Cynulliad Cenedlaethol Cymru

I call Members to order. 

The first item on this afternoon's agenda is questions to the First Minister. The first question is from Michelle Brown, but Michelle Brown is not in Plenary, therefore question 2 will be the first question—Alun Davies. 

Austerity remains the force that shapes our public services, driving demand and reducing our ability to respond. This Welsh Government remains committed to public services that are publicly funded and publicly delivered by staff motivated by a powerful sense of public service.

I'm grateful to the First Minister for that. I think many Members, like me, were very pleased to hear the finance Minister making a statement last month on how digital Wales will be moving forward. I was particularly interested, of course, in her view that a digital skills academy will be based in Ebbw Vale, in my constituency, and that we will be investing in chief digital officers across all parts of the Welsh public services, creating a very real cluster of excellence where we can drive digital change. The First Minister will be aware that the economy Minister and the education Minister both visited Thales in Ebbw Vale over the past few weeks to launch the cyber security presence there, which is a part of the Tech Valleys initiative. Will the First Minister, therefore, outline how he sees the cluster in Ebbw Vale, but the wider drive to create digital public services in Wales, moving forward over the next few months, and how we can ensure that this cluster of excellence that we're seeing developed in Ebbw Vale can be the basis and the foundation of further economic growth and excellence in public services?

Can I thank Alun Davies for that and for drawing attention to the fact that we are about to recruit a new chief digital officer for the Welsh Government? The current chief digital officer, Llywydd, I'd like to pay tribute to her time in office and wish her well in her retirement. We will bolster that Government-wide post with chief digital officers in local government and in health, and all of that will be put to work alongside the cross-Government ministerial digital board that is chaired by the Minister for Finance and Trefnydd. 

Digitisation of public services is one of the key ways in which we know we can go on making a reality of our determination that public services are properly available to citizens right across Wales in a way that matches their contemporary experience. That sense of being in the forefront of the development of digitisation is absolutely what is happening in Ebbw Vale and through the Tech Valleys region, with the work of Thales, with the skills academy, with the centre for digital public services, which will be operational in Ebbw Vale from April 2020, and bringing together there, Llywydd, the infrastructure that we need to support these developments but, very importantly, creating the skills that mean that the workforce in that part of Wales will be well equipped to be at the forefront of these developments. 

I'd like to ask the First Minister what plans the Welsh Government has to spread prosperity across the country through the development of public services. I think we need to listen to those who feel that we're at risk of imitating England's mistake in overconcentrating power and economic development in one part of the country. Now, one of the ideas that Plaid Cymru has put forward, which I'm sure the First Minister is aware of, is that of a regional renewal Act to decentralise power, ensuring that every part of the country receives its fair share of investment and that public bodies are established in parts of the country that really could do with new jobs. There are parts of my region in the south-east that have experienced depopulation and economic decline that could really do with Welsh Government support—areas like Tredegar, like Merthyr and like Ebbw Vale. Transport links in those areas are so poor and the foundational economy is crying out for investment. So, First Minister, I'd ask how you think the Government can help to improve public services in areas like this so that they can be built back up and be made attractive for businesses to be established there in the future, as well as attracting new local amenities that could boost those communities.

I thank the Member for that question. The regional impact of the economy is something absolutely at the forefront of the way in which the Minister for the economy is shaping his policy and his department to deliver in that regionally fair way, although, as the Member's question illustrated, Llywydd, inequalities within regions are more pronounced than inequalities between regions in Wales.

So, making sure that, within a region such as south-east Wales, which has some very prosperous parts of it and some engine-room parts of the Welsh economy—how do we make sure that the fruits of that advance are felt everywhere? That's at the heart of the fair work agenda, it's at the heart of the social partnership Bill that we will bring forward in front of this Assembly and, to revert to Alun Davies's point, digital services have to be viewed through that inequality lens as well.

In that way, I think the way that the Welsh Government approaches these things can be distinguished from the way that these matters have been approached elsewhere in the United Kingdom. We want to create, as the well-being of future generations Act says, a more equal Wales, and that more equal Wales is rooted in equality of opportunity in the economy.

First Minister, your 2016 manifesto pledge, and I quote, 'We will seek to create stronger, larger local authorities', as Welsh Labour apparently recognised the then vital role that local authorities play in everyone's lives—. Can you provide an update, please, on your reform of local government, or is this promise going to go in the same bin as the M4 relief road?

Well, Llywydd, there is a Local Government and Elections (Wales) Bill being presented at this Assembly. It will demonstrate the way in which we will create local authorities that are resilient for the future, retaining the 22 local presences, with a front door that people have become familiar with now over nearly 30 years, and yet to require collaboration on a regional basis for core local government services and activities. In that way, I believe we will marry together the advantages of having local authorities that are close enough to populations for people to feel ownership of them, and a sense of accountability to those populations, with the advantages that regional working for key purposes brings. That Bill will be in front of this National Assembly, and the Member will have every opportunity to contribute to its debate and development.

Questions from the party leaders now. Leader of the opposition, Paul Davies.

Diolch, Llywydd. First Minister, the number of confirmed cases of coronavirus in Wales has now risen to six and is expected to rise further. Therefore, it's absolutely crucial that any public information campaign now reaches all parts of Wales so that the public is fully aware of the steps they can take to protect themselves and their families and limit the spread of this virus. What further steps can the Welsh Government take to ensure it maximises the coverage of any public information campaigns in Wales? What additional steps is the Welsh Government taking to ensure that the people of Wales quickly recognise the symptoms of the virus and are properly signposted to the appropriate advice and treatment?

I thank Paul Davies for that important question. He's right to say that there are six confirmed cases in Wales at present, but all the evidence and expert advice that we have says that that number will rise. This does give us an opportunity to make sure that the public messaging that we offer is clear, concise and understandable to people. 

At yesterday's meeting of the COBRA committee, chaired by the Prime Minister, we agreed that it was important that those messages should be UK-wide. So, many people in Wales, as the leader of the opposition will know, receive the bulk of their news from outlets outside Wales. So, consistency of messaging across the United Kingdom becomes, I think, particularly important in this case, and we will work closely with other UK Governments to make sure that there is no confusion in messaging between different parts of the United Kingdom. Here in Wales, there is already, I think, a very effective symptom checker available through the Public Health Wales website, where, if anybody feels that they need to check what they are experiencing against coronavirus symptoms, it takes them through a series of very simple steps and gives them advice at the end of it. The 111 system now provides advice right across Wales free for people in the coronavirus field, and we will continue to use trusted sources of advice through the NHS and through Public Health Wales to make sure that, where public messaging is being made available, it reaches as many people and as quickly as possible. 

First Minister, I understand now that the UK Government has established coronavirus ministerial leads across Government departments, and perhaps you could tell us if the Welsh Government is doing the same to explore all issues and impacts that the virus may have. For example, there's very little guidance or information around the public transport network, particularly given that research published in BMC Infectious Diseases found that those using public transport during flu outbreaks were up to six times more likely to pick up an acute respiratory infection. Of course, there are some very valid concerns around public transport as there are often high numbers of people travelling in overcrowded train carriages, there can be poor ventilation and a lack of hygiene facilities on board as well. And yet travelling on the public transport network is still essential for many people around Wales. Can you therefore tell us what research has the Welsh Government done on the level of threat posed by using the public transport network in its current state? Can you also tell us what discussions the Welsh Government has had with public transport operators across Wales about how they can ensure that passengers are as safe as possible when travelling? And what additional resources are being offered to public transport operators to ensure that they have what they need to ensure that their vehicles and stations are as clean and safe as possible?   

I thank the leader of the opposition for those questions. 

In the Welsh Government, the Cabinet now discusses coronavirus issues at all our meetings, and we have established a core ministerial group that will meet in between regular Cabinet meetings to make sure that we are in a position to respond urgently and immediately where such a response is necessary. The COBRA committee ministerially meets twice a week as well, and Welsh Ministers are always represented at those meetings. 

The current best advice that we have from chief scientists and from chief medical officers is that people should continue to use public transport as they would at any other time, and that there are no current difficulties in people doing that. But this is a disease that the evidence tells us is going to develop further, may develop rapidly as we've seen elsewhere in the world, and to return to the first point that Paul Davies made, Llywydd, it is therefore very important that members of the public have access to changing advice, because, as the course of the disease develops, so the position in relation to advice on public transport will develop alongside it.

We operate, as I think we only can, on the best advice that we can get, and we do that on a shared UK basis using the scientific advisory group, the chief scientist and the four chief medical officers. Individual Cabinet colleagues are taking action to contact the sectors for which they are responsible to make sure that those sectors are making preparations for what may need to be faced as the disease develops, whether that is being able to provide a service with fewer staff, because more people will be unwell and fewer people will be in work, or whether it is in responding to physical infrastructure matters of the sort that Paul Davies referred to in relation to public transport.  

First Minister, of course, I'm pleased that the UK Government and the Welsh Government have worked together on legislation to strengthen the Welsh Government's powers on matters like quarantining and mass gatherings, and, as you're already aware, some schools in Wales and across the UK have closed their doors to students at risk of coronavirus. Of course, schools are a particular problem in terms of stopping the spread of the virus, and so it's important that there are mechanisms in place for the Welsh Government to close schools, if it needs to.

As the threat of the virus spreading is still high, what preparations have the Welsh Government made for the impact that this could have on schools, colleges and universities across Wales at this stage? What discussions have taken place with Ministers across the UK about developing contingency plans for the education sector and, indeed, the health service, should there be a significant increase in the number of children and young people affected? And what discussions has the Welsh Government had with the nursery and early sector, given that children under five, and especially those under two, are at higher risk due to their lower resilience?

Again, I thank the Member for those important questions. We have, indeed, been working with the UK Government on an emergency Bill that is likely to be presented in the House of Commons, and are reaching agreements with other administrations across the United Kingdom on powers that need to come to Wales to deal with devolved services, including the education sector.

We're very aware, Llywydd, that—in what will be an emergency procedure—we will need to work with the Commission to make sure that there are opportunities for the Senedd to scrutinise those proposals as they affect Wales, alongside any LCM that the Government will bring to the floor of the Chamber. The Bill will provide powers for Welsh Ministers in relation to education, and those powers will need to be used at the time when they are most effective.

And if I could just make this one point, Llywydd: in yesterday's COBRA meeting, the point that chief scientists and chief medical officers were most keen to make was that the powers that the emergency Bill will provide need to be deployed at the point when they will make the biggest difference, and shouldn't be used prematurely. Because if you use them prematurely and then need to use them again, the level of public compliance with those measures is likely to decrease. So, if you're going to use powers that are significant, you have to time them properly, and we will act on the best advice that we get from those authorities on timing.

In the meantime, contingency plans, of course, are being developed, and Paul Davies is right to point to the early years sector. Just to give one example of the thinking that is going on: there are regulations, as the Member will know, that in the childcare setting there is a ratio of adults to children, and that ratio is set in regulations. Now, if there are fewer people to work because of the onset of coronavirus, we may need to be more flexible in that regulatory ratio, and that's our thinking and that sort of work is going on already.

And he'll also, finally, Llywydd, be aware that this is a sector that is particularly vulnerable economically because it relies on the fees that it gets from paying parents. What we don't want to see—we've been in dialogue today with the UK Government in advance of tomorrow's budget on this point—is viable and important Welsh businesses going out of business because of a short-term impact, albeit a severe short-term impact, from this condition. We'll be looking to the UK Government to assist in making sure that those businesses can be helped through a difficult period, because we will need them once coronavirus is over.

Plaid Cymru leader, Adam Price.

Diolch, Llywydd. First Minister, I believe it's been confirmed that all cases of coronavirus confirmed in Wales had recently returned from Italy. What measures have you taken as a Government to identify Welsh residents who have returned from Italy since the outbreak of the virus, and what extra precautions are in place to ensure that the disease is contained as best as possible?

And also, I was wondering if you could respond to some of the comments made by the shadow Chancellor yesterday when he criticised the speed of action in the response by the UK Government and tardiness on the part of the Chancellor and called for the UK Government to get a grip. To some extent, these comments were echoed by the former Minister Rory Stewart. Do you think that these comments are in any way legitimate concerns at this stage?

Llywydd, on the first point, I don't think there is a useable mechanism by which any Government can track people returning to this country from many parts of the world, not just north Italy, other than through the actions that the UK Government has put in place through the ports and airports. We continue to work at a Welsh level where we have some shared responsibility in that regard.

The advice to people who have returned from other parts of the world where coronavirus is in circulation is very clear: they should not simply turn up at a GP surgery or at an accident and emergency service, they should phone first, they should get advice. The Member, I know, is aware that, in Wales, we have had a particular emphasis on home testing for people. We take the test to the person, so that they don't run the risk of coming into contact with people who could then be infected by them.

The six cases that we have identified in Wales so far are, we believe, people who have been in contact with others from another part of the world. We don't think we have, at this point, community spread in Wales, but the advice is that that is a matter of time. So, while we remain in the containment phase, that will develop into a delay set of actions at the right time.

And that takes me to the second point that Adam Price has raised, and it's the point I made in answer to Paul Davies about speed. The advice we were getting yesterday, Llywydd, was that timing of actions is really important. If we move, for example, today, to a regime in which anybody who had the first signs of a cold were asked to self-isolate, it's almost certain that what they would be self-isolating with would be a cold, because colds are in circulation, and coronavirus is not. So, they would stay home for seven days, with all the inconvenience that that causes, for no very good purpose. If, in 10 days' time, coronavirus were to be circulating and we asked them to do it again, the behavioural modelling tells us that people would be more reluctant to do it a second time, having gone through it all once and found that it wasn't serving a useful purpose.

So, while I think there's every right for parliamentarians to challenge the Government, to ask those questions, to be critical where they think criticism is justified, we will work on the basis of the best evidence that we have and, at the moment, we think that the sequencing of the actions that we are likely to have to ask of Welsh citizens is at the right point at this moment, and that we will time any further things we ask of them so that those asks happen at the point where those actions would have the biggest effect in slowing down the spread of the virus.

Coronavirus is obviously putting pressure on the NHS in all four nations. Labour's shadow health spokesperson, Jon Ashworth, yesterday asked the health Secretary in England for extra resources because critical care beds in England were at 81 per cent capacity during the week that the latest coronavirus figures were available. The Welsh Government's own task and finish group said: 

'NHS Wales has a lower number of critical care beds for the size of the population than the rest of the UK.'

The availability of NHS beds obviously needs to increase drastically, given that hospitals have been operating above the safe level of 85 per cent occupancy for almost 10 years. In the circumstances that we're facing now, have you already identified how you would secure additional critical care beds? And if so, how many?

Llywydd, we are looking to the UK Government for extra resource to support the NHS and to support the economy. We'll be looking to the budget tomorrow to see that the assurances that have been given by the Chancellor are turned into more specific figures for us tomorrow. There are more intensive care beds in Wales as a result of the actions of this Government. Many of us here will remember the debate around the organ donation Bill and the need to increase critical care capacity to make a success of that Act.

But I want to try and say to Members in the most sober way that I can, Llywydd, if a realistic worst-case scenario were to emerge in which 80 per cent of the population contracts coronavirus and 25 per cent of the population contracts it in a way that requires significant medical intervention, that is going to place an enormous strain on all our public services, including the health service, because people who work in the health service will be equally affected by the virus. So, we will face a position in which there will be significantly increased demand and real strain on the people who are left to supply it.

So, of course we are working with the health service to identify the plans that can be put in place, the resources that can be mobilised; but these resources won't simply be beds, they will be people to provide the services that are needed. And in a situation where 25 per cent of the population are significantly ill, that will have an impact on those people too. We know that this will be an impact that will be felt over many weeks, and the resilience of the people who we are relying on to come in and respond in an emergency will be difficult to sustain week in and week out over that prolonged period.

The cusp of what may turn out to be a global pandemic is obviously not a time when anyone would want to be contemplating closing facilities within the NHS. Five weeks ago, when asked if you would intervene to keep accident and emergency services at Royal Glamorgan Hospital, you said we're not remotely at that point yet. In the next two weeks, the health board will make a final decision. Have we reached that point? And if so, will you intervene today?

Llywydd, there is a very well set out and legally necessary process by which a decision arrives on the desk of a Welsh Minister. That is a process in which those organisations that have a legal right to refer a matter to the Minister's desk are the people who have to do that, if they choose to do it. We're not at that point. The health board will have to make its determination, and then an organisation, such as a community health council, who can refer that matter to a Minister for determination, would have to decide to do that. That's how the process works. That's how the process has to work to be legally watertight. And, we're not at that point. We may not get to that point, because the decision has to be referred for a Minister to take a decision. But, if it does happen, Ministers have legal responsibilities. And that's why it has been so important, in all of that, that Ministers don't pre-judge a situation in which any decision they then made would be vulnerable to challenge. 

Leader of the Brexit Party, Mark Reckless.

Diolch, Llywydd. First Minister, if I may turn to flooding, the industry association for forestry businesses, Confor, says that Welsh Government's and NRW's interpretation of the Environment (Wales) Act 2016 resists changes to any landscape where the habitat or designation is not for woodland. Given the flood mitigation benefits of tree planting on uplands, and the opportunities for decarbonisation are there as well, do you agree that guidance for interpreting the Act is now outdated?

In 2017, the Climate Change, Environment and Rural Affairs Committee looked at barriers to tree planting. Confor and Tilhill Forestry were among those who gave evidence, and said that the environmental impact assessments were a huge barrier to tree planting. Since that report, the environmental impact assessment regulations have not changed. Would you agree that it's time we did more to enable tree planting, given the declared climate emergency and the devastating flooding we've recently seen, and should this include updated environment Act regulations and guidance to remove barriers to tree planting?

Llywydd, let me begin by agreeing with what the Member has said about the beneficial impact that tree planting can have in relation to flood prevention. Increasing forest cover within river catchments increases canopy evaporation, enhances ground water storage, improves soil structure and resilience, and, very importantly, slows the flow of water. So, there is a strong case that the Member has referred to that additional tree planting has a part to play in flood defences.

There is a balance to be struck between the planting of additional woodland and the impact on biodiversity. Now, because that balance has to be struck, we have a regime in Wales in which, if planting of woodland above five hectares is proposed, then an environmental impact assessment has to be carried out to make sure that the extra tree planting, with its benefits, doesn't crowd out other important objectives in the environmental field. The Minister, I know, is considering at the moment whether that five-hectare threshold is too low, and might be raised. That would have a beneficial impact in making it easier to plant trees, but we would have to be confident that it would not lead to significant biodiversity loss, which might, by itself, outweigh the advantages that the tree planting would bring. 

I welcome the Minister giving that reconsideration. However, Confor also mentioned the issue of where a landscape is designated in some other way, say an upland sort of moorland, that they find there is a presumption against tree planting in those areas. And they can be much cheaper areas, say £1,000 a hectare, rather than several thousand, making the planting much more economic and likely to go ahead. Should we not also look at those designations, and allow greater flexibility for tree planting?

Now, decisions around dredging are affected by the EU water framework directive, and we know that the use of dredging reduced significantly around the time that directive was passed and then implemented. Now, we know that greater dredging would not mitigate all flooding, but it might have made a difference in some cases, for instance, the river Conwy, where we heard from Janet Finch-Saunders. Vikki Howells, from your own benches, made a similar point last week from a south Wales Valleys perspective. Meanwhile, the resumption of dredging the Somerset Levels does seem to have helped in that area. If coupled with regulations that encourage upland tree planting, couldn't increased dredging mitigate future flood risk? Now that we've left the EU, shouldn't we develop our home-made practices and frameworks for dredging and flood protection? And do you agree that these should encourage upland tree planting and make it easier to undertake appropriate dredging?

Well, on the first issue of designation, Llywydd, designation is there for a reason; it's for other sorts of protections. But, in a post-Brexit world, the plan that my colleague, Lesley Griffiths has been taking forward that began as 'Brexit and our land' and is now 'Sustainable Farming and our Land', does point to the fact that, in the future, the public will be prepared to pay farmers to do things that have a direct public benefit, and additional tree planting may well be part of one element in the repertoire of things that the public will be prepared to pay for, for the reasons that the Member outlines, and that may have implications for designation. 

As for dredging, in our collection of evidence from local authorities, as we begin to move, we hope, into the recovery phase from recent flooding, one of the things we will be discussing with those local authorities is whether dredging, additional dredging, would have had an impact on the flooding that was experienced. So, it's actively under consideration in that evidence-based way, but we will want to hear from each local authority about their particular circumstances. In some places—I am probably wrongly anticipating—but from what I've seen so far, my anticipation is that there will be some instances where additional dredging would make a difference, but that it may not be a solution that has a beneficial impact everywhere.

I thank the Member for that question, Llywydd. The Welsh Government has successfully supported local and community renewable energy projects since 2010, and continues to do so through the Welsh Government energy service. We have set challenging local ownership targets to ensure that we are retaining wealth and providing benefit to communities across Wales.

I thank the First Minister for his answer. I think that one of the things we don't want is our natural resources being turned into wealth in another place rather than Wales.

Energy transmission has changed from power station to end user, now with lots of local generation going to the grid. I remember the diagram that showed a power station in one place, lines going all the way, and ending up in factories and houses. That's not the case now because local generation can go into the grid. But there are two problems that exist. One is: what progress is being made on access to the grid? Because I understand that, in some areas, especially in mid Wales, there's great difficulty in getting access to the grid, and that some areas have got access to the grid because former power stations have closed, and therefore the grid has got greater capacity. And also, local storage and usage. People have heard me talk often about batteries, and the need to make huge developments in batteries. Because, rather than using the grid, if people could generate electricity locally and use it locally, then that would be of benefit to everybody.

I thank the Member for both of those important questions. Llywydd, I share something of the frustration that I hear from local generators, of the difficulty in getting National Grid connections. And I spoke about this with the incoming chief executive of Ofgem, in a conversation with him on Friday, and I look forward to him coming to Wales to continue that conversation. And Welsh Government officials are meeting with the National Grid and distribution network operators today. Because we need investment at the UK level, in innovation and cost reduction for storage, and for grid connection. And in some parts of Wales, our opportunities to take advantage of the many natural assets that Wales has for renewable energy generation—whether that's onshore wind or marine—both of those are being held back by the lack of investment in National Grid infrastructure here in Wales. So the Member makes a very important point about that, and about the need for National Grid to attend properly to the needs of Wales.

In relation to battery storage, and innovations of that kind, the Welsh Government wants to play our part in supporting industries that are developing new technologies in that field. My colleague, Ken Skates, has supported an important development in the Neath Port Talbot area that is all about battery storage and the technologies that will allow that sort of local storage on which the ambitions that we have for renewable energy generation here in Wales will depend.

I go back to the days when John Griffiths had this portfolio, and tried to raise this very point about connection to the grid, and the way it's holding back deployment of renewables here in Wales. And indeed, when it comes to battery deployment, there is a moratorium in south Wales until 2026, on any commercial deployment of batteries. So the point about Ofgem's role is well made by the First Minister. It is a fact that we do not have a board member from Wales on the Ofgem board, and, very often, when you interact with Ofgem, they refer to the Government as the Government at Westminster rather than the devolved Governments. Many of the energy responsibilities do reside here, especially planning permissions, et cetera. It is vital that the control period that Ofgem work to when they subsidise infrastructure development has a Welsh angle to it. Do you support Ofgem making a space for a Welsh board member to be appointed, so that Wales's voice can be heard when these decisions are being made?

I thank Andrew R.T. Davies for that. Of course we want to improve the answerability of Ofgem to Welsh interests, and the capacity of Ofgem itself to understand and to recognise particular Welsh circumstances. So shall I say that I was heartened by the fact that the incoming chief executive sought a phone call very early on in his tenure, to talk about what they intend to do to improve the service that they provide to Wales? I'm heartened by the fact that he has committed to an early visit to Wales so that he can meet a wider range of Welsh interests. And if a board member from Wales would assist in making sure that we have a better service from the system in the future then, of course, I'll be very happy to take that up with him. 

