Cynulliad Cenedlaethol Cymru

[Interruption.] That was a timely alarm, so it brings us to order in the Chamber this afternoon.

Item 1 on our agenda this afternoon is questions to the Minister for Health and Social Services, and question 1 this afternoon—Siân Gwenllian.

We have reaffirmed our commitment to improve access and quality of perinatal mental health services both in the community and for in-patient care in the 'Together for Mental Health—Delivery Plan: 2019-22', which was published in January.

At a recent meeting of the Children, Young People and Education Committee, a psychiatric consultant and medical director for mental health at Betsi Cadwaladr University Health Board said that it appears that, 'we probably need about four beds of a mother and baby unit' in north Wales.

He went on to say that the board was willing to pilot a new model of care.

Now, what becomes clear, whatever the figure, and whether you need a unit or not, is that we do need urgent action to develop unique provision for mothers and babies in north Wales. Things have started in south Wales, at last, with a pro tem unit, but there is nothing that seems to be happening in terms of mothers in north Wales, who continue to have to travel a long way from home or are treated on psychiatric wards without their babies, or decide not to seek the necessary assistance at all. Will you, therefore, give directions to the relevant bodies to look into the options for north Wales with the aim of creating unique provision so that mothers in large parts of the country aren't left behind?

Well, I thank Siân Gwenllian very much for that very important question, and, as she says, we are making progress now with south Wales, but we certainly now need to move along with the situation in north Wales.

We have been having discussions with providers in England to discuss options for a joint provision, but those proposals are now on hold, because the English service is actually looking at developing its own provision. It is going to resume talks later on this year, but we're not sure when that will actually come. But, I know that Betsi Cadwaladr has said that it is interested in developing its own unique type of service. It has also mentioned a service for women who don't actually want to go into any beds at all. So, I think that's certainly something that we could look at, because it's very important that we do recognise that, at such a crucial time, women should feel able to have treatment and should be able to get it near home. So, we certainly will follow up those points.

Well, reference was made to the Children, Young People and Education Committee and, of course, their 2017 report 'Perinatal mental health in Wales' noted that

'north Wales alone does not have the necessary birth rates to sustain a specialist MBU, we call on the Welsh Government to engage proactively with providers in England to discuss options for the creation of an MBU in north east Wales that could serve the populations of both sides of the border.'

The Minister accepted their recommendation that the Welsh Government engaged, as a matter of urgency, with NHS England to discuss options for the creation of a centre in north-east Wales that could serve the populations on both sides of the border, saying 'I have asked the Welsh Health Specialised Services Committee to work with Betsi Cadwaladr University Health Board to consider options in north Wales, including this recommendation.'

Well, by my reckoning, that was 28-29 months ago, when the recommendation was urgent and the Minister said that he had asked then for that work to go forward.

The Betsi Cadwaladr website's only reference to perinatal mental health talks about their mental health service as close to their homes as practicable for mother and baby, but it doesn't refer to that key mental health provision. Only last month—and I'll conclude here—BBC Wales reported that mothers in Wales are suffering due to the lack of a specialist in-patient mental health support unit two years after Welsh Government promised to develop one. Why are we still waiting to hear, and if, as you indicate—I'm sure you do indicate—that, currently, discussions with England are on hold, why can't the developing model in England continue to develop on a cross-border basis, as proposed, rather than on a singular basis, recognising a border that could negate the recommendations in this committee report?

I thank Mark Isherwood for those questions. As I said in response to Siân Gwenllian, the Welsh Health Specialised Services Committee has engaged with providers in England to discuss options for the creation of a mother and baby unit in north-east Wales that could serve the population of both sides of the border. And I think, as you've acknowledged, those discussions have now stopped, because the English services, they've got this provider collaborative initiative, which is provision of local services in England, and they want to see how that turns out before they go into any further discussions with us. So, that is the situation at the moment, but certainly, we do intend for those discussions to resume this year, and certainly, we are going to look at anything that Betsi Cadwaladr itself proposes.

Thank you. We are currently identifying cases of the virus, isolating patients, and tracing anyone who has been in contact with them. If the disease becomes established in the UK, we will need to consider further measures to delay the rate and extent of its spread.

Thank you. Minister, may I begin by commending you personally for the calm and authoritative manner in which you have led the Welsh Government's response to the coronavirus outbreak? Yesterday in the Senedd, Minister, you made a most welcome statement updating the citizens of Wales on how the coronavirus action plan is developing. My constituents in Islwyn have greatly welcomed your commitment to prioritise the authorisation of supply of personal protective equipment to all GP practices across Wales, and as supplies of personal protective equipment start to be issued, is your department able to offer timescales for when every GP practice in Islwyn will be equipped?

Also Minister, can you reiterate the advice that the Welsh Government would give to Islwyn residents who present with significant flu-like symptoms, about attending work, their GP surgery and/or an accident and emergency department? Because, inevitably, people worried that they may have this virus will seek medical attention, but also, as usual, the chronic respiratory conditions such as asthma or chronic obstructive pulmonary disease, or those with seasonal flu viruses, chest infections, pneumonia and other ordinary respiratory conditions. Minister, what is the best course of action for these people to aid themselves, their families and the wider community?

Thank you for the questions. On personal protective equipment, I made the decision and the announcement over the weekend about protective equipment to go to general practice. We expect that to be completed within the week across the whole country, so, in Islwyn, obviously, I would expect that every practice within Islwyn will have that within that time frame. If any Member is aware that they have a local practice where that hasn't happened, then I'd be grateful to hear about that so that we can resolve it. I announced yesterday that community pharmacies will also be supplied with personal protective equipment and those supplies will be going out before the end of this week as well. So, having made the decision we'll be able to move rapidly, and we're in the fortunate position that we expect that Wales will have all of that equipment issued and in place within a shorter timescale than England—that's partly about the size and the logistics involved. So, we're in a good place there.

And I think it's an important point to reiterate as well, the things that the public can do themselves. The normal advice about 'catch it, bin it, kill it', wash your hands, but also the normal advice that we'd give and would ask you to follow if you've got significant flu-like symptoms, not to come into work; not to go into places where you're at risk of actually other people acquiring them, with significant consequences. That is normal advice; not just now, with coronavirus potentially circulating, that is normal advice that we would ask people to follow.

For people who are concerned and want medical attention, it's really important that people do not go into their local surgery or into a hospital. Please follow the advice to call 111. It's available across the whole country, and you should then be given advice and guidance on what to do. If you need to be tested, we've already been able to test over 90 per cent of people in their own homes, but also, there are now at least 11 drive-through testing centres across Wales. More are being created by different health boards, and those are for people who are advised to go and attend them. So we're doing all that we could and should do to keep people at home where they need to be, to give them the advice and the provision that they need, and again, if the position changes, then the Government and our chief medical officer, together with other Governments in the UK, will be clear about the reason for that change in advice and what we're then advising people to do. It really is important that all of us take on our individual responsibility as elected Members in what we do to keep our constituents safe, and what our constituents in turn do to keep themselves, their families and other people safe as well. 

