You talk about the fact that it’s bringing together everything and it’s going to bring forward a new method of governance, et cetera. So, can you tell me, Cabinet Secretary, why does it make only, I think, one mention of the regional partnership boards and why is there absolutely no mention of how GP clusters should be governed?
Because on regional partnership boards we have an architecture that we’re developing and working with. They’re part of the remit of bringing together our larger public services with partners to deliver across the health and social—well, the social care and well-being Act. In terms of the governance around clusters, there are opportunities to consider that as we go through this, because we haven’t got a fixed view on how to resolve some of the governance challenges.
This is an opportunity to take up the debate started within the Green Paper in 2015. There are clear links between the reform of CHCs and delivering service reform across health and social care, and these proposals aim to rely on the assistance of regulation and inspection. They’re being developed together to maximise benefits for the wider public. That’s why the White Paper sets out proposals for a new national and independent body to replace CHCs. And actually there’s a point there, I think: in lots of the debate today there’s been a suggestion this body will no longer be independent and, again, that is simply not what the Government proposes in the White Paper consultation. And the new body will engage at a national, regional and local level across health and social care. The proposals are high level because I have to strike a balance in terms of this being a consultation on White Paper proposals rather than being detailed legislation.
The consultation has, of course, generated lots of debate—over 700 consultation responses already received ahead of the closure of the consultation on 29 September. And, again, I do take issue with the comments that were made that this is somehow a sham and that this is being rushed through. This is a genuine consultation. I did not have a fixed view on what a new national body should look like, sound like, or how it should be organised, but I do think we need to continue the debate started in 2015. As with any consultation, next steps will take stock of the constructive ideas generated through the consultation and, importantly, we’ll work in partnership with stakeholders to do so.
I don’t recognise the accusations that have been made that we’ve somehow excluded CHCs or that they weren’t told what would happen within the White Paper, or that although they were given an assurance they would take no part in it. That simply isn’t true. But I am pleased to see that CHCs themselves have given consideration to the White Paper and they set that out in their own paper, ‘A new people’s voice body for health and social care: Our proposals’. I understand that’s been shared with all Members. And, importantly, CHCs do not ask for an extended consultation period. They also recognise that the inspection of premises should change. They have a call to ensure they have the opportunity to visit places where care takes place, but they do not want to undertake an inspection function. They themselves recognise that should be undertaken by an independent expert body, and they certainly don’t make the call for deliberate duplication that we heard from one Member in the Chamber today. I’m pleased to say that I think their proposals are generally constructive. They don’t all align with what’s set out in the White Paper; that’s the point about having a consultation. So, there’s much common ground between us and I look forward to working through with them those proposals in the future. They themselves recognise the opportunity presented by the White Paper to reform and deliver positive change.
The Llywydd took the Chair.
So, a new people’s voice body for health and care requires primary legislation. I really think, though, that it will be independent, it will have a complaints advocacy as part of its central functions as the White Paper sets out, and, of course, I expect that local and regional participation in the new body and, yes, it will be able to deal with cross-border issues. And I note what the chair of the—[Interruption.] I won’t have time, I need to finish. The open letter sent to party leaders by the chair of the CHC board sets out what they consider the public would like to see in a citizen voice body, and I agree with her statement that the end of the consultation should be the beginning of this process, and not the end. I know that people can be fearful of change, and I realise that some concerns have been expressed, but I’m clear that an effective mechanism to ensure the citizen voice is represented is a key part, and a part of the success of the overall new arrangements that we are proposing. We will, of course, look to build on experiences in England, Scotland and other places in deciding how to move forward. But there is no suggestion, and there never has been, that we would simply replicate the Scottish Health Council model. We do want to think about what is working and what is not working in other parts of the UK and to generally learn from that and to build on good practice. So, the White Paper should be seen for what it is: an opportunity to strengthen the voice of citizens across a progressively integrating health and social care service, and to develop a model that works for Wales in the here and now and in the future.
I call on Angela Burns to reply to the debate.
Diolch, Llywydd. I’m not frightened of change and, to be fair, all the people who took part in this debate, I think without exception, weren’t particularly frightened of change. I think everyone acknowledged the fact that CHCs do need to change in some way or other. However, Cabinet Secretary, your carefully well-modulated platitudes do not reassure me, because let’s be very clear, this fit for the future documentation has been rushed through. I think Rhun ap Iorwerth used a wonderful way when he talked about it being a, I think it was, ‘scramble’. And it certainly has been scrambled.
Let’s just start at the very, very beginning. Yesterday, we met here to talk about the interim report on the parliamentary review, and we all talked in that about how one of the key themes that they are bringing forward is the engagement of the citizen, is about making all of us step up to the plate, take ownership of our health, stop being so demanding on the health service, accept our own responsibilities and shape, influence and become part of the solution to the problems we currently have. And yet, this fit for the future paper, which you’ve brought forward whilst we’re still doing the interim report and the full report on the parliamentary review—so, for me, there’s the first contradiction. Why do this now? Why not wait until that final report, because it’s so integral to the way we go forward with our NHS? So, we’ve got the parliamentary review, we’ve got this consultation coming out, we’re talking about the citizen being at the heart of it, and yet this fit for the future does row back a bit.
I appreciate the CHCs need to change. I appreciate they should have a wider and better remit. I appreciate they should be better resourced, and not just better resourced, because most of the people on the CHCs are passionate, caring local volunteers, and I think Mohammad Asghar made a very good point when he talked at length about that locality, because with the best will in the world HIW are not based in, you know, my little bit of Pembrokeshire, my little bit of Carmarthenshire, your bit of Ynys Môn. They are a central body. We want to have local people who can hold our local health boards to account, and not just to account, but to influence, to help change, to make those suggestions—Nick Ramsay brought forward the commentary about how issues over linen supply were solved because of the involvement of the CHC. So, here we are, saying we want to have the patient, the citizen, the voice of people really integrated, and yet you’re closing that door. So, that’s my first complaint.
My second complaint, though, and even more is that this Government does enough consultations every year, so you should be really good at them by now. This is a totally rubbish consultation. It is too fast, it’s been left to the last minute, there are not all the places, the meetings or the promised focus groups and all the rest of it. You very proudly say you’ve had 700 responses, but, actually, ordinary people, the people who Eluned Morgan says don’t know anything about CHCs, where’s their voice in this? Why haven’t they been asked about it? This is really, really important. Mark Isherwood very clearly said that the CHCs are saying that they would like a bit more time.
Nobody here is frightened of change. Let’s have some change, but let it be the right change, and, above all, let us actually come true. Minister—Cabinet Secretary, forgive me. You talk the talk, you’ve got to walk the walk. Engage with the people of Wales and make them the heart of this. The CHC doesn’t belong to you. It doesn’t belong to the health board. It belongs to the people of the area it represents. It is their one and only really good voice that belongs to them. It, at the moment, has an opportunity to be loud, strong, and forceful, and you, if you do not have courage and you do not really buy into it, you’re going to make it a tiny, weeny, weak voice and the people who will suffer—the people we’re all supposed to represent.
The proposal is to agree the motion without amendment. Does any Member object? [Objection.] I will defer voting, therefore, under this item until voting time.
Voting deferred until voting time.
The following amendment has been selected: amendment 1 in the name of Paul Davies.
The next item is the Plaid Cymru debate on superprisons. I call on Bethan Jenkins to move the motion.
Motion NDM6506 Rhun ap Iorwerth
To propose that the National Assembly for Wales:
1. Calls on the Welsh Government to oppose the construction of a super-prison in Port Talbot.
2. Further calls on the Welsh Government:
a) not to sell or release any Welsh Government land for the purpose of construction of the proposed super-prison;
b) to develop the local economy through supporting businesses in the industrial park; and
c) to make representations to the UK Government in support of alternatives to large prisons.
Motion moved.
Diolch. Since the announcement of a new major Titan or superprison was announced back in March of this year, it has alarmed people across the communities I represent in Port Talbot and the wider area too. It’s galvanised a wide cross section of the community and led to a genuine cross-party effort in Port Talbot to say ‘no’ to this prison. It’s led to people getting involved in democracy who have never done so before, and I’m pleased to be able to have this debate today so we can outline why I think all Members of this Assembly should join those of us campaigning against this prison by saying ‘no’—not just here, but anywhere in Wales.
There are a multitude of reasons why we should reject this plan. They range from the problems with the site itself through to wider concerns about what we want our criminal system to look like. What do we want from Government spending in our communities? Just because we have an offer from Government of ‘investment’, is it the right kind of investment for our community? The site itself, proposed on Baglan Moors in Port Talbot, is deeply problematic. It sits in a flood-risk zone, and according to Welsh Government’s own technical advice note 15 development policies, there should be no building of the scale of this prison on the land in question. It will do nothing to aid the sustainable development and improvement of the area, and so should be avoided. I understand that the designation of this land was changed from a C2 flood-risk designation to a C1 zone, so perhaps the Cabinet Secretary could clarify what the reasons for these changes are.
The site is in the middle of the Baglan industrial park, part of the enterprise zone, clearly earmarked for development of enterprise. This prison will not build on the entrepreneurial potential of the area, and one major local employer in advanced manufacturing has said they will seriously consider leaving the area if the prison goes ahead.