May I thank Llyr Gruffydd for the question? Progress continues to be made in many dimensions of mental health care in north Wales. I congratulate staff at Ysbyty Gwynedd and in community hospitals in Betsi Cadwaladr University Health Board on achieving dementia friendly accreditation. Across mental health services, the board acts to prioritise prevention and early intervention in patient care.

Whilst, of course, there are good news stories such as the ones you’ve mentioned in terms of some of the care, we are aware that one of the reasons that the health board was placed in special measures was because of failings when it comes to mental health services. Now, it was disappointing to read a report last year that was a review of psychiatric therapies in north Wales, which listed a whole host of failings. It mentioned patients having to wait for unacceptably long times; a lack of strategic workforce development; and a lack of data leading to a huge gap in making decisions based on evidence. And in Plaid Cymru’s debate just last week on this issue, we heard how patients from Wales have been placed in units in England that have been shown by the authorities not to be meeting the standards that we would expect them to meet.

Now, it’s almost five years since the board was placed into special measures, but many of those failings remain. So, the question, of course, is when will you as a Government take responsibility for this list of issues that still haven’t been resolved? Indeed, when will we see the Welsh Government placed into special measures on this issue?

Well, Llywydd, of course I acknowledge the fact that problems in the mental health services were part of the reason why the decision was taken to put Betsi Cadwaladr health board into special measures in the first place, but many things have improved in the mental health field over the intervening years since being placed in special measures.

On psychological therapies, as the Member will know, this was a report commissioned by the board itself. It will go to the board's quality and safety committee on 17 March. The Welsh Government is providing over £1 million in additional investment directly to the board to act on the recommendations of the report, which it itself commissioned. And, while there are many matters that that report highlights that the board needs to attend to, that report also pointed to many examples where there are innovative, imaginative and committed actions being taken by teams providing psychological therapies in north Wales.

And, as far as patients placed outside Wales are concerned, there is a continuing fall in the number of patients placed in that way. In 2018, 130 patients from across Wales were placed in services in England, and last year, in 2019, that had fallen to 96, and that's as a result of concerted efforts that boards across Wales are making to repatriate services and to bring patients closer to home, and I  think that is exactly the right thing for them to do.

Where patients have to be placed across the border—and there will always be examples of very particular need—then we have our own assurance team that visits people in those places, that ensure that even if the service, as a whole, is under scrutiny, that the service provided to that Welsh patient is of a standard that we would be prepared to recognise. And if that is not the case—and let's not forget that in the recent example of St Andrews hospital, it was because of a visit from a Welsh inspector that concerns were raised—then we no longer place patients there and we make alternative arrangements where that is necessary. 

On 22 January, north Wales community health council wrote to your health Minister, drawing his attention to the report referred to—the independent review of psychological therapies in north Wales, undertaken independently by the TogetherBetter collaborative consultancy—and drawing his attention to its findings of a lack of shared vision, of strategic clarity and oversight at health board and divisional level, a lack of strategic and integrated workforce development, and much more, and said, after nearly five years in special measures, much of it related to mental health services—these findings are deeply disappointing. They also told me that they found the Minister's fairly bland response disappointing too. How do you respond to the contents of the letter I've received from a professor of psychiatry who left Betsi Cadwaladr on 31 January, and who stated that the problems related to the changes proposed by the management of Betsi Cadwaladr University Health Board, after taking on the services in north-west Wales—none of the medical or nursing staff there support it?

I've not seen that letter, Llywydd, so I'm not in a position to respond to it. I was aware of the letter from the CHC on 22 January. The Minister's response at the time pointed to the fact that that was a report that was due to be considered by the board, and that it was for the board, as the commissioner of that report, to give it first consideration. As I said in my answer to Llyr Gruffydd, the report is going to the board's quality and safety committee on 17 March and I know that the Minister will want to hear from the board the plan that it will put in place to respond to the recommendations of the report that it itself had commissioned.

I thank John Griffiths for that question, Llywydd. Almost £23 million of regeneration grant and loan funding has been approved for projects in the Newport City Council area since 2014. The Welsh Government continues to work collaboratively with the city council to ensure the successful delivery of their current and future regeneration project.

Thank you for that, First Minister. I do think that that strong partnership between Welsh Government, Newport City Council, business, social landlords and others has borne considerable fruit and helped to meet the challenges of finding alternative uses for our city centre. And soon there will be a further example of that when a substantial four-star hotel opens up in Newport city centre, close to the Friars Walk shopping centre, which itself, of course, was a result of that partnership just a few years ago. But nonetheless, First Minister, there are ongoing challenges, because retail is changing at such a pace, with so much online shopping and so on, so there will be a need to continue and I think strengthen that partnership, and I wonder if you would take the opportunity today to commit to building on the progress made to date by strengthening further that joint working between Welsh Government, Newport City Council, business and social landlords in the city.

Llywydd, I'm very pleased to make that commitment, because Newport City Council I think is a real example of a local authority with ambition for the regeneration of its city centre, and a willingness to work in partnership with the Welsh Government, where we are able to provide assistance to them in doing so. There are many examples of this that John Griffiths has referred to, from the Ringland community hub in his own constituency—visited recently by my colleague Hannah Blythyn—to the £17 million Connecting Commercial Street programme. And as I said in my original answer, Llywydd, there are a series of potential further investments in Newport, whether it's the Tirion Homes investment on the former Whiteheads steelworks site—and I'm very pleased to see an application from the city council to the Welsh Government's £5 million fund for green infrastructure and biodiversity in urban areas, and particularly looking forward to working with the city council on the initiative that was announced some weeks ago by the Welsh Government, where we had to provide new powers to local authorities and a £13.6 million fighting fund to tackle blight caused by abandoned buildings in towns and cities across Wales. And I know that Newport council has put forward a number of buildings where they think using the powers and the funding will allow them to regenerate those buildings, to prevent the blight that they currently cause to surrounding areas, and to bring them back into genuinely beneficial use.

First Minister, research by the Local Data Company shows that Wales has the highest shop-closure rates in the United Kingdom. In the first half of the last year, the number of shops in Newport fell by 3.5 per cent. The Welsh Retail Consortium points out that retail accounts for over a quarter of the business rate take in Wales. Although small business rate relief and transitional rate relief are a welcome recognition of the need to keep down costs for firms, three quarters of the retail employment is with firms who do not qualify for this. First Minister, do you agree that the existence of such relief schemes demonstrates the urgent need to reform business rates in Wales to help regenerate city centres such as Newport?

Llywydd, I agree that there is a case for the reform of the business rate system. It's why we will bring forward proposals to reform the appeals system. It's why we've agreed to bring forward by a year the re-rating exercise for business properties. But if I understood the Member's suggestion rightly, I would not agree that what we need to do is to reform the help that we offer small businesses in Wales in order to siphon help away from them and to provide it to large multinational retail outlets.

The nature of the retail high street is changing, and it's certainly changing in Newport, and old ways of just trying to make the previous model work faster will not sustain retail into the future. We want to work with the sector to be part of the necessary reform. We want to use the millions and millions of pounds that we invest in rate relief schemes to create sustainable retail businesses for the future.

Llywydd, the Welsh Government has put in place a package of support for individuals, businesses and local authorities in the immediate response phase to the flooding. We will consider what further support we can give as more information becomes available, and as things move into the recovery phase.

Thank you for your response, First Minister, and thank you, more importantly, for the proactive work that you and your Government has carried out. The scale of the damage caused to infrastructure by the recent flooding is becoming all too clear, with, for example, in Rhondda Cynon Taf alone, nine bridges having to be replaced, in addition to damage to roads, culverts and river walls, with an estimated cost to my local authority of £44 million and rising. Now, the UK Government has recognised its responsibility, so isn't it time the Prime Minister puts his money where his mouth is? Will you raise with the UK Government the need for them to provide sufficient financial support to make sure that we can properly repair the damage to infrastructure?

Llywydd, of course we're heartened to hear the Prime Minister say in the House of Commons that cash certainly will be passported through to Wales to assist in the recovery phase. My colleague Rebecca Evans raised this directly with the Chief Secretary to the Treasury in London earlier today, and we do look forward—in the budget tomorrow, if possible, but if not then, as urgently as can be thereafter—to receiving more than an assurance, but some hard cash. Because, as Vikki Howells has said, Llywydd, while the Welsh Government has been able to find and to fund, from our resources, help for individuals, businesses and for local authorities in dealing with the immediate impact of the flooding, when it comes to bridges that have been washed away or need to be demolished, roads that will need to be reconstructed, and flood defences that will have to be revisited and re-strengthened, capital investment on that scale is what the United Kingdom is there to help to provide. We look forward to the Prime Minister's assurance turning into the help that local authorities in Wales need.

First Minister, of course you will be aware that a number of businesses in Llanrwst were flooded out on 9 February as a result of storm Ciara, yet it was only 4 March 2020 when the Minister for Economy, Transport and North Wales directly announced financial support for businesses. That was nearly a month after the event. Some have ceased trading, some are awaiting insurance payouts, and some have had to turn to savings to continue operating elsewhere. Whilst we all welcomed the £2.5 million support on the day the funding was announced, your Welsh Government explained that

'Further details on how to apply for the fund will be made available in the coming days through...Business Wales.'

This is unacceptable, as is the fact that, as of yesterday, Business Wales was still advising that the application forms for the funding are not available. Will—[Interruption.] Do you mind?

Just ask the—. You need to ask a question, Janet Finch-Saunders.

Will you explain, First Minister, why you have betrayed the businesses in Llanrwst, why they've had to wait a month and they've still not seen a penny, and what measures will be taken to improve this access to much-needed funding? It is a disgrace.

Well, Llywydd, the Member lets herself down, as she does for the second time in a week. She lets herself down when she uses language of the sort that she did to me in posing that question. There will be help for businesses in her constituency from the Welsh Government. Not a penny from her Government. She talks about a month on. Where was her Government? Where was the money coming from her—? Not a single penny. Let me tell you that. Reflect on that, maybe, when you make these accusations in future.

There is £2.5 million that I am very glad indeed—very glad indeed, Llywydd—that will be made available to businesses in the Member's constituency. They know what they have to do; they have to contact Business Wales. And this is public money, Llywydd. It is absolutely right that Business Wales have to carry out a minimum number of proper checks to make sure that the money goes to the right people in a way that would stand up to scrutiny. Of course that is right. To give you an example, Llywydd, of how quickly help can be made through the discretionary assistance fund: we've now had hundreds and hundreds of payments already made, and hundreds of thousands of pounds in the hands of householders who needed that help. We will do the same with the help that we are providing to businesses and they will know that that help has come to them as a result of the decisions made by this Welsh Government, where her Government has done absolutely nothing.

I'm sure the people who've been affected by floods, the last thing they want to see is a shouting match in this Chamber.

I welcome the extra £500 that the Government has announced for people without home insurance for flood damage. I'm also grateful for the additional money that has been generously donated by people to the various appeal funds. Money raised throughout the Rhondda by individuals and groups will go directly to those affected, and it's fantastic that I can tell you this afternoon that Trade Centre Wales has donated £50,000 to the fund Rhondda Plaid Cymru established, which will clearly go a long away.

However, there is a disparity between what people in Wales are entitled to compared to what people who've been flooded in England can expect to receive. There they have a property flood resilience scheme that allows flood-hit homes and businesses to apply for up to £5,000 to help them become more resilient to future flooding. This would be so useful in many instances that I've come across, not least for some residents in the Britannia area of Porth, some of whom have had their back walls washed away. Where they used to have a protection against the river, now they're exposed, their gardens and their basements, to the surging River Rhondda. As things stand, those home owners are responsible and residents are not entitled, as far as I'm aware, to any support to remedy this and to protect themselves. As we both agree on the need to futureproof communities from flooding of this kind in the future, will you consider making a similar scheme available in Wales?

I thank the Member for that question and, indeed, for the tone in which it was asked, for her recognition of the help that has been provided. I want to absolutely associate myself with what she said about the enormously generous community response that there has been to people in distress. 

The funds that we have made available at this point, Llywydd, have been to deal with the immediate impact of the flooding—people whose goods have been destroyed and needed just an immediate cash injection to be able to deal with that impact. As we move into the recovery phase then of course we will look to see what other forms of help might be available. I'm very happy to study the example that the Member has highlighted this afternoon to see if something of that sort can be put in place here in Wales. 

First Minister, can I first of all thank you for how speedily you came into Treforest in the aftermath of the floods? Now, the Treforest industrial park is an area that has been massively hit: many, many businesses, tens of millions of pounds of damage, and there are many hundreds of jobs that are at stake on that. The first thing I'd say is that the three-month business rate credit that businesses are going to be getting if they've been affected is very much valued. I know that is being funded by Welsh Government, but I would like to make the point of course that there will be some businesses that will take a lot longer to actually be able to get up and running again and I wonder whether there is scope for flexibility where those who have particular difficulties in getting up and running would be able to get, perhaps, further extensions to that. I wonder if that's something you'll give some support to. 

The other point I would make is this: there are literally hundreds of jobs at stake in the Treforest industrial area and in this particularly difficult climate we're going through. Had they all been concentrated in one factory there would be immediate packages of support. Of course, with a lot of small businesses, it is a much more complex situation. I wonder if you would actually find time to pay a visit to the industrial estate there to meet with some of the businesses to discuss their particular needs, the support that has been given, but also what may need to be done in order to get that estate up and running and to protect those hundreds of jobs?

Llywydd, can I recognise the very particular impact that flooding has had on the Treforest industrial estate? The three-month business rate holiday that the Welsh Government will fund was, again, part of that immediate response package. I will be meeting the leader of Rhondda Cynon Taf council on Thursday of this week to discuss the recovery phase with him, including the recovery that is necessary at Treforest, and will of course take up with him whatever ideas he has and others have to be able to respond to the ongoing difficulty that businesses in that part of Wales face. 

Finally, question 7. Jenny Rathbone. 

Can I thank the Member for that, Llywydd? Our strategy for reversing the decline in biodiversity encompasses large landscape scale projects such as the national forest, as well as support for the smaller things that all communities and organisations can deliver locally, such as the actions supported by our new Local Places for Nature scheme, launched last month. 

Thank you for that, First Minister. I absolutely celebrate the Local Places for Nature scheme, but I first of all just want to highlight the work of WWF, planting seagrass on the Pembrokeshire coastline, which is going to be equivalent to two football pitches and is fantastically good news for about 100,000 fish and 1.5 million invertebrates, because of the way in which it has restorative capacity for our oceans. But I'm afraid I don't have any coastline in my constituency, so looking to—[Interruption.] Yet. [Laughter.] So, looking to the Local Places for Nature initiative, which I think is really fantastic and, obviously, I will be wanting to work with my community, both to try to green the concrete jungle areas of my very inner city areas as well as to get more fruit trees and fruit and vegetables planted across the constituency, I wondered if you can say a little bit more about how the Local Places for Nature scheme, managed by Keep Wales Tidy, is going to operate, because I was a little surprised to see that the deadline for the first round of bids was last Friday, which certainly took me by surprise and really doesn't give ordinary people long enough in order to put together a bid, given that it was only announced at the end of last month.

I thank Jenny Rathbone for that, Llywydd. We spent an earlier part of questions today talking about forests and woodland, and the contribution that that can make to the impact of climate change, and the seagrass development today is another very good example of natural responses to what we see going on around us. I will be very interested to see how that develops around Pembrokeshire.

As far as the Local Places for Nature scheme is concerned, I want to pay tribute to Keep Wales Tidy for the work they are doing with us on this. There will be 800 starter packs available through Keep Wales Tidy, Llywydd. They will provide everything that a local community group or a community council might need—tools, bulbs, advice and so on—to allow a community to create their own butterfly, fruit or wildlife garden. There will be an equal number of packages available for all those three things.

And I know—I saw recently that the Member had been out in Plasnewydd in her own constituency carrying out a street audit of green infrastructure in that very densely populated inner city part of Cardiff. This local places scheme is exactly intended to assist those groups who want to do those small things that make a real difference to biodiversity.

The reason why Keep Wales Tidy went for an early first call is because they and we are very anxious to get this money out there doing good things. It will not be the only call that they will make, but we wanted those organisations that were ready to go and had plans in place to get the money as fast as we were able and then to inspire others to do even more. 

Thank you, First Minister.

The next item was to be questions to the Counsel General. Those are postponed until tomorrow.

The next item, therefore, is the business statement and announcement.

Before I ask the Minister, the Trefnydd, to provide her statement, just to say that I have very many Assembly Members wanting to ask a question. I urge you all, if you want to improve your colleagues' chances of being called this afternoon, to be succinct in your questions. I was particularly lengthy in the First Minister's questions this afternoon, so I want to keep this to a 30-minute statement, if at all possible, in light of what we have ahead of ourselves for today.

With that, Mohammad Asghar.

Thank you, Presiding Officer. May I ask for a statement from the Minister for health about measures to tackle diabetes in Wales? Diabetes in Wales is now a health crisis, with the number of people suffering from the disease having doubled in the last 20 years. Wales has the highest prevalence of diabetes in the United Kingdom, and NHS Wales estimates that 11 per cent of our adult population will have this condition by 2030. Diabetes UK Cymru has welcomed the measures introduced in the Welsh Government's obesity strategy, 'Healthy Weight: Healthy Wales', but says that we need sustained action if we want to support people to lead healthier lives, create a healthier environment and shape a healthier nation. Minister, since Wales is the only country in the United Kingdom without a diabetes prevention programme, please could I ask for a statement from the Minister on what action he will take to address this health crisis in Wales? Thank you.

Before I respond to Mohammad Asghar, I probably should set out that there are several changes to this week's business. This week's oral questions—

I'm sorry, I forgot to call you, Trefnydd. [Laughter.]

That's all right. This week's oral questions to the Counsel General and Minister for European Transition in respect of his law officer responsibilities will take place tomorrow. The Minister for Health and Social Services will make a statement shortly on coronavirus, COVID-19 update. As a result, the statement on International Women's Day will issue as a written statement. Finally, as a result of the number of amendments tabled and groupings, I have extended the time allocated to Stage 3 proceedings of the Health and Social Care Quality Engagement (Wales) Bill. Draft business for the next three weeks is set out on the business statement and announcement, which can be found amongst the meeting papers available to Members electronically. 

In respect of the request for a statement made by Mohammad Asghar, I know that the Minister for Health and Social Services has only recently made a statement to the Assembly on the 'Healthy Weight: Healthy Wales' programme, which did encapsulate some of the concerns that Mohammad Asghar has raised this afternoon. But I would encourage him to also write to the health Minister with his specific concerns about diabetes in order for them to be addressed through correspondence. 

I know that a fair bit of time has been given in the Senedd to debating and scrutinising the Government on its planning and action in terms of the floods, but I've got a number of matters outstanding from my constituency that have so far stalled. I've got a case of a resident flooded in Treorchy who's seen his kitchen flood six, seven, maybe eight times now since the heavy rain began a few weeks ago. Water is gushing into his garden and through his kitchen walls. He believes that a drain has collapsed underneath the main road outside his home, yet the council say it's his responsibility, on his land. I'm wondering if the Government has got any scope to intervene in cases like this.

I've got another case where a resident doesn't have insurance. Their roof was blown off in storm Ciara and then further damaged during storm Dennis. The Government previously said it wants to help people who've been affected by both storms, yet the council have decided that this family isn't eligible for the council funding, which then excludes them from Welsh Government funding and the support that they should be able to access for not being insured. Will the Welsh Government agree to look at cases like this that have been turned down to ensure maximum flexibility within the system to catch cases like this?

I've got many other issues that I'd like to raise but I'm mindful of time, Presiding Officer. If I could just raise one final point, and that's about blocked culverts in general. This is now a huge problem right across the Rhondda. The council don't seem to have the capacity to clear and repair all of the culverts and waterways and, in some cases, these drainage systems need rebuilding. Pentre and Blaenllechau are two good examples of where drainage damage has caused floods into people's homes, but we've also had a house in Llwynypia that was flooded from an overflowing culvert, a street in Ystrad was flooded just last night, and people in homes in Ynyshir are fearful because the culvert drainage system overflowed there again last night. Now, if the council doesn't have the capacity to deal with all of this, can consideration be given to drafting in labour and support from elsewhere? For example, could volunteer groups or even the army be requested to help in situations like this? We need a plan for our waterways and our mountain run-off water; we don't seem to have one now that inspires confidence on the part of the residents that I speak to, who simply can't relax every time it rains.

Thank you to Leanne Wood for raising those specific issues of casework that she's received from people affected directly by the flooding, and then that overarching concern about blocked culverts. I will ask Welsh Government officials to speak to Rhondda Cynon Taf council on those issues that you've raised, because, in the first instance, they are matters for the council, but it'd be very important for Welsh Government to understand in more depth the concerns that you've raised. So, I'll make sure that those conversations take place.   

Trefnydd, could we have a statement on planning procedures in Wales? You may have seen some of the dramatic pictures of my constituent Mr Lee Evans's house perching precariously on the side of the river this week. This happened after the river bank eroded some 30 ft during Storm Dennis. His is one of two properties in this situation, both a part of the Redrow housing development at Carnegie Court in Bassaleg. Planning permission had been turned down by both Newport City Council and the planning inspector. However, this decision was eventually overturned in 2007. Although procedures have since changed, following recent events, questions were obviously being asked about the validity of this process, and I'd welcome a statement detailing why this decision was taken at the time, and, in light of what we now know, will there be a review into how decisions regarding new builds are made in relation to potential flood risks?

Secondly, I'd like to ask for another statement. I was pleased to see the Minister for environment  providing a written statement on dog breeding last week. I and many of my constituents are eager to see the end of this distressing and appalling way that some dogs are treated on puppy farms, and this needs to be done urgently. Could we have a statement and a timetable on when that action might be taking place?

Thank you to Jayne Bryant for raising her constituent's particular concerns regarding the case of planning permission that you've described, and the issues particularly affecting new build. The Minister with responsibility for planning was here to hear those concerns, and it would be helpful if you could write to the Minister with some further details on the specific case to which you refer in order to give some more consideration to the concerns that you've been able to talk about this afternoon in the Chamber.

In terms of the ways forward for dog breeding, I know that it is the intention of the Minister to bring forward the necessary changes as soon as possible. She's also indicated that she would be looking to legislate within this Assembly term on the issue of puppy sales as well. So, I think that there are important steps ahead of us in terms of improving animal welfare, and particularly dog welfare in Wales, but I will ask for some further clarity on those timescales.

Through you, Trefnydd, could I ask the Minister for Economy, Transport and North Wales for a statement on arrangements being put in place in relation to coronavirus on public transport? Public-funded transport such as the flights between Cardiff and Anglesey, TrawsCymru buses and Transport for Wales trains are, of course, places where a significant proportion of people are in an enclosed space for long periods of time. For example, I came down on the train with another Assembly Member yesterday. What I experienced concerned to me greatly. During the four hours, numerous people came and went—I tend to use a table so I can do work on my way down—not once were the tables wiped, and the train, actually, was not very clean. Later on, my Assembly colleague went to the bathroom and I was advised that no hot water or soap was available on the train. Now, you're aware, as am I, that the strong messages coming from Public Health Wales and, indeed, Governments at all levels is the necessity to be able to wash our hands and to maintain strict personal hygiene levels. Will you ask the Minister for that statement? Because I do believe he does have a part to play in terms of giving good advice to our transport operators, so that both they and their staff and, indeed, those travelling on public transport in Wales can feel confident that this matter is being taken very seriously indeed.

Oh, and I have another statement—[Interruption.] Sorry.

Carry on, Trefnydd. No—you've given way to the Trefnydd. The Trefnydd will answer.

Okay. So, this is an important issue that the leader of the opposition also had the opportunity to question the First Minister about during First Minister's questions this afternoon, but I will be sure to have this discussion with my colleague the Minister for economy and transport, because the response to coronavirus is very much a cross-Government response and, equally, it's something that every individual in Wales has their part to play in as well.