Minister, hospitals in England are being asked to carry out more video-based consultations with patients to reduce the risk of spreading coronavirus. NHS England have said that they hope this move will reduce the number of people in hospitals and lower the potential for transmission. Minister, will you look at this innovation to see if it would benefit patients in Wales? And what measures are you considering to safeguard communities in Islwyn and elsewhere in Wales? 

Finally, we all know that the Chancellor of the Exchequer has announced £20 billion funding to tackle this coronavirus, so how much funding are you hoping to have in Wales to not have that silly disease coming to this part of the world? Thank you.

On your point about remote consultations so that people don't necessarily need to attend in person, we've already had a programme of work to do exactly that through the health service. For example, many people now can have advice about eye health conditions without actually needing to go and see a consultant. We've managed to improve access by making use of our primary care contractors in doing that—pharmacy and optometry being really good examples of that.

However, coronavirus accelerates the need to do that, to avoid person-to-person contact, where possible. That explains why, yesterday, I announced that I have made a decision to actually implement a Wales-wide solution in particular in primary and community care, to allow more video consultations to take place. We've also increased and beefed up the 111 service so that it can be across the whole of Wales to deal with advice and information on coronavirus.

It'll be the same for those areas of hospital practice that need to continue. But actually, regarding the way that our hospitals will work if the coronavirus becomes more embedded and more significant, it won't so much be about the example I've given about eye care taking place where images are swapped and sent over; it'll be more and more about how we make use of our hospitals for the sickest of people and the need to displace other activity, if that is what is required. If you look at the example of Italy, the stage they're at and the severity they have, it's an entirely different scenario for the way that the healthcare system needs to work. So none of us should pretend that, if coronavirus is a more significant issue, we can still maintain business as usual.

As for the money that the Chancellor has announced, obviously I've been preparing for questions here today, but I look forward with interest to the detail of the announcements that have been made. But, equally, the point that the Minister for Finance and Trefnydd has made is that, regardless of the headline announcements today, funding is dealt with on a needs basis across the UK to deal with the reality of the impact that the coronavirus will actually have.  

Minister, the constituents of Islwyn are like many other constituents—like mine in Aberavon and others across Wales—who have deep concerns and anxieties over the spread of coronavirus and the implications it could have for their families. I very much welcome the updates you keep giving this Chamber regarding that and your keeping us informed as to the progress and actions that should be taken. That's very welcome.

I also welcome the dissemination of that information to the people of Wales, as much as possible. However, when we do see cases of coronavirus—and, in Neath Port Talbot alone, there have been six identified, the largest number in a single place in Wales at this point it time—and then we've seen one in Cardiff, where it was reported that a member of staff of Sky's call centre was identified as having the coronavirus, and they then took the decision to deep clean that particular site. As such, people who hear of cases within their own locality, where maybe their children have been attending a school with children of a family who have been identified as coronavirus victims ask questions as to how we ensure things are safe. What discussions are you having with public bodies, including local authorities, to ensure and reassure families and parents that, when an incident occurs, everything is being done to ensure the safety of their family in those locations and, if necessary, deep cleaning will take place if it's appropriate? It is important that those messages get out, because if we don't get that messaging and communication right, the rumour mill starts, and that is one of the worst things that can happen in a situation like this. We need facts, not fiction. Therefore it is important that we get the communication right. 

I completely agree with the ending that the Member has left there, because it's really important that all of us behave responsibly and provide information from trusted sources to our constituents. So that is information that the Governments of the UK are providing, including on the Welsh Government website, where we have got clear guidance for schools, and our guidance is that schools should remain open. There is no evidential basis to close schools now, and there's a challenge here about some people's perception that the Government should act and do things like closing schools, when, actually, all of the evidence available to us now is that it would not be effective in either delaying the coronavirus outbreak or indeed reducing potential mortality. And if it were appropriate, it may be appropriate later, but it is absolutely not appropriate now. And the example I've given is: it's not just about the science, about potentially having a second peak in an outbreak, where you could potentially have higher rates of mortality; there's a real challenge about if you close schools, who looks after them? It takes people out of the workplace. Or, if people have people to look after that child, it's unlikely to be registered childcare; it's often kinship childcare, and, often, those people are grandparents, older relatives and people who are in the highest risk category. So, actually, we do need to follow the science; we do need to follow the evidence, and to repeat those trusted sources of information. 

And your point about local government is well made. So, in the planning we're already doing, we are definitely speaking with local government. I briefed cabinet members with social care responsibilities from across each part of Wales on Monday, about some of the challenges that they need to plan for. I'm speaking to leaders of local government across each part of Wales, and each party, all together at the same time, tomorrow as well. So, we're making sure that we're having direct conversations with local government to be prepared. And to really reiterate: we are not going to make choices to risk the health of the public; we're going to make choices on the basis of evidence, and the best available scientific advice, and we will continue to do it and be open with the public about what we are choosing to do and the advice we're giving them on how we want them to behave as well. 

We now turn to spokespersons' questions, and the first this afternoon is Plaid Cymru spokesperson, Rhun ap Iorwerth. 

Diolch, Dirprwy Lywydd. Some questions initially on preparations for an increased intensity of outbreak, and it's important to put those preparations in place. We know from international experience that critical care capacity could become very, very important here. I've been looking at some figures today that show that critical care beds per 100,000 people in the UK is low, compared with global standards, and in Wales it is certainly much lower than in England. Both I and Adam Price asked yesterday what has been done to ensure that we are increasing capacity. I'm not sure that we had the answers that we wanted yesterday, so I'll ask again: what is being done now to make sure that capacity is being increased as much as possible, because current capacity is not going to be enough? I accept that there may be a different nature to the kind of capacity that we will need compared with normal times, but I think it's very important that we have a description from Government of what exactly is being done to make sure that we increase capacity in this very, very important area. 

I recognise the broader point that's being made. The relative levels of critical care capacity across the UK are lower than other European countries; that's true. I don't think now is the time to try to get into any of the funding or other challenges that we might have in a normal period of politics; it's really what we can do now to improve the capacity that we have, for what we expect to be an influx of really sick people who are coming to our health service and need care. And, so, yes, we are already planning what is possible, both in terms of the staff that we have, the staff that we need to protect, in terms of their welfare and well-being, because if we do see significant absences across the economy and public services, that will affect the health service too. We're also needing to think about what else is possible, even if it isn't what we currently recognise as critical care in the way that we provide it, and what that means in terms of redeploying staff. That also means switching off other activity within the health service. So, this isn't a simple matter of flicking a switch and we automatically double our capacity; it's actually about how much we can change within the service; how much we can redeploy our staff, and then what we do to, as best as possible, meet those other healthcare needs. And, as I've said, that may mean treating people in their own home in the coming weeks or months, when we would today expect them to be admitted into a hospital.