We need to have answers to questions about what we are supposed to do about prisoners who are released on probation and into the community. As far as I could see from a letter that was sent to the MP for the area, it was particularly why Port Talbot was chosen for this site, as opposed to other sites in Wales.
It’s also worth pointing out that the Welsh Government passed the Well-being of Future Generations (Wales) Bill to ensure sustainable development, which, at its heart, is supposed to emphasise developments that are beneficial for the long-term well-being of local communities. I fail to see how building this prison doesn’t fly in the face of that legislation. We are talking, amongst other things, of building a prison in the flood-risk zone in a ward in which 42 per cent of homes are at risk already.
This prison has also, at least for my party, become a symptom of the failures of the UK criminal justice policy: the failure to change course and focus on proper rehabilitation with a goal of keeping those who don’t need to go to prison out of prison. Instead, the superprison programme is intended to deal with as many offenders as possible in the cheapest possible way: prisons outsourced to private contractors where, then, there is a financial incentive for those companies to work against reducing the prison population. The UK Government is starting down the road of the United States and potentially igniting a problem that will be extremely difficult to eradicate in future: the beginnings of the UK’s very own mini prison industrial complex.
I have been encouraged by the cross-party nature of the opposition to the prison in Port Talbot, but—and there is a ‘but’—the Welsh Government needs to own up to what its angle is on the prison, because what’s truly perplexing is that a Labour Welsh Government, supposedly committed to the ideals of social justice, is backing this at all.
We also need to consider what kind of economic message this sends. The Welsh Government is content for Wales, is it, to import prisoners from other parts of the UK when we don’t need those extra places here in Wales. The Minister, the Cabinet Secretary, is shaking his head, and, if he wishes to intervene, then I will, of course, be happy to take that intervention.
The suggested site for the prison is part of the Port Talbot enterprise zone, which is owned by the Welsh Government and was created at the height of the steel crisis as an attempt to encourage business activity in the area. Boosting business, encouraging exports, and strengthening Wales’s heavy industry should be the Welsh Government’s priority for the area, but instead it has thrown its weight in support of the superprison, and, if it has not, then I would like to see clarification of that today. A prison—
Will the Member give way?
Thank you.
Could she allude to how we’ve indicated that we are supportive of the prison? What documentation has the Member got to show?
Well, I’d love to have more documentation, but what we’ve found out is that you have had conversations with the UK Government. You’ve given them a list of potential sites from Wales. As I understand it—and, again, I’m happy to be corrected—you did not need to give the Ministry of Justice that list. In fact, it would take them putting a compulsory purchase Order on that land, should it come to it. So, from legal advice I’ve sought from the National Assembly, there is no compulsion on you, Cabinet Secretary, to have given them that list. And, if I’m wrong, then, again, I’m happy for you to intervene or to tell me in your reaction to what I say here today. I also understand, from an e-mail I’ve seen from our local councillor Nigel Hunt in Port Talbot, that you have actually disposed of that land to the MOJ. So, again, if that is not correct, then please—. That’s an e-mail he, I think, has had with the local council. If that’s not the case, then, again, I’d like to have clarification. We are, of course, seeking to get answers wherever we possibly can. This is not an attempt to undermine anybody. We’re trying to get answers all along the way.
I’d like to end these remarks by saying I would like to praise the work of the working group in Port Talbot, which includes members of different parties—and everybody wants to work positively to keep this land for industrial development and business development—who are working together for the future of the town and for the future of Wales. And we do not want to have the scraps from Westminster in the guise of this huge prison, because I worry, and others worry—because they tell me—that this prison will have irreversible side effects on the area. We don’t want to have this prison imposed on us. In fact, people in Wrexham did not want to have the prison imposed on them, but they were told that there would be more spaces for Welsh prisoners, and yet we’ve seen articles in Welsh papers only yesterday telling us that there are not those Welsh prisoners in Her Majesty’s Prison Berwyn. So, what is the rationale, therefore, for building these superprisons in Wales? I’ll tell you what it is, but not in my words, but by a former prisoner interviewed by ‘The Guardian’—sorry, a prisoner, not a former prisoner—at HMP Oakwood in Wolverhampton. He says:
‘You pull [Wormwood] Scrubs down, you can make it into flats worth millions. Let’s cut the’—
beep—
‘That’s why they are doing it. It is easier and cheaper to warehouse everyone in Wales.’
That’s what’s happening.
I have selected the amendment to the motion, and I call on Suzy Davies to move amendment 1, tabled in the name of Paul Davies.
Amendment 1—Paul Davies
Delete all and replace with:
1. Welcomes the UK Government’s £1.3 billion investment to modernise and upgrade the prison estate across Wales and England, creating hundreds of modern prison places and replacing old and overcrowded establishments with new, fit-for-purpose buildings.
2. Recognises the Welsh Government’s role in promoting and earmarking the proposed site at Port Talbot for a new super prison in south Wales.
3. Calls on the Welsh Government to conduct a full and thorough consultation with local residents and businesses on the likely impact of developing a new prison in Port Talbot.
4. Believes a full exploration of alternative sites should be undertaken by the Welsh Government with a proposed list made public.
Amendment 1 moved.
Well, thank you, Presiding Officer.
A gaf fi ddatgan, ar gyfer y cofnod, fy mod, tan yn ddiweddar, yn ymddiriedolwr Teuluoedd a Ffrindiau Carcharorion, sydd wedi’i leoli yng Ngharchar ei Mawrhydi Abertawe, sy’n debyg o ddioddef yn sgil dyfodiad y carchar categori C newydd hwn, rwy’n amau? Efallai bod yr Aelodau’n gwybod hefyd fy mod wedi fy hyfforddi i fentora unigolion sydd mewn perygl o aildroseddu, ac roeddwn yn aelod o grŵp trawsbleidiol Christine Chapman ar blant yr effeithiwyd arnynt gan garchariad rhiant ynghyd ag Aelodau eraill yma.
Er nad wyf yn honni bod hyn yn rhoi unrhyw ddealltwriaeth benodol i mi mewn perthynas â’r ddadl hon, rwy’n teimlo bod yn rhaid i mi wneud sylwadau ar annifyrrwch peth o’r rhethreg ynglŷn â’r penderfyniad hwn i ddod â chyfleuster modern ar gyfer troseddwyr risg isel i fy rhanbarth. Oherwydd, lle bynnag y caiff ei leoli—ac mae gennyf feddwl eithaf agored ar hyn mewn gwirionedd—nid tomen sbwriel yw hon. Nid gwladfa gosbi ddiwydiannol ei maint ydyw—
Will you take an intervention?
No, I won’t. You ought to intervene on your party, actually, Leanne. You’ve worked in the probation service, and you’re allowing members of your party to talk about importing prisoners as if they’re some kind of toxic English commodity. I think it’s disgraceful. You have been absolutely right to criticise how careless tongues have dehumanised refugees and asylum seekers, yet I see no intervention from you on the casual way that you’ve allowed prisoners to be dehumanised in this debate on the new prison.
Our Victorian prisons also dehumanise people. In Swansea prison, the staff have tried very, very hard to mitigate pretty grim conditions, but the space just does not lend itself to rehabilitation. The facilities for prisoners’ families are better than they were, not least because of the work of FFOPS, which I mentioned earlier, but I suspect that most of us here would recognise that it’s far from ideal. This new facility—and there are three others to be built in England—is not a wicked alternative to prison reform—
Will you take an intervention?
Maybe at the end.
[Continues.]—and stopping re-offending, as Bethan Jenkins suggested in March and today. It’s incorrect. It is part of that reform.
Would you allow an intervention?
Can we just leave it at the end? I’m sorry. I will take it if I have time. I’m saying that this prison is part of stopping re-offending. These outdated prisons, with dark corridors and cramped conditions, will not help offenders turn their back on crime, and nor do they provide our professional and dedicated—[Interruption.]—I’ll come to that—dedicated prison officers with the right tools and environment to do their job effectively. [Interruption.] I’ll come to that.
In Parc prison, which houses higher-risk offenders, you will have seen how that modern environment lends itself to helping prisoners become more personally resilient and less likely to reoffend. We have been over and over the facts about the higher levels of mental ill health and illiteracy, of adverse childhood experiences, within our prison population, and it is in a modern, rehabilitative prison where many get their first genuine chances of help. It is wrong to characterise these so-called ‘superprisons’ as huge, un-nuanced spaces. It’s worth Members revisiting observations made by both the Cabinet Secretary and Mark Isherwood back in July, both having visited HMP Berwyn. They themselves have said that the site is made up of smaller human-scale units appropriate to targeted rehabilitation and education services, offered by expert third sector and other external organisations. I seem to remember that Coleg Cambria is in Berwyn, and I look forward to the detail of what will be the equivalent in this prison.
As for the site, yes, I think it’s right for both Governments to show their workings on this, actually. Is Welsh Government just so keen to push this forward so they can get shot of this piece of land at last? It’s been hanging around for years. It would be a mistake, I think, to ignore the passionate views about this. Some very useful points have been made by the group in Port Talbot, and I’m sure we’ll hear more today, notwithstanding that grubby tone I mentioned earlier. But I think it does help to have a fuller picture, and that’s why I moved the amendment as tabled.