As shadow Minister for international affairs for Plaid Cymru, I've been told the story of a young footballer here in Wales. Can I ask whether the Government will make a statement on the situation of Rolando Bertrand, the 21-year-old and footballer with Bellevue Football Club in Wrexham, who moved to Wales a year ago with his family, but is now at risk of being deported to Nicaragua? He and his family played a part in anti-Government protests, and as a result they believe they've been blacklisted by the Nicaraguan Government. By going back there, it would put his life in danger. So, can I thank the Government for looking into this situation? Thank you.

Again, thank you to Dai Lloyd for raising this particular issue. I will certainly explore it myself to better understand the issue. I know that you'll also be making those important representations to the Home Office in respect of their deportation processes and so on, but I'll certainly gather some further information.

Trefnydd, I wonder if you could arrange for there to be a Government statement on the action that's being taken by Welsh Government in respect to insurance of properties and businesses in flooded areas. There are houses that were insured, some not insured, some will not be able to get insurance or be able to afford insurance. The same equally applies to businesses. Some of them may now have difficulty gaining insurance or being able to afford insurance, which will obviously affect the viability of businesses and the retention of jobs. I appreciate much of the area around insurance is not a devolved matter, but it seems, working across the UK and with the Association of British Insurers and other interests, there is a real need to review the insurance arrangements and the insurance schemes that exist to protect businesses and residential properties for the future.

As the First Minister set out in First Minister's questions earlier on, our first actions have been about giving that initial and immediate response to the impacted households, businesses and communities. But, as we look forward and have the opportunity to reflect on the flooding, there will be these larger questions that we need to explore. With regard to insurance, there is a scheme called Flood Re, which is a joint UK Government and industry partnership, which is there to give households that have been flooded in the past or are at risk of flooding access to affordable insurance. I think that that is a good scheme that perhaps could be well promoted to those households that have been affected by the recent flooding, and those businesses, in order to try and give them some comfort that there is opportunity for insurance in future.

Can I call for two statements? First, on the extent of prostate magnetic resonance imaging before biopsy across Wales. Prostate Cancer UK has shared its latest freedom of information request data showing the extent of prostate MRI before biopsy across Wales. This found that three out of seven health boards across Wales are not yet providing the scans to the standards set by the PROMIS trial and recommended by the National Institute for Health and Care Excellence. A further two are offering biparametric MRI, a simplified version of the scans, although they say plans are in place to complete the process of ensuring that all areas are providing access to full multiparametic MRI by 1 April, only a matter of weeks ahead. They also found that there were restrictive eligibility criteria in Abertawe Bro Morgannwg University Health Board and Cwm Taf University Health Board, and that the increase in prostate MRI capacity over the last 12 months was unknown in both Betsi Cadwaladr and Cwm Taf University health boards.

Prostate Cancer UK is therefore calling for radiology units to receive the resources they need to ensure every man who could benefit gets access now, and has developed a planning tool to help health providers calculate the increase in resources they will need to plan for in their areas. I call for a statement accordingly, not to criticise, but to seek a way of closing the bridge, which is a smaller bridge, but action is nonetheless still required.

Secondly and finally, could I call for a statement on forestry and biodiversity? We heard some comments from the First Minister earlier, but, as you'll be aware, the Welsh Government wants woodland cover in Wales to increase by at least 2,000 hectares per annum. When I attended the curlew summit in 10 Downing Street as the Wales species champion for the curlew last July, we heard that widespread planting of conifers in uplands had led to massive habitat loss, and it was not just the planted land that destroyed the birds, but the land in a large area around the forest ceased to be sustainable habitat for ground-nesting birds as the forest provides ideal cover for predators, mostly foxes, carrion crows and badgers. We need to know, therefore, in the context of the commendable goal to increase forestry and woodland in Wales, how we're going to ensure we have the right trees in the right places to genuinely protect biodiversity.

I'm grateful to Mark Isherwood for raising those issues. The first was the issue of prostate cancer and those MRI tests. I know that there is an intention by the health Minister to bring forward a statement in due course on the cancer strategy, and there'll also be an opportunity to raise issues tomorrow with the Deputy Minister for Health and Social Services during the cancer debate. So, there will be several opportunities in the near future to explore those issues.

On woodland cover, I know that there are particular pieces of work going on across Government, but the particularly interesting and exciting one, I think, is the work going on in terms of the national forest for Wales. I know the Minister will be making a statement very, very shortly—I think the intention is to launch this week.

I'm pleased that the Minister for agriculture is in her seat, just to note what I intend to raise. The Minister has stated that the new regulations on water quality will be laid within the next few weeks. I don't see in the business statement any reference to an oral statement to run along with the laying of those regulations over the next three weeks' business. You will know, of course, that these regulations have been very contentious, they have been the subject of points raised in this Chamber, and certainly they've produced a huge amount of correspondence for me and many other Members in this Chamber. They make far-reaching changes, and I would expect nothing less than an oral statement to go along with the laying of these new regulations, in order to ensure transparency, an opportunity for scrutiny, and the accountability that should go along with such a statement. So, can I ask you to confirm, Trefnydd, that there will be an oral statement alongside any new regulations laid on water quality, whenever they're brought forward?

Llywydd, the Minister is obviously here to hear your request this afternoon. I only have the information in terms of what's been laid on the business statement and announcement today, but we will certainly be listening to the request that you've made this afternoon.

I appreciate time is short, so I'll be brief. First of all, an issue raised by a number of Members in this Chamber today: that of flooding. Can I concur with those previous comments in terms of support that's available to businesses and homes, indeed, across Wales? Particularly those homes that may not have access to conventional flood insurance. I visited one home in Monmouthshire, in the town of Monmouth itself, where there's an issue with the electrical sockets, for instance, and there's some cost involved in repositioning those. Perhaps there could be some sort of grant available for those affected by flooding without insurance.

Secondly, an issue I've raised on many occasions: that of roads, and the Chepstow bypass. I wonder if we could have an update at some point in the run-up to Easter from the Minister for transport regarding progressing a Chepstow bypass, and any discussions that might have been held between either himself and his counterpart in Westminster, or indeed the relevant officials, to try and progress that important project.

Again, I would highlight the important potential of Flood Re as a potential way forward for people who have found it difficult to get flooding insurance because either they've been flooded in the past and the insurers won't take them on, or because they're on a property that is deemed to be at risk of flooding. It is a Government and industry partnership in order to deliver that, to ensure that people do have access to affordable insurance in those circumstances. So, I'd recommend that to Members, to explore it further as to whether it's something that they can explore with their constituents.

And of course, I will speak to my colleague the Minister for transport with regard to the request for an update on the Chepstow bypass.

Two months ago, I asked for a Government statement about health workforce planning, because I was concerned that a number of GP surgeries in my region were at risk of closure. Local councillors who also raised the issue were accused of scaremongering, but last week we received confirmation that three surgeries are to close in Gilfach, Lansbury Park and Penyrheol, all managed by Aneurin Bevan health board and all in the Caerphilly County Borough Council area.

I'm really concerned that the surgeries that will now have to take on thousands of new patients in light of these closures will struggle to deal with the extra demand, and that some people will have to travel to very far away places if they don't have their own transport. They might have trouble re-registering and accessing the new surgeries. I was out talking to residents in Lansbury Park last week, and one constituent told a colleague of mine that he was only just able to walk to a surgery round the corner, but he didn't know how he was going to be able to reach somewhere that was much further away.

I've previously mentioned that the BMA GP heat-map analysis showed that 32 surgeries are at risk of closure in the Aneurin Bevan health board area. Three of these have now closed, or are about to close, which means a further 29 could still be at risk.

My previous request for a statement went unheeded, I'm afraid. So, I'd like to ask again for a statement from the Welsh Government setting out what support will be made available to patients, pharmacies and surgeries that will have to cope with these new closures? Secondly, what immediate steps will the Welsh Government take to prevent the closure of further surgeries in their region through timely recruitment? And finally, how does the Welsh Government intend to turn around this disastrous failure to plan its future GP workforce in the face of growing demand? Diolch, Trefnydd.

Health boards are working with partners throughout the clusters to adopt and adapt the primary care model for Wales, with its focus on support for self-care and delivering a seamless 24/7 service that prioritises the sickest people, making effective use of the multiprofessional workforce. And of course, this year, the Welsh Government has provided an additional £10 million for clusters to decide how to invest in the support of the primary care model for Wales. 

With regard to the specific GP practices to which you refer, I do know that the Minister has had some discussions with the local Members, and that the health board is now offering a package of support to each of those practices that are likely to see an increased number of patients. Of course, there's huge work going on, isn't there, to try and encourage people to work in Wales, and actually, successful work in terms of recruiting new GPs into the training programmes as well. But the Minister has heard your request for a statement. It's very difficult to accommodate all statements; we get about 20 or so requests every week, with only a small number of slots in which to respond to them, but we do our best to try and accommodate things as much as we can.  

Thank you, Trefnydd. 

The next item, a statement on International Women's Day, has been tabled as a written statement.

Therefore, the next item is a statement by the Minister for Health and Social Services, a coronavirus update. I call on the Minister to make the statement—Vaughan Gething.

Thank you, Llywydd. The situation in Wales continues to evolve and we now have six confirmed cases. More cases will be diagnosed both here and elsewhere the UK in the coming days. In response to the changing situation, we have jointly developed an action plan with the UK Government and the other national devolved Governments. This builds on our experience of treating infectious diseases and our planning for an influenza pandemic.

The action plan deals with what we know currently about the virus and the diseases it causes; how we have planned for an infectious disease outbreak such as coronavirus; the actions we have taken so far in response to the current outbreak; what we're planning to do next, depending on the course that the current outbreak takes; and, of course, the role that the public can play in supporting this response, now and in the future.

I have asked the chief executive of NHS Wales to establish an NHS Wales and social services planning and response team to draw on appropriate expertise and to be in the best position to address response issues as we move through the phases of this outbreak. This team will provide ongoing support, co-ordination and integration of the health and social services response. They will co-ordinate their work with the wider remit of the Welsh Government emergency co-ordination centre. As an immediate action, assurance has been sought and confirmed from all health boards with acute hospitals that they are ready to accept patients into their isolation facilities.

This weekend, I authorised the supply of personal protective equipment to all GP practices across Wales. Supplies of personal protective equipment to community pharmacies will be sent out later this week. We are mobilising our pandemic stockpiles for health and social care, so that this stock is in a state of readiness to be pushed out as and when necessary. 

We are still taking action to detect early cases, to follow up close contacts, and to prevent the disease taking hold in this country for as long as is practically possible. If the disease becomes more established in the UK and in Wales, we will need to consider further measures to reduce the rate and extent of its spread.

We will therefore look to take new powers for Wales through the UK-wide coronavirus Bill to be introduced in the House of Commons, to be able to help systems and services work more effectively in tackling the outbreak. The Bill will strengthen quarantine and mass gathering powers, and will allow for the closure of schools and colleges, if necessary, to contain the spread of coronavirus. All four UK Governments across the UK have agreed on a single piece of UK-wide legislation as the right approach. However, I do want to reiterate the point that, in that single piece of UK-wide legislation, it is a clear expectation that all those powers that are currently devolved responsibilities will remain the responsibilities of Ministers in devolved national Governments. 

Our NHS will have to make some changes to how it operates. That includes care and advice by phone and information technology. I have decided on a new software system to be made available across Wales to enable video consultations for people with their GPs. We have already introduced an online symptom checker, hosted by our NHS Direct Wales website. There is, of course, the daily update on the Public Health Wales website too. This should help to reduce pressure on front-line staff, and better support people with information and advice.

We want to strike a balance between keeping people safe and minimising the social and economic impact. Our decisions will reflect the scientific evidence, and take into account the trade-offs involved. The actions we will consider include encouraging greater home working, not using public transport and other behavioural measures that people can voluntarily take to slow the spread of the disease. We will consider if those with more minor symptoms should self-isolate, but this will be informed by expert advice on the epidemiology of the outbreak, and we are not at that point today.

It is worth reminding ourselves and the public, though, that people with significant flu-like symptoms should not attend work, their GP, or an A&E department. That is not new advice—that is the current advice at all times of the year.

Some major public events, as we've seen, have been cancelled or postponed outside Wales, to limit the risk of transmitting coronavirus. A number of schools have closed in other countries for similar reasons. These are possible future options for us too. We are, however, not at that stage. Schools should remain open, and there is no rationale to cancel major sporting fixtures at this point.

But some of the most effective measures involve all of us—not just the Government or the NHS. For instance, simple personal hygiene procedures can significantly limit the spread of the virus, as can prudent self-isolation for those at particular risk. Employers can and should support their staff to take such action, without creating undue alarm. To mitigate the impact on businesses, the Welsh Government has registered COVID-19 as a notifiable disease. This will help companies seek compensation through their insurance policies in the event of any cancellations that they may have to make as a result of the spread of the virus.

We are moving towards enhanced monitoring arrangements at Cardiff international airport. This will mean that every aircraft that lands here from a region identified by the case definition will need to declare any symptomatic passengers to Public Health Wales's port health teams before disembarking.

Outside the UK, the risk changes daily. The Foreign and Commonwealth Office also updates its advice to travellers regularly. And people who intend to travel abroad should check the Foreign and Commonwealth Office website for the most up-to-date travel advice before they travel. The latest advice for returning travellers from the highest-risk parts of the world is to stay indoors, avoid contact with other people, and call 111. That is true even if they do not have symptoms. Those areas are: Iran, the Hubei province in China and Italy. For returning travellers from areas that are deemed lower risk, the advice is to stay indoors and avoid contact with other people only if you develop symptoms. This now includes all of Italy outside of the locked down areas I've already mentioned.

There is further advice available from Public Health Wales and the Welsh Government for people who have not travelled but are nonetheless concerned. That too will change as the pattern of the outbreak changes and as our understanding grows. But following such advice is always better than listening to often ill-informed rumour and speculation. In particular, I would urge people to check the advice that is available before presenting themselves for diagnosis, which, of course, risks wasting finite NHS resources. We are continuing to offer community testing to people in their own homes. In addition, 111 is now available across all areas of Wales for coronavirus advice.

The First Minister and I continue to attend COBRA meetings. We will continue to work with UK Ministers, the Scottish and Northern Irish Governments, our chief medical officers, and public health agencies, across all four nations.

No-one should be under any illusion about the threat that the coronavirus presents. There are plain and serious risks to people's health, including in particular people who are already vulnerable. And a large-scale outbreak also carries wider risks of social and economic disruption. 

This outbreak will not go away quickly and it will get worse before it gets better. But, at the same time, we have long been prepared for an outbreak like this, and we are learning more about this particular virus each day. That knowledge, combined with the dedication of our health professionals and others right across public services and the independent sector, allows us to reduce the risks as far as we possibly can. I will, of course, keep Members and the people of Wales fully informed of any steps that we take here in the Government. 

Thank you very much for your statement, Minister, and for keeping me, on behalf of the Welsh Conservatives, so well briefed during this situation. Just going through your statement, I have a number of questions. Are you able to confirm to us the level of seniority that the members of the NHS Wales and social services planning and response teams will be—in other words, that they've got the stripes to make things happen out there in the NHS? Are you able to confirm to us how many isolation beds we currently have available throughout our whole NHS? Because I'm assuming that isolation is literally quite different from intensive care, because they're the ones within the walled glass environments, so I just wanted clarification on that.

I was very pleased to see the personal protective equipment going out to GP practices and pharmacies, and I wondered at what point you might consider issuing them to domiciliary care workers and to care workers in residential homes, and what advice you might be giving to owners of private homes as to what precautions that they should be taking.  

You were talking about the technology to underpin this, and I must say that the symptom checker is very good, because I tried it out, and I think it's very clear and I commend you for that. Of course, an awful lot of older people will not necessarily have access to IT or be able to use IT, and I wondered what you might be putting in place, or what instructions you will be giving to older persons who can't actually use a symptom checker and what they should do. I'm assuming you might say back to me '111', and, again, I just wanted to have some clarification on that, because I was up in Wrexham Maelor Hospital meeting staff last week, and I also met with a couple of GP practices, and they were quite confusing on their message back to me as to the efficiency of 111 in north Wales. There was talk about the 0845 number being on a divert and that they weren't convinced that actually 111 was universal. So, perhaps, you could just confirm that, so that we can move forward on that one. 

And, again, while we're on the subject of older people, I appreciate that this isn't for now, but in the weeks coming up, will you be talking to and have you had any discussions with organisations such as supermarket leaders, to perhaps put in place some kind of way for older people who have to stay at home because they've got severe health risks like chronic obstructive pulmonary disease, or because they're a higher risk population, to be able to phone in supermarket orders and get them delivered? Because, again, particularly I know that in my constituencies, there is a significant number of older people who simply do not have access to that IT equipment to be able to put an order out to one of our favourite supermarkets. 

I've got a specific question that I'd like to ask about the workforce. In a previous statement, you said that you planned to employ volunteers and staff who've recently left the NHS. So, they're going to be current. Could you confirm that locum doctors will be offered contracts that will cover them and their families in the event of serious ill-health or even death if they die in service because of this? Will you be looking at that going forward? Because it's one thing to ask a retired GP or a retired consultant perhaps or nurse to come back in and cover a shift and they've recently retired, we can get them a quick fitness to practice certificate—I understand all of that and that will, no doubt, be taking place—but we also need to cover them if the worst happens. So, can you just confirm that perhaps this will be an area that you would look at?

You've also talked about the opportunity of video consultations, which actually I think is a very important step forward, but, again, are you giving some thought to what plans might be in place for the areas where video connectivity, because of our IT infrastructure, simply isn't available, and I could give you quite a few notspots in my constituency where that really wouldn't happen?

There are lots of questions to ask on coronavirus, and I simply am not going to take up lots more of your time. My last question would be that, of course, South Korea believe that they've passed the peak, and that they're now coming down the other side; they're quietly confident. They've been very effective in how they've dealt with it. They have a different social structure, and a different culture, but one of the things that they did use was they used social media to help to track a coronavirus-identified patient. Obviously, I don't know—I assume that they had permission—but to track where they'd been, so that they could then try to use that kind of technology to find out who else might be at risk. Could you just tell us whether or not you've got any thoughts in the weeks ahead? As I say, not now—I appreciate it's not in place at this moment—but we all recognise that this virus is going to expand. The situation will get worse and the things I've mentioned are just things that we could do to help perhaps to chase down or to mitigate, and I just wondered if you'd been looking at somewhere like South Korea, who think they're through the worst of it, to learn what best practice we can to help us contain the situation, or at least manage the situation, in our country.

Thank you for the series of comments and questions. Your first point about the new team that I've referred to within the Government: the fact that I've instructed the chief exec of NHS Wales to set this up, there should be more than enough stripes, to use your terminology, within the NHS to make sure that people respond with an appropriate level of seniority. It's about co-ordinating the work within the Government as well as the interface together with the health service. And on your point about isolation measures, going back to some of the points the First Minister made in questions as well, this is actually about how we ought to flex up our capacity to meet people, but also we're going to need to treat people in different ways. People who would normally come in to a hospital setting for their care—we may need to treat teach more and more of those people in their own home in a different way. So, actually, I don't think we should get fixated on the number of beds we currently have but actually about our capacity across our whole system to be able to treat more people, and what that means, and the different treatment choices we'll need to make, and what we'll actually then need to do, for example, together with both regulators and royal colleges as well.

When it comes to the personal protective equipment for general practice and pharmacy, and what that might mean for other people who have direct contact with, in particular, at-risk groups of people—that goes into part of the conversation we're having, not just with the staff in domiciliary and residential care, but also one of your later points about the work with supermarkets. I've already instructed officials to have those conversations about providing goods to people who may be in their own homes for a longer period of time, but it's also about the work the local government in particular will need to do, both in planning for a change in the nature of the way in which services will be delivered, about the way they deliver services in people's homes already, either because they're directly providing that care, or they're commissioning care, and the way in which they'll need to plan for a different way to deliver services—again, potentially with fewer staff at some point, but also potentially with an increase in demand coming through their doors too.

On your point about IT access, the steps that we've taken to provide a consistent piece of software across the system is a real step forward, but that doesn't mean that it has universal coverage, because you're right to point out that there are some people who either don't have IT equipment or don't have access effectively to it for a number of reasons. So, there are also things—[Inaudible.]—other people as well. And again, that's a challenge that not just the health service faces, but a range of other public services too.

And on your point about access to the symptom checker, Public Health Wales have already provided a range of advice posters that talk about symptoms in there, so it's not just an online forum. I've seen in my recent trip to north Wales what that means, and at Cardiff Airport—where they're visible; I think they're very clear—but also a range of businesses have used exactly the same information posters. And that goes back to the points being made before about clear and consistent advice in using advice from a trusted source of information so I'm really encouraged by the way in which that very simple and clear advice is being used in a wide range of areas.

And I'm happy to reiterate the point about 111. It is an all-Wales service—an all-Wales service for coronavirus. So, if people are concerned, they can ring that number from any part of Wales to be provided with advice and guidance.

On the report about indemnity for people who are locums, I'm happy to explore that area further to see about whether we do need to change any of our current arrangements to make sure we have the right numbers of staff in the right place to provide care and treatment and also give people the assurance they may be looking for.

And on your final point about international learning, not just from South Korea, but from more broadly across the world—that was part of your discussion at COBRA this week. It's part of the discussions I've had on a regular basis with the chief medical officer, because what appears to be slightly different advice is being given in different parts of the world, but it's also learning from people in different stages of an outbreak as well. Actually, the work of the World Health Organization will be really important in this. But we certainly want to be linked in to the best possible advice, not just across the UK, but internationally too, about lessons we can learn—and we're slightly behind where other parts of the world are with this outbreak—to try and make sure we make better choices here, or we better understand the choices we are inevitably going to be faced with. So, yes, it's important in the here an now. It will also be important afterwards. So, once we're after the peak of the coronavirus outbreak in the UK and across the globe, it's how we learn from what's happened and understand what we'll better need to do in the future.

May I thank the Minister for the statement and thank him for the briefings provided both to me and to other party spokespeople at this time?

May I just tell you a story about a doctor who contacted my office to complain about the 111 line, because she dealt with a patient who'd had to pay £10 to call the 0845 number because 111 didn't work and the patient wasn't able to use a landline at that particular time? This particular patient and her husband had travelled back from Italy recently, where they'd been on holiday with friends. Having returned, those friends who lived in England were tested and tested negative for COVID-19. The patients in Wales then got a headache and a cold and phoned the 0845 number, but they were told that they were unlikely to be at risk and that they didn't need to be tested. But because their friends in Essex had been tested, they felt that they should take further steps themselves and they decided to drive to Ysbyty Gwynedd. They spoke to a nurse there who triaged them over the phone. The doctor then put an apron and gloves on and went out of the car to ensure that tests and diagnosis could be provided, and what I've heard is that there was a lack of understanding even among hospital staff in terms of out-of-hours medical care in terms of what exactly to do in cases such as this. This is a cause of concern, of course, if the front-line staff themselves don't feel that they have the appropriate advice to provide to people, or appropriate clothing to protect themselves, although I do note, and am thankful, from the statement that GP surgeries are to be provided with appropriate clothing now.

There are a number of questions arising from this for me. First of all, if people can't contact 111 for some reason, or perhaps can't afford to phone the 0845 number, is there a risk that we are missing some cases? What steps will be taken in order to strengthen that 111 provision further?

If staff in hospitals feel that they don't have the necessary equipment to safeguard themselves, is there an expectation that they should be provided with that clothing and equipment? Also, what steps are being taken to strengthen the provision in hospitals for those people who act contrary to the advice provided and go to hospital in any case? Because people are going to do that, unfortunately. I hope there'll be few cases, but it will happen. So, what will be done to ensure that hospitals are ready for that?

If I could also make an appeal for an update on the more intensive care capacity. It is crucial, I think, that we at this point in time do ensure that that capacity is in place for more intensive care beds to be provided in hospitals. I do think that it's fair to say that our experience from other nations in looking at what happens elsewhere tells us that the kind of care provided to people at that point where their illness becomes serious, whether the care is appropriate for them and good enough for them at that point, can make the difference as to whether those individuals survive this virus or not. So, what's being done now to ensure that that capacity is built for the needs that could arise over the next few weeks and months in terms of intensive care in hospitals?