Now, I'm not in a position to share direct and detailed plans. I'm working through the detail of those plans and the instructions we'll need to give the health service of what those plans would be. We've worked through them. I met medical directors from across Wales on Friday of last week. I met with royal colleges from across Wales last week as well, and so, we are deliberately drawing together people that need to be there to make those choices. As soon as we do have a decision to make, with the plan to go with it, we will, of course, share that information. And in the way that I have already briefed, not just the Plaid Cymru, but also the Conservative health spokesperson, we want to continue to make clear what those plans are, and the detail of them, and to be able to share information on a trusted basis, as well as being able to provide public information for everyone to see and hear. And that, of course, will involve not just members of the health committee, but all Members across this Chamber. I fully expect to be making weekly statements on the position in relation to coronavirus for the foreseeable future.

Capacity will be needed in other areas too, below critical care. I fear the loss of community hospitals will be something that we rue, somewhat, in coming months. We will perhaps need to build capacity for isolation, for example, and I can relay to you the offer made by one hotel owner, for example, offering a hotel to be used, perhaps as somewhere where people can be isolated. Are there plans to create that kind of capacity within the system—perhaps turning to hotels, or other locations, or even to the army too. Because there is capacity that can be built within the military when it comes to isolation.

We're considering all options. And that's both part of our pandemic influenza planning that is being stepped up; it's also part of what local resilience fora are looking at, to consider what takes place in each of the four areas. And that involves not just devolved public services, it of course involves the regular relations we have together with non-devolved services. So, for example, the police are involved in each one of our four local resilience fora as a matter of course, in terms of that emergency planning and delivery response. We are also, of course, considering the potential role the army may have to play. But it comes back to what role is required, and who is best placed to serve that. So nothing is ruled out—certainly—in terms of the provision we have, and, as I said in answer to your first question, how that meets the need we expect to see coming through the health service and other public services, and where are the right places to try and increase that capacity, and, equally, the activities that we recognise will need to be delayed and put off for a period of time, and that, of course, depends on the length and severity of the outbreak.

And a short collection of questions, just to finish off. We know that Italy reached the point where they needed, or felt they needed, a nationwide lockdown. I'd appreciate just an idea of the kinds of plans that are being put in place, initially perhaps, for local lockdowns, and what preparations are being made for that.

Secondly, on 111, and the telephone triaging that is going on at the moment. I've contacted your office today with a specific concern about the parents of a constituent of mine who have returned from a cruise, contacted the triage centres on telephone—as they were instructed to do—were told, 'No, you're not in a risk category.' Others who were on the same cruise, I am told, have since been diagnosed as having COVID-19. You can imagine, therefore, the concern of my constituent and her parents. She can't visit her parents, because she suffers from pneumonia herself. So, again, it's a portrayal of the wider problems here. So how can we be sure that the telephone triaging isn't missing people who actually perhaps should be in a higher risk category? These people had said, 'Listen, we think we are at risk', and they were told that they were not, and they think that now they should be tested. I'll wait for a response from your office on that.

But also, we're still hearing from people who are saying they've tried to contact 111, and have been, for example, guided to a website, which tells them, '111 isn't available in your area.' Will you gather data on the use of 111, failure to connect to 111, and on how many people who do try to use the services—as they rightly should—are either not getting through, or are being sent to other websites, which are just not able to help them?

There are real, practical questions there, and I'm glad the Member managed to raise some of those with my office earlier today. And I would encourage any other Members, from any party, who have similar experience with constituents, where they're not sure about the advice they're being given, or they've been directed to the wrong part of the system, to raise those with my office. Because I want to make sure that they're resolved sooner rather than later, because we may well see more use of those services in the coming weeks. Some of that has come because people have been directed and gone to the wrong 111 service—so, the 111 service in England, where it says it's not available in your area. So, the 111 telephone advice service is available in every part of Wales. There is a symptom checker available on the NHS Wales Direct website. We want to try to ensure that people are using the service that we have set up and created and want to minimise the risk of people going to a different service over the border that may not direct them to the right path for their help and advice. But I don't want to lose sight of the experience that people do have of using the 111 service, and, as I say, I reiterate to them that I'd ask Members from all sides to contact me if they have the sort of experience you've described.

On the point about how and when people should be tested, it comes back to people following the advice and the guidance they're given. But I have asked again for some clarity to be reiterated, because we've seen some headline instances of people who are, for example, on cruise ships coming back, what happens to them, if people are symptomatic when they return, and to be clear, that the advice is consistent and isn't confusing for members of the public. So, I am taking the opportunity to do that, and will be able to reiterate that with the regular information that Public Health Wales provides and I'll also make sure that that advice is circulated specifically to Members.

But on the sorts of things that might happen, or might be required, I think we need to look at the circumstances in each country. We can learn, of course, from different countries' experience. And Italy, they're a European country we have links with, with a developed and modern healthcare system. There are parallels there for us to look at. Seriously, there are some differences, though. They have an older population than Wales does as well that may explain some of the challenges and the numbers they have coming through. But certainly the experience there of them finding that their health service is effectively overwhelmed now, well, part of that journey is how early and when we take action, because timing is really important, and that's been the advice from our own scientific advisers to all four Governments in the UK and indeed our four chief medical officers.

The danger is that if we act too early, it's the point that the First Minister made yesterday about the level of compliance if we ask people to act again. There's also a danger that we depress the peak of the coronavirus outbreak and we have a second peak later on, rather than being a wholly effective measure. There's also the risk that if we time it too late, then we could effectively bolt the stable door once the horse has bolted, because actually Italy is now in a position where it looks as if there's significant community transmission. And the value then of taking really restrictive measures, our scientific advice doesn't suggest that that's an effective measure at that point.

And it comes back to the difficulty that Ministers have to stand up to and recognise in making choices and advising the public, and that is about following the evidence and the best scientific advice about what we should do and the choices available to Ministers to make, rather than looking to have something that, from a communications point of view, may look as if we're making big and difficult choices and showing how seriously we're taking it, but may not actually be the right thing to do both to depress the peak of the coronavirus outbreak to allow services to recover and cope, but equally to make sure that we resolve and reduce, as far as possible, the potential mortality of the coronavirus outbreak.

And I would not want to be in a position where I've taken a series of actions that may look as if we're doing something that is gripping the situation from a public point of view, and subsequently find out that actually it was the wrong choice and our mortality rate may be higher at the end of it, and that is not a choice that I think I could live with. 

Conservatives spokesperson, Janet Finch-Saunders. 

Diolch Llywydd. Of course, spokespersons are to scrutinise and challenge you, Minister, and I've done my fair share of that over the past few years. But I would like to put on record my thanks to you, as our health Minister, for the hard work, obviously, going on behind the scenes and the plans that you are putting in place and also for keeping us, as Members, updated and keeping the public informed. I felt that that should go on record, thank you. 

Now, coronavirus is most significant amongst older people and people whose immune systems are already compromised. These people are to be found in greater concentrations in residential care, nursing homes and in the domiciliary homecare setting. The seriousness of the threat is clear when considering the care home near Seattle, where there have been more than a dozen deaths and all the home residents now are confined to their rooms.

Last week, the First Minister advised that the Welsh Government would do more to provide advice to the social care sector. Care home residents are worried, care home providers and those delivering domiciliary care are worried. There is talk of issuing guidance, encouraging friends and relatives not to visit people in care homes until the risk of contracting the disease is more manageable. What steps will you be taking to support care home residents and reduce the risk of them contracting the virus? 