I’d like my constituents to be fully and accurately informed, rather than making decisions on speculation in some cases. To this end, the Ministry of Justice will be holding a two-day event shortly to hear from residents directly—directly—to discuss face to face. That’s a chance to test concerns about the proximity to homes, for example, although I do recall the First Minister reassuring us on the same issue, as it affected the siting of Parc in the past. It’s a chance to test those additional demands on local services by prisoners and their families. It’s a good point, but, in the case of Berwyn, I think new money did follow to help meet that demand. It’s a chance too to test those claims that there’ll be between 200 and 500 jobs in this, as well as construction jobs. Because I think it’s actually a fair point to say that some of these jobs could be moving from other areas, but I’m not convinced that it’ll be all of them, nor that ancillary and supply-chain jobs—and certainly construction jobs—would come from outside the area. I don’t think it was the case in Berwyn, and the UK Government has stated a clear intention that as many jobs as possible will be local. So, I recommend that constituents take full advantage of this before responding to the statutory consultation, to which I also hope that they will really respond.
[Interruption.] Oh, sorry, I’ve run out of time.
We’ve all seen the economic and social pain that Port Talbot has suffered of late. I have to say that turning Wales’s industrial heartland into an industrial-sized penal colony is not the solution to years of neglect that that community has suffered. I want to concentrate in my remarks on the economic dimension, but I would say to the Conservative Member: look, it’s not humane to dragoon people—prisoners—and move them hundreds of miles away from their family. The evidence shows that rehabilitation is far less successful if people are moved hundreds of miles away from their families, and that’s what the superprison concept essentially represents. Let’s look at the real motivating factor behind this Conservative policy—[Interruption.] If you’d like to intervene on me, I’ll take your intervention. Let’s look at the real motivation. This is austerity—[Interruption.] All right, okay, I’ll take an intervention. Go on.
I’m looking forward to what you are going to say, but I hope you will provide evidence for what you are about to assert.
I’ll tell you this: what the real motivating factor is—. I’ll send you the—[Interruption.] I’ll send you the evidence. The real motivating factor is this: it’s austerity meeting inhumanity. The Government’s own forecasts have shown that HMP Berwyn is going to be the cheapest prison to run in England and Wales. That’s effectively what it is. It’s a big box, but for people. Where is the humanity in that? What we are doing, effectively, is that we’ll be the only country in the world that’s going to be importing prisoners from another country. It’s not good for them, it’s not good for anyone, and the evidence shows that. We are turning the south Wales of now into what New South Wales was 200 years ago. And this allusion that is put about, that this is going to be good for the local economy Port Talbot, it’s completely fallacious, completely dishonest, as the UK Government has admitted. Look, the real driving force here is you’re building the superprisons in order to shut the Victorian prisons. So, 200 jobs in this superprison in Port Talbot, and 600 jobs lost in Cardiff and Swansea. You don’t need a Fields prize in mathematics to work out that that’s a net loss. To put it another way, effectively, there’s your lacklustre response to the steel crisis, and you’re now expecting us to actually celebrate the fact that there’s going to be a net loss to the south Wales economy.
Now, I have to say to the Welsh Government, we’ll listen to what the Minister has to say. There has been an offer by the Basque aluminium company for this piece of land in the Baglan enterprise zone, which was set up as part of the response to the economic crisis. Take that offer. There is a company that is a successful company, which wants to expand and is obviously part of a cluster in terms of metals and materials in that area. So, there’s no actual reason why that offer should be refused. Take it now. Announce today that that offer is going to be accepted.
I have to say, though, that I heard earlier today the comments that the honourable Member—I’m allowed to say that about a Member of the House of Commons, aren’t I?—for Aberavon, Stephen Kinnock, or, as I shall now call him, ‘the grand archduke of Nimbyism’, saying that, actually, it would be all right as long as the prison was moved from Port Talbot to down the road in Swansea. His attitude seems to be that it’s not that he’s against a superprison in south Wales; it’s rather a case of ‘not in my business park’.
Let’s reiterate: Wales does not need superprisons as part of our economic strategy. It’s not good for the prisoners themselves, who should be rehabilitated in their communities. And if they are low-risk prisoners, they should be in the probation service. But, of course, you privatised that, didn’t you? The fact is that it’s not good for our economy. The numbers that have been offered to us in terms of jobs, they’re worthy of the side of a big red bus. And I would say to the Welsh Government: please, the reason we have a Welsh Government is, when the Westminster Government says jump, don’t ask ‘how high?’ When we actually believe that this is not the right way for us as a nation, then we should say so unequivocally, with one voice. We are better than this. The people of Port Talbot deserve better this. Let’s say ‘no’ to this pathetic excuse for an economic policy and social policy that actually should mean that you hang your heads in shame.
In opening this debate this afternoon, the Member for South Wales West established several threads within the discussion, including the effectiveness of superprisons in reducing reoffending rates and offering inmates a safe environment for rehabilitation, whether Wales needs more prisons, and the unsuitability of this site in Baglan for the new prison, as announced by the Ministry of Justice on 22 March. At present, some of these issues are not devolved to the Welsh Government, but the ownership of the land being proposed, and thus the impact of the development, is within the Welsh Government’s control, and as the constituency Member for that site, it will come as no surprise to Members in this Chamber that I will focus on the unsuitability of the location and the impact the development would have on my local community.
However, I will raise my concerns over the effectiveness of the approach of the UK Government of building more superprisons to replace overcrowded Victorian prisons as a means of achieving its goal of reducing reoffending rates. I struggle to find any evidence, empirical evidence, that they actually do reduce reoffending rates as a result of any improved rehabilitation within them. So, surely, the Ministry of Justice would be well served by taking time to analyse the effectiveness of the superprisons it already operates—HMP Berwyn, and HMP Oakwood in Birmingham—before it goes ahead with its cost-saving plans for more. In fact, there is greater evidence out there that there are known problems with large prisons. Even as far back as 1991, Lord Woolf demonstrated the problems, further demonstrated by a study by the chief inspector in 2009, and more recently in a damning report on HMP Oakwood. The Welsh Government should reflect on these, and the social impact upon both communities and inmates prior to any decision they will make upon the sale or lease of the land within its ownership for development of a superprison.
Llywydd, I will now move on to the unsuitability of this site and why I’m calling for the Welsh Government not to release this land to the Ministry of Justice for this new prison. In her opening remarks, Bethan Jenkins highlighted many of the challenges to the arguments used by the MOJ for this decision, including many that needed consideration in the planning process. I concur with those and will expand upon some, but I won’t have time to do them all, unfortunately.
Let’s start with the argument for the economy, as already outlined by Adam Price in one sense: one that implies that the MOJ thinks that Port Talbot will take any jobs, no matter what. Well, we do need to diversify the local economy, and we need to improve labour market indicators—GVA and unemployment. But this proposal will not do that. This site is within the Port Talbot waterfront enterprise park and an area that has been earmarked to help the economy grow by encouraging existing businesses, or new businesses, to invest in growth.
Will you take an intervention? I just wonder if you can clarify whether this land has been designated as where the Swansea metro is due to pass through, and therefore if we were to put a prison onto this site, that would obviously have smooth implications for the smooth running of the Swansea metro.
I thank the Member for that. I actually can’t give the answer, but it’s an interesting point we can add to the list of questions we will be asking.
We already have businesses saying they will move out. Now, moving out means they’re not coming in, and therefore we’re losing business to the economy. The MOJ claims this prison will bring new jobs to local people—numbers, by the way, that they can’t confirm. Never mind the 200, they actually can’t confirm, because they’ve said to me they don’t know how many until they know which operator. Well, that operator could be a private operator, so they haven’t got a clue. By the way, if it’s a private operator, the Labour Party manifesto in this year’s general election actually stated we should not be involved in building any more new private prisons.
The reality is Swansea and Cardiff, both Victorian prisons, will close, and those jobs will be transferred to this site. That means no new jobs, actually, but people coming in, but they won’t necessarily move into the area. Supply chains will also go with them, so no supply chain jobs coming in. Once operational, there will be no growth. This will not meet the objectives of the enterprise zone of bringing growth to our economy. What will bring jobs are new industrial units to attract other businesses to come in and to invest in We haven’t got units of 5,000 to 10,000 sq ft; let’s get them in. Why not do the same here as for other areas of Wales and establish a strong offer for businesses?
Cabinet Secretary, I have actually asked the Welsh Government for published evidence to support the claims of economic prosperity from building a prison, and I hope that we will get some, because I haven’t had any yet. Can I also ask the question of whether the Welsh Government has had discussions with the chair of the enterprise zone board and if he is in favour of this proposal?
Cabinet Secretary, also, the history of this site is known to local people, including myself. I can remember when ponies were walking across it as a marshland. We can all tell you that this location is the wrong site for this development. My call to you now, and in the future, will be, ‘Don’t sell this land, or lease this land, to the MOJ’.