I want to thank you for the comments and questions. I think your story of real experience in the recent past is important for all of us. On 0845, the old 0845 number, that is a cost that phone providers themselves charge and we're not in control of that. That's really frustrating, but we've taken the step to have an all-Wales 111 service so that it's a consistent number, so that we're not asking people in different parts of Wales to check which number they should use. I think it's really important, those points about clarity and consistency in the message that we have.

I'm really clear that if they need more resources, then we'll find more resources to give them more capacity to deal with people. There is something then about our whole NHS system understanding what to do, both about whether they need to use protective clothing or equipment, but also to make sure that people do themselves understand, in a simple and a clear way, how they should behave with members of the public. I think your point about the fact that they drove to a hospital site when that's exactly what we're asking people not to do, and our challenge about reinforcing for people to please follow the advice to keep them and other people safe—it's about keeping them safe, their family, their loved ones, but also people they may never have met. This is a really serious position.

The choices that we may well be faced with making will be choices that are imperfect, in the sense that we may be making choices about putting off activity within the health service to prioritise the most serious activity; we may be asking people to deliver treatment in a way that isn't what you'd expect to deliver in the here and now today, because of the capacity and because of the demand that we may see coming through our doors. The situation in Italy should tell us something about the choices we may face.

Italy is not a developing world country, they have a good developed world health system, and yet their healthcare system is over-topped at present. They've over-topped all of their intensive care capacity, including having scaled that up by redeploying their staff, and they're having to make some of the choices that the First Minister described as well. They're talking about treating people in hospitals not in the sort of position that they might otherwise have wanted those people to be in, in an intensive care bed, but they may not have those beds because they're full; they're talking about people who may need ventilation, they don't have that, they're thinking about alternatives. As I've said several times, we may be treating people in their own homes when today we would definitely be saying, 'That person should be in a hospital, in a bed with a certain level of escalation.' These are not trivial choices we are actively contemplating having to make.

Even if we flex all of our capacity, if we switch off other areas of activity, if we redeploy all of our staff, it is still possible that if we don't take steps, if we don't take effective measures, we could be over-topped. It is also possible that, doing everything humanly possible, a new condition that we don't have a vaccine for, we don't have effective anti-viral treatment for—it is possible when you look at the reasonable worst-case scenario that a range of our services could be over-topped. That's the challenge we're facing, so the seriousness of all the choices we make are real. As I say, the scale of what is happening in Italy now should reinforce that, not just the rise in the death toll numbers, but also the numbers of people that are seriously unwell at present today in Italy and they're having to care for.

So, I'll be happy to deal with all of those points as we come through and have to make choices, both about choices that we are making, about change in the way the health service works, but also about choices that we are saying we don't need to make. Again, we're asking the public to follow the advice that we're giving from trusted sources, the Government the national health service, and to make sure that we do follow that advice and not some of the alternative advice that exists from alternative commentators that are being giving a platform on social media and the broadcast news. I saw an interview Rory Stewart did—a former Cabinet Minister—and he was suggesting that the Government should ignore the scientific advice and take action early, in advance of what the science tells us. That is entirely the wrong thing to do. I was very disappointed because it's highly irresponsible, so this Government will make choices even if they seem counterintuitive. I re-provide the reassurance that we are definitely definitely listening to the four chief medical officers across the UK and we are definitely looking to the very best scientific advice we have to base our decisions upon.

I think the thoughts of all of us in this Chamber and elsewhere are with all those people who are currently suffering from this virus and those who believe that they might be but are maybe awaiting diagnosis, as well the families of those who have already died. I think this is one of the most terrifying threats to us as people and to our society that I've certainly seen in my lifetime. I can remember on no other occasion how a disease like this has spread across the globe and has infected so many people and caused so much suffering in societies across the whole of this world. 

I'm glad that the Welsh Government is listening to experts, and I'm glad that the Welsh Government is following the advice that our scientists and doctors are providing to us. It is absolutely essential that, in responding to this crisis, we follow the best advice and scientific analysis that we have available to us. I'm also very pleased to see that the Welsh Government is working closely with the other Governments across the United Kingdom to ensure that we do have the sort of holistic response that we require. I would say that I believe that the Welsh Government is the only administration, if you like, in this country capable of co-ordinating all of the responses required across all of our public services and across all of the different services that we will require as a country to come through this virus. I hope that the Minister—he hasn't mentioned this in his initial response, but I trust the Minister is working closely with his colleague sitting next to him, the Minister, I think, who is responsible for civil contingencies, and perhaps he would explain the structures that the Welsh Government are putting in place to ensure that we have the full, civil contingency response that we will require.

But I think the thoughts of many of us are with those people working in the national health service who will bear the brunt of this virus and the human consequences of this. Many of us have been seeing and hearing and reading of the impact that this is having on the medical service and the health service in Italy and the impact it is having on the people working within the health service in Italy who have to take life and death decisions, who are working long hours under extraordinary pressures to deal with the human impact of the virus. In my experience, one of the most difficult civil contingencies that we've dealt with across the United Kingdom was that in Salisbury, and the poisoning that took place there some years ago. One of the lessons learned there was the burnout and the impact that responding to these emergencies has on people over an extended period of time. Clearly, the incident in Salisbury was an isolated, single incident; this is something that is going to be happening in every community across the whole of this country over an extended period of time.

I hope that—. And perhaps the Minister will explain to us the sort of measures that the Government is putting in place to protect national health service workers and to ensure that we're able to support people working in the national health service to ensure that they have the support that they need, but to also look outside of the national health service to ensure that we have the care available for vulnerable people, people who may be living alone, people who might be living with life-limiting conditions at present, to ensure that they are kept safely in their homes and in their communities, but also support for small businesses as well. This is extending beyond, perhaps, this Minister's responsibilities, but it is easier for a multinational to withstand this than a corner shop, and we need to ensure that the small businesses of this country are protected as well. That takes us to ensuring that our public services have the support that they require as well. Local government, amongst others, amongst education and elsewhere, will be on the front line in dealing with much of the impact of this virus, and we need to ensure that our public services have the support and the co-ordination that they also require. 

Finally, Minister, in your statement, you outlined four-country legislation that is going to be passed by Westminster to provide Ministers here with the powers that you require in order to deal with this, and I very much welcome that, but can you assure us that the powers that you will be taking will be subject to sunset clauses so that these powers do not remain on the statute book at the end of this emergency, so that we don't, almost by accident, grant the Government enduring powers over our lives outside of this emergency? 

Thank you for the series of questions. I think I'll start with some of your early points—I'll try to take them in order. I don't always agree with Matt Hancock, and I certainly don't always agree with Boris Johnson, but, during our COBRA calls, there has been a genuinely serious and grown-up attempt to go through issues and to reach agreement on finding the best way through. In fact, the Prime Minister has said, and I agree with him on this, that the greatest risk of panic and the wrong response is often politically driven demands in contradiction of the science and the evidence. So, our response is based on the science and on the evidence.

In terms of the work we're doing across Government, I have already met with Julie James at the start of the now very regular COBRA meetings. We've had a conversation, and I've met with her lead official who co-ordinates much of the civil contingencies work. We've also formed, as the First Minister said, a core ministerial group—if you like, a COBRA Cymru group of Ministers—and we're meeting each week. I chaired the first meeting of that group last week. We're meeting again tomorrow, so there'll be regular conversations between Ministers so that Ministers are informed of different choices that are being made, but, equally, so Ministers can co-ordinate choices within their own portfolio areas, because every group of stakeholders working to every group of Ministers will be affected by this somewhere along the line, as you say.

And it's not only the choices that we make there, because your specific choices around small businesses, I think, are really important. Because there is a range of measures that Welsh Government could take, but, actually, on many more of those, there's action that the UK Government will need to take on a whole-UK basis. I hope that the budget tomorrow sets some of those out. That's why the finance Minister was in London at the start of the day to have that conversation. That, again, came from a previous COBRA meeting, where there was agreement that that meeting should take place with finance Ministers in all of the devolved national Governments.

We'll then need to see what measures are taken tomorrow, but as the outbreak develops to make sure there's a fleet-of-foot response from the Government across the UK as well. Obviously, the economy Minister has already asked his officials to look at the measures that we could take here to support small businesses in particular. That, potentially, could be as a consequence of the public health advice that we give. If we ask people to stay at home—if we ask more people to stay at home—that could have an impact on either the custom that goes out, but also people going to work themselves. A small business say with five employees—well, if two of those people are asked to stay at home, that can make a really big difference to the running of that business.

Your point about the human impact of this, I think, is also really important as well, because we're really talking with the Royal Colleges and regulators about the potential impacts of making different choices and holding people to standards at the time. But there is a human impact in, if people are seeing large numbers of very sick people, not making choices that they would otherwise make, and not feeling they're able to be in control as they would normally expect to be in delivering health and care, and that's something that we discovered both at the partnership forum, the NHS partnership forum, between the Government, the employers and trade unions on Thursday in north Wales, when I attended.

Again, we're trying to work through some consistent advice, so we don't see a wildly varying approach being taken between different NHS organisations here in Wales. There is a broader point there about public services too, because it won't just be NHS workers who will find themselves in a very difficult position, as you point out. That's a matter that I went through with social care cabinet colleagues from local government yesterday. So, across all parties, they recognise that they need to go and look at the way in which they run their services, and, obviously, the leaders of every local government organisation will need to think about that too.

I'm pleased you made the point about social isolation—if we're asking people to stay at home, what that means, regardless of the age profile. Given that we understand that social isolation and loneliness are a real challenge for lots of people, if we're then asking more of those people to not have that social interaction, again there's a choice for the Government, for the health service, but also for local government, about what form of social interaction can those people have to make sure that they're still being checked up on and not ignored, if we're asking them to avoid what would otherwise be normal social contact that helps people to stay well and healthy. So, it isn't a simple measure of, 'Take one step and that will keep everyone safe.'

The final point I'd make is just to give you some reassurance about the emergency powers Bill. All Ministers are cognisant of the fact that, in asking the legislatures across the UK to trust Ministers with powers, there should be some safeguards, and that definitely includes sunset clauses. So, any legislation, you'd expect to see sunset clauses in that about not just how powers are enacted but how powers get switched off again as well, because I recognise completely the point that the Member makes. 

Thank you for your latest update, Minister, and I welcome the measures the Welsh Government, Public Health Wales and our excellent NHS staff are taking to protect us from the spread of the SARS COV-2 virus. Some of the measures, such as the new software to enable video consultations, will enhance our health service beyond this outbreak, and we must capitalise on this service, which, in this instance, replaces face-to-face contact and is absolutely necessary at this point.

At this point, it is important to reiterate to the public that we must all try to be as not panicked as possible, and while it is right that we prepare for all eventualities, there is no need for the public to change the way they go about their day-to-day activities, apart from taking precautions against respiratory illnesses, such as regular hand washing and never touching your face with unwashed hands. But this guidance should be normal practice, and we must note that influenza kills more than 0.5 billion people a year, so it's important to keep that in perspective.

It is also important to check the information that is readily available to the public and ensure that it is updated, and also to ensure that our most vulnerable in society have access to all of this information and our hard-to-reach communities are also made easier, so that they can interact regarding information on this virus.

So far, we have six people infected with SARS COV-2, and that's 0.0001 per cent of the population of Wales: six people out of 3.2 million. So, it is reassuring to note that, across the UK, there have been around 320 cases out of a total population of 70 million. It is important also to note that we keep our perspective, prepare but do not overreact, and the biggest threat in any viral outbreak is public panic. Rumour is currently our biggest enemy and social media is rife with fake cases and fake cures, and everything from drinking bleach to snorting cocaine. It has led to panic buying, resulting in short-term shortages as the supermarkets restock, further adding to the rumour mill.

So, Minister, what discussions have you had with the UK Government and have had with the social media platforms about the best way of tackling the spread of misinformation, and how to promote information from trusted sources such as Public Health Wales? I would once again like to thank you for the measured approach the Welsh Government is taking in preparing for the impacts of a COVID-19 outbreak.

I have just one or two questions relating to preparations here in Wales. Minister, last year the Welsh Government made preparations for a 'no deal' Brexit by securing warehouse space and stockpiling certain medicines. Minister, what role, if any, will those measures play in preparing for a wider scale outbreak?

And, finally, Minister, there have been reports that the SARS COV-2 virus will impact the availability of pharmaceutical ingredients coming out of India. This supply chain is vital to the generic medicines trade, so what discussions have you had with the pharmaceutical industry about the best ways to mitigate any threats this virus will have upon the supply of pharmaceutical products? Thank you.  

Thank you for the comments and questions. On your questions, there is already an NHS team that is taking—. There was an announcement—you might have seen publicity on it yesterday—in terms of some of the points about search engines and which terms are going to come to the top of those outcomes and results to make sure they're from trusted sources, but also in terms of trying to rebut on social media some of the more lively conspiracy theories but the range of information and misinformation that is in the public realm, and that is a real problem for us.

Our 'no deal' preparations will actually stand us in relatively good stead, both in terms of stakeholders who have a range of measures to deal with interruptions in their supply, but also the warehouse you mentioned. We actually purchased that, and so we do have some additional resilience. But the challenge comes, like you said in your question, about generic medication. We need to be upfront about what we can do, but also, if there are steps that we can't take, to be clear that we can't take those steps as well. So, we're looking for intelligence from the pharmaceutical industry itself, which manufactures and imports those medications, to understand if there are risks to supply and if there are alternatives or not.

And I think the final point I'd make is that, with the low-level flu that is relatively circulating here, with the low level of people who have coronavirus in Wales today, we expect that over the coming days more people will be diagnosed with coronavirus. So, the relatively low number of cases today should not be taken as a sign that this is nothing to worry about and there's no need to do anything about it. This is a real concern. There is already community transmission in some parts of England; that will take hold in other parts of the country.

So, we have to absolutely understand we will have more coronavirus cases in Wales; there will be people who will become unwell. What we can't anticipate exactly is how many people that will be and the impact that will have upon our services. This is not like another mild flu season taking place out of winter. We don't have a vaccine for coronavirus, COVID-19; we don't have effective antiviral treatment. So, if this circulates widely, it will have a real impact on the health of very many people who are already vulnerable. That is why we're taking it so seriously; that is why we're taking extraordinary steps; that is why there is so much co-operation between four Governments who would otherwise have plenty to disagree about at the top of their agenda.

Thank you very much, Minister.

Item 6: the Regulation and Inspection of Social Care (Wales) Act 2016 and Regulated Services (Miscellaneous Amendments) Regulations 2020, and item 7: the Social Care (Wales) (Specification and Social Care Workers) (Registration) (Amendment) Regulations 2020. I propose, unless any Member objects, in accordance with Standing Order 12.24, that the following two motions are grouped for debate.

Therefore, I call on the Deputy Minister for Health and Social Services to move the motions—Julie Morgan.

Thank you, Deputy Presiding Officer, and I move the motions. The two statutory instruments before you today amend the Regulation and Inspection of Social Care (Wales) Act 2016, and there a number of regulations that flow from that Act. It's the intention that these amended regulations come into force on 1 April. Both sets of regulations are an important step towards realising our goal to professionalise the social care workforce, to continue to raise the quality of care, and to ensure that workers get the support and recognition that they do deserve.

The miscellaneous amendments regulations deliver several key changes. First, they amend the regulations about service registration that enable the service regulator, Care Inspectorate Wales, to request additional information from individuals who make up the governing body of an organisation registering to become a service provider. This includes, for example, the individuals on the board of directors or trustees. The service regulator is then able to take this information into account when assessing the fitness of the service provider.

Secondly, the regulations also provide additional clarity about the notifications that providers must make to the service regulator. They require that providers make a notification when there is any change to the key decision makers of the organisation, regardless of its legal entity.

Thirdly, they also require providers of domiciliary support services, care homes for children, and secure accommodation services to employ only those individuals who are registered with the workforce regulator, Social Care Wales, within six months of commencing employment. This will also apply to anyone engaged under a contract with these service providers, including agency workers.

The social care workers registration regulations enable Social Care Wales to open the register to individuals working in care homes wholly or mainly for adults, and in residential family centre services, who can join the register voluntarily from April 2020. This provides these workers with a two-year lead-in period, during which the workforce regulator, care workers and their employers can work together to prepare for mandatory registration, which we plan to introduce in 2022.

Registration recognises the professional responsibility of care workers who provide absolutely vital care and support to people with increasingly complex needs. It'll help to ensure workers are suitably qualified and trained for the work they do. It will provide those workers with access to additional support and resources from Social Care Wales. Registration also provides additional safeguards to the public so that, should an incident occur, workers can be held to account by the workforce regulator. Thank you.

Thank you. I have no speakers. We have to take the votes separately. Therefore, the proposal is to agree the motion under item 6. Does any Member object? No, thank you. Therefore, in accordance with Standing Order 12.36, the motion is agreed.

And, again, the same, the proposal is to agree the motion under item 7. Does any Member object? No. Therefore, again, the motion under item 7 is agreed in accordance with Standing Order 12.36.

We now move on to item 8, which is a debate on the police settlement of 2020-21, and I call on the Minister for Housing and Local Government to move the motion—Julie James.

Thank you, Deputy Presiding Officer. I am today presenting to the Senedd for its approval details of the Welsh Government's contribution to the core revenue funding for the four police and crime commissioners, or PCCs, in Wales for 2020-21.

Before I do so, Presiding Officer, particularly given the recent events, I'd like to record my gratitude to all of the Welsh emergency services for their resilience and fortitude, and I'm sure these comments will be echoed in this Chamber and across the residents of Wales. Those who serve in our police forces across Wales not only keep our communities safe, they maintain the highest standards of duty, dedication and, at times, bravery. This was demonstrated most recently when they worked with others to protect and save some of our communities from the recent storms. I recognise the importance of the Welsh police forces and their vital role in protecting and serving our communities here. The police service in Wales is a positive example of how devolved and non-devolved services can work effectively together.

Members will be aware that the core funding for the police in Wales is delivered through a three-way arrangement involving the Home Office, the Welsh Government and council tax. As policing policy and operational matters and non-devolved, the overall funding picture is determined and driven by the Home Office. The established approach to setting and distributing the Welsh Government component has, therefore, been based on a principle of ensuring consistency and fairness across England and Wales.

I would also like to thank PCCs for their patience this year. Due to the now, sadly, normalised chaos and uncertainty from Westminster, the PCCs did not have a provisional police settlement this year. With delay after delay to the UK budget, due to the general election, exiting the European Union, and now a new Chancellor to add to the ongoing uncertainty, this year's PCCs have had to notify their police and crime panels of the proposed change in precept fewer than two weeks after being informed of their funding allocations. Still the UK Government has not published its 2020-21 budget, leading to continuing uncertainty for our public services, businesses and individuals. 

As outlined in the final police settlement announcement on 22 January, the total unhypothecated revenue support for the police service in Wales for 2020-21 amounts to £384 million. The Welsh Government's contribution to this amount, through revenue support grant and redistributed non-domestic rates, is £143.4 million—and it is this funding you are being asked to approve today.

As in previous years, the Home Office has decided to overlay its needs-based formula with a floor mechanism. This means that, for 2020-21, police and crime commissioners across England and Wales will all receive an increase of funding of 7.5 per cent when compared with 2019-20. The Home Office will provide a top-up grant totalling £14.4 million to ensure both Dyfed-Powys Police and North Wales Police meet the floor level.

The Home Office advises that this settlement includes the funding to recruit an additional 6,000 police officers shared amongst the 43 forces in England and Wales. The Welsh Government is determined to strengthen the economy and create employment opportunities across the country. I welcome the opportunity for people across Wales to consider a career in the police forces. The Prime Minister has committed to a target of 20,000 new officers over the next three years. However, for this to happen, I urge the UK Government to pledge to provide the associated funding to our police and crime commissioners for future years.

As in 2019-20, the Home Office will continue to provide a specific grant to PCCs in 2020-21 to fund the additional pressure as a result of the UK Government's changes to the pension contribution rates. The Home Office has kept the grant value at £143 million in 2020-21, with £7.3 million of this allocated to PCCs in Wales. PCCs also have the ability to raise additional funding through their council tax precept. The UK Government has set the upper precept limit for PCCs in England to £10 in 2020-21, estimating this will raise an additional £250 million. Unlike the limits that apply in England, Welsh police and crime commissioners have the freedom to make their own decisions about council tax increases. Setting the precept is a key part of the police and crime commissioner's role, which demonstrates accountability to the local electorate.

We appreciate that difficult decisions are necessary in developing plans for the coming years with only a one-year budget. The Welsh Government is committed to working with PCCs and chief constables to ensure funding challenges are managed in ways that minimise the impact on community safety in Wales. As part of this, the Welsh Government in its 2020-21 budget has continued to fund the 500 community support officers recruited under the previous programme for government commitment. The Welsh Government has maintained the same level of funding for the delivery of this commitment as in 2019-20, with £16.8 million agreed in the budget for next year. One of the main drivers behind this project was to add visible police presence on our streets at a time when the UK Government is cutting back on police funding. The full complement of officers has been deployed since October 2013, and they are making a positive contribution to public safety across Wales. They will continue to work with local communities and partners to improve outcomes for those affected by crime and anti-social behaviour.

Returning to the purpose of today's debate, the motion is to agree the local government finance report for police and crime commissioners that has been laid before the Assembly. If approved, this will allow the commissioners to confirm their budgets for the next financial year. I therefore ask Assembly Members to support this motion today. Diolch.

Labour's March 2010 UK budget statement revised down the growth forecast, reduced borrowing, and stated that the scale of the deficit meant the UK didn't have enough money. In consequence, it also announced £545 million of cuts to the police to be made by 2014. Since 2015, UK Government has raised its contribution to overall police funding in line with inflation, including specific areas such as cyber-crime, counter-terrorism, and tackling child sexual exploitation. The UK Government has now announced a £1.12 billion increase in 2020-21, taking the total settlement for policing to £15.2 billion. This includes £700 million for 6,000 additional officers by the end of March 2021. As the Minister indicated, the UK Government aims to recruit 20,000 total new officers across the UK.

The majority of funding for police and crime commissioners comes directly from general Government grants, as we heard—London and Cardiff—and around a third comes from the council tax police precept, which is increasing this year by 6.82 per cent, £273 per annum, in Gwent; 5.9 per cent, £273 per annum, in south Wales; 4.83 per cent, £261 per annum, in Dyfed Powys; and 4.5 per cent, £291 per annum, in north Wales. Although the South Wales Police Federation stated in 2016 that the council tax precept gap with the other Welsh forces had now been closed, it's apparent that, although north Wales has the lowest percentage increase, council tax payers there are still paying more than the Welsh regions facing the biggest percentage increases.

Following a long-term reduction, levels of crime have remained broadly stable in recent years. While in the latest year there's been no change in overall levels of crime, this hides variations seen in individual crime types. Excepting fraud, the latest figures from the crime survey for England and Wales show all main crime types showed no change. As the Office for National Statistics has said:

'Although the number of offences involving a knife has continued to increase, there is a mixed picture across police forces and overall levels of violence remain steady'.

The budget increases in north Wales will fund 10 more officers for the major crime unit, 20 new auxiliary police staff, 16 additional response officers, and five more community safety officers, including three for the rural crime team. This weekend, the Home Secretary and Secretary of State for Wales joined the North Wales Police to see how they're tackling the county lines drug problem in the region. As well as announcing their plans to recruit new police officers, the Home Office also confirmed that they'll be providing North Wales Police with nearly £150,000 to invest in 167 new taser devices, part of £576,000 across the four Wales police forces. This comes as part of a UK-wide uplift that will see £6.5 million divided between 41 police forces. Speaking in north Wales, the Home Secretary said:

'I'm committed to providing forces across Wales with the powers, resources and tools they need to keep themselves and the public safe.'

She also said that she was consulting on a UK Government's police covenant, called for by the police federation, recognising police officers' service and sacrifice, and enshrining their rights in law. Other steps recently taken by the Home Office were highlighted, including expanding stop-and-search powers, and plans to increase the maximum sentence for assaulting emergency service workers.