I thank Janet Finch-Saunders for that question and she's absolutely right that older people, and older people with complex health needs, are at much greater risk. And so we want to do all we can to protect them as much as possible, and we are working very hard to do that. The director for social services and integration is taking the lead in the Welsh Government. We're liaising very closely with the local authorities, which are obviously very close to the care sector, and we have got a lead director appointed to look at this subject. The lead director is from Powys. We've set up a working group that is looking at all the sorts of issues that she raises. There has been guidance already issued to the social care sector. It's guidance that is joint with England. So, it is the same guidance, but we are looking to produce another set of guidance, which will be done by a working group with all the people involved.

Thank you. One in 17 adults in Wales work in the social care sector. The United Kingdom Homecare Association has advised that it is important for social workers to understand that home care visits could take much longer than the usual expected time whilst dealing with people who are unwell, and warn that the situation was potentially extremely serious, particularly with regard to having sufficient staff to support older and disabled people in community settings.

Similarly, I have received an e-mail that highlights concerns that one infected domiciliary care worker could potentially unknowingly carry the virus into the homes of countless vulnerable older residents. Therefore, will you explain what steps you are taking to assist our care workers to reduce the risk of contracting the virus? What emergency measures will be taken to protect vulnerable individuals receiving home visits, and state what support will be provided to social care providers to help them find replacement staff, should some employees have to self-isolate? And a question I have is: are all 15 cases of coronavirus that have been identified in Wales actually designated as COVID-19? [Interruption.] Well, coronavirus covers a—.

Yes, I believe they are, answering that last question, yes.

If you look at the social care sector, there's a wide variety of issues that arise: there are the people who are living in residential care or in nursing homes; there are those people who are receiving domiciliary care, and then these are the staff who are going in, who Janet Finch-Saunders has referred to. And it's obviously crucial that we address all of those issues, about what is to happen if anybody in any of those groups becomes infected and how we deal with the whole situation. So, for that reason, we have set up a social care planning and response group, which includes local government—because, as I said, we're working very closely with local government—it includes the Wales Council for Voluntary Action, because it’s absolutely crucial, I think, that we work very closely with the third sector in addressing all of these issues, because the third sector may be very close to some of the communities that we are talking about, but also the third sector does have many volunteers who work there and who I'm sure would be willing to help us in this situation, if it does escalate. And it also includes Care Forum Wales, which, again, is a very important body to work with. So, we are working with all those bodies and what we want to do is to come up with another set of guidance, which will address those very important issues that she has raised.

Thank you. I think my next question is more directed to the health Minister. Sadly, there is good reason to be concerned too about front-line health staff. I've received correspondence from a Welsh general practitioner who has highlighted a lack of personal protective equipment and masks for front-line staff, but also people such as receptionists, nurses and housekeeping staff. He has rightly explained that there are not enough of them to be able to self-isolate, if there may have been possible exposure, and to still cope with the amount of pressure on our health service. What urgent action will you take to ensure that every front-line member of staff receives and uses the personal protective equipment as directed?

Well, I think the health Minister did, in his earlier response, say that these were going to be provided. And certainly this is an issue that we have discussed within the Government, but it's obviously a very important point that we are taking very seriously.

The Brexit Party spokesperson, Caroline Jones.

Diolch, Llywydd. Minister, Dr Andrew Goodall told the Public Accounts Committee on Monday that he's very disappointed that three of Wales's seven local health boards are millions of pounds in deficit. Do you share his disappointment that Betsi Cadwaladr, Hywel Dda and Swansea Bay are forecasting a combined deficit of over £92 million for 2019 to 2020? Betsi Cadwaladr is predicted to be £41 million in the red; Hywel Dda not far behind with a £35 million deficit. My own health board, Swansea Bay, will be £16.3 million in deficit, and that's enough to employ around 465 radiographers. Minister, why can some health boards break even and others rack up massive deficits?

Well, the issues are different in different health boards, and of course I'm disappointed, not just at the failure to meet the target, but about the extent of that failure between different health boards themselves. In Hywel Dda, you'll know that we've undertaken a series of interventions and reports around their challenge and the opportunities for them to improve. It should, though, be said that on a performance end, Hywel Dda have made real improvements over the last few years. So, they are in a better place in performance terms, whereas in Betsi Cadwaladr, they haven't had the requisite grip and the control in terms of both performance and finance. So, whilst Hywel Dda health board can put their performance figures in a positive way, it's not quite the same story in north Wales, and you'll notice that both of the previous finance directors are now no longer in post. There's a recovery director who is having an impact on the financial discipline within the organisation, and, of course, there is now an interim chief executive following the change in leadership. And in terms of Swansea Bay, the disappointment is tempered with some optimism, based in reality about the future, and, again, the list of opportunities they have to improve the financial running.

There is one point that I think I need to make on a general level, and it is that if coronavirus is anything like as significant as we think it is, then the normal way of operating the health service will change significantly. So, the normal way that we want to hold organisations to account within the Government and within this place will have to change. I cannot expect the health service to behave in a radically different way in prioritising significant numbers of really sick people coming through the doors, if I'm then also saying, 'I want you not to lose any sort of progress on referral-to-treatment times, and I want you to try to make sure that money is being spent in a certain way.' Now, there'll be some points about financial discipline and opportunities to save money that will still exist in a way that doesn't harm the service, but there will need to be a sense check about what will really happen, and then what will be the longer term consequences if we do have a significant outbreak, on both resources, the overall pledges the Chancellor has made about the NHS having whatever resources it needs, and what that means in broader performance terms for the health service then to try to recover and catch up on.

Thank you for that answer, Minister. Of course we all have to live within our means, but we can't just cut funding to health boards without impacting upon patient care. Take the new medicines fund, for example: the Welsh Government funds novel treatments for the first 12 months, and then health boards have to find funding for future years. So, what assessment have you made of the impact that this is having on local health board finances? And we also have to account for known unknowns, as you've already said—the coronavirus. But also, for example, the impact winter pressures will have on services throughout the rest of the year. And this year we have the added unknown of the impact that COVID-19 will have on services both planned and unscheduled. So, Minister, how resilient are NHS finances, and what steps are your Government taking to ensure financial pressures do not impact patient outcomes? Thank you.

Well, I think there's a broader point here about financial improvement across the health service in the last three or four years. I took a particular choice, on taking on the Cabinet role, that I would make sure that whilst we make sure the bills are paid—so that patient care is not compromised, that staff don't have to worry about whether they're going to get paid in the last two months of the year—we would highlight the reality of performance of each organisation, so rather than trying to find a new way to inject money into the system towards the year, as we were often accused of doing, we've been really upfront about the financial performance of each organisation. That greater scrutiny and accountability, and some of the very direct conversations that I have had, and that the chief executive of NHS Wales has had, I think have seen a real improvement. Even at the start of this Assembly term compared to where we are now, we are definitely moving in the right direction, but there is still more to do than I would wish there to be.