Now, another question is the claim that the prison will offer inmates preparation for following release. Wonderful, but that preparation will include work placements. How many businesses are actually being approached and asked whether they will take this opportunity? I can tell you: none. How can reform work if a basic analysis hasn’t been undertaken into delivering rehabilitation? The whole economic and rehabilitation premise of this development is flawed.
Llywydd, I know there’s little time, and, in concluding my contribution, I ask the Cabinet Secretary: if prisons were devolved to Wales, would the Welsh Government build a superprison in the heart of a community on such flimsy evidence? I sincerely hope not. There’s clearly no justice coming to Port Talbot from the Ministry of Justice. Instead, I ask the Welsh Government to deliver it and say ‘no’ when asked to sell or lease the land to the MOJ. Set our economy as the priority, and not the MOJ’s desire to save money.
It’s a pleasure to take part in this debate. I’m grateful to follow David Rees’s strong contribution there, because obviously it was a shock to us all when Carl Sargeant, the Cabinet Secretary, announced the intention to build a superprison potentially housing 1,600 prisoners in Baglan earlier this year. We did not see it coming. Welsh Government obviously were not involved in any discussions prior—
Will the Member give way? I don’t wish to disparage anything, but, just for clarification, actually the announcement came from the MOJ, not Carl Sargeant. I don’t want to defend him, but it was theirs, unfortunately.
I’m grateful for that clarification, David, but I was expressing my sense of shock when we had the statement from the Cabinet Secretary that day back in March. Granted, the decision—more of that later on—was not the Cabinet Secretary’s; he was merely the conduit of it here, but it didn’t lessen the shock that some of us felt. But I’m grateful for your intervention anyway.
Up to that point, obviously, I hadn’t detected a popular groundswell of public opinion wanting a prison in Port Talbot, I’ve got to say. No public clamour at all. There was, and is, public clamour for a tidal lagoon in Swansea bay, there is public clamour for electrification of the main railway line from London to Swansea, but a superprison in Baglan—public clamour came there none.
Now, of course, this unexpected announcement—via the Cabinet Secretary—came about because obviously policing, crime and justice are not devolved to this National Assembly for Wales. Westminster can announce things and that’s it. Yet, policing is devolved everywhere else, obviously: Scotland, Northern Ireland, London, Manchester even, but not Wales. And this isn’t just an argument about powers for its own sake, but, in terms of criminal justice, the need to tackle the revolving door of reoffending, as alluded to elsewhere, is paramount.
This deficiency cuts across that. To try and prevent offenders from reoffending, a concerted, co-ordinated response is required across all public services and local voluntary and charitable institutions. Because, for offenders leaving prison, we need housing, housing for people on their release; we need education and training possibilities; we need general health services; we need mental health services; we need drug and alcohol treatments; we need social services support. All of these already overstretched services are devolved to Wales. We manage them from here. Co-ordination with policing, probation, criminal justice and prisons, which are not devolved, is very difficult therefore, which is why we can just have this sudden announcement, whoever announced it, wherever—and I’m grateful to the Cabinet Secretary for that announcement back in March.
But because criminal justice and prisons are not devolved, this is how we can have this sort of announcement, and are we expected to pick up the pieces with our devolved services already overstretched here in Wales? Because preventing reoffending is already a very difficult task. Persistent reoffending rates are a testimony to all of that. But in the end, this superprison is not needed. There is no popular public clamour out there for it. It’s not welcome. Vote for the Plaid Cymru motion. Diolch yn fawr.
My view regarding the potential building of a prison in Baglan, Port Talbot—and I live in Port Talbot—has always been that public consultation is extremely important, along with risk assessments, environmental factors—for example, traffic congestion—and, as previously mentioned, flooding in the area. We must also take into consideration alternative suitable sites. But should the above criteria be passed and the green light given, we have to accept that prisons are permanent features of our society. What alternatives are there to imprisonment? We’re open to suggestions.
A custodial sentence is often the last resort by judges where reoffending has occurred or the crime has been too serious. And where there is crime, there is a victim. Try telling a lady who’s been the victim of domestic abuse with a broken nose and broken ribs that we are looking for an alternative to prison for the offender. There will be public outcry. The victim of a crime needs to feel safe and secure in their community. Taking a perpetrator out of society for a period of time gives the victim peace of mind and the perpetrator a chance in prison to rehabilitate.
If prisoners are locked up in cells 23 hours a day, there is very little chance of rehabilitation happening or of it being successful. My work in HMP Parc concentrated heavily on rehabilitation. Prisoners are not locked up 23 hours a day, but were actually out for 14 hours a day, as per contract. A typical day would be: breakfast at 7 a.m., exercise and shower; prisoners then went to various groups: education, industries, work, court discharges, visits with family. The industries provided horticultural work, woodwork, metal work, printing, to name just a few. With regard to rehabilitation, there is a family unit, which concentrates on building family life following crime and provides mediation with that family. There is an armed forces unit, particularly for PTSD, drug and alcohol issues and family breakdowns. Some also train—some prisoners train as listeners and work with the Samaritans. They then leave prison, and many have gone on to become councillors. The health and wellbeing unit assists with disabilities and concentrates on how to improve lifestyles, make changes to benefit health, learning about nutrition, dealing with obesity, prevention of diabetes and so on. There is a healthcare unit for poor copers with mental health issues; there is a voluntary testing unit for people who have taken drugs but have quit and wish to be tested randomly to make amends to their family and contribute positively to society. D block is a pre-release block, which links up with probation. A jobs fair is held every six months and prisoners meet with prospective employers on this unit. Prisoners are released into the community prior to release for a day now and then; this is not a new concept. When prisoners are released permanently, where do they go? They go back into the community with as much preparation for this release as is possible, and day release is important. Some prisoners have been fortunate and were selected from HMP Parc for the merchant navy. So, there are positives of rehabilitation that are not being portrayed here.
One of my proudest moments was after handing a prisoner who was from a travelling family his mail. He tore it up in pieces and threw it at me like tiny confetti. I told him someone had taken time to write it, and perhaps he should have read it first, and would he now mind cleaning it up. He cleaned up his mess and went back to his cell. He explained later in a one-to-one that he could not read at all, hence the reason he always seemed to be breaking rules; he couldn’t read the policies, could he? Initially, I helped him on a one-to-one, and later he joined a class. After a year, he proudly took the letter from his mum and read it to me.
The prisons in Wales are always at full capacity, which can lead to overcrowding. Some Welsh prisoners end up in England, making visiting impossible. Therefore, if we are to successfully rehabilitate and integrate offenders, then surely family visits are of paramount importance. There is also the employment factor to consider: employment within our steelworks has been drastically reduced in Port Talbot and many people would welcome the opportunity to retrain. It is not just prisoner officer jobs; there are non-operational roles: catering, healthcare, to name but a few. Money spent outside will boost the economy. During construction, it would be great if Welsh steel was used and local labour also provided. Due to opportunities at HMP Parc, many have left and now lead former productive lives upon release. However, private contractors are not tendering for prisons, and therefore, I suggest that the inference that this is a lucrative business is slowly going down the pan. Yes, we can look at the positives and negatives of tagging as an alternative, but, at the end of the day, if we are having a prison, public safety is of paramount importance, as is the safety of staff and prisoners, and any prison must be properly resourced to bring about successful rehabilitation and safety of staff. Thank you.
I am very uncomfortable with the proposal to build a large prison in Port Talbot and with the political games that are accompanying it. I don’t buy the argument that this is a non-devolved issue. This is about the type of country we want Wales to be, and Monday’s announcement of a commission on justice in Wales, led by Lord Thomas of Cwmgiedd, the current Lord Chief Justice, offers us an opportunity to have greater devolution of the judicial system in Wales and also to have the debate about the kind of picture that Welsh justice looks like. I’d like to see a prison system that doesn’t warehouse people but focuses on rehabilitation. That is my strong instinct, but in reflecting on what to say in today’s debate I looked at some of the evidence, and the evidence is mixed. I think we do need to weigh the importance of keeping prisoners close to their families with the other evidence that shows that separating offenders from their peer group can help with the cycle of reoffending. Evidence shows that prisoners in newer prisons have better outcomes than those housed in older prisons, and this is a much bigger factor in recidivism than the size of the institution. Many argue that larger prisons are too impersonal to support effective rehabilitation, whilst others argue that the economies of scale provided by larger prisons mean better and wider training and employment facilities can be provided. So, the evidence is mixed.
The economic case isn’t clear cut either. People argue—
Will you take an intervention?
I’d be happy to give way.
I appreciate your point that the evidence is mixed, but I haven’t yet found any evidence to show that larger prisons actually reduce reoffending rates. I think that’s the crucial element here. They’re arguing that it does, but yet I haven’t found the evidence that it actually does. It might be approaching it, but I haven’t seen the evidence yet.
As I said, I think the evidence is mixed. There’s conflicting evidence on the point and, as I said, my personal prejudice is against superprisons. I chaired a public meeting in Wrexham at the time of the debate there, and did some work to oppose the prison in Wrexham. So, that’s my strong inclination. However, to be fair, we’re looking at the evidence, it’s not a clear picture, and I think we need to spend more time establishing the true picture and our position on it.