In January, I visited Titan, the North West Regional Organised Crime Unit, to receive a useful presentation on their role and their capabilities to prevent and protect, dealing with matters such as serious and organised crime, the control of drugs, county lines, economic crime and cyber crime. Titan was established in 2009 as a collaboration between the six police forces in north Wales, Cheshire, Merseyside, Greater Manchester, Lancashire and Cumbria, to tackle serious organised crime that crosses county borders in the region. They told me that an estimated 95 per cent or more of crime in north Wales operates on a cross-border, east-west basis, and almost none on an all-Wales basis, and the north Wales police representative present also confirmed that all their north Wales emergency planning is done with their partner forces in north-west England, and they have no significant operations working with the other police forces in Wales.

Labour and Plaid Cymru, of course, propose the devolution and Cardiff control of justice and policing, while a Welsh Conservative Government would instead work with the UK Government to deliver policing and offender management services in Wales that reflect our devolved responsibilities. We would back the law-abiding, hardworking silent majority; not give a vote to prisoners convicted of sexual and racist crimes, as Labour and Plaid Cymru propose. Diolch yn fawr.

The British Government seem to have recognised the damage that they've done with 10 years of cuts to policing. However, one year, or even two budget increases will go nowhere near far enough to reverse the damage that's been done. So, this increase in funding must be the first step in addressing the chronic lack of funding that still exists. To address the chronic problems that Welsh police forces face, the funding formula, we believe, must be reformed. 

The current formula discriminates against council tax payers in Wales. The formula doesn't adapt to urban and rural needs, and the potential for recruitment from the apprenticeship levy is not being utilised. The plans to fund 20,000 police officers doesn't cover what has been lost since 2010. Plaid Cymru therefore wants to see a funding formula for Welsh police forces that is based on population and need, rather than the UK Government's flawed formula. The Welsh Government also has a part to play to ensure that funding to tackle the root causes of crime is addressed. Youth services in Wales have had their funding cut by 38 per cent, which equates to a loss of £19 million since 2010, inevitably making police officers' work much more difficult. Proper and adequate funding of other services, like, for example, mental health support, would also be very helpful to the police. 

Despite their various constraints, Plaid Cymru's police and crime commissioners have launched a three-year early intervention fund worth £800,000 to address adverse childhood experiences, as part of an attempt to tackle the underlying causes of crime. The National Farmers' Union have used north Wales as a case study for tackling rural crime. Dyfed Powys Police have created schemes such as Farmwatch to provide crime prevention advice, and they've launched Checkpoint Cymru, which diverts low-level offenders away from the criminal justice system. These principles can be applied elsewhere. Imagine what those police and crime commissioners could do with secure funding that isn't tied to Westminster's agenda. Diolch. 

Thank you, Deputy Llywydd. When Mark Isherwood was making his speech, it reminded me a little bit of some of those Soviet economic reports you used to get—the last five-year plan was absolutely fantastic, but not as good as the next five-year plan. I'm afraid there's a real danger when you start being so selective in terms of the figures that you actually use. And I think we need to look at where we are. When we debated this last time, the state of play was an 18 per cent increase in violent crime, a 14 per cent increase in knife crime in south Wales, a 25 per cent increase in Wales, 84,000 crimes unsolved, and, since 2010, we now have—well, we then had 682 fewer police officers. Now, those figures go together. What is the situation now? The situation now is that we actually have around 762 fewer police officers than we had in 2010. Crime and serious violent crime is increasing. We've become very dependent on the additional 500 police and community support officers that are funded by Welsh Government out of our own funds—not money that should be allocated by UK Government for that. And in fact, when we look at the PCSO figures across the UK, we've actually lost in the region of 6,680 police and community support officers across the UK, with, obviously, the consequential effect within Wales, which is why the Welsh funding on this is so absolutely important.

And Leanne is absolutely right to raise the issue of those areas of funding for the work that the police do that is not just about catching criminals, but is engaging within society, whether it be mental health, drug and alcohol funding, rehabilitation, and so on—all those things that are partnership, which have an impact on policing and have an impact on the social stability of our society and the well-being of our communities. And the fact of the matter is that, with the fact that we have a modest increase in real terms this year, it doesn't get over the fact that, in actual fact, over the next five years, we actually need—if we're going to restore the Tory cuts since 2010—to recruit 53,000 police officers, when you take into account the retirements. Now, this is the same—. Mark is guilty of the same manipulation of figures that we had over nurse numbers, and so on—that when you're actually taking in recruitments, and the need for ongoing recruitment, the picture presented is very much different.

Now, for anyone who speaks to the Police Federation, to police and community support officers and to the police and crime commissioners, you get a number of very important points coming to the fore, one of which is that, even with the recruitment of those police numbers—if we were able to achieve that—what we have actually lost, which will take a decade to replace, are the skills and the quality of policing that has been achieved. Because we have been losing some of the most well-qualified and experienced police officers. And the other point they make is that not only will it take a long time to repair the Tory damage to policing, at the moment, not much has changed. And that's the best you can say about the Tory record on policing—not much has changed, the damage they wrought since 2010 is still there, and it will take decades to recover. The modest settlement we have is only a very, very small start, scratching the surface.

I'd like to start by echoing the Minister's thanks to police officers across the country for the work they do in keeping us safe in our communities. They've been under enormous pressures over the last few weeks and months, and I think all of us would want to join together and recognise how they've responded to those pressures. And they've done so having suffered year-on-year cuts over the last decade. Austerity has not been kind to our police forces. In fact, the UK Government—the Home Office—is spending less in cash terms this year than they were spending a decade ago. And whilst we hear from the Tories that they want to put more resources into the police, what I would say to them is, 'Why don't you start with where you started back in 2010, when you started attacking the police force?' And we need to ensure that we do have the resources in place to ensure that our police are able to keep us safe.

But not only have the Tories cut back on the total amount of spending that the police have available to them, they've also transferred funding from the police. Mark Isherwood said that a third of funding comes from the council tax. In fact, in 2010-11, 33 per cent—he was right, 33 per cent—of funding came from council tax. Today, this year, that figure is 47 per cent—it's nearly half funded through council tax. And the Home Office funding, which was 40 per cent in 2010-11, is 32 per cent today. So, there's been a real transfer of responsibility for funding the police from the Home Office, from the United Kingdom Government to Wales, to the Welsh Government and to council tax payers. The vast majority of funding from the police today is raised here in Wales. Nearly 70 per cent of all police funding in Wales today comes from sources within Wales, and that means that we also need the structures available to us, not simply the budgets, but the structures as well.

People in Blaenau Gwent are concerned about what they see all too often: the anti-social behaviour, whether it's stones thrown at buses or drugs being used on the streets. They want to feel safe in their homes and safe on our streets. But they also recognise and understand that the policing response to these challenges are only a part of the question, a part of the answer, because the police have to work alongside local government, the education services, health, particularly in terms of dealing with some of the huge issues around mental health and drugs facing us today. They have to work with social services; they have to work across the whole range of services to provide a holistic response to the challenges that we face in our communities. People understand that. I am at a loss why the United Kingdom Government doesn't understand that. 

I hope, Minister, in replying to this debate, that you will be able to confirm that you will be taking forward the work of the Thomas commission on devolving the police, so that we do have, in the future, not only a properly funded police force, where the police officers have the resources available to them to protect our communities, to protect our people, to keep us safe, so that they're not continually overstretched, under far too great a pressure as individual officers, but that they're also located and a part of the family of Welsh public services, working together within our communities for the benefit of the whole of our communities. I give way to the Member for Bridgend. 

I'm grateful to my colleague, Alun Davies. Does he share my bewilderment at the argument that, because crime is cross-border between England and Wales, as if that was a unique situation, it means that the larger country must therefore control the policing of the smaller country as well? Does that not mean that, sensibly then, the Republic of Ireland should be controlling policing across the whole of the island of Ireland? That is the logic of that argument. And does he also agree with me that, even though crime is cross-border, it is perfectly possible for policing co-operation to continue, as it does between the republic and the north, between England and Scotland, and there is no reason why the people of Wales cannot have control over their own police forces?

I do agree very much with what the Member for Bridgend has said. And, of course, what the Conservatives are confusing is the detection of crime and resolving the issues arising from crime and finding the answers to crime. And I listen to Conservative Ministers who are very happy to devolve responsibilities to parts of England, to Manchester and to London, of course, but Wales isn't good enough for the Tories. The Tories never think that we are capable of managing these matters ourselves. 

And the Member for Bridgend makes a very, very important point, and in looking at the wider issues of criminal justice, I cannot believe that any Welsh Government of any colour, of any stripe, would have allowed a situation to occur where there are no facilities for women in our criminal justice system in our country. That is a standing rebuke and a disgrace and something that the United Kingdom Government has to take responsibility for. 

Thank you. Can I now call the Minister for Housing and Local Government to reply to the debate? Julie James. 

Thank you, Deputy Presiding Officer. I'd like to thank Members for their interests and their contributions today and reiterate once more my thanks to the police service across Wales, particularly in the light of their efforts in the recent flooding events. 

I'm not too sure where the first contributor, Mark Isherwood, was going as he started, but it was quite obvious that he sought to lay the blame elsewhere for his Government's obviously poor choice in cutting funding to the police, a poor choice that reverberates still today, as all other contributors acknowledged. 

Community safety is a top priority for this Government and, whilst this settlement is better than some may have expected, we are under no illusion that one better settlement makes up for the previous 10 years under the UK Government's austerity agenda. Indeed, some police and crime commissioners have expressed concern that, whilst additional funding has been provided for some new officers, there is insufficient funding for the existing complement. This, of course, is a matter for the Home Office and we urge them to address it as an urgent priority. 

We are committed to working with PCCs and chief constables to ensure that these challenges are manged in ways that limit the impact on community safety and front-line policing in Wales. Continuing to work in partnership to identify and take forward opportunities is as important, as is demonstrated by a successful deployment of the 500 community support officers.

We also, of course, continue to push for the devolution of criminal justice and policing in line with the Thomas commission's recommendation. I could not agree more with the comments of various contributors around the Chamber: it makes no sense at all that policing is not devolved when all other blue-light services are devolved, and it quite clearly would be better if we co-ordinated the thing entirely from a devolved point of view. I wholly endorse all the contributions on this point, and particularly Carwyn Jones's excellent summation of how idiotic the argument made the other way actually is.

Having endorsed that thoroughly, Deputy Presiding Officer, I commend this settlement to the Senedd.

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

I now move to item 9, which is a debate on Cardiff Airport and I call on the Minister for Economy, Transport and North Wales to move the motion—Ken Skates.

Diolch, Dirprwy Lywydd. I'm proud of what the Welsh Government has done to support Cardiff Airport, a vital part of Wales's economic and transport infrastructure, and I'd like to begin my contribution today by making one very clear point. In 2013, the airport, had it continued under the existing commercial management, would have closed. It would have closed. Jobs would have been lost. We would have lost the main arterial air route into the south Wales, and businesses, exporters and travellers would have lost the opportunity to utilise an airport closer to their homes and premises than Bristol and Heathrow, and many other airports.

Since the Welsh Government stepped in to save the airport, we have invested in it, and delivered improvements to the terminal building and runway facilities. That investment has been recognised by the aviation industry and has led to a portfolio of airlines establishing new routes from Cardiff Airport to destinations around the world.

Cardiff Airport now directly supports more than 2,000 jobs and in 2018 delivered almost a £0.25 billion of gross value added to our economy. But the catalytic effect of the airport is even more significant, with economic analysis suggesting that Cardiff Airport is worth up to £2.4 billion to the UK economy. It leverages 5,500 supply-chain jobs and a total of 52,000 jobs in the wider economy. So, now is the time, I believe, whatever our political views, to come together to support this vital economic asset and strategic piece of transport infrastructure.

Now, in the early hours of last Wednesday, the devastating news of Flybe going into administration was announced. It's true that Flybe will impact Cardiff Airport in terms of passenger numbers. But I want to congratulate the airport team for moving rapidly to secure the Cardiff to Edinburgh route with Loganair. And I'm pleased to say, Dirprwy Lywydd, that discussions with other airlines are ongoing, and last week I had discussions with the Secretary of State for Wales and the UK aviation Minister. I've spoken on a number of occasions to the airport chief executive and chair to discuss how we can support discussions on route take-up; most recently, yesterday afternoon. And despite the loss of Flybe, the financial impact relates to just under 6 per cent of the airport's turnover. This is testament to the excellent planning and management at the airport.

Dirprwy Lywydd, I welcome scrutiny. It's right and proper that the National Assembly for Wales scrutinises the Welsh Government. It's right and proper also that we are scrutinised on our stewardship of public money and of the environment. It's also right and proper that we debate the future of the airport. However, Dirprwy Lywydd, it is not right and proper to talk down the airport. Can I make it clear that we are not wasting millions of pounds of taxpayers' money? We're investing in the long-term future of the airport in providing a commercial loan repayable, with interest, to the taxpayer. Due diligence has been taken and the support is in line with EU state-aid rules. And I wish to work collectively with Members to support Cardiff Airport and I would ask Members to reflect on this offer as this debate continues. Nick Ramsey.

Thank you, Minister, for taking the intervention. As you know, as Chair of the Public Accounts Committee, which has been looking at this issue recently, we as a committee certainly have no interest in talking Wales down or being negative for negative's sake. You will know, however, that we have asked officials, in terms of those loans and those repayable loans—we accept that loans are necessary, but it is important that there is clarity on when those loans start to be paid back and the end point of that process as well. So, would you accept that there is an issue here that needs to be addressed, and, yes, you are right to invest in the airport, but would you agree that the public do need to have confidence that that process is not effectively a blank cheque?

Absolutely, I would. Absolutely, I would, and I'd say to the Member as well, I welcome PAC's interest in the airport. And in terms of when those loans should begin being repaid, it's obviously for the airport to judge what is in its best financial interests, and this answer has been given to, certainly, the Economy, Infrastructure and Skills Committee.

Now, before talking further about the specifics of Cardiff Airport itself, I think it's important that we actually place this debate in the right context that it deserves. And Dirprwy Lywydd, we are facing challenges on a global scale: our climate is changing rapidly; we're seeing the impact now that the coronavirus is having on the economy and on the people of this world; Brexit is fundamentally reshaping our trading and external relationships; and recently we've seen refusals for three major airport expansions at Heathrow, Stansted and Bristol—all on environmental grounds. So, all of this creates not only challenging market conditions for aviation, as demonstrated by the recent collapse of Flybe, but important questions about the role of aviation policy in Wales. And I believe that it's important to address this head on, to develop our understanding of the evidence base around the airport's carbon emissions, to look at how Cardiff Airport could become a UK centre of excellence for low-carbon aviation, and, of course, to understand the role and the potential of Cardiff Airport in our post-Brexit existence.

The Cardiff Airport master plan for 2040 offers an opportunity to address all of these challenges, including the potential for a sustainable transport interchange and also sustainable locally owned energy. Ownership of the airport gives the Welsh Government a unique opportunity to lead the way in developing low-carbon and technological solutions for the industry. And we are in discussions, I'm pleased to say, with universities and with industry partners who are keen to utilise the airport as an exciting test bed.

The strategic social importance of Cardiff Airport is demonstrated most by the connectivity created between north and south Wales. This link is important for both the social and economic connections between the north and south of our country. And the route, I'm pleased to say, has grown in passenger numbers under Eastern Airways, who were recently awarded the contract for a further four years. Moreover, Cardiff Airport is now responsible for the operation of Anglesey Airport's passenger terminal facility.

But turning back to Flybe, I'd like to say that our thoughts go to the employees and passengers who have been affected by its collapse. We do regret that the UK Government's failure to intervene in the Flybe situation has led to such devastating consequences. We consider this to be symptomatic of the negative policy position it takes in relation to regional airports and to regional connectivity across the United Kingdom. It is within the UK Government's gift to vary its interpretation of state-aid rules to align with the rest of Europe, and to remove the regulatory costs that burden smaller, regional airports. So, once again, I call on the UK Government to devolve air passenger duty to Wales, as it has done for Scotland and for Northern Ireland. The airport is a valuable, strategic national asset and one that we should all be immensely proud of.

Thank you. I have selected the three amendments to the motion, and I call on Russell George to move amendment 1, tabled in the name of Darren Millar. Russell.

Thank you, Deputy Presiding Officer. Can I thank the Government for bringing forward this debate today? I think this is an appropriate debate to have, and I also appreciate, when the Government tabled this debate, at that point, Flybe hadn't gone into administration, which makes it, of course, all the more important that we have this debate today. And like the Minister said, it's also right to pay tribute to the dedicated staff of Flybe, and also the loyal customers, of course. And I appreciate that there's still much concern and much work to do, and I'm pleased that the Minister's outlined a number of meetings that he had last week in terms of the support for further routes to and from the airport. I think that's to be welcomed.

I certainly hope that our Welsh Conservative amendments to this debate today are seen as constructive. I do believe that they are. They are our plan from these benches in terms of where we believe the direction of the airport should go. In doing that, I should also, Deputy Presiding Officer, move our amendments, put forward in the name of Darren Millar.

But I actually think that there's much that we can agree on between the Government's benches and our benches, and in fact between other Members as well. I think we've all got the same long-term aspirations for the airport. The Minister said in his opening comments that whatever our particular views are, we want to support the airport, and I agree with that. There's much that we can agree on. I think where the disagreement perhaps comes is how we get to the objectives that we both want to see.

I put on record, of course, that our view is that Cardiff Airport should be returned to private ownership. In saying that as well, it would be useful perhaps to have some clarification of the Government's position on that, because it's certainly—and I stand to be corrected—

Will you take an intervention?

In a moment, yes. I stand to be corrected, but certainly the previous First Minister, I understood, did see Cardiff Airport being returned to private ownership, but I'm not sure what the Government's position is now.

There are two interventions now. I'll go for Mick first.

Thank you for taking the intervention in respect of literally your ideological views in respect of privatisation. But would you agree that the privatisation that occurred in 1995 of the airport turned out to be an absolute disaster?

I'm happy to take an intervention from Carwyn Jones as well. [Laughter.] I'll answer that.

I'm grateful. Two brief point. First of all, just to remind you of course that the Conservative mayor of Tees valley has indeed bought Teeside airport and branded it as an airport for the people. I wonder how that fits with his argument. Secondly, just as a matter of information, what I said when I was formerly First Minister—I'm not now—is that in time there was scope to sell off shares in the airport but to keep 50 per cent plus one share in the hands of the Government in order to keep a controlling share.

Well, thank you for that clarification. It would be useful to know from the Minister, at the end of this debate, if that remains the Government's position as well.

In terms of the other airport that Carwyn Jones mentioned, of course that was purchased for a fair price. I don't know the details of that particular airport, but what I will say is this: we, on these benches here, do believe that Cardiff Airport would be best run in private ownership. We don't believe that Governments are good—. They're not aviation experts and we believe that the airport is better run in private ownership. But I appreciate, as Mick Antoniw said, that there's a difference of philosophy in terms of where we stand on this. You can still support an airport without buying an airport, of course.

But let's also have an honest debate in this Chamber about where we're at as well. Previously the Government has talked about the increase in passenger numbers. Yes, it's great that the passenger numbers are growing, but let's remember that in 2007 passenger numbers were at 2.1 million and the Government's own plans and projections tell us that we'll hit that 2 million figure, which is an important figure in terms of the break-even point we're told, when the airport will return back to making a profit, we were told originally that that would be in 2021, now we're told that that will be in 2025. So, we've got to put into context some of these figures. There's often a lot of spin, I'm afraid, around some of the statistics that we see in terms of the airport.

Let's also be realistic about the financial position of the airport. Since it's been in Government ownership, there's been pre-tax losses that have been made every single year whilst it's been in the Government's ownership, and £18.5 million of pre-tax losses last year. Also, of course, in 2014 the net assets of the airport were worth £48 million and now they're worth—according to the balance sheet of the airport—£15.7 million. I appreciate what the Government Minister says in terms of the value of the airport in terms of other wider economic benefits, but let's also remember these statistics at the same time.

I appreciate that I'm running out of time, but I think I took an intervention. Am I allowed a couple more minutes?

No, no, you can finish your speech as quick as you can and I'll tell you when you've gone over time. Go on.

Thank you. I was just looking for some guidance. Thank you, Deputy Presiding Officer. 

But, certainly in terms of our plan for the airport, we have a number of points that we would bring forward. First of all, we would invest in the airport's capital infrastructure to enable the airport to diversify and generate new sources of revenue. I think that's important. This airport, of course, could be a symbol of great prestige and a gateway to Wales, and I often agree with points that Carwyn Jones makes in terms of the perception of Wales having an airport. Even if that might not be serving the whole of Wales, there is a perception issue there, which I would entirely agree with. There's also the support that certainly a Welsh Conservative Government would bring in terms of prioritising direct flights to the USA and one to Manchester. Manchester is especially important, given its status as a hub in the north of England, also serving the north of Wales. We'd also develop a new marketing strategy for the airport. I think that's important as well, and also, to put it on the record, we would absolutely, as Welsh Conservatives, be seeking from the UK Government to devolve air passenger duty and, once it is devolved, to scrap it as well. So, I appreciate we're at a difference, odds, to the UK Government, but that's our position here as Welsh Conservatives. I think—[Interruption.] I can't— 

No. No, he's way over time. 

—or I'd be happy to. And, finally, we'd also want to see improvements in terms of transport links to the airport in terms of rail, road and public transport as well. But we on these benches do believe there should be a fair return for the taxpayers' money, the investment. Each taxpayer in Wales paid £38.50 for that original investment in Cardiff Airport, and we'd want to see that, of course, returned to the Welsh taxpayer. 

I call on David Rowlands to move amendments 2 and 3, tabled in the name of Caroline Jones. David. 

Diolch, Dirprwy Lywydd. Can I open by saying that the Brexit Party will be supporting the Government's motion? We will not be supporting the Conservative amendments, although there are a number that we would support, as we note the irony of their call for the Welsh Government to invest in the airport infrastructure, given their repeated opposition to the Government's past investment strategy for the airport. We would like to note here our past record in supporting the Welsh Government's decision to buy the airport, which undoubtedly secured its future. Quite apart from the airport's economic impact on Wales generally and on job creation for the region, we believe Cardiff Airport plays a crucial role in projecting Wales to the world. 

Whilst our first amendment seems to have been achieved, as this was confirmed by the airport's chairman, Roger Lewis, in the briefing session held by the airport officials last week, our second amendment calls for the Welsh Government to seek private investment within five years, but we wish to note here that this should be on a minority basis, with the Welsh Government keeping at least 51 per cent of the equity. We believe this would be the only way to protect the airport's survival long term. We also wish to acknowledge that recent events, such as the collapse of Thomas Cook and, most recently, Flybe, will have a short to medium-term effect on the airport's finances, as could the potential for a catastrophic effect ensuing from the coronavirus epidemic. One can only surmise that, had the airport remained in private hands, its very existence would have been in jeopardy. We should also recognise that there may be a short-term need for the Government to give further financial support to the airport should the coronavirus situation take a serious hold. However, we would hope that, in such an eventuality, the UK Government would commit to supporting the air industry in general. 

We also endorse the calls by the Government and the Conservatives for the UK to devolve air passenger duty. Their present stance is totally indefensible, given that this tax has, for a long time, been devolved to the Scottish and Northern Ireland Parliaments.

Finally, we issue a call for further investment by the Welsh Government to establish far better access to the airport, with a direct link from the M4, and even the possibility of a rail link. Such investment could dramatically affect the success of the airport. 

Can I just say that I've got a longstanding interest in the airport, because, when it was in public ownership, when it was owned by the three counties, I was a member of the airport committee at that time, as a councillor? I remember the annual reports, really, of public investment to actually build up the airport and to actually fund the first major international-length runway that enabled jumbo jets to land. Year on year, that airport expanded and, in actual fact, its passenger numbers were on a par at that time with Bristol. So, there is an ignominy to the fact that you had a publicly owned airport that was part of an integrated economic plan, that was serving the public and business within Wales, and then a bizarre ideological decision was taken by the Tory Government that it had to be sold off. 