But in terms of the new treatment fund that you referenced, it's been a great success. The reason that we introduced it was because there was inconsistency across Wales when new treatments were introduced and available. They're available at different points depending on which health board you were served by, and some of the challenge is not just the consistency but the timeliness of that—it could vary significantly across Wales. They were supposed to be introduced and available within 90 days, and some health boards were not able to do that on a regular basis. 

We knew that there was a particular problem in the first year of introducing new treatments, and the ability of health boards to have new treatments come onstream during the financial year and to plan effectively for them, and that was why they were introduced in such an inconsistent way. So, the new treatment fund has levelled that out so there is now a consistent service. And rather than being over three months, people expect new treatments to be available within about two weeks. So, there's a really significant intervention with, in health terms, a modest sum of money, but a really impressive and consistent outcome. I'm very proud of the action that this Government has taken to do so.

Question 3—Janet Finch-Saunders.

I think I've got—

Okay, you're not ready to ask your question.

Yes. The health board is progressing the work on plans to recruit the right person to this crucially important role. Although decisions about employment matters are for the health board and its chair to make as the employing organisation, I am wholly committed to providing the support needed to the health board to deliver the improvements that are still required.

Thank you for that answer, Minister. Despite being in special measures for nearly five years, the problems at Betsi continue to let down those who rely on it. The issues at Betsi have not been replicated in all boards across Wales, so it's clearly the running of that particular board that's at fault. A new chief exec may help, but a chief exec doesn't act alone—he or she is part of a board who make recommendations as to how the NHS in north Wales should develop, tackle its problems and decide on its priorities.

Last year, a cross-party committee of this place found that the health board were making unacceptably slow progress in sorting out its failings, but the buck does stop with you. Isn't it time to review how these health boards are constituted? In order to ensure that the treatment and care of patients are prioritised, isn't it time to insist that the majority of the members on any health board should come from clinically trained backgrounds?

I think there are two points there: one is the point about how the health board is constituted and then the make-up of the board and clinicians making up the majority. In terms of how the health board is constituted, if there's a broader point about its organisation and the scale of it, I actually think that for north Wales to improve, to try to undertake a structural reorganisation in order to change to have not one Betsi but two I think would be a mistake. If we did that, we would definitely lose a significant period of time while people look inwards about who's going to run those new organisations—i.e. decouple—then what you do about the fact that there are three hospitals across north Wales. Where does the middle one go? What does that mean in terms of service planning and co-operation, both within the same health board now but, potentially, in more than one organisation? So, I'm not persuaded that more than one organisation in north Wales is the answer.

In terms of your point about the structure, when it comes to the independent membership around the board table, we have deliberately, over time, constituted a mix of executive members, people who work for the health board as employees and independent members with the mix of skills that people require. It certainly doesn't always follow that people who have been clinicians in the health service make good managers of the health service, and we'll see that in all walks of life. I was a lawyer—I had some skills as a leader and a manager. My wife, who is still a lawyer, was a better manager than me, in terms of some parts of the role, but that had not really much to do with our ability as lawyers. So, it's about how your professional background lead you into the choices that an organisation makes, because, actually, someone who was a great doctor isn't necessarily the right person to run the finance function. Someone who has been a great nurse through their whole career isn't necessarily the right person to sit around the board table as an independent member. That's why we have an independent public appointments process, overseen by the public appointments commissioner, to try to make sure we get the right people.

It's also why we've reset our expectations about the way that independent members are not just appointed, but how they behave and their willingness to not just support the organisation, which is only part of their role, but it's about the scrutiny and the challenge and the leadership role they have around the independent members' table. And, actually, within north Wales, with the relatively new chair—he's only a couple of years or so into the role—he has brought a different leadership style and a different level of scrutiny that's changed the culture of independent members around the table, and all of our independent objective assessment, including the inspectorate, say that has made a real and positive difference. The challenge is going from that to real, definable improvement in accordance with the special measures framework that I set out for Members recently. 

I do agree with you that you've got to have the right person in the right place doing the right job, and I also agree with you that the new chair of Betsi Cadwaladr has made some extraordinary changes and does appear to have the energy, the drive, the initiative and the experience to be able to lead that organisation forward. But the reality of the situation is that the ex-chief executive was basically in the job a couple of years too long, and so that health board has stagnated over these past few years. I appreciate you've got an interim—or the board have got an interim—chief executive in. However, what I really want to understand is how long will the hunt for a new chief executive take. And can you assure the Senedd that there are no barriers in place to ensure that that health board actually has the finances to recruit the best-quality individual with the best level of experience to lead it out of the doldrums that it has sat in for the past five years? Because not only will that chief executive need to have huge experience in running large public service organisations, but will also have to have a spine of steel in order to cut like a knife through butter to get rid of some of the other levels of management that perhaps are not experienced enough, and not capable of bringing that health board forward.

I think there are two points there. One is the licence but the expectation that a chief executive will make changes that are difficult—difficult internally within the organisation, but also, speaking honestly, within the broader politics around the health service. Any time difficult choices are made, most of us objectively end up seeing that there's a reason for a difficult choice to be made. But, actually, if you're a local political actor of any and every party—it's not a partisan point—it can be very difficult then to go along with either supporting that change or giving it the room to take place. Now, from my point of view, I want a chief executive within north Wales who is going to make the changes that the health board requires and that the people of north Wales deserve to see happen. For me, I'm prepared to wear some political flak and difficulty to get the right things done, because that's the overriding objective: to see north Wales healthcare improve and to take some of the robust choices that I think the chair wants to see made as well, that independent members are now signed up to do too. And, within that, then, having the right person, there is absolutely no bar in terms of money. If we need to go outside the normal salary range for chief executives within Wales, then we can do so because, again, I'm interested in getting the right person to make a real difference.

Objectively, I think most Members would sign up to that. We'll have to see what happens then when that person is in post and trying to deliver some of that change. But, whoever it is, it won't simply be a case of them sitting at a desk and banging it and saying, 'Now we have to do what I'm saying'. They've still got to be able to bring their staff with them, to set up plans that have logic to them, that have evidence behind them, and can set out why they'll improve healthcare in north Wales both for the staff who deliver it, and the public who receive it and take part in it.    

We've just heard that the recently departed chief executive was in post for a little too long; you could probably say that about the three chief executives who've served during the period that the board has been in special measures and under the direct control of Welsh Government. Now, I know that you're reticent to direct the board to do anything, but, as Minister, I'm sure you can convey a few key messages to the new chief executive officer. And one of those, I would suggest, should be that the board needs to get to grips with the number of management consultants that it's engaging with—up to 40, I believe, in recent times, costing over £6 million to the taxpayer. No wonder they're heading for another hefty deficit this year. So, will you convey to the new chief executive that the time has come for them to get a grip on this relentless engagement with consultancy managers. They have managers who are employed and, if they were doing their jobs, then we wouldn't need these additional people at a huge cost. So, please tell them it's unacceptable and it has to change. 