As I was just about to say, the economic case isn’t clear cut either. People argue the megaprison will bring new jobs both in the construction and in staffing required. But, as we’ve previously discussed in this Chamber, without reform to procurement rules, projects of this size often see jobs imported from outside the area, and if Swansea and Cardiff prisons close then the job impact will quickly disappear.
We’re also selling off this land like it’s got no other worth or potential, and, as Jenny Rathbone has already indicated today, there are indications from Mark Barry’s blueprint—his version of the south Wales metro network concept, which I think is an exciting vision—that this land could well be an important part of reducing journey times between Swansea and Cardiff and beyond. So, that should also be a key factor. Now, that again is at an early stage and we’re not clear how that will develop. So, I think we need to deal with these issues before we sign off this deal. Until we have this debate—crucially, the debate about the type of country we want to see and the justice system we want to see—in passing—[Interruption.] I’m just closing; I’m sorry, Leanne.
Is it a ‘no’?
It is a ‘no’, I’m afraid. I do apologise. [Interruption.] Until we have the debate about the sort of justice system we want to see in Wales, then it’s premature to pass this motion and I will therefore not be supporting it at this time.
I call on the Cabinet Secretary for Communities and Children—Carl Sergeant.
Thank you, Llywydd. I’ve listened carefully to today’s debate, but the Government will be opposing both the motion and the amendment as laid.
I must start by setting the record straight on the actions and powers of the Welsh Government, and some of the contributions that were made in the Chamber today. Responsibility for prisons lies with the UK Government. The Welsh Government was approached by the Ministry of Justice as part of an exercise across England and Wales to see if we knew of any land that could be developed for this scale of prison. We supplied a list of 20 sites. We regularly provide a list of this type—[Interruption.] In a second I will, Dai. We regularly provide this type of service for all businesses and all developers.
I thank the Cabinet Secretary for taking the intervention. I appreciate that the Welsh Government provides that service for all businesses, but in your response to me in May you highlighted the criteria the MOJ supplied you for sites. One of them was that it shouldn’t be a flood plain, and yet you supplied a site, which is this particular site, which is on a flood plain. Could you tell me why that site was supplied?
The details around that would be a general principle that there are mitigation measures that all businesses can react to in terms of flood plains and flood developments, and it is certainly not unusual for us to provide opportunities of land usage for all businesses, as I said. That choice is by the developer then, if they wish to pursue to develop or otherwise.
The Ministry of Justice expressed its desire to proceed with a planning permission application for a prison facility at Baglan in Port Talbot. We were not part of the decision process that selected Baglan as a preferred site.
Will you take an intervention?
One second. The Government is not playing a role in developing the prison or a role in the community. We may comment on the proposals when they become available.
Llywydd, we have granted the Ministry of Justice two licences to carry out work on that land. These include ecology mitigation measures and, again, this is normal practice. Developers want to know what the make-up of the land is prior to putting in a planning application. We have also been asked by the Ministry of Justice to discuss an option agreement for the land. We have not sold the land to the Ministry of Justice or come to an agreement regarding the sale or discussed the value. It is not a fait accompli as many have suggested in here and externally, as we’ve heard. If alternative offers for the land come forward, there is nothing to prevent us from assessing the economic benefits of that and accepting a good offer.
As you’ve specifically referred to it, have you entered into the option agreement with the MOJ that you just referred to?
What I said was we have been asked by the Ministry of Justice to discuss an options agreement about the land, but we have not sold the land or discussed an agreement on the sale or the value of the land.
You haven’t entered into the option agreement, then.
No, we haven’t. I’m happy to take an intervention.
I just wanted to clarify, because you said you hadn’t been part of any decision-making processes. But on 28 June, in communities questions in response to my question on the prison, you said your department have been, and I quote, involved
‘in terms of deciding and offering sites that were available right across the south Wales region’.
So, you were either involved in deciding or you weren’t, Cabinet Secretary.
Sorry, I think that the play on words or interpretation of what I said—. If I may clarify that position, as I have just done today, we have offered 20 sites across the south Wales region, as we would do for any business or any other developer. That is not unusual for the way Governments do business. I think—. Dai, did you want to intervene?
Not at this point.
Okay.
I do. [Laughter.] I just wondered if you could clarify why, if this area has been designated as suitable for installing a Swansea metro—why, then, the Government offers it up as a possible site for building, as that seems to be in contradiction.
Well, respectfully, these are matters for the Ministry of Justice. This is not in our ownership—[Interruption.] This is not our project. This is of the Ministry of Justice. What we do welcome is the Ministry of Justice’s intention—[Interruption.]
Allow the Cabinet Secretary to continue, please. He’s taken many, many interventions. Allow the Cabinet Secretary to continue.
I’m very grateful, Llywydd. I took about five interventions. We welcome the Ministry of Justice’s intention to hold a two-day community event that will give visitors and residents the chance to see and comment on the proposals before a formal planning application is made. And I’ve heard many contributions from Members in the Chamber this afternoon, which are all valid conditions around planning, and they should be consolidated and given as evidence in that process.
Llywydd, we call on the Ministry of Justice to make sure that there is full and genuine consultation for the communities that are represented by Members here today. If a planning application is received by the local authority, then residents will have the opportunity to engage with that planning process and I would encourage them to do so. Prison policy is not, as I have said, a devolved matter, but I’d like to share some thoughts on the wider questions posed here today.
I understand that there are not enough places here for the number of category C, low-risk prisoners in south Wales. It had also been suggested that a new prison would deplete local health and education budgets. Let me make it quite clear: as at HMP Berwyn, these services will only be made available if sufficient funding is secured from the UK Government to do so.
I don’t think anyone would disagree with the Ministry of Justice’s wishes to replace ageing, ineffective prisons—as Caroline Jones referred to—with modern, fit-for-purpose facilities in which a rehabilitation culture can be successfully developed. The prison estate and its management are matters for the Ministry of Justice and Her Majesty’s Prison and Probation Service. I would oppose sending anyone to prison unnecessarily. Equally, however, we do need to protect our communities from harm, and prisons clearly have a role to play in that. Dai Rees.
I thank the Cabinet Secretary for allowing me the intervention. I appreciate that the prison estate is the responsibility of the MOJ, but in this particular case the land is owned by the Welsh Government and, therefore, it’s a decision for the Welsh Government on the social needs as well as anything else. And particularly as we have the possibility of Swansea and Cardiff closing because they’ve been claimed to be Victorian prisons, and the UK Government’s policy is clearly to shut them, we could end up with a situation where there are two major prisons within 10 miles of each other and, therefore, it’s not actually serving the social needs of the inmates and their families in other parts of south Wales.
Respectfully, to the Member, I think what we should remain to do is stick to the facts. We are making many assumptions about what’s happening here. The two-day event held by the Ministry of Justice with your community is an important process where you can ask those questions effectively, which, I hope, will be answered accordingly by the Ministry of Justice.
Llywydd, the issue in regard to the prison estate, as I mentioned earlier on, is a matter for the Ministry of Justice. These are not decisions for us to make, but before we flatly oppose a modern prison we should think about the cost of that to Welsh prisoners, their families and not least the communities to which they return on completion of their sentences. Even prisoners and their partners, families and children should not have to visit them in institutions that cannot fully respect the human dignity of both prisoners and their families. I think we should ensure that for all.
The Ministry of Justice anticipated, when operational, this development will create around 500 new jobs and inject around £11 million a year into the local economy. These are certainly issues that should be taken up with the Ministry of Justice. As Dai Rees has said, he wants to see the evidence around that, and I think it’s a fair question to ask. There is a significant amount of alternative land allocated for employment use in the area. I refer Members to the local development plan. The Welsh Government has and will continue to make a comprehensive support package available for companies in Neath Port Talbot that wish to expand and grow. As we oppose, in the amendments, in the last two years we’ve offered nearly £1.5 million to nine companies in that area, as well as £13 million across the Tata Steel estate.
Llywydd, I recognise the need to move on, but as regards the flooding issue, as Members asked earlier on, it will be up to the Ministry of Justice—
Will the Cabinet Secretary take an intervention?
The Cabinet Secretary is well over time already. I do understand that you’ve taken several interventions already, but if you bring your contribution to an end, then you won’t need to take any other interventions. [Laughter.]
I’m very grateful for your advice, Llywydd. Just in regard to the flooding issues, it would be up to the Ministry of Justice to make a case through a flood consequence assessment as that process moves forward. The motion and amendments, in different ways, invite you to endorse misleading accounts of the role and actions of this Welsh Government. We’ve not chosen the site. The proposal will be subject to a full planning process. The Ministry of Justice decides to proceed or not, and the Welsh Government will continue to work to promote the economy in the area. [Interruption.] I urge Members to reject the motion and the amendments today, Llywydd.
I call on Bethan Jenkins to reply to the debate.