I appreciate, when I put the intervention to Russell George that the privatisation was a disaster—. I appreciate that he has difficulty admitting that it was, but you know it was and I know it was an absolute disaster. In actual fact—

Will you take an intervention?

Yes, please, certainly.

The point is that the Government—in fact, all Governments—could have done more to support the airport during that time, such as road links, public transport links, rail links. All Governments of all colours could have done more to support the airport when it was in private ownership, and perhaps we wouldn't have got to the position we have done now. 

Well, I'm glad to hear your support for investment in our airports, but you don't—[Interruption.] But you really don't answer the point that the privatisation was a disaster, just as the privatisation of the railway network has been a disaster, just as bus privatisation has been an absolute disaster.

In 2012—the last year that it was in private ownership—it actually suffered a loss in that year of almost 17 per cent in passenger numbers. It is absolutely right: we would not, in Wales now, have an international airport if the Tories had been running the country. We would also have lost 2,500 jobs, we would have lost the contribution of hundreds of millions of pounds to the Welsh economy, we would have lost a key component in the development of an aviation industry that's actually quite important within my constituency. So, the actual decision by Welsh Government—by a Labour Government—to step in and repair that damage was fundamentally important.

Now, when the airport was taken into public ownership, the Tory Member of the European Parliament for the south-west, Ashley Fox, criticised Welsh Government rescuing it, because it challenged Bristol Airport. So, you have the English Tories actually supporting their regional airport. You can only ever dream, can't you, of a Welsh Conservative Party supporting a Welsh airport and Welsh industry? Their total—[Interruption.] Their total subservience. And that is the reality of the situation—Bristol Airport has flourished at the expense of the privatisation of Cardiff Airport.

Now, we need to move on, because we have Qatar Airways, which has made a very significant impact on the airport, and, of course, the chief executive officer of Qatar Airways basically says it should be left in public ownership, because to put it into privatisation would put it at risk of hedge funds and the international markets. 

There's no doubt that the airport industry is going through a difficult time. There is no doubt we are still being disadvantaged in decision making by the UK Government, and I suspect the Tory influence over Bristol actually has an impact on that. But there is no doubt that, since we took it into public ownership, there has been a 60 per cent growth in passenger numbers in the airport. It now has a role within an economic plan. Investment in the airport is not only necessary but modest. The £38 million invested in Cardiff Airport, compared with the £500 million debts of Bristol Airport, I think stands by comparison, and I think we will need to invest further.

But the reality is that that investment or those loans that are made are at a commercial rate, because to do otherwise would be in breach of either EU rules or in breach of World Trade Organization state-aid rules. So, Deputy Llywydd, the airport has become a really important economic asset for us. It is also—. One has to say: what would be the status of Wales, of this country that we represent, if we did not have an international airport, if we could not bring major international figures—major sporting figures, economic figures and political figures—into our own airport, that we had to say, 'No, you have to divert via Bristol'?

Dirprwy Lywydd, the crux of the matter is this: the Tories almost destroyed our airport. We have rescued that airport. The airport now has a future. It is certainly a difficult time, but I know that it will survive, and it has to survive, because it has a Government that supports it and values it.

It's a pleasure to contribute to this debate. I was a bit overeager earlier in that I made one of my substantive points, actually, to the Minister not long after he started speaking. He enthused me so much that he knows where I'm coming from on this.

It's quite clear that an airport such as Cardiff is an important piece of not just Welsh transport infrastructure, but also of the UK transport infrastructure as well and, indeed, of course, as a link to other parts of the world and, more recently, to Qatar through the links made with that airline, of course, becoming a global hub as well. And the issue of funding is, I don't think, in doubt. Of course, an airport like that needs support and, of course, as Mick Antoniw said, commercial loans form a part of that, because, of course, with state-aid rules, those are going to have to be of a commercial nature.

The issue that the Public Accounts Committee has looked at in detail is the long-term sustainability of that type of funding, and what, importantly, would happen at a point in the future where those loans weren't available. If we just look in detail at the loans that have been provided, the airport has now fully drawn down the loan facility of £38 million. The most recent £21.2 million has, I believe, been consolidated with the existing facility, although the Minister might want to clarify that, as there was some questions raised about that during the recent committee meeting.

So, importantly, what is the future strategy for Cardiff Airport, and at what point are these loans no longer going to be available? I made the point earlier about a blank cheque, and it's important that the public have the confidence that, at some point in the future, either the airport will continue to be funded and that is part of the strategy, and the Welsh Government may want to say that is how we see it surviving in the future, or it will be able to stand on its own two feet. That's probably not the appropriate phrase in this context, but I think that's what the public look at, and that's what the Public Accounts Committee look at, in terms of the viability of this piece of infrastructure.

We're currently looking at another loan of a further £6.8 million, I believe. So, there is more money going towards the airport. We've only seen recently, with the consequences of Flybe, that, whatever strategy the Welsh Government develops, and however in the future it sees that vision for the airport developing, it has to be futureproofed against future shocks, such as the collapse of an airline. The collapse of an airline can have a totally disproportionate effect on the running and the financial viability of an airport, far more than in any other type of transport infrastructure or transport hub. We took evidence from Roger Lewis that confirmed that—that, actually, when it comes to the running of an airport, the potential catastrophic loss of one airline can have a major effect. 

We were reassured, I have to say, that Cardiff, unlike some other airports, actually isn't as dependent—I can see the Minister nodding. It's not as wholly dependent on one airline as others, and I think that that has shown where there really has been progress made with that airport. I know often Welsh Government seems to think that this side of the Chamber is just overtly negative, talking Wales down—I can see Mick Antoniw nodding; I'm going to turn that round in a minute—and not looking on the bright side, but, actually, I'm willing to accept as the Chair of the Public Accounts Committee that there have been some good changes made, and, at certain points in the past, that airport did not look viable, so things have moved on and there have been structures put in place. But it's important in the future that there is a vision for that airport that supports what the Welsh Government wants to do with it. 

Can I just mention air passenger duty? The former First Minister, who contributed earlier sitting in on this debate, used to like to talk, when he was First Minister, about the tools in the toolbox, along with the former finance Minister, and APD is clearly a potentially very important tool in that toolbox. I agree with other people who have spoken on all sides of the Chamber, including this one, that that should be devolved. It is nonsensical that other parts of the United Kingdom have access to that sort of devolution of taxation and the transport Minister here doesn't, and the finance Minister doesn't. That isn't fair, that isn't right, and we have supported you consistently in saying that that should be devolved. I think if the Welsh Government did have air passenger duty devolved to it, then it would at the very least open up the options available to you in supporting pieces of major infrastructure like Cardiff Airport. And, for the good of all of us, for the good of the Welsh Government, for the good of the public, for the good of all of us who contribute in these debates over many months, I think that in the future we want to get to a position where that airport, yes, is funded, but ultimately becomes sustainable so that Wales can have an airport that it can be proud of.

I rise on this occasion to support the Government motion—and these benches will not be supporting any of the other opposition amendments—unusually for me. Some Members who don't know me as well as others will be very surprised to hear that I love a bit of consensus, me. It's been really good to see that there is an element of consensus around this debate. We all do agree that our nation and this part of our nation needs a viable airport; we may have differences about how we want that to be run in the long term. It's been really encouraging to see, Dirprwy Lywydd, that we have consensus about the devolution of air passenger duty.

We can't do without an airport. In the longer term, we all know that we need to reduce the amount of air travel that we have, but there is also clear, consistent academic evidence that regions without their own airport suffer from that. There is the practicality of people moving in and out, but there is also that message—and others have mentioned this—and needing to send out that message that Wales is open for business, that we are here. And I think we do have to remind ourselves of the history here: there's absolutely no doubt that we would have lost that airport if the Welsh Government hadn't stepped in. That's completely clear. And at risk of breaking down this consensus, I do completely agree with Mick Antoniw: privatising the airport was never the right thing to do; it was always going to be challenging, when it had such a close competitor in Bristol, to make it viable without an element of public support.

Now, on these benches, we are very relaxed about this major piece of infrastructure being in public ownership, because we are very well aware, as others are, that this is normal. In lots of other parts of the developed world, it is perfectly normal for Governments to own, support and run, albeit at arm's length, key pieces of infrastructure, because those Governments know that the markets cannot always be trusted to deliver for the people. Sometimes they do, but in this case, they clearly would not have done, and we would clearly have been without an airport.

I want to just touch briefly on the devolution of air passenger duty. As I've said, I'm really glad to hear the Conservative benches wholeheartedly supporting it. It is, as somebody said, indefensible and iniquitous that every other part of the UK has this tool that they are able to use in whichever way they see fit. And there lots of ways that it could be used: it could be used to attract new carriers; it could be used to penalise people who fly too often or who fly for unnecessary reasons. But we need to be making those decisions here. It is not appropriate.

Now, I suppose I'm a little bit concerned, given that our Conservative colleagues have told us they've been advocating this for a long time, that they appear to be being ignored at the other end of the M4, and I wonder if this is something to do with the previous Secretary of State for Wales's apparent obsession with cross-border economic regions. I wonder whether he was perhaps a little bit too interested in the long-term viability of Bristol Airport, not that we wish any ill to Bristol Airport, but if it's either/or, I know where I want to be putting our resources.

I am optimistic, though, given what's been said today, that with a new Secretary of State, with a very clear message from the Welsh Government, but also today from this Assembly, that we can send that message very clearly to the new Secretary of State and ask him to advocate for this position. The current situation is just not defensible. It isn't fair, it isn't just, and long term it won't work.

With regard to points 5 and 6 of the motion, I just want to say a little bit more about point 5. The Flybe situation was disappointing, and I want to express my gratitude to the Minister today, because he has kept us very much informed about the developments. When you heard that a quarter of the flights going out were Flybe flights, it was a moment of being really, really concerned. As others have said, our thoughts have got to be with those people who are at risk of losing their jobs, though I understand—and the Minister may be able to confirm this today—that some of those jobs, the ones in Cardiff Airport, have already been protected by other carriers; and the passengers for whom it was hugely disruptive—people who couldn't go to job interviews, people who couldn't go to family occasions. But, of course, those people might not have been able to go at all if we hadn't had an airport. But, I'm very grateful to the Minister for keeping us in touch.

It does beg the question as to whether or not the Westminster Government kept its promise to Flybe shareholders, but I think it's fair to say that this is a very challenging market. This is not the first regional carrier that has collapsed. What's really important is that we retain the viability of our airport. I was pleased to hear from the Minister that it's not as devastating as we thought it might have been.

So, we're happy today to support the Government in supporting the airport and to support the motion. We need to reduce, as I've said, our flying, but in order for that to be possible we need to have more effective regional connectivity. Until we have that, if we don't have our own airport, people will simply fly from elsewhere, so a thriving airport is vital to us all. We will support the Government motion today, and we will support them in continuing to support the airport. The Minister will, of course, expect us to scrutinise him rigorously as to how he does just that.

It's good to see that there's considerable unity around supporting our international airport, and I think it's good to hear the Chair of the Public Accounts Committee recognising some of the changes that have been made to make the airport viable. It's absolutely the case that, if the Welsh Government hadn’t taken it over in 2013, the airport would have closed. End of story.

We have to recognise that it's about 2,500 jobs directly or indirectly being maintained here in south Wales. In the difficult economic circumstances we find ourselves in, that's very important revenue. We know from the discussion we had with Cardiff Airport's senior executives on Monday last week that they are already earning more money than it costs to run the airport, and they have been doing so for the last three years. So that's a very important point, because were that not to be the case that obviously makes for a potentially very difficult situation.

We know that the tipping point is about 1.6/1.7 million passengers a year. So, obviously, we are in a dangerous situation at the moment as a result of coronavirus, which is obviously disrupting everything in terms of the world economy. But it is actually only £36.2 million, Nick Ramsay, that Cardiff Airport has drawn down so far of the possible £38 million—that's what we heard in the Public Accounts Committee. We need to place that £36.2 million commercial loan in the context of what other regional airports are carrying in the way of debt. We learnt last week that Liverpool has a debt of £102 million; Newcastle £367 million; Leeds Bradford £125 million; and Bristol Airport £590 million debt.

Will you give way, Jenny?

Yes.

Just on your previous point there, the statistic I've got in front of me is definitely that the Welsh Government has now fully drawn down that £38 million, but I'm willing to discuss that with you later. It may be that I've got the wrong end of the stick, but I think that that money has been drawn down.

Okay. I agree that £1 million or £2 million is a lot of money, but I think that the point is that they are still within the amount of money that's already been agreed with the Welsh Government, further to the collapse of Thomas Cook.

So, there's no doubt that the collapse of Thomas Cook, and indeed Flybe, and on top of that coronavirus, are delaying the timescale by which the company is able to repay the loan to the Welsh Government. And the company executives were perfectly frank about that, even though it was before we knew about the demise of Flybe. 

But for every company that fails in normal commercial circumstances, there is another who is a potential beneficiary. So, we've seen TUI increasing the number of flights out of Cardiff. We've seen some of the Flybe routes taken over by Loganair. There'll always be commercial companies who will see somebody else's pain as a business opportunity, and that's absolutely fine.

I agree with Mick Antoniw that the previous Secretary of State for Wales should more accurately have been described as the Secretary of State for Bristol and the south-west, because he seemed far more interested in that. Quite why the Member of Parliament for the Vale of Glamorgan hated his local airport so much, only he knows. Maybe the flight path went over his house. [Laughter.]

But there are many reasons why Cardiff is more likely to survive the current difficulties for all airlines across the world than many other regional airports in the UK; it's because there are several features of Cardiff's airport that make it a much better bet in the long term. One is the fantastically long runway that we have got, which is far longer than the runway in Bristol or Birmingham, which means that it's ideal for long-haul airlines. Whatever the climate change emergency, it is difficult to envisage that all of us who need to travel to the United States are going to go by boat. Some people are going to continue to need to go by plane. So, having this very long runway—positioned mainly over the sea and agricultural land, which means it's far less disruptive than an airport in a built-up area—means that it's ideal for future runways.

On top of that, it's got the relationship with the British Airways maintenance centre, and it has the capacity to become a centre for innovation. For example, we discussed autonomous pods that are operating at Heathrow, which could be used to connect Rhoose station with the airport terminal, which would overcome one of the weaknesses that Cardiff Airport has at the moment. So, I think that this is an airport with a future, and is a very good Welsh Government investment.

Finally, Rhianon Passmore.

Thank you, Deputy Llywydd. It was reassuring to hear from the Minister that the recent and highly regrettable news that Flybe ceased trading on 4 March does not affect the overall viability of Cardiff Airport; but equally, aviation is indeed having a very difficult period, and we know that Brexit is playing its part in this.

But, the on the record doom-mongering from the Conservative Party opposite about the long-term future of the airport has proved to be unfounded, and it is unwelcome for the airport and those whose jobs rely on it. So, I also suggest that we do not talk Wales down. The day after the Flybe announcement, Cardiff Airport confirmed it had secured agreement with Loganair to step in and operate this crucial Cardiff to Edinburgh service starting on 23 March, so it's a shame that the party opposite did not welcome this. If they support the airport and they support Welsh infrastructure, it is my belief that they should.

It is also right, again, I think, to underscore here that Cardiff Airport is indeed an important piece of strategic transport infrastructure. It is a key economic asset for Wales, and as such its vitals are strong. Nearly 1.7 million passengers flew from Cardiff Airport in 2019. That's up 7 per cent on the year before, the busiest year since 2009, and up by 65 per cent since our Welsh Government involvement. Last year also saw the airport post a 34 per cent growth in commercial revenue. These are real facts.

There is much talk in this Chamber of Wales becoming a mature nation in its own right as a member of the United Kingdom family of nations. So, what self-respecting nation does not want or have its own airport servicing its capital city and the wider nation, and the 52,000 supply-chain jobs that go with it, including research and development? If we choose to shirk our national responsibilities to Wales, we would stand aside as regional English cities like Bristol and Exeter's airports grow. We are an aspirational and ambitious nation, and I know that the Welsh Labour Government will not shrink from standing up for Wales. It is vital for Wales's trading economy post Brexit to support Cardiff Airport as part of a high quality, integrated and low carbon public-transport system.

The Welsh Labour Government has also consistently called for air passenger duty to be devolved to Wales, and I'm glad that the Tories opposite now support it. I would ask them to take that message back to their UK masters. Independent expert analysis demonstrates clear economic benefits for Wales if air passenger duty is devolved, and obviously a subsequent decision taken by Welsh Ministers to reduce that air passenger duty. As the UK leaves the EU, the devolution of air passenger duty is a means by which the Welsh Government can promote the economic attractiveness of Wales, and growth in Wales in unison with the Welsh Government's existing economic policies, and is a key attraction for our investors. So, I'm pleased that there is now cross-party support across the Assembly for powers for air passenger duty to be made in Wales.

And I would also say—put it very simply, then—if Members do back Wales, then they will back the Welsh Government and Cardiff Airport. It is time that we all stand up for Wales, and it's time to end the talking down of Wales.

Can I now call on the Minister for Economy, Transport and North Wales to reply to the debate? Ken Skates.

Diolch, Dirprwy Llywydd. I really am grateful for all Members' contributions this afternoon, especially to those Members who are supporting our motion, and to those Members on the Conservative benches who are now backing the Welsh Government position against UK Government policy.

I do feel that it is most important that we recognise that it's our collective responsibility to support and promote the airport—not to run it down on social media or to use it as a political football. You would never, never, ever hear elected public servants running down John F. Kennedy airport or Charles de Gaulle airport, or any other of the world's publicly owned airports.

Let me be absolutely clear, we will not allow Cardiff Airport to fall out of the control of the public of Wales, and operating on their behalf, the Welsh Government. Our position today remains consistent with our position in 2013, in 2014, in 2015, right through to the present day. We are, of course, open to private sector investment in the airport, and the potential for the private sector to take a stake, but we as a Welsh Government took back control of that vitally important piece of infrastructure, and we will retain control on behalf of the people of Wales.

A question was asked of me by Russell George—a very important question about what aviation experts believe is in the best interests of the world's airports: whether they should be publicly owned or privately owned. Now, when we talk about experts, Donald Trump, the President of the United States, he likes to consider himself an expert in lots and lots and lots of things, but you don't hear him rushing to try to find buyers in the private sector for all of those publicly owned airports in the United States. And as Helen Mary Jones said, public ownership is the global norm. In fact, around 85 per cent of the world's airports that carry passengers are publicly owned.

Now, I did hear David Melding joking, I think, about David Rowlands not being a capitalist anymore because he's a supporter of the public ownership of the airport, but you wouldn’t accuse President Donald Trump or former New York Mayor, Rudy Giuliani, or any of the other right-wing supporters of public ownership of airports in the US of not being capitalists. You would not accuse Nicolas Sarkozy and you wouldn't have accused Jacques Chirac of being anti-capitalist for their support of public ownership of Charles de Gaulle and many, many other airports in France.

Now, at the start of this debate, I offered to work collectively with Members in this Chamber, and that still stands. But, please, do not use carefully selected statistics and present them in a way that's designed to skewer the future of the airport. And today, I think that statistic that is most often used by those who wish to talk down the airport was once again raised, and it concerns the loan—the investment—that's being made in the airport. But as Jenny Rathbone rightly identified, that relatively small amount of investment in Cardiff Airport pales into insignificance against some of the debt that many other airports have, including Bristol Airport that currently carries a debt burden of more than £0.5 billion.

Now, Nick Ramsay, I thought, made a vitally important point—that it's essential that we consider the impact of the collapse of any airlines when we consider supporting the airport with commercial loans. I can tell Members that, as part of our due diligence, we stress-tested the financial strength of the airport against the collapse of Flybe. Now, Cardiff Airport is not in the same position that many other small regional airports are in today as a consequence of Flybe's collapse—airports such as Southampton, where 95 per cent of traffic was provided by Flybe, or other airports that are in similar positions, such as Belfast or Exeter—and that's because of the diversification that's taken place at the airport in the last two years. It was interesting last week, Dirprwy Llywydd, that the BBC re-ran a story online from 2018. The headline was something along the lines of 'Collapse of Flybe would be devastating for Cardiff Airport'. That is not the case today, but it would have been the case in 2018. I am convinced that, had the Conservatives won the election in 2016 and sold off the airport after that election, then today, as a consequence of Flybe's collapse, the airport would have collapsed as well.

Will you take an intervention?

Yes, of course.

I'm grateful to you for taking the intervention. You may wish to take this opportunity to share with the Chamber the news that you gave me about the Flybe jobs that have already been saved at the airport. Of course, that's no consolation to those employed in other airports who were not so fortunate, but I think it would be helpful to have that on the record and perhaps reassuring.

I think it's really important. Helen Mary Jones makes a really important point about the human impact of Flybe's collapse, and I am pleased to say that, as a consequence of Loganair intervening and taking up the Cardiff to Edinburgh route, they have prioritised jobs for Flybe staff and this includes at Cardiff Airport. I am also encouraged by very recent discussions that the airport is having with other airlines who also could step in and take over vitally important routes.

I'd just like to say that I am genuinely grateful to the Welsh Conservatives for their support of our position on air passenger duty and their support for the call for a route between Cardiff and Manchester to be established. It's ironic though because, of course, we asked the UK Government to promote a public service obligation from Cardiff to Manchester and they refused to do so, to the European Commission.

So, I ask for the support of all Members in calling on the UK Government to consider three vitally important measures in its review of regional connectivity. First, remove the regulatory cost burden on regional airports, as is done in Europe. Second, open up new public service obligation flights between the UK regions and also to Europe. Thirdly and finally, but vitally important, is air passenger duty: devolve APD to Wales so that we have control to deliver our policy objectives.

Thank you very much. The proposal is to agree amendment 1. Does any Member object? [Objection.] Okay. So we defer voting on this item until voting time.

Before we move to voting time and the Stage 3 debate on the Health and Social Care (Quality and Engagement) (Wales) Bill, I will suspend proceedings for 15 minutes. That's 1-5 minutes. The bell will be rung five minutes before we reconvene, but could I encourage Members to return to the Chamber promptly? So, a 15-minute break and the bell will be rung five minutes before we reconvene. So, the Plenary now stands adjourned.

We will move now to voting time. The only vote is on the debate on Cardiff Airport. The first amendment will be the first vote, and therefore I call for a vote on amendment 1, tabled in the name of Darren Millar. Open the vote. Close the vote. In favour 12, no abstentions, 38 against. Therefore, amendment 1 is not agreed.

Amendment 2: I call for a vote on amendment 2, tabled in the name of Caroline Jones. Open the vote. Close the vote. In favour 13, no abstentions, 37 against. Therefore, amendment 2 is not agreed.

Amendment 3—I call for a vote on amendment 3, again in the name of Caroline Jones. Open the vote. Close the vote. In favour 14, no abstentions, 37 against. Therefore, amendment 3 is not agreed.

The next vote is on the motion tabled in the name of Rebecca Evans. Open the vote. Close the vote. In favour 39, no abstentions, 12 against. Therefore, the motion is agreed.

The next item on our agenda is the Stage 3 proceedings on the Health and Social Care (Quality and Engagement) (Wales) Bill.

The first group of amendments relates to the duty to secure quality in health services—workforce planning and appropriate staffing levels. Amendment 21 is the lead amendment in the group, and I call on Angela Burns to move the lead amendment and to speak to the other amendments in the group. Angela Burns.

Thank you, Presiding Officer. I formally table the amendments here in my name. I would like to, at the outset, Minister, say that these are by way of probing amendments. You do have the opportunity, by your response, to ensure that we don't have to spend time in voting from 21 to 34. 

These amendments have been retabled by us from Stage 2. They were previously tabled as a mix from Helen Mary Jones and from me, and they are in support of committee recommendation 4, because I think it is necessary to remember the Royal College of Nursing's comments on the Bill at Stage 1, saying that this Bill is an ideal opportunity for the Welsh Government to progress with the principles of the Nurse Staffing Levels (Wales) Act 2016 and to broaden its applicability. It's particularly relevant to section 25D of this Act, which is about making sure that local health boards and NHS trusts may undertake these provisions in order to enable them to comply with their duties under this Act.