I think what has to change is delivery, and it's the delivery against an understanding of what their challenges are and their opportunities for improvement, and, actually, some of the work that we have commissioned around the health board, about the real understanding of where they could and should improve their finance function, what that means for the service, but also about having a clinical plan for the future to understand how they want to deliberately shape services in north Wales to provide better care. And that's the fundamental challenge the health board needs to grip, and of course they'll need the right people in post to do that, but, if they do have a deficit and if they can't recruit the right person at the time, they may need to make use of consultancy in exactly the same way that people, wherever they are in public services, or, indeed, in some parts of the private sector, from time to time need to use consultancy. But the level of that has to be appropriate. It has to help the health board on its way to the improvement journey that Members across the Chamber recognise it still needs to take.

In support of the UK action plan, which builds on existing pandemic flu preparedness work, a planning and response group involving both senior officials and key external stakeholders has been convened. This will provide strategic co-ordination and support within Government and across the health service. This, of course, includes ensuring NHS accident and emergency preparedness right across Wales.

Thank you for that response. You heard from Rhun ap Iorwerth a little earlier today about the lack of capacity within A&Es across Wales for dealing with pneumonia-like symptoms that may arise from coronavirus—perhaps another consideration for those who are pondering the future of the Royal Glamorgan at the moment, which also serves my constituents.

Apart from the logistics of moving people with these symptoms safely through a hospital that's full of sick and elderly, frail people, there's also the effect on financial planning that the local health boards will be looking at. There have been promises from the UK Government for moneys to mitigate the challenges that are facing the whole of the UK. Are you in a position to tell us yet about how that actually might make its way to Wales? Are we looking at Barnettisation or cost per head or consequential losses? Have you got any steer on that for us at the moment? Thank you.

You're right to say—and as I've indicated both in previous statements and in questions that I answered earlier today—that we'll need to consider how to change the service. That both means about people who currently go through an accident and emergency department and into a hospital, how that may change and how some of those routes work, but also to make sure there's more capacity within hospitals. So, we'll actually need to help people out of hospitals to make sure there's capacity for really sick people to go in over coming weeks. We don't yet understand all of the numbers, because we're not at a point to be able to actually predict that more clearly, but we know that we'll have to do some of that, and so already there are conversations within health and social care about how that could and should happen sooner rather than later.

I also reiterate the point that I made that we will, effectively, have to pause some of our normal performance management expectations and monitoring. It would not be a fair test to set for the health service to say, 'You have to keep on doing everything now as you do today and cope with significantly increased demand as well'. So, the challenge about the finance and our ability to plan—I'm afraid we're not in a position to understand exactly what the headline pledges from the Chancellor that he's made today actually mean. He said on the weekend that the NHS would have all the resources it needs. The Finance Minister and Trefnydd went to a meeting, in fact, yesterday morning, a very early meeting with other finance Ministers from the other three national devolved Governments and the Chief Secretary to the Treasury, and we—. We still don't yet have a full picture of what that means in practice, about whether there will be a headline measure that comes now to help us deliver and plan services or whether this will simply be about, at a later point, whether a needs-based provision will be provided. But there's been a broad indication that there is a recognition that this is a UK-wide challenge and won't be dealt with in, if you like, the normal way of delivering the funding that's allocated. But we want to see the detail of that, and, as we get that, I'll be more than happy to be upfront with Members and the public about what that means.

Question 6 [OAQ55199] is withdrawn. Question 7, Hefin David.

Through the Welsh infected blood support scheme, the Welsh Government provides a comprehensive package of ex gratia payments as well as extensive wraparound support, which includes psychological support, benefit advice and support and signposting to other public services we can provide across Wales.

Thank you, Deputy Minister. I think, before I ask my question, I should pay tribute to the work you've done as a backbencher, before you entered Government, as chair of the cross-party group on contaminated blood and the work you did forcing the UK Government into the inquiry. That is certainly recognised. But I do have some questions about where we are today.

On 9 January, I wrote to the health Minister on behalf of my constituent Kirk Ellis, who was affected by the contaminated blood scandal. He's unwell and is increasingly anxious that his family are unable to provide financially for him, should anything happen to him. I'd also say there are members of the public who are members of the cross-party group on contaminated blood in the public gallery today, and they've come in to specifically hear this question.

Kirk has found out—Kirk Ellis has found out—that he is financially worse off than he initially thought, as victims in England receive payments for their children at a rate of £3,000 a year for the first child and then £1,200 for each other child. So, therefore, with a three-year-old, Kirk is £9,000 worse off than if he lived in England. There's a clear case to answer here, and it is, of course, incumbent on the UK Government to take the lead and to provide the funding. But also there is a differential in England, Scotland and Wales as to what people receive. In Scotland, the widows and widowers of people who have died will receive financial compensation. That is not the case in England or Wales. But the key issue—the key issue—until the inquiry has published its findings, there is a discrepancy across the United Kingdom.

Victims in Wales are asking the simple question: why can't we just pay them what they are rightfully owed? Minister, can you just answer that question? And also, please would you attend a future meeting of the cross-party group to talk to victims about this particular issue?

Well, I thank Hefin David for that very important question. I was pleased to meet members of the cross-party group earlier on today at the beginning of their meeting, and I know how strongly they feel about this issue.

There are four separate schemes in the four countries of the UK, and it is hard to compare them, because they are so different. However, I know it is absolutely right that, on average, beneficiaries in Wales receive, on average, £12,000 less than their English counterparts, although Wales does supply psychological support, which has been praised by Sir Brian Langstaff, the chair of the inquiry. But the Government believes that there should be parity between the four schemes. It has been difficult to make progress through all the changes of Ministers in Westminster. We recognise that the issue about the widows is very important, and that is something that members of the haemophilia cross-party group have consistently lobbied about—the fact that it's only in Scotland that the widows are recognised. So, I think that is a very important issue that we must look at.

We are planning a meeting of the four Ministers for the four devolved bodies. We want to move to a position of parity. I absolutely accept what Hefin David says, that it isn't right that victims here in Wales should receive less than in other countries. So, that is something we are addressing as soon there is a Minister who is designated in the Government in Westminster and as soon as we're able to have a meeting.

Finally, question 8, Paul Davies.

Our priority is to ensure the people of Wales, including those in west Wales, receive health services that deliver the best possible outcomes for patients. Achieving the vision that we set out in 'A Healthier Wales' will help to deliver that priority.

Minister, to improve services in the Hywel Dda University Health Board area, it's essential that vital services are as accessible as possible to local people, and that includes services being based at Withybush hospital. Can you therefore tell us what discussions you've had with Hywel Dda University Health Board about the provision of services at Withybush hospital, as well as any discussions you've had regarding the creation of a new hospital in west Wales, as the people I represent want to see essential services like the A&E department being maintained at Withybush hospital?

Well, this is a question about the delivery of the healthier west Wales plan. You'll recall the significant engagement that took place with both staff and the public, and then actual front-line members of staff presenting options to the health board for the future. And, within that, the community health council chose not to refer the possible options in. So, there is now an agreed strategy within west Wales about what that will mean. That will both be about—as we've seen the parliamentary review recommending in broad terms—some services needing to be concentrated to provide better services, better quality of care, and other services being delivered on a wider range and basis, including within the community.