Well, if anything else, I’m glad we’ve had a fiery and engaging debate for those of us who have wanted to have that debate today, but I must say that I am disappointed with the reaction of the Cabinet Secretary because we’re in a week where we’re discussing devolution and the powers that we have. Sometimes, even if you don’t have the powers in your grasp, you have the moral authority to change things as a Cabinet Secretary. You have the power not to release that land to the MOJ. There may be processes that business follows, but you don’t have to always follow that process. You do not have to give the MOJ that list of different pieces of land for them to develop—[Interruption.] Well, they don’t simply have to do that, so do you—? I would like for you to intervene on me, Cabinet Secretary, because you were shaking your head when you said you hadn’t taken an opinion. Do you support this prison? So, then we can actually have you on the record saying if you do or not, because I’m still not sure. Carwyn Jones as First Minister seems to be happy for the prison to come to south Wales. Are you in favour of this prison?
Well, the Member clearly didn’t listen. You said earlier on that this isn’t about politicising this, which is exactly what you and your colleagues have started to do. This is—[Interruption.]
Allow the Cabinet Secretary to intervene. Carry on, Cabinet Secretary.
I’m very grateful for your advice, Llywydd. The issue for us is if an offer comes into that land base, as I said during my contribution, it’s still open for offers from other businesses. We haven’t fixed an opinion on whether the prison should go ahead or whether other business should go ahead. That is completely normal business.
So, will you therefore—? Envases, as Adam Price said, the company by that site, has said that they would be interested in purchasing it, and it’s been empty for so much time. Why have you not invested in this land prior to now? Because it’s on an industrial park, it’s your obligation to do that. I said—I didn’t say we wouldn’t be political; I said we are working cross party, and we are working with Members of your own party in Port Talbot who are opposing this development, and I would gladly carry on working with them for as long as we can in this regard. I won’t have time to go through everybody’s comments, but I do take issue with some of the comments from Suzy Davies, who is usually quite progressive, as opposed to being a mouthpiece for the Conservative Party on a UK level. I mentioned, many times, about rehabilitating prisoners. We do not want—. I speak to prisoners about this and they themselves say they do not want to have a superprison, that that does not aid them. They call them ‘warehouses’, they say they are churned in and out of the system. That is why we are fundamentally opposing this.
I’m not sure that it’s worth going through all comments, but I did think that it was important to hear what Lee Waters said in relation to a justice commission for Wales, but we know that Labour MPs on a UK level have opposed criminal justice being devolved to this place, so I would hope, through this justice commission for Wales, that we can see those MPs changing their minds. I hope that David Rees, as the local Member who spoke so eloquently here today, will be supporting the Plaid Cymru motion, as I hope other Members of your party will, because you spoke strongly as to why this area should be used for economic development, and why, from research you’ve done and others have done, that you cannot find strong reasons as to why a superprison should be built in Port Talbot. So, I look forward to working with you further on that.
I will bring my comments to a close, but this is not about trying to alienate or to talk down prisoners. We all, in this room, know how we want to support them and rehabilitate them, and we all have people who come to us in our communities to say how that should be done. But privatising the probation service is not going to help aid that process either, and I think we all have to work together to ensure—[Interruption.]
I can’t hear Bethan Jenkins. Can I hear Bethan Jenkins’s final contribution?
Adam, do you want to make an intervention? [Interruption.] I’m going to pull this debate to a close, and I thank everybody for such a lively debate if nothing else.
The proposal is to agree the motion without amendment. Does any Member object? [Objection.] I will defer voting on this item until voting time.
Voting deferred until voting time.
And that brings us to voting time, and the first vote is on the Welsh Conservatives debate on community health councils. I call for a vote on the motion tabled in the name of Paul Davies. Open the vote. Close the vote. For 16, no abstentions, 37 against. And therefore, the motion is not agreed.
Motion not agreed: For 16, Against 37, Abstain 0.
Result of the vote on motion NDM6505.
I now call for a vote on amendment 1, tabled in the name of Jane Hutt. Open the vote. Close the vote. In favour 28, no abstentions, 25 against. The amendment is therefore agreed.
Amendment agreed: For 28, Against 25, Abstain 0.
Result of the vote on amendment 1 to motion NDM6505.
I call for a vote on amendment 2, tabled in the name of Rhun ap Iorwerth. Open the vote. Close the vote. In favour 53, no abstentions, none against, and therefore amendment 2 is agreed.
Amendment agreed: For 53, Against 0, Abstain 0.
Result of the vote on amendment 2 to motion NDM6505.
I now call for a vote on the motion as amended.
Motion NDM6505 as amended:
To propose that the National Assembly for Wales:
1. Notes the Welsh Government’s White Paper—’Services fit for the future’, which sets out a range of proposals to strengthen quality and governance in health and care services in Wales.
2. Notes that a single national community health council in Scotland was regarded as not sufficiently independent of government by the Scottish Parliament’s Health and Sport Committee.
Open the vote. Close the vote. In favour 28, no abstentions, 25 against. Therefore the motion as amended is agreed.
Motion as amended agreed: For 28, Against 25, Abstain 0.
Result of the vote on motion NDM6505 as amended.
The next vote is on the Plaid Cymru debate on superprisons. I call for a vote on the motion tabled in the name of Rhun ap Iorwerth. Open the vote. Close the vote. In favour nine, three abstentions, 41 against, and therefore the motion is not agreed.
Motion not agreed: For 9, Against 41, Abstain 0.
Result of the vote on motion NDM6506.
I now call for a vote on amendment 1, tabled in the name of Paul Davies. Open the vote. Close the vote. In favour 17, no abstentions, 36 against, and therefore amendment 1 is not agreed.
Amendment not agreed: For 17, Against 36, Abstain 0.
Result of the vote on amendment 1 to motion NDM6506.
Now a vote on—no. Nothing has been agreed, either the motion or the amendment. Therefore, that brings voting time to an end.
We now move to the short debate, and if Members who are leaving could do so quietly, I will call the short debate in a few moments’ time.
The short debate, therefore: Huw Irranca-Davies to speak on the topic that he has chosen. Huw Irranca-Davies
Diolch, Llywydd. In opening this debate, could I just point out that I’ve agreed for Suzy Davies to speak in it, and Dai Lloyd also? So, in opening this debate I’m putting a request to the Cabinet Secretary this evening for his help in resolving a long-running issue affecting primary care in Llanharan, Brynna and the surrounding area. The request isn’t made lightly. I’d prefer not to do it. It’s made out of some frustration after the continuing efforts of concerned local residents and community activists, community and county councillors, myself and others, to find a way forward over the last 18 months, and I’ve personally invested a significant amount of my time and that of my office team to find progress, and I know that councillors like Geraint Hopkins and Roger Turner, community councillors like Chris Parker and others have worked diligently behind the scenes as well.
The Deputy Presiding Officer took the Chair.
A brief history of this matter would be of help. Around 18 months ago there was a sudden and unexpected change to the service provided to Llanharan and Brynna residents by the local Pencoed Medical Centre. There had long been a so-called satellite GP branch surgery provided in Llanharan and Brynna under contract by the Pencoed Medical Centre, which the residents would say is no substitute for a medical centre of their own serving the ever-expanding communities of the Llanharan area. It did at least provide a reasonable and appreciated service for those elderly and other patients who did not have their own transport or for whom public transport was difficult or along with taxis too expensive, or those who were time constrained through work or other commitments. I should also point out, by the way, that this is no criticism of the clinicians and the other staff at Pencoed Medical Centre, and the care they surely, of course, want to provide to all their patients wherever they reside. This is a criticism of the structures and the funding steams that seem to get in the way of seamless patient care, not least when, as in this situation, the patients and the practice fall into two different health authority areas.
But those changes 18 months ago brought in a noticeable and instantly noticed reduction in the hours of GP provision in this branch satellite service. The change, as I say, was sudden, and unexpected. Many patients were taken by surprise. Understandably, many residents were deeply concerned at what seemed like a shock withdrawal, or at least a significant diminution of services to those who did not find it easy to travel to Pencoed. A public meeting was organised in response to these concerns. Well over 100 people attended that meeting and—I don’t use some kind of Trump inauguration exaggeration here—the corridors were lined with people trying to hear what was being said within. In addition to local residents present, there were councillors and community councillors, regional and local Assembly Members, the Member of Parliament, Chris Elmore, representatives of the Pencoed Medical Centre, ABMU, the community health councils and others. But this was no lynch mob; they were trying to get the facts of what was happening and what was clear then and is clear now is that the administrative border that separates ABMU and Cwm Taf is a real and pressing issue. Perhaps the recent proposal that the eastern side of ABMU and Cwm Taf health authorities be merged may help resolve this issue, but we can’t wait forever.
The Pencoed Medical Centre sits within the ABMU region and patient funding is through ABMU, yet, through historic service patterns, whilst the majority of the patients in Pencoed go to either the Pencoed medical practice or to the other neighbouring one, a significant proportion of its patients—in fact, the majority, I understand, of those patients at the Pencoed Medical Centre—fall within the Llanharan and Brynna areas, which lie within the Cwm Taf catchment. You can see the cross-border problems that arise with funding flows.
Pencoed Medical Centre, in reducing its service, is simply working to the detail of its contract—no more, no less. A health board cannot insist that they provide a certain service. The financial incentives need to be aligned with patient needs and, to be fair to Pencoed Medical Centre, there is a logic to the argument they put that investing in enhancing the service provided at Pencoed is better for all patients who can attend there—who can attend there. But those branch surgeries in Llanharan and Brynna have long satisfied the requirements of older and less mobile individuals who find it simply difficult to attend the Pencoed Medical Centre through constraints of cost, health, transport or time.