Now, surely this chimes with what the Minister also said at Stage 1, when he said that the duty of quality is more than just a cultural change, and I agree with him. To have a cultural change, all clinical staffing groups should be part of sufficient workforce planning. Amendment 33 outlines that the Welsh Government must take reasonable steps to ensure that there are a sufficient number of specific healthcare staff, including nurses, midwives and medical practitioners. As I noted at Stage 2, it was heartbreakingly clear in the case of Cwm Taf that a number of factors, including an insufficient level of midwives, caused the catastrophic collapse in the provision of safe care that we saw there.

So, we believe it's the Welsh Government's duty to ensure that it's not repeated again, and we think that this Bill is a very good vehicle to do that through. There is no routine reporting of midwifery vacancies, and Healthcare Inspectorate Wales's national review of maternity services in Wales won't be published until later this summer. So, without this key data on an ongoing basis, rather than a one-off review, we're not aware of whether there are enough maternity staff in every health board in Wales.

The first part of amendment 34, a duty to ensure appropriate staffing, is intended to hold the Welsh Government to the same standards and expectations as an NHS body. It does require the Minister to demonstrate what action has been taken to achieve this. Now, let me be clear, with the cases that we're now seeing of COVID-19 appearing in Wales, and noting the potential pressures on staffing that a full outbreak will have, now is the time to monitor pressures within the health system, so that we know whether our health boards are able to deliver those safe levels of care.

The second part of our amendment, the duty to have a real-time staffing assessment in place, will ensure that staffing levels are regularly monitored so that NHS bodies and Ministers actually respond to issues as they happen in real time, instead of only responding to agreed procedures from months or years before. As I noted at Stage 2, there are already issues with safe nursing levels, as the Royal College of Nursing is still concerned that neither the Welsh Government nor NHS Wales publish national figures for nursing vacancies using an agreed definition of what constitutes a vacancy. And annual data published by the Welsh Government on nursing levels does not adequately reflect patient need or service development, including comorbidities and an ageing population. 

The third and final part of the amendment, the duty to have a risk escalation process in place, will give every single member of staff a clear mechanism to raise concerns if they are working in settings where they feel the levels of available staffing are not conducive to safety. 

At Stage 2, it was noted by the Minister that he would not support these amendments—so, I understand that at the moment—as the Bill would not be the appropriate mechanism for enacting a change of this magnitude, and that applying any principles of the nurse staffing levels Act to all other clinical staffing groups in Wales without the same degree of consideration and scrutiny would be inappropriate and inconsistent. Yet, as we have so often said before with Welsh Government legislation, the Bill's provisions on the duty of quality are overly broad. It therefore risks becoming an aim rather than a duty, without specific mechanisms for health boards to undertake the necessary action to ensure it is upheld and monitored routinely. 

I do also, Minister, dispute your concerns about the financial considerations, as having appropriate staffing levels in place will cost NHS bodies and Welsh Government less money in the long term due to less sickness and stress-related illnesses, as well as improved mental health for all staff. The amendments also recognise that the onus is not solely placed on NHS bodies, and that Welsh Government have a role to play in the long-term secure future of staffing levels for NHS bodies.

I do note the points that you raised in Stage 2 in your letter to the Chair of the Health, Social Care and Sport Committee on 26 February, in which you said that Schedule 3 to the Bill amends subsection 47 of the Health and Social Care (Community Health and Standards) Act 2003 to require NHS bodies to take into account the healthcare standards. However, as will be outlined in my amendments in group 7, these standards have not been updated since 2015. Since then we've had a rapidly ageing population, as well as advances in technology that mean they are fast becoming obsolete. Therefore, I would be grateful if the Minister could outline a timeline on the refreshed standards, as well as placing on record his commitment to a clear mechanism to review these standards regularly.

Minister, should you be prepared to answer these questions on the health and care standards, as well as commit to supporting amendments 36 and 37, I would be prepared to withdraw these amendments.

We on the Plaid Cymru benches will be supporting these amendments, but I would like to take a few moments to explain how we will engage with this Bill more generally at the outset.

There are a number of reasons why we believe we're unable to support the Bill as currently drafted and that it's unlikely that we could support the Bill after we've gone through the process that we're going through today. There are a number of reasons for that, and the main reason is that this Bill would weaken the voice of the patient by abolishing the community health councils, which have been strong advocates for patients, and that's certainly true in the part of Wales in which I live, in north Wales. And there's also a failing in the Bill in providing instead of what we have now a model that would provide the same independence and the same understanding of the reality and the needs for health and care services in various parts of Wales.

But there are other parts of the Bill that we also think are inadequate. What we have here is a Bill that appears to be putting quality at the heart of service planning, but then fails to sufficiently, clearly and robustly define what the expected quality and standards are, referring rather to health and care standards, and the latest document that defines those is dated 2015, I believe. Therefore, there are fundamental weaknesses here that we regret that we haven't been able to tackle in an appropriate manner during this Bill's processes through the Senedd. And here I pay tribute to Helen Mary Jones for the work that she did as health spokesperson for Plaid Cymru during the earlier stages of this Bill's progress through the Senedd.

Turning to the specific amendments, the Minister, I know, will no doubt say today that the health and care standards already consider the need for workforce planning. Standard 7.1 says that

'Health services should ensure there are enough staff with the right knowledge and skills available at the right time to meet need.'

Is that enough in itself? There are also a range of criteria that are used to explain what that means. That includes matters like attending training programmes, that the workforce are able to raise concerns, that health boards have effective workforce plans. That's what we're told currently. But I'll ask you, as Members: do we genuinely believe that these criteria are being adhered to at the moment? The evidence I see is that they are not, and we have an opportunity in this Bill to strengthen that. We need something more robust. I would suggest a direct reference to the workforce on the face of the Bill.

So, we'll support these amendments on the workforce because you cannot have an NHS without a workforce, and I sincerely hope that these amendments will pass.

I thought long and hard about whether to table my own amendments to this Bill, and in the end, I opted to support amendments put forward by my colleagues. The whole point of amending legislation is to improve it, to ensure that the resulting Act will benefit the people who chose us to represent them. Instead of us all going our own way with competing amendments, it was better to put aside party differences, and at the end of the day, it matters little to the people of Wales whether amendments were put down by the Welsh Government, Welsh Conservatives, Plaid Cymru or the Brexit Party. All that matters is that this legislation delivers upon its stated aim of improving quality and engagement in both health and social care.

I chose to support Angela's amendments in this group because, like her, I don't believe the Welsh Government has gone far enough in its duty to secure quality in health services. A lack of strategic workforce planning has left our NHS short-staffed, which, in turn, has had a dramatic impact on services in recent years. If we are to improve quality in health and social care, we have to ensure that our excellent staff have the time to care. Because Governments of all colours failed to do any adequate workforce planning, we have staff shortages across the board. Many hospital departments only function because of the heroic levels of determination of staff. Unfortunately, burn-out is all too real. We can only secure quality if we have our health and social care services staffed with sufficiently and suitably qualified and competent individuals, and I urge Members to support the amendments in this group.

A constituent wrote to me last month after publication of the report on hospital vascular services' overhaul leaving people fearful in north Wales, this was written by the north Wales community health council, the public watchdog that holds the Betsi health board to account, and which the Welsh Government is considering disbanding—exclamation mark. As the sector has told me, only independent bodies give true challenge.

Community health councils were abolished in England in 2003. Abolition took three years against much opposition. The fate of English community health councils was sealed when the then UK Government did a deal with the Welsh, Scottish and Northern Irish administrations at the time, allowing them to keep their own community health councils if they supported the abolition of English community health councils.

The Francis report found that community health councils in England

'were almost invariably compared favourably in the evidence with the structures which succeeded them. It is now quite clear',

the report said,

'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.'

And Andy Burnham, who was then an MP, doubted in retrospect the wisdom of abolishing community health councils. He said their abolition was not the then UK Government's finest moment:

'It seems we failed to come up with something to replace CHCs that did the job well.'

Well, the hands-on experience of those who worked in the organisations that followed community health councils in England was that effective monitoring and scrutiny was lost for a substantial period of time on each occasion there was a reorganisation.

As I said here three years ago, in terms of staffing, for year after year after year, Labour Welsh Government has dismissed warnings that we faced a GP crisis in north Wales, given by professional bodies, including BMA Wales, the Royal College of General Practitioners Wales, and by myself and shadow Cabinet colleagues on behalf of the NHS Wales staff and patients who've raised their concerns with us.

Speaking here in January, I noted that, at the end of 2019, the Royal College of Nursing launched its 'Progress and Challenge' report on the implementation of the Nurse Staffing Levels (Wales) Act 2016, which said that:

'The nursing workforce in Wales is facing a national crisis. The high number of vacancies...estimated...as around 1600 at a minimum'—

quote—

'are compounded by greater shortages in the care home sector and the prospect of significant losses to retirement over the next...10 years.'

They pose questions for the Welsh Government, including:

'How are the "special measure" arrangements'—

for Betsi Cadwaladr University Health Board—

'monitoring and supporting the board to be compliant with the Act?'

'Will you increase student nursing numbers as Betsi Cadwaladr University Health Board has requested?'

'Will you support the placement of non-commissioned student nurses'—

from Glyndŵr University—

'as the Betsi Cadwaladr University Health Board has requested?'

Well, BMA Cymru Wales is now calling for safe staffing to be enshrined in Welsh legislation, supported by the Royal College of Nursing Wales, Royal College of General Practitioners Wales, Academy of Medical Royal Colleges Wales, the Royal College of Physicians Wales, the Royal College of Surgeons Edinburgh and Royal College of Midwives Wales. They say the safety of patients depends on doctors and healthcare staff working in a safe system, but, due to the ongoing treatment and retention crisis in the NHS, doctors no longer feel this is the case, and fear the health of their patients is at risk. They say Wales has recognised the importance of legislating for safe nurse staffing levels with the Nurse Staffing Levels (Wales) Act. They say that Scotland has taken action to legislate on safe staffing with the Health and Care (Staffing) (Scotland) Act 2019, passed with cross-party support. They say that doctors are facing increased pressures, medical staff are being pushed to breaking point, and that vacancies continue to climb. They say there aren't enough doctors to fill rota gaps, and the inevitable knock-on effect is a drop in standards of care for patients.

Collectively, they strongly welcomed recommendation 4 from the Health, Social Care and Sports Committee report referred to by Angela Burns, recommending

'the Minister amends the Bill to make specific provision for appropriate workforce planning/staffing levels as part of the duty of quality.'

They said, 'We believe the guidance must be included in Part 2 of the Bill so that, at the very least, Welsh Government can introduce guidance to NHS bodies that informs them how they can achieve the duty of quality. This guidance should address the need for effective workforce planning.' A similar guidance process is set out in the section on duty of candour.

I therefore urge this Assembly to support Angela Burns's amendments. I welcome the support from across the Chamber, but note that, if the Minister is able to bring forward his own proposals to address these concerns, Angela would withdraw her amendments. We wait to hear what he might have to say. Thank you.

Thank you, Llywydd. I want to thank, at the outset, people who have worked on this Bill to date, both the scrutiny we've had through the committee process, as well as officials and all those who engaged in the White Paper stages and wider consultation. We will have various points of disagreement, and some points of agreement, through the passage of this evening. I won't respond to some of the broader comments about the future arrangements to replace community health councils; we'll come to that group later in the Bill.

In terms of staffing, of course, this Government supports the principle of having sufficient staff in our health service: having the right staff in the right place with the right skills.

I want to address the amendments in this group in two parts: firstly, whether the definition of quality should explicitly include staffing levels itself, and, secondly, amending the Bill to include a staffing duty.  

I want to be clear: the duty of quality, as drafted, is deliberately broad. It captures all aspects of the health service and relates to everything the health service has responsibility for. Workforce considerations are clearly a key enabler to meet the duty of quality. No body can ensure it secures services that are, for instance, safe and effective and provide a good experience unless they've given consideration to the types and the numbers of staff needed to achieve that.

And we are deliberately using the internationally recognised definition of quality put forward by the former Institute of Medicine in the states, and the person who went on to lead that institute was Don Berwick, who took part as one of our international experts in the cross-party endorsed parliamentary review. As I have said, having the right staff in the right space with the right skills is, in effect, the resource needed to secure improvements in quality. Staffing in and of itself is not defined as meaning quality. The workforce is there a key and most significant enabler in being able to secure improvements in quality.

Now, as has been said, Schedule 3 to the Bill links the duty of quality to the health and care standards, which have a whole theme, with detail on them, on staff and resources. NHS bodies will therefore need to demonstrate that full consideration has been given to workforce matters in discharging the duty of quality.

As I've indicated previously, and in particular in the useful and constructive discussions we had after Stage 2 with other parties, the standards are kept under regular review, and, in fact, a review is about to take place within this year. The passage or otherwise of this Bill will obviously help to inform the review of those standards and the framework we expect people to respond to.

The statutory guidance will deal with the application of the duty across all functions of the health service, and will undoubtedly highlight the importance of workforce planning, alongside the requirement to consider securing improvements through areas such as prevention, health improvement, and taking action to address inequality in outcomes.

I'm pleased to confirm that the RCN and the BMA have offered to work with us on developing the guidance, and of course I very much welcome that offer. The amendments on staffing levels being included in the definition of quality are not, therefore, in my view required.

Turning to the amendments that seek to extend the staffing duty to Welsh Ministers, I have to say at the outset that I'm firmly of the view that making a change of this magnitude by way of amendments to a Bill is simply not the right approach. The Nurse Staffing Levels (Wales) Act 2016 benefitted from significant planning and considerations of the financial ramifications, and was subject to the full scrutiny that we would all expect for such a landmark piece of legislation. And it was important to ensure that it was done in the right way. Applying any of the principles of that Act to all other clinical staffing groups in Wales without the same degree of care, consultation, consideration and scrutiny would be wholly inappropriate.

The Royal College of Nursing in their own evidence to the health committee acknowledged that a change of this magnitude is not something that they believe is suitable to try and achieve by way of an amendment. When you consider not just the headline measures, but also the process measures as set out in the highly detailed amendments for reporting mechanisms, you would have to do a considerable amount of financial work on the workforce implications as well as the availability of staff and having the tools to calculate staff—the appropriate levels of staff—in different settings.

In the case of inserting a section 25AA, as set out in the amendment put forward by Angela Burns, it would inappropriate and impracticable to level such a duty on Welsh Ministers when it is health boards and trusts who have that operational responsibility for those staffing considerations. The proposed amendment is in essence an extension of section 25A of the Nurse Staffing Levels (Wales) Act 2016 to all clinical staff, and it's very clearly a duty for health boards and trusts.

It is important to recognise that NHS bodies already have arrangements in place for ensuring that managers and senior decision makers are informed of staff shortages where this is likely to present a risk to patient safety. These arrangements include decisions to be taken 'in-hours' and 'out of normal working hours', and that includes arrangements for informing executive board members where appropriate, for them to make choices.

I am therefore unable to support the amendments put forward in this area, and ask Members to oppose them.

I call on Angela Burns to reply to the debate.

Diolch, Llywydd. I guess your answer's no real surprise, Minister, to any of us who believe really passionately that, to have a duty of quality, you need to have the right staff in the right place at the right time. And I think to those of us who've seen over the last few years again and again the instances where there haven't been enough staff and they haven't been in the right place and they haven't been at right time, and it has led to some very, very sad and demoralising situations within the NHS—.

That initial legislation, when it first came in, as introduced by your Cabinet colleague Kirsty Williams, was groundbreaking. But we've done nothing to build on it, and we've done nothing to really take it forward. Now this supports a recommendation in the health committee. This was a recommendation where we took an awful lot of witness evidence. This is what the specialists are saying. This isn't just Angela Burns, Welsh Conservative, or Rhun ap Iorwerth, Plaid Cymru, or Caroline Jones, Brexit Party, just trying to be difficult and invent something. This is actually as a result of really considered evidence by the specialists. And if you ever say it once when you stand up in this Chamber, you say it many, many times: 'We must listen to the clinicians. We must listen to the professionals.' We did. We did, hence these amendments.

I've never been one for legislation lite—I do believe, if you do legislation, you have to do it really well, so it has a really effective part. And the whole point of this Bill is about quality and about candour and about patient representation. And I fail to understand how you can possibly hope to deliver that level of quality if there are chances that you do not have the right staff, whatever they are, in the right place at the right time.

And I will just add one last thing, which is you make the comment that health boards are already supposed to be doing this. Well, we know that they're not, so I would like to move these amendments tabled in my name.

The question is that amendment 21 be agreed to. Does any Member object? [Objection.] We proceed therefore to a vote on amendment 21. Open the vote. Close the vote. For 23, no abstentions, 28 against. Therefore, amendment 21 is not agreed.

Amendment 22.

Angela Burns, is it being moved?

Yes.

The question is that amendment 22 to be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 22, tabled in the name of Angela Burns. Open the vote. Close the vote. In favour 23, no abstentions, 27 against. Therefore, amendment 22 is not agreed.

The next group of amendments is the group that relates to the duty to secure quality in health services and the meaning of quality. The lead amendment in this group is amendment 60, and I call on Rhun ap Iorwerth to move and speak to the lead amendment and to speak to the other amendments in the group. Rhun ap Iorwerth.

Thank you, Llywydd. I would assume that these amendments are quite central to what we're discussing here today. This is a Bill that relates to quality within health and social care, and these are amendments defining exactly what we mean by quality and what we mean by the standards that we expect within our services here in Wales. There are amendments here related to prevention of ill health, there are amendments related to reducing health inequalities, and also amendments on the need to provide accessible health services through the medium of Welsh, because we believe, in those three areas, we do need very real quality, and we need high standards in what we should expect. I expect the Minister to reply to this debate by saying that standards in health and care already take account of these issues. So, let's look at some of those.

Standard 1.1, first of all, refers to preventative behaviour and deals with health inequalities, and it states that:

'People are empowered and supported to take responsibility for their own health and wellbeing and carers of individuals who are unable to manage their own health and wellbeing are supported. Health services work in partnership with others to protect and improve the health and wellbeing of people and reduce health inequalities.'

Now, I don't feel that that, in and of itself, is always delivered. We may need to go further than that.

When it comes to the Welsh language, there is no particular section related to the Welsh language. What we have is a mention of the Welsh language in other parts of the standards. Standard 2.7, for example, is related to the safeguarding of children and adults at risk, and it says this:

'Priority is given to providing services that enable children and vulnerable adults to express themselves and to be cared for through the medium of the Welsh language because their care and treatment can suffer when they are not treated in their own language.'

There is also reference to the Welsh language in the standards as a means of providing equal access to everyone to services, stating that people should see that respect is shown to their cultural identity, and that they should be able to access Welsh language services without any barriers, although not everyone responsible for providing the care would be able to converse through the medium of Welsh.

But these are standards that have been in place since 2015, and I don't think that anyone could argue that every NHS institution is delivering those kinds of standards and that quality of service. I think failing to include a section specifically on the Welsh language suggests that it's not really thought of as particularly important in terms of quality, of the standards that should be expected by people. It feels like something that has been bolted on at the end.

So, we reject the notion that the current standards are sufficient and we would consider all of those three categories that I've mentioned—prevention, reduction of inequalities, and the Welsh language—to be important enough to place on the face of the Bill. The Minister has already conceded that safety, effectiveness and the experience should be on the face of the Bill as part of what quality supposedly means, despite the health and care standards also referencing those too. He has defined some new things he wants to emphasise by bringing them on to the face of the Bill. Why not prevention, reduction of inequalities, and the Welsh language? We see no reason why other important factors in the quality of a service shouldn't also be on the face of the Bill. It allows for a clearer signal to be sent about what the Welsh Government considers important.

The other question to ask is that if all these important indicators of quality are already part of the health and care standards then why the need for this legislation at all? Isn't quality already part of legislation underpinning the NHS? If the answer to that is that the standards are inadequate for the Minister to enforce on health boards, then what we need is either the strengthening of the current guidance on standards, or for standards perceived to be important and not currently being met to be put on the face of the Bill. So, either the standards are sufficient, in which case there's no need for the Bill, or they're not, and we need this Bill. If they're not, then this Bill needs to have a far stronger section on defining what quality is. So, I ask you to support these amendments. Diolch yn fawr iawn.

The Welsh Conservatives support all of these amendments, and Rhun ap Iorwerth very neatly took my words, which were: if we don't have a definition of what quality is on the Bill in all the areas, then what is the point of the legislation? If they're already doing it, if the health boards are already doing it, then we don't need the legislation.

With the previous set of amendments that I tabled a little bit earlier, that's the whole point: health boards should be doing it. If they're not doing it—. We should be achieving this level of quality in our NHS; we're not achieving this level of quality in our NHS in all of these areas that you raise—three very important areas: the Welsh language, prevention of inequalities, and the prevention work—and it is absolutely key that we do just that. So, we support your amendments and thank you for tabling them.

The elements of quality set out in the Bill are non-exhaustive and deliberately broad, as I said in the debate on the first group. It is intended that quality will align with the internationally recognised definition of quality. And, again, that is intentional, given the broad-ranging functions of NHS bodies, and I do not want to risk diluting that approach or making it cross-purposes. And it's worth remembering that equity is one of the six domains recognised in the internationally accepted definition of quality, and therefore needs to be an important component of any decisions taken to secure improvement. I therefore won't be supporting the amendments brought forward in this group.

Importantly, as Members know, the Bill already makes a significant, and in this context very relevant, amendment to section 47 of the Health and Social Care (Community Health and Standards) Act 2003. That does mean that health and care standards must be taken into account by NHS bodies when discharging their quality improvement duty, and as I've already said those standards are being updated.

The health and care standards are comprehensive and mean that NHS bodies will have to consider matters relating to workforce, improving population health, equity, and the Welsh language in discharging their duty, because these are all covered in our current standards, and will be covered in the revised ones. These will be reinforced and set out in the statutory guidance that I've already referred to.

So, whilst I understand the sentiments behind the amendments, I don't believe they're required as the Bill, because of the alignment with the standards, will ensure that those requirements are covered in a manner in which they have statutory force, but also in a manner in which they can be revised, as indeed we have done at five-yearly intervals for some time. The amendments to expand the elements of quality are therefore, in my view, unnecessary, as they are already provided for.

To summarise, in my view, all three of the areas highlighted are catered for in the health and care standards that underpin the duty of quality, and the guidance can further reinforce this. There will also be important considerations for Welsh Ministers when taking decisions with a view to securing improvement in the quality of services. I therefore ask Members to oppose the amendments in this group. 

Rhun ap Iorwerth to respond to the debate.

Diolch yn fawr iawn, Llywydd. I'm grateful for the signalling of support from Angela Burns and the group opposite; disappointed, but not surprised, in not gaining the support of Welsh Government and Labour Members. To me, it's clear enough that the statutory guidance that we have now isn't delivering the quality that we want as strongly as we could. It strikes me that if we're not seeking to actually enhance the quality of services through a health quality Bill, well, what on earth is the point of having a quality Bill? A cynic would suggest that this is a Bill that is meant to achieve something else, which is to get rid of the community health councils and their ability to be a thorn in the side of Welsh Government, and that it needed to be padded out with other things. But I'll leave it there.

The question is that amendment 60 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 60, in the name of Rhun ap Iorwerth. Open the vote. Close the vote. In favour 21, one abstention, 29 against. Therefore, amendment 60 is not agreed.

Is amendment 61 being moved? Rhun ap Iorwerth.

Yes, move.

The question is that amendment 61 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 61, in the name of Rhun ap Iorwerth. Open the vote. Close the vote. In favour 21, one abstention, 29 against. Therefore, amendment 61 is not agreed.

Amendment 62, Rhun ap Iorwerth.

Formally.

The question is that amendment 62 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 62. Open the vote. Close the vote. In favour 21, one abstention, 28 against. And therefore, amendment 62 is not agreed.

Amendment 23 in the name of Angela Burns is the next amendment. Is the amendment moved? 

Move.