You'll have seen, for example, some of the concerns people had about having a midwifery-led unit on the Withybush site; actually, there is no evidence, despite hundreds and hundreds of births, that it has compromised the care of women or their babies. We still, though, do continue to invest in the Withybush site; for example, the more than £3 million to complete improvements to wards 9 and 10 at Withybush hospital. So, there will continue to be an important role for the Withybush site to play in the future.

In terms of the new hospital option, I'm looking to receive a business case from the health board that sets out where they are and, as and when that's received and advice is provided to me about whether to support the next stage of that, I will, of course, make that clear. So, those are plans the health board are developing. I have a decision-making role, but I do look forward to—sooner rather than later, I hope—receiving that case to allow us to make a determination. And you and other people within west Wales will then get to see something about the vision for the future in terms of deliberately reshaping healthcare within west Wales and, indeed, the significant investment that will be required to make that happen.

Thank you, Minister.

I wish to draw Members' attention to the Catalan delegation joining us in the public gallery, led by the President of the Catalan Parliament, Roger Torrent. My thoughts at this time are also with the previous President of the Catalan Parliament, Carme Forcadell, who remains to this day in prison. I'm sure Members here will want to join me in wishing President Torrent a very warm welcome to Wales and to our Senedd. Croeso. [Applause.]

The next questions are to the Minister for Finance, and the first question is from Mandy Jones.

Welsh rates of income tax of 10p per band were introduced last year and apply to income tax payers resident in Wales. On 3 March, the Assembly voted by 43 to one in support of Wales's rates remaining unchanged in 2020-21.

Thank you for that answer. Minister, your Government has made a commitment to not increase income tax rates during this Assembly term. What assessment have you made of the impact of increased rates of income tax on the Welsh economy and Welsh families, should a rise be instigated in the next Assembly?

The static costing of a potential rate change is relatively straightforward. For illustrative purposes, a 1p increase or reduction across all three bands in 2020-21, or in a future Assembly, would increase or reduce revenues by approximately £220 million, with the vast majority of revenues, of course, being generated through the basic rate. So, that would be the effect of a 1p change.

I think it is for all of us as Assembly Members, as we seek to develop our manifestos for the next election, to consider how and if we would use our Welsh rates of income tax, and also then to demonstrate to the people of Wales what the impact would be on their lives. So, for example: were there to be a reduction of 1p and a reduction of £220 million to the Welsh Government budget, it would be incumbent to demonstrate where those cuts would fall; and, equally, were there to be an increase of 1p and an increase of £220 million for the Welsh Government budget, it would be important to set out where that additional spend would be made.

Minister, you've just given a perhaps understandably clinical analysis—certainly at the start of your answer there—as to the effect on revenues of income tax changes. What you've said is, of course, totally technically correct, but increasing or reducing taxes does, of course, have other effects, which UK Government has been dealing with for a long time: behavioural changes, for instance. Increasing taxation may well bring more money into the coffers and allow you greater money to spend on public services; but at the same time, reducing taxation, as well as lowering the amount of revenue, may also of course stimulate, and almost certainly would stimulate, entrepreneurialism and encourage people to work harder, knowing that they're going to keep some of their money. So, all that has to be factored in.

I noticed, in the Chancellor's budget today, he mentioned that there was going to be a new Treasury office, or new Treasury officials, coming to Wales. I wonder if you could tell us what you know about that announcement at this early stage. And also whether, when it comes to making changes to income tax, you think there's potential for yourself and for the Welsh Revenue Authority to work closely with that new Treasury office, as a base of experience, so that when you do come to make these changes in income tax in the future, up or down, it's done with the best possible evidence, and we know full well what the effects are going to be on the Welsh economy.

I do think that any decisions should obviously be based on the best possible evidence, and this is one of the areas that we can explore in further detail in Finance Committee tomorrow, where I'll be giving evidence on what the potential impact might be of different exchange rates over the side of borders in the UK. But of course, we don't have much or any evidence, really, within the UK at the moment, because the Scots have only been collecting their own Scottish rates of income tax in recent years, and the first outturn data is due shortly. So, we actually don't have that evidence base to explore in detail. We can look at other areas of the world—parts of Canada, for example, have different rates of income tax in different areas—but those behavioural impacts I don't think will necessarily be read across. But as I say, there's lots of opportunity to discuss that in more detail in committee.

In terms of the Chancellor's announcement about a Treasury presence here in Wales, we don't have any detail as to what that might entail. It could be additional staff, perhaps, at the HMRC building. We're not sure what the detail is, but obviously we will be exploring that. We're really keen to work closely with HMRC and Treasury, because it's really important that we share information and ideas in order to give the best possible service to people in Wales. So, we look forward to more information on that posting. My only slight nervousness about it is the fact that we didn't hear anything today about the replacement of European funding, and of course we were hoping to hear a little bit about the shared prosperity fund. Now, whether or not the Chancellor sees a role potentially for that Treasury presence in administering that fund is something that causes us a little bit of nervousness, but we look forward to exploring it in further detail.

I have regular discussions with the Minister for Housing and Local Government, covering a range of matters within her portfolio, including those relating to empty houses. This includes investment in our property loans programme, targeted regeneration investment through our empty property thematic fund, and our town centre loan fund.

But the truth is that we have around 3,000 empty homes in north Wales, and some of them have been vacant for a decade and more. This is a huge waste of resources, isn't it? Because we are crying out for affordable homes, but we have thousands of empty homes in north Wales, and then we're seeing houses built on greenfield sites and on flood plains in north Wales. So, certainly, it remains a problem. We know that the turning houses into homes programme had an ambition of bringing 5,000 empty houses into use, but I think only 98 were returned to the housing sector in the year 2018-19. So, can you tell us what consideration you're giving to other incentives, which may be more effective, that could be used to encourage the owners of empty houses to tackle this problem?

Welsh Government's property loans programme has available a mix of capital grant and repayable loan financing worth over £42 million, available through local authorities to owner-occupiers to improve properties and to bring those empty properties back into use. Of this, £11 million has been allocated to the six authorities across north Wales to help those owner-occupiers and landlords bring sub-standard homes back into use. To date, over 350 loans have been issued, and nearly 300 empty properties have been brought back into use across north Wales as a result of that funding alone. But I agree that we need to be looking to explore what more we can do. And of course, we've introduced the transforming towns empty property fund of £3.2 million, and that's supporting a project operating across an area within Gwynedd and Anglesey; that seeks, again, to bring those empty properties back into use.

By the end of December 2020, we will have produced a finalised national action plan for tackling empty properties, setting out our national and local objectives, and that's a piece of work that I have discussions on with my colleague the Minister for Housing and Local Government. More widely, we're looking at what we can do to support local authorities through better use of compulsory purchase orders, because some of those properties that could provide excellent homes and excellent properties for other purposes are ones that are a real blight on communities at the moment. So, we're making sure that every local authority has the skills and the confidence it needs to tackle empty properties in Wales. We're doing that by introducing an industry expert in the field of property management, who is delivering a series of training events to every single local authority in Wales.