Over the last year, I’ve spoken with the medical centre and I’ve suggested to ABMU that they offer the medical centre some additional funding that could help in the short term to restore, or partially restore, the original level of service to Llanharan and Brynna branch surgeries. It would go a long way, Minister, to soothing the continuing discontent. So, I would be really grateful for the Cabinet Secretary’s assistance in seeking clarifications on the reasons why the original service at Llanharan and Brynna, or something like it, cannot be restored to assuage those current concerns, especially if additional support has been offered by ABMU, as I understand may indeed be the case. I fully understand that the discussions between a private medical practice and a health board can be delicate, that some commercial confidences must be protected, but I do believe that local people, including those who attended the original meeting, deserve a frank report on what efforts have been made by ABMU and the Pencoed medical practice to respond to their concerns. I think people would be, frankly, disappointed if it were found that support had been offered that could restore the service and alleviate those concerns, and that such support had been declined for whatever reason.
Before I turn to the larger strategic issue, let me just strengthen the case in two significant ways, knowing that evidence-based policy is good policy indeed and that the Cabinet Secretary would support that. I was delighted that the community health councils, at our instigation, got together to look at the issues of patient satisfaction among those who attended the Llanharan surgery and the Brynna surgery—fascinating what they found. I have to say that, overall, the patient satisfaction with the Pencoed surgery was 65 per cent—those who said that they were satisfied to some extent or another. But 65 per cent of those who attended the Llanharan and Brynna surgeries were dissatisfied. It’s quite fascinating. The majority of patients—65 per cent—generally happy with the overall experience that they received from the practice overall, but 65 per cent attending the Llanharan branch surgery were dissatisfied with opening times. The majority of people in the Llanharan area, it says in the report, are unhappy with the opening times; they saw it as inequitable. It caused particular difficulties, the community health council was told, for working people and those who needed to collect prescriptions. Few patients reported travelling to the further surgery, however, when they did this, it had an impact on travel arrangements. More people needed to secure lifts from friends or family or community transport, and some had to rely on taxi services. And people expressed frustration about what I referred to before, about the care pathways associated with being registered with an ABMU practice. These comments were made by patients across the practice footprint, who felt it would be more convenient to streamline the process that was currently causing problems.
And they made recommendations, Cabinet Secretary. They identified a need for rejigging the appointment system, and that is going on at the moment. It’s causing some issues with settling in, but there is a change going on at the moment with the practice. But, they said the practice may wish to look again at the provision offered at the Llanharan branch surgery, to ensure that services are organised to best meet the needs of the population, and this might include providing some later appointments. That is what used to happen. That’s why people can’t get there anymore. The practice may wish to explore alternative ways for Llanharan patients to access prescriptions, possibly by working with local pharmacies, instead of going all the way to Pencoed, and so on. And Cwm Taf UHB should consider if boundaries of nearby practices could be extended to offer residents in the Llanharan area a choice of accessing a Cwm Taf practice. They made specific recommendations. It would be great to see if we could act on those.
But, let me go further, because the other aspect is the massive growth in the population of the Llanharan and Brynna area. In the 10 years from 2005 to 2015, the Llanharan ward grew by 14 per cent in homes—450 additional homes. In the Brynna ward, it grew by 17 per cent with an additional 657 homes over that 10-year period. Overall, over 1,100 new homes in a 10-year period in Llanharan. But, that’s not all. If we actually look ahead at what is going to happen in future, we can see that the adopted local development plan for Rhondda Cynon Taf proposes a strategic development site at Llanharan for around 2,000 more houses. I’m not decrying this; it’s a popular destination. This is a commuter area with a well-serviced railway station, with a bypass thanks to good decisions by a Labour local authority and Labour Ministers to work together to provide it. It’s making it more attractive—2,000 more houses. The same development plan allocates a site in Brynna for 200 more houses. This is growing like Topsy and we need to actually match that up with the provision.
So, in addition to seeking the Cabinet Secretary’s assistance in seeking clarification on why the original service could not be restored in some shape or form, let’s look at that bigger issue. It’s clear that it’s not simply a perceived but a real and lived difference in the experience of patients in Llanharan and those in Pencoed, and I want an equitable service, a good service for everybody. I don’t want to diminish what’s going on in Pencoed, I want to raise the standards in Llanharan and Brynna. I want them all to receive a great service and I’m sure the medical practice that services the area would want exactly the same. It’s not currently happening.
So, that second piece of evidence to do with the growth in homes leads me to my second point. Llanharan is a great community. It’s going through great transformation once again. It used to be pre-industrial, rural Glamorganshire, then it expanded massively through the industrial revolution, through rail and through collieries and then through open cast, and now we’re looking, with the advent of new rail links and new road links, to take it into a new era as well. It’s a popular growing place along the south Wales seaboard. It’s going to grow rapidly.
So, I’m pleased, over the last 18 months, Cabinet Secretary, that the leaders of Cwm Taf health authority and Rhondda Cynon Taf council have been willing to engage in exploratory discussions aimed at resolving the underlying primary care needs of this community. Local councillors like Geraint Hopkins and Roger Turner have played their part too, alongside community councillors. We’ve all been exploring whether there is a will to work in partnership to create a new primary care facility, fit for this century, that would service the needs of this growing population as well as the adjoining communities.
And we can tantalisingly imagine the possible model for primary care provision fit for the future in Llanharan and the area. Elements of it can be seen already in brilliant examples like the Gilfach Goch medical centre in the Ogmore constituency, and the many others that have been devolved in partnership with Welsh Government, local authorities, health authorities, GPs and clusters working together. It could involve, for example, teaching practice for GPs and allied professions. It could bring together the relevant services in one place for that community, with midwives and district nurses, dieticians and chiropractors—a range of professionals beyond the old-style, much loved, but so last century GP practice—with a knowledgeable onsite pharmacist who could advise on regular ailments and prescribe, thereby freeing up the precious time of the GP. And all of this, Cabinet Secretary, as you support, helping to keep people healthy longer in their lives and closer to home, without having to resort to emergency or acute care in a hospital bed. Who knows? Perhaps even on a site, with the help of Rhondda Cynon Taf, combining modern elderly care facilities too.
Cabinet Secretary, this has been your mission as Welsh Government itself to transform the style of primary care and of social care, keeping people healthier closer to their homes, reducing the over-reliance on GPs, utilising more effectively allied health professionals, breaking down the barriers between health and social care without costly structural changes. You’ve been doing this transformation elsewhere. I’ve seen it, I’ve seen the positive health outcomes. It is transformative; it transforms people’s lives. So, Cabinet Secretary, people in Llanharan are ready to have that transformation.
So, could I ask: to resolve the immediate issues, could the Cabinet Secretary help facilitate a meeting with ABMU and Pencoed Medical Centre to see whether a way can be found to resolve the disparity in dissatisfaction with patient experience between those who reside in Llanharan and Brynna and those who reside in Pencoed? I want them all to receive a great service. Secondly, could you help play a part in facilitating a meeting with ABMU and Cwm Taf health boards, Rhondda Cynon Taf and other potential partners, to examine those options for the development of new facilities? A medical centre, by the way, is already included in the strategic development site, so let’s fast-track these discussions. This would help resolve, in a meaningful way, the underlying issues linked to the massive housing and population growth in the area. If he could agree to assist us in getting progress on these matters and breaking the logjam, I know that would be appreciated by all in the local community, including those who are watching from the gallery today, and I look forward to others’ contributions.
Thank you very much. You indicated two people. They’ve got something like 45 seconds between them to respond to the debate, so it’ll be a challenge. Let’s see how we go. Suzy Davies.
First of all, thank you for the hard work that you’ve done on this as well, and also for highlighting why CHCs are so important to our local communities. There’s been some difficulty in getting a new public meeting together to update the community on this, partly because of the unwillingness of representatives of the practice to attend, but the reasons they give for their unwillingness to attend are quite interesting. The first is that they haven’t heard from the steering group that was talked about—it’s got to be at least a year ago now—to help smooth the way on this, but secondly and more importantly is that they haven’t heard from ABMU. This is a health board that’s already had some difficulties dealing with surgery issues in Porthcawl, and if they’re not even prepared to engage now with you, hopefully, on this, then there are serious questions for me about how willing they’re going to be to engage in GP cluster conversations, which are going to be critical to the vision we all have for the future.
Well done. Dai Lloyd.
Thank you. Just briefly, I work in a branch surgery in Penclawdd, which is several miles from the home—mission control—in Gowerton surgery, but it’s expensive, premises wise. Premises budget needs to be looked at. It’s also quite extravagant in terms of staffing and IT technology. None of that is insurmountable, particularly in view of new housing; it just needs organisation and a go-to attitude, but it requires money, organisation and political drive.
Thank you very much, and I call on the Cabinet Secretary for Health, Well-being and Sport, Vaughan Gething, to reply to the debate.