Yes, it is. Is there any objection to amendment 23? [Objection.] We therefore move to a vote on amendment 23, in the name of Angela Burns. Open the vote. Close the vote. In favour, 23, no abstentions, 27 against. Therefore, amendment 23 is not agreed.

The next amendment is 24. Angela Burns.

Formally.

The question is that amendment 24 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 24. Open the vote. Close the vote. In favour 22, no abstentions, 28 against. Therefore, amendment 24 is not agreed.

Amendment 25 is the next amendment. Angela Burns.

Formally.

The question is that amendment 25 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 25. Open the vote. Close the vote. In favour 23, no abstentions, 27 against. Therefore, amendment 25 is not agreed.

Amendment 63, in the name of Rhun ap Iorwerth, is the next amendment. Is it moved?

Formally.

The question is that amendment 63 be agreed to. Does any Member object? [Objection.] We move to a vote, therefore, on amendment 63. Open the vote. Close the vote. In favour 21, no abstentions, 30 against. Therefore, the amendment is not agreed.

Amendment 64, Rhun ap Iorwerth.

Formally.

The question is that amendment 64 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 64. Open the vote. Close the vote. In favour 21, no abstentions, 29 against. Therefore the amendment is not agreed.

The next amendment is amendment 65, Rhun ap Iorwerth.

Formally.

The question is that amendment 65 be agreed to. Is there any objection? [Objection.] We therefore move to a vote on amendment 65. Open the vote. Close the vote. In favour 21, no abstentions, 29 against. Therefore, the amendment is not agreed.

Amendment 26 is the next amendment, Angela Burns.

Formally.

The question is that amendment 26 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 26, in the name of Angela Burns. Open the vote. Close the vote. In favour 23, no abstentions, 28 against. Therefore, that amendment is not agreed.

The next group of amendments is the third group, which relates to the duty to secure quality in health services and the power to issue guidance. Amendment 16 is the lead amendment in this group. So, I call on Angela Burns to move the amendment, and to speak to the other amendments—Angela Burns.

Diolch. I formally move the amendments tabled in my name. The point of these amendments is to give the Welsh Ministers the duty to secure quality in health services through the guidance principle. They seek to support recommendation 2 of the committee, which requests that the Minister issues statutory guidance. In Stage 1 evidence, stakeholders highlighted that the Bill was simply not strong enough in setting out what that duty of quality is and how it would be measured. 

These amendments have been drafted with the support of the Welsh Government and the Minister, and we're grateful to the Minister for this. They essentially say that Welsh Ministers must issue guidance to NHS bodies. Although we have tabled this, I would also be grateful if the Minister would confirm that the proposed guidance will include how the duties of local health boards, NHS trusts and special health authorities are assessed, as well as a demonstration of improved outcomes and how innovations and improvements can be implemented across Wales. It's about growing those small shoots, isn't it?

At Stage 2, I also mentioned that assessments are key planks to the duty of quality. They enable the relevant health authorities to provide us with uniform information about their quality indicators, and this is also how they move from what was criticised as an aspirational duty by the chair of the Welsh NHS Confederation management board to a very real and enforceable duty.

At Stage 2, the Minister noted that he agreed about the importance of setting out how NHS bodies can demonstrate an improved outcome as a result of taking steps to comply with the duty, and he shared the desire to see how innovations and improvements designed in one area could be spread and scaled across Wales. As I said at that Stage, we believe that getting the guidance right before the duty of quality comes into effect is essential. We're still not quite clear yet how that guidance will help health authorities to achieve the set levels of expected improvement, so again I would be grateful if the Minister would outline a little bit more detail on that guidance, especially given that he expects the guidance on the duty of quality to include the need to consider how a body works in partnership delivering services in an integrated way to secure improvements. And as we all know, partnership, co-production and collaboration are a very important part of raising the level of quality and the level of candour within our health boards. Thank you.

I'm also supporting the amendments in this group. If we are to have any chance of achieving the duty of quality, we must have statutory guidance in place that instructs health and social care providers on how they can go about implementing the duty of quality. Without statutory guidance, we leave it open to interpretation by the local health boards and local authorities. A duty of quality doesn't differ from region to region; it requires consistency and, therefore, we need national guidance. These amendments will ensure a single national approach.

The Minister—Vaughan Gething.

Thank you, Llywydd. Following considerations at Stage 2, I have had constructive discussions with opposition Members and I am pleased that we've been able to reach a shared position with Angela Burns on this. By specifying in statutory guidance the evidence to be used and the way such evidence has been assessed, that will require NHS bodies to report openly and transparently on the actions that they are taking to secure improvements in quality outcomes. Importantly, in undertaking that assessment, NHS bodies will also be required to evidence how they are taking the health and care standards we discussed in the first two groups into account in discharging their duty of quality. That means that NHS bodies will have to consider all the matters set out in health and care standards, which includes matters relating to workforce, improving population health and equity. That will be explained in the statutory guidance. There is a point here about the statutory guidance that we're committing to produce on each area of the Bill: we want to see that co-produced in the way that we deliver it, rather than simply delivered by the Government. I am therefore happy to support all the amendments in this group in the name of Angela Burns.

Angela Burns to respond.

Thank you very much indeed. It's sufficient to say that there are two words that bring joy to my heart. Caroline, you mentioned 'consistency', that's what we need; Minister, 'evidence', that's what we need. Thank you very much for supporting the amendments.

The question is that amendment 16 be agreed to. Does any Member object? Therefore, amendment 16 is agreed.

The next amendment is amendment 27. Angela Burns.

Thank you very much—

Do you want to move amendment 27?

Sorry, I beg your pardon. I move. My listening Welsh isn't as good as I think it is. [Laughter.]

Moved, then.

Amendment 27. The question is that amendment 27 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 27. Open the vote. Close the vote. In favour 22, no abstentions, 28 against. So, amendment 27 is not agreed.

Amendment 28, Angela Burns. 

Formally.

The question is that amendment 28 be agreed to. Does any Member object? [Objection.] Therefore, we proceed to a vote on amendment 28. Open the vote. Close the vote. In favour 22, no abstentions, 28 against. Therefore, amendment 28 is not agreed.

Amendment 66, Rhun ap Iorwerth.

Formally.

The question is that amendment 66 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 66. Open the vote. Close the vote. In favour 21, no abstentions, 29 against. Therefore, amendment 66 is not agreed.

Amendment 67 is the next amendment—Rhun ap Iorwerth.

Formally.

The question is that amendment 67 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 67. Open the Vote. Close the vote. In favour 21, no abstentions, 29 against. Therefore, amendment 67 is not agreed.

Amendment 68 is the next amendment, in the name of Rhun ap Iorwerth.

Formally.

The question is that amendment 68 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 68. Open the Vote. Close the vote. In favour 21, no abstentions, 29 against. Therefore, the amendment is not agreed.

The next amendment is amendment 29, in the name of Angela Burns.

Is the amendment being moved?

Formally.

Therefore, the next vote is on amendment 29, in the name of Angela Burns. The question is that amendment 29 be agreed to. Does any Member object? [Objection.] Therefore, we proceed to a vote on amendment 29. Open the Vote. Close the vote. In favour 22, no abstentions, 28 against. Therefore, the amendment is not agreed.

Amendment 17—Angela Burns.

Formally.

The question is that amendment 17 be agreed to. Does any Member object? Amendment 17 is agreed.

Amendment 30, Angela Burns.

Formally.

The question is that amendment 30 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 30. Open the vote. Close the vote. In favour 22, no abstentions, 28 against. Therefore, the amendment is not agreed.

Amendment 31, Angela Burns.

Formally.

The question is that amendment 31 be agreed. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 31. Open the vote. Close the vote. In favour 22, no abstentions, 28 against. Therefore, the amendment is not agreed.

The next amendment is amendment 69—Rhun ap Iorwerth.

Formally.

The question is that amendment 69 be agreed. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 69. Open the vote. Close the vote. In favour 20, no abstentions, 29 against. Therefore, amendment 69 is not agreed.

Amendment 70, Rhun ap Iorwerth.

Formally.

The question is that amendment 70 be agreed. [Objection.] We therefore proceed to a vote on amendment 70. Open the vote. Close the vote. In favour 21, no abstentions, 29 against. Therefore, the amendment is not agreed.

Amendment 71, Rhun ap Iorwerth.

Formally.

The question is that amendment 71 be agreed. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 71. Open the vote. Close the vote. In favour 21, no abstentions, 29 against. Therefore, the amendment is not agreed.

The next amendments is in the name of Angela Burns—amendment 32.

Formally, Llywydd.

The question is that amendment 32 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 32. Open the vote. Close the vote. In favour 21, one abstention, 28 against. Therefore, the amendment is not agreed.

The next amendment is amendment 18—Angela Burns.

Formally, Llywydd.

The question is that amendment 18 be agreed. Does any Member object? Therefore, amendment 18 is agreed. 

Amendment 33, Angela Burns.

Formally.

The question is that amendment 33 be agreed. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 33. Open the vote. Close the vote. In favour 21, no abstentions, 28 against. Therefore, the amendment is not agreed.

The next amendment is amendment 34—Angela Burns.

Formally.

The question is that amendment 34 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 34. Open the vote. Close the vote. In favour 22, no abstentions, 28 against. Therefore that amendment is not agreed. 

The next group is the fourth group of amendments, which relates to non-compliance with the duty to secure quality in health services. Amendment 35 is the only amendment in this group, and I call on Angela Burns to move the amendment.

Thank you, Presiding Officer. I formally move amendment 35, tabled in my name. Members, I want teeth, not for me but for the NHS, and amendment 35 is tabled in support of committee recommendation 6, which asks the Minister to make a specific provision for the consequences of non-compliance with the duty of quality. I've re-tabled this from Stage 2 because, actually, I think it's vitally important that if we have legislation, it must have checks and balances built within it and the whole point of this is to give the Government, give the whole system, those very, very important teeth.

It's not intended to have a detrimental impact on the financial position of health boards, trusts or special authorities, but it could be dealt with through the NHS escalation and intervention arrangements by the health Minister. During evidence sessions and the committee's consultation, it was clear that many stakeholders wanted to introduce consequences for the non-compliance in relation to both the duties of quality and candour. The British Medical Association noted that this needed to be addressed, stating,

'Unless some form of sanction or corrective action is triggered, we believe that the proposed duty would run the risk of lacking effectiveness, and at worst would become a mere box-ticking exercise.'

The Royal College of Nursing noted that there

'has to be a consequence to doing it or not doing it, otherwise there's no incentive to do it, in a sense, at the most basic level.'

Minister, your response at Stage 2 didn't give me any reassurance in the slightest. You said, again, in your commentary from Stage 1, that there were existing mechanisms, including escalation measures, that would underpin the failure to adhere to that duty of quality. Furthermore, you went on to say that these arrangements were part of wider governance and accountability within the NHS, and you believe that it provided opportunities for scrutiny and appropriate, timely action and learning.

Well, I'm sorry, Minister, but I don't believe we are using these mechanisms and I don't believe they've provided opportunities for timely action and learning. I don't see health boards acting really quickly or learning their lessons. So, for example, we're still dealing with the fallout from some of our worst situations: Tawel Fan, where Betsi Cadwaladr is still in special measures four and a half years later, meaning that special measures and direct Government intervention haven't had much effect on the board's governance arrangements. An independent review of its psychological therapy services—you know, mental health services—highlighted that it is still failing in many areas. So, you would have thought that, after Tawel Fan, they would have actually looked at that quality in that element of the health services.

I don't really want to dwell too much on Cwm Taf Morgannwg's maternity services, but we've got to say it here. This is the truth: despite numerous reports between 2010 and 2018 stating that the board's maternity services at Prince Charles Hospital and Royal Glamorgan Hospital were in trouble, including a damning internal report by a consultant midwife, who said there were systemic failings, they were ignored by senior management. So, where's that duty to secure quality in health services? This is a direct mirror of what we've seen at Betsi.

So, Minister, members of the governing party, I really want you to think about this. This could be a really useful piece of legislation to drive quality, to drive candour through the NHS, but it has to have some teeth, and this whole amendment is about giving those teeth to the whole Act in order to ensure that we do get that real compliance. We can't afford for our NHS to carry on in a way where we cannot hold people to account and actually make sure that there are improvements. Duty to secure quality, non-compliance, give us teeth.

Very briefly, just to endorse that. Any legislation needs to have teeth and we need to ensure that the legislation does have force, as Angela Burns has said. We will be supporting this amendment, and we will be arguing that it would be meaningless to pass legislation unless there are implications when someone contravenes that legislation. 

I will clearly expect all NHS bodies to demonstrate how they comply with the new quality duty in an open and transparent way. The new annual report will be a key vehicle for evidencing this. The amendments that we have just passed, 16, 17 and 18, will set that requirement out very clearly. This, along with other mechanisms, such as integrated medium-term plans, provides that range of opportunities to assess how the duty is being discharged. 

Our existing NHS escalation and intervention arrangements should be seen within a wider governance and accountability framework within the NHS at both individual body and system levels through the quality and safety committees, the quality and delivery meetings, and joint executive meetings between the chief executive of NHS Wales and the chief executives of health boards and trusts and their senior teams. These all provide opportunities for scrutiny and appropriate timely action and learning.

I also expect HIW to take a close interest in how an organisation is discharging its duty as part of its inspection and review work. I've already stated, and am happy to state again for the record, that there are a range of levers that may be used where a body is not exercising its functions properly and these include the escalation and intervention arrangements.

The amendment provides that Welsh Ministers 'may' issue an intervention order if an NHS body has failed to exercise its functions in accordance with the duty of quality. The circumstances in which the Welsh Ministers may issue an intervention order are already set out within the National Health Service (Wales) Act 2006. This includes where an NHS body is not performing one or more of its functions adequately. It is therefore unnecessary to add the provisions in these amendments to the face of the Bill, and I ask Members to oppose them.

Angela Burns i ymateb.

Thank you, Llywydd. Failure to comply with the duty to secure quality in health services—you're absolutely right; it does say that

'sections 12A, 20A and 24A, they may make an intervention order in respect of the body.'

However, you've made escalation orders across our health boards because of failures in quality of care: Tawel Fan, Cwm Taf to name but two; there are other— smaller, thankfully—instances. The whole point of this is about giving a driver, it's about putting the focus on it, it's about ensuring that, when people are under pressure, they really realise, with absolute clarity, what—

Would you take an intervention, Angela?

Absolutely. Of course I will.

I'm very grateful to you. Do you agree with me that, if we persist in passing laws in this place where there are no clear consequences on the face of the law for the people who break the law, we risk bringing the whole democratic institution into disrepute? I, for one, am sick and tired of being asked to vote for legislation where nothing happens to somebody who breaks those laws.

I don't think I need to say any more, Llywydd, because I think Helen Mary has absolutely encapsulated my entire feeling on it, which is why we brought this amendment. We've got to up our game. The whole point of this legislation is about us upping our game, and making sure that those who run our health boards, the management teams, really make sure that providing quality care to our NHS citizens, the people who use our NHS, is actually one of their primary jobs, not an also-ran. Members, I really ask you to think about this hard and to support our amendment.

The question is that amendment 35 be agreed to. Does any Member object? [Objection.] Therefore, we proceed to a vote on amendment 35. Open the vote. Close the vote. In favour 23, no abstentions and 28 against. Therefore, the amendment is not agreed.

The next group is group 5, which relates to the duty to secure quality in health services and data. Amendment 38 is the only amendment in the group, and I call on Angela Burns to move and speak to that amendment. Angela Burns.

Thank you, Presiding Officer. I've been an Assembly Member for about 10 years now, and I've sat on a whole variety of committees—finance, health, education, children and young people, as it was—and all the time we talk about 'How do we know?' How do we know that we're performing well? How do we know that we're meeting our targets? How do we know we're delivering the outcomes for the money that we're spending? This amendment, amendment 38, which I formally move, is about getting the data so we have the information so we can make the planning.

It is an amendment that was based on a suggestion by the Royal College of Surgeons in their written evidence to the committee, but it actually runs true throughout the whole of the objective of this Bill. We want to know how well our surgical outcomes data is doing at a unit level. Again, I want to remind Members of another exciting fact: how many times have any of you—and maybe not you, but I'm sure Members of Plaid Cymru and I'm sure Members of the Brexit Party, I know Members of my party and I'm sure some of the independent Members will have put in freedom of information requests to try to drill down to get that information to find out what happened: where; when; how? How many things have been achieved; how many operations have happened; what type of operations; where are the blockages? Because by knowing what is going on, by having that data, you can actually start to have good governance. You can go back, you can challenge and you can scrutinise. This amendment is all about getting good data.

I listened, Minister, to your response at Stage 2. You were very concerned about a prescriptive list of information, and I took that on board. As a result, the amendment here at Stage 3 is broader and it's also with an inclusion that the data is shared with Ministers and Public Health Wales to help inform your future work and planning. This is about helping you and helping your NHS teams to perform better, to do a better job, to know what is going on.

I was very disappointed by your response to the Chair of the Health, Social Care and Sport Committee. It's not good enough to list off the current indicators by which health boards must measure their performance. I do note the work surrounding the Once for Wales concern management system on the recording of incidents, complaints and adverse outcomes in healthcare, as well as the aim to develop a single framework for measurement and benchmarking of quality-related data under the five-year quality and safety plan, but I don't think these are yet sufficient to properly analyse patient outcomes. I think it would be prescient for the National Assembly for Wales to monitor the progress of those programmes closely given the past issues we've had with data collection. I would like to remind Members that it was only recently that we found some of the data at Cwm Taf Morgannwg was completely wrong. They had mislaid I think it was 2,700 operations, appointments and results. We need efficient, good data. This Bill gives us the opportunity to do it. Please, Members, consider that and pass this amendment. 

Rhun ap Iorwerth.

Thank you for the opportunity just to say a couple of words. This is also an area where, if we are going to have a Bill that is worthwhile, we have to look for ways to have an impact through it. We know from experience that a lack of data is holding us back, in terms of our ability to increase quality within our health and care services. We support the amendment. We know that data, and the shortage of data, is a problem within the NHS. It is important, for me, to think that we should be getting LHBs to prove that they are complying with legislation, because, otherwise, all we’ll get is some kind of ambiguous certainty that everything is right, until we end up in a situation similar to Cwm Taf again, where we find that things are not okay. This is an opportunity to respond to that situation.

The Minister to respond, Vaughan Gething. 

Thank you, Llywydd. There are already many systems in place to collect, analyse and publish data across our national health service. Much of this is captured on a Wales and England basis, if not a UK-wide basis, such as the range of national clinical audits. It is what is the done with that data that is, of course, key. Amendments 16, 17 and 18 dealt with the requirement for Welsh Ministers to issue statutory guidance in relation to the quality duty and for that guidance to include the evidence for how an assessment has been made to ensure a stronger focus on using data and for that data to be reliable in enabling a body to make decisions that will ensure improvements in quality outcomes.

And, as Angela Burns knows, there is already considerable work under way to streamline and improve our data and that important things are routinely measured in a consistent and clinically relevant way. Because one size will not necessarily fit all. We have to retain some flexibility to determine and review what data is collected in the best and most effective ways, to keep pace with technology and other evidence-based requirements. For example, the changes in the clinical model adopted by the ambulance service, widely adopted in England and Scotland, have necessitated changes in data collection and the way we hold the system to account for their performance.

The work under way to implement the cancer pathway will also necessitate changes to the type of data we collect to see if we are securing improvements in the quality and delivery of the service. Our intention is to develop cancer data and intelligence in order to support better system planning and delivery. That will involve the collection, use and publication of a more comprehensive set of activity data.

And, as Angela Burns referred to, we're working with the service to finalise a five-year quality and safety plan that describes a range of high-level strategic recommendations, including a specific action around addressing measures, data and analytics.  A collaborative programme of work will be established to take that plan forward, with one of the aims being to develop a national approach to measuring and benchmarking quality-related data. I expect that plan to be published ahead of summer recess within this calendar year.

NHS Wales is also in the process of implementing a new system, as referred to: the Once for Wales concerns management system for how local health boards and NHS trusts record, report, monitor, track, learn and make improvements from incidents, complaints, claims and other adverse outcomes. The aim of this is to achieve consistency of data management and workflow design in these areas, across Wales. It is intended that the new system will be implemented over the coming year.

I understand where this amendment is coming from and agree with the Member about the importance of consistent, streamlined and cohesive available data. As I have explained, work is under way on a number of fronts to achieve just that. As evidenced by some of the work in this area that I have described, I don't agree that we need further legislation to achieve this. Legislation would certainly add to bureaucracy and take away flexibility and has a real potential to slow down and even stifle innovative work in this area. I therefore cannot support the amendment.

Angela Burns to reply to the debate.

Thank you for that. Some of the words that I find the most slippery are words like 'intend' and 'expect', because they don't actually tell you when you're going to do something and how you're going to do it.

So, let me just remind Members: in July 2013—we're now in 2020—so, seven years ago, the Welsh Government said it would work to publish—in fact, you didn't just say it, you announced that you would work to publish surgical outcomes data in Wales at a unit level, with a promise to consider individual outcomes data at a later date. It's not been progressed; it's not been achieved. This amendment is intended to drive your Welsh Government promises forward and to remind the Minister that we've already asked to make this an urgent priority, as has already happened in NHS England.

Why is that important? Because if you knew what was happening, for example, with operations, how many are cancelled and whether that cancellation is for a clinical or non-clinical reason, from the health board and from the patient—. We have a little bit of that data, but simply not enough to understand where the pressures are or what is contributing to long waiting times, what is contributing to the bottle necks, and how we can resolve it. Seven years—still not delivered. I'm not holding my breath. If this doesn't get passed, I'm not holding my breath that we will see that data brought forward in a really timely manner, where it is useful to help us to frame or reframe the way we work in our NHS.

The question is that amendment 38 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 38. Open the vote. Close the vote. In favour 23, no abstentions, 28 against. Therefore, the amendment is not agreed.

The next group of amendments is group 6, which relates to the duty to secure quality in health services and a register of managers. Amendment 72 is the only amendment in this group. I call on Rhun ap Iorwerth to move that amendment.

Thank you very much. I do urge you to support this amendment. Should we be able to expect, or should we hope to have, the clinical staff, the best possible doctors, nurses and so on, within the NHS? I think we should, and there are systems in place to ensure that standards are maintained. Should we expect and hope to have the best possible managers within the NHS? Yes, I would argue that we should, but we don't have the same systems in place to try to maintain those standards.

What this amendment does is to create a register of NHS managers and a body with oversight of that register. We have made some changes since Stage 2 proceedings in order to ensure that that oversight body does have the ability to put competencies in place and to place sanctions on managers who fail to reach certain standards.

In the case of nurses, doctors, midwives and other health professionals, there are regulatory bodies in place that insist on high standards, which have the ability to discipline staff if they fail to attain those standards, to put things right when standards are not attained, where there is negligence, and then it's possible to prosecute in accordance with those regulatory standards. But among managers, we don't have those arrangements in place that would ensure that we should insist on a particular standard. We have excellent managers within our health service in Wales, at all levels. We need to give those managers within the NHS pride. We need to celebrate good management. But if we do that on the one hand, then on the other hand we need to ensure that we have those tools in place and that we have systems that provide a yardstick, where we can say, 'Yes, this is the expected standard.'

As we know, we have had too many experiences within the NHS in Wales over the years where managers have fallen way below the standards that we should expect of them. There are grave implications where managerial errors and mistakes have been made. And very often, we will see a manager moved on and taking another role in a health board without there having been processes followed, either to correct, to penalise or to bring sanctions into play, but mainly in order to improve standards.

I understand that some preparation has been made in terms of the kind of system that we are suggesting here, and that this is something that the Government realises should be addressed, but, for some reason, there is an unwillingness, or there has been an unwillingness, to say, 'Well, that's enough of a throwaway attitude towards standards among managers—let us do something to correct the situation.'

I don't think that we can drive standards up to do more with less, and to use resources far more efficiently, unless we have a mechanism in place to improve management. Although the Government will reject this amendment, I fear, I do truly believe that this is an area where the Government should be focusing on, and that this should have been a core part of the Bill, if the purpose of that Bill was to raise standards within health and care.