Thank you, Deputy Presiding Officer, and thank you to Huw Davies for another opportunity to speak today in the Chamber, but in particular for using today’s short debate to highlight the importance of accessing high- quality primary care services.
Our local healthcare services account for more than 90 per cent of people’s contact with the healthcare system here in Wales. Of all the points that were made today, it’s been really interesting that so much of it has focused on the hospital-based part of that system and yet the great majority—as I said, over 90 per cent—of people’s interaction takes place in our local healthcare service. And I certainly want our local healthcare service in Wales not just to be based on the principles of prudent healthcare as a mainstay of a sustainable health and care system that is generally able to respond to the changing needs of our population, but I share what you say as well: I want every single community across our country to have not just high-quality healthcare locally, but actually to have good access to it, to have really great care and to understand what that looks like. And in many parts of the country, that will look different to the system that has served us well up to this point in time, because I recognise the stress and the pressures that we frequently discuss in this place over the future of our local healthcare service, and in particular GPs as significant, if you like, leading parts of our local healthcare system, because we recognise that local healthcare is changing, and it needs to.
There are so many drivers that we frequently rehearse in this Chamber and otherwise, but we want it to deliver more care closer to home, with a more preventative approach: so, the idea of treating illness, moving beyond that to actually how you prevent ill health, and having a much wider team of people. That’s why our national primary care plan sets out key actions to improve local health, and that includes developing a more integrated, multi-professional workforce that collaborates at a very local level to meet people’s needs at, or close to, home, and recognises that much more care could and should take place in people’s own homes. I’m really pleased that you mentioned in your own contribution the reality that we want to keep people out of hospital. There’s much more that we could and should do.
I think that, sometimes, this sounds like a bit of a platitude, saying, ‘This is the course we want to do’, and then we go back, as politicians, to talking about hospitals again. If we can’t get this right, as we discussed in the parliamentary review, there’s a really difficult future ahead for the whole service. And, increasingly, though, we are seeing health boards collaborating with GP practices and other local service providers. Some of this is already happening, with pharmacists, community-based nurses, therapists, dentists, optometrists, mental health teams, social workers, third sector workers and others, through the 64 primary care clusters we’ve created. That’s to optimise the best use of our available resources and people’s time and expertise and the money we’ve directly provided to each of those clusters to spend on local priorities. Because I recognise that there are significant parts of Wales where they’re struggling to recruit and retain GPs. We talked about that earlier, in the Health and Social Care Committee’s report—not just the measures we’re taking on—[Inaudible.]—and others, but cluster working is a really important part of what we want to do to keep great local healthcare. That should lead, and is already leading, to greater collaboration between GP practices—they didn’t always talk to each other, frankly; so, it’s between the practices, not just within them—as they identify new ways of organising themselves and making effective use of their available resources.
Our national programme of Pacesetters has been really interesting in helping to identify more sustainable ways of working and providing services, like the federation of GP practices that is moving to the same place in the Bridgend locality, and the social enterprise in southern Powys, the Red Kite social enterprise. And that’s been so interesting, because that’s drawn together GP practices that previously did not talk to each other, and they were not friends of each other, and, now, they wouldn’t have it any other way. They’ve got a different way of working with each other, the way that people actually access the service, and they’ve just taken on board a GP service in Presteigne—where the previous GP practice was handing back its contract, they’ve taken that on. So, there is an appetite amongst the profession to work differently, because more practices are seeing the advantages of coming together to provide a better environment to work in for staff in the service, but also a better platform to deliver great local healthcare with and for the public.
I think this is where it comes back to how the national programmes can look at the challenges that you raise, because a significant part of the concern that is being taken up at the national Pacesetter programme is access. It’s a common concern about the ability either to get an appointment or to get a convenient and local appointment. Much of what you say is about access to local care. From that model, that new way of working with Pacesetters, much of it focuses on how you have a triage system, whether it’s on the phone or online or whether it’s nurse or GP-led, but a way to actually try and direct people to the right part of care. That could be going to see a GP; that could be having advice you can deal with at home; it could be going to the pharmacy; it could be coming in to see a physiotherapist or a different healthcare professional. And what we’ve seen in significant parts of that is that it actually speeds up access to see a healthcare professional, and it actually helps people to get directed to the right part of the service, so GPs don’t get overloaded with people they don’t need to see and, potentially, they don’t get to see people that they really could and should see, and I know this is an issue that the Member opposite has recognised in his own working practice well, about how you make the very best use of GP time. Now, more anticipatory care, to be designed to keep people at home rather than being admitted to hospital, and that’s where we’ve seen the development of the virtual ward-type models around the country as well—.
Now, the other part I just wanted to focus on before I go from the national to the local is the common element service in the way of pharmacy, because, again, you mentioned the point about could pharmacy be an option for people to get a service more locally. Actually, Cwm Taf have been really go-ahead on this in the way they’ve gone out after the Choose Pharmacy service. So, we currently have over 350 pharmacies in the country offering the service; 75 of them are in Cwm Taf. One of the pilots was in the Cwm Taf area, in Aberdare, and it was really interesting how the local GP practice recognised that it had helped them to manage the numbers of people coming through the door, and not just the numbers, but the appropriateness of people coming through the door as well. And people actually trusted their pharmacist. They had a private room to go and see them, they’re registered healthcare professionals, and it’s been enabled and empowered by access to a version of the GP records. There’s something about the safety. And, interestingly, Cwm Taf have told me that they think that the Choose Pharmacy service has helped to eliminate handwriting mistakes in scripts to be delivered as well, so there’s actually a significant benefit from a safety point of view as well. Now, in March, that service will be available to at least 400—certainly more than half—of the pharmacies in Wales, and we want to see genuine national coverage of this service.
It’s National Eye Care Week, but I won’t go on to talk about optometry because I do want to address directly the points you made about the local issue. And this comes on the back of an issue that other parts of the country recognise: population growth—current and planned population growth—that we know is going to happen, and you referred to Llanharan and Brynna being areas that are well connected from a transport point of view. The challenge is how we design so that services reflect what we currently have and will have, as opposed to waiting for those services to be overloaded.
And there’s something about the future of those services as well, and recognising that we want to work with independent contractors. So, we’d like to work with the current independent contractors to provide really good, high-quality care. And I do recognise what you say about the fact that this practice has invested in Pencoed. So, they haven’t been afraid to invest, and invested in one of those sites. And I also reflect on and recognise the comments that the CHC made on the potential that, if they can’t get somewhere where they think local residents want them to be, they may want to ask Cwm Taf to see if one of their other providers would want to come and open a list in the Llanharan and Brynna area. I think that means there’s a greater imperative to want to have a local conversation where—[Inaudible.]—there’s a different alternative.
That’s where I go back to the point to address the concern or the question that you raised about the offer of investment, and it partly deals with Suzy Davies’s concern about ABM as well, because my understanding is that the Abertawe Bro Morgannwg University Local Health Board did offer some investment for services to stay in the Llanharan and Brynna area. I don’t know why that hasn’t been taken up, but I am happy to ask if that previous offer from the Abertawe Bro Morgannwg health board area can still be on the table as part of an open conversation.
The final point, which I guess is your main ask from me, is whether I am prepared to use my good offices, to use one of those phrases, to try and engineer a conversation with relevant stakeholders. And I think it’s really important that you mentioned the local authority, because, to be fair to Rhondda Cynon Taf local authority, in other parts of their footprint they’ve been really helpful about making use of not just their ability to access capital in a different way, but also look at the estate that they have as well, to see if there’s an opportunity to try and re-engineer primary care with them as a partner—not just deliver what we currently have, but come up with a different way of doing it. I’ll happily take an intervention if I’m allowed, and then I’m going to finish.
I thank the Cabinet Secretary for taking this intervention, and he makes a very valid point. This isn’t—and, in fact, I would want to make sure that the existing Pencoed Medical Centre was part of this conversation, but there are good examples with Rhondda Cynon Taf. The proposal they’re looking at in Mountain Ash at the moment is very much a partnership between the local authority, looking to identify sites, together with the health board, looking to identify could they do this as an all-singing, all-dancing, and teaching practice sort of thing. It’s that partnership model that we want, but the difficulty I have, and this is why I’m asking you today, is actually getting all those people to come together. And I do understand, I would say to the Cabinet Secretary, that Pencoed Medical Centre have had their fingers burnt once on this before. They’ve been led up this thing, and I think they might be slightly reluctant. So, any help you can give to actually facilitate sitting down with trusted people around the table to say, ‘Let’s discuss this. How do we resolve this?’—. Because I know that there is a will from partners, from the health board, and from the authority and others to do this; we just need all players at the table.
And that’s the final point to finish on. I am happy to say that, yes, I am prepared to invest some time to try and get people to sit around the same table at the same time. So, both health boards, yourself, and any other local representatives that could and should be involved—. And, of course, to make sure that Pencoed are part of the conversation. So, a conversation with them and with their public, as opposed to a conversation about them, is what I’d like to see engineered, and I hope that all those people do take up the opportunity to do that to have some clarity for the local public about what the future holds, as everyone recognises there’ll be more people in this part of Wales, not fewer, in the future.
Thank you very much. That brings today’s proceedings to a close. Thank you.