Minister, like Llyr, I was looking at the data for 2018-19, and it is quite disappointing. It's a challenging area—empty homes in the private sector and asking local authorities to use their various financial mechanisms to get some of these homes back in use—but there's a variation in performance. The Isle of Anglesey brought 12 per cent of their private properties that were not in use back into use; 1.6 per cent in Conwy; 8.6 per cent in Denbighshire; and 5.6 per cent in Wrexham. So there's quite a variety there, and I do hope that the best practice is improved further and then adopted by the other authorities. 

Yes, there is a variation in success in terms of bringing those empty homes back into use. Hopefully, the work on the CPOs, which I've just outlined, will prove useful to local authorities that have thus far struggled in this area, because we know that some local authorities have felt that they don't have either the capacity or the confidence to engage in that particular area of work.

Council tax premiums are also a useful tool in terms of tackling empty homes and, again, they've been used to different effect and to different levels across Wales. We do know that premiums will be charged on almost 6,700 long term empty dwellings in Wales in the next financial year, and the number of long term empty dwellings has fallen by over 1,000 since the premiums were introduced. So, it certainly is having an impact. 

Thank you. We now turn to spokespeople's questions, and the Plaid Cymru spokesperson, Rhun ap Iorwerth. 

Thank you very much, Deputy Presiding Officer. A few questions on coronavirus and the preparations for that. In terms of the pressures on health and care services specifically, could you give us some idea of the kinds of discussions that have been happening between the Minister for Health and Social Services and yourself in order to ensure that the appropriate resources are made available, even if they're not required at the moment? Because we do need to know that a lack of resources will be no barrier at all when the fight against coronavirus intensifies.

I have been having these discussions with my colleague the health Minister in terms of how we deal with COVID-19, and there are also discussions that I've had with colleagues from the other devolved nations, and also with the Chief Secretary to the Treasury. We're clear in Wales that funding is not going to be a barrier to the NHS being able to deal with the coronavirus. We were also clear at our meeting with the Chief Secretary to the Treasury that funding that flows from the UK Government in relation to this exceptional circumstance should be done on the basis of need. I was really keen to press home the fact that, in Wales, we have a proportionately older population and, obviously, that puts us at potentially larger risk of having to look after people who are much sicker. So, that's something that we need to very much bear in mind as funding is allocated across the UK. We don't yet know how the picture will develop in the different regions of Wales, so this is very much an ongoing discussion, but I do want to give that confidence that funding is not going to be a barrier to supporting the NHS.

Thank you very much, and I would appreciate updates on the resources that are being released, along with updates on the steps in terms of safeguarding people's health. That point is centrally important, of course: we can't look at some model that would share funds according to population, because different parts of the UK could be hit very differently by COVID-19.

Moving, then, from the health element to the economic element, which of course is a substantial element of the concern as we move forward, the UK Government in today's budget has announced a package of support for small businesses, which of course will be under pressure. One idea is to freeze business rates for certain businesses; there is talk of a loans plan for businesses that have been affected by coronavirus; and there's also a pledge that the Government will assist companies with statutory sick pay for those who miss work because of coronavirus.

Now, it's very important that those packages are also outlined by the UK Government, but it's also very important that we hear from the Welsh Government how prepared you are to seek different ways of alleviating the concerns of business now and being ready to step in. We haven't heard the details of such plans to date, but now would be a good opportunity for us to discuss that. 

I was pleased to make the case to the Chief Secretary to the Treasury yesterday that there should, in this budget, be a package of support for business, and I was pleased to see that delivered on. So, as you mentioned, there will be some things in there that will help support people in the immediate crisis. For example, the sick pay will be paid from day 1 rather than day 4; the Prime Minister previously announced that. But I think things went a bit further today, in terms of statutory sick pay for everyone who is advised to stay at home even without symptoms. That will be forthcoming, and I think that's really welcome. People can get the sick note from 111, and people in the gig economy will have easier access to benefits; I think that's really welcome, although I think we do need to see some more of the detail.

I understand that the employment and support allowance will be available from day 1 rather than day 8, and that the UK Government is also temporarily removing the minimum income floor in universal credit and relaxing the requirement to attend a job centre, so much of those conversations can be done online or over the phone. I think that is really to be welcomed, and I'm almost hoping that necessity will prove to be the mother of invention in terms of making universal credit work better for people, particularly for people in Wales. 

The statutory cost of sick pay for SMEs could hit them hard, so I've been really pleased to hear that announcement from the Chancellor today that businesses with fewer than 250 employees can claim back the cost of sick pay for up to 14 days, and that will be refunded in full. I think that's an important measure for businesses. I was making the case yesterday for HMRC to scale up the Time to Pay service, and, again, I was pleased to see that reflected in the announcement today. 

The UK Government has a dedicated helpline, announced today, but, of course, we already have that through Business Wales, which is there to support businesses in this particular circumstance. 

And, finally, sticking with the budget, and with the Chancellor indicating that the UK Government will be launching a fundamental review of business rates, we're certainly of the view that we need a fundamental review, and we wish that we could have moved quicker in Wales. We've had review after review; I'm sure the time should have come some time ago for some action to be taken. As part of that fundamental review, the UK Government will consider plans to scrap business rates and replace them with a land value tax. Now, Plaid Cymru is currently looking at how land value tax might work in Wales; Welsh Government, for some time, has been looking at this. Is now not the time to seize the momentum, that there is a changing context, and the UK Government warming to the idea perhaps? And will we see some action soon on LVT from Welsh Government?

Well, you'll certainly see, very shortly, published, the document that we commissioned, which does look at the implications of land value tax and what that would mean for Wales. This is part of a suite of research that we've commissioned that looks at various aspects of local taxation, both for non-domestic rates and for council tax. We've also had a piece of work that looks at what the implications would be of re-evaluation, for example, and who the winners and losers would be there; what would be the distributional impact in terms of geography across Wales? Over the course, now, of this spring, there will be several pieces of research published, which, together, will provide all of us with a suite of really insightful evidence in order to consider the way forward.

But, of course, business rates—it's not something that you should reform just for the sake of it. We need to be sure that any reforms are made in a way that meets our Welsh Government priorities more widely. And I have to say that I was really pleased by the announcement today that the UK Government has finally caught up now, and that half of businesses in England will no longer be paying business rates. But, of course, we've had that situation in Wales for a very long time. 

Thank you. Conservative spokesperson, Nick Ramsay. 

Diolch, Dirprwy Lywydd. Minister, the Chancellor of the Exchequer has today, in his budget, announced a number of key funding commitments to small and medium-sized enterprises, as well as to the hospitality and retail industry, in light of the threat of COVID-19, which was just raised by the Plaid Cymru spokesperson. Today's announcement also includes an extra £360 million a year to the Welsh Government, more investment in infrastructure and more investment in broadcasting, such as S4C. So it's looking as though austerity—so beloved by members of your Government to talk about—is nearing an end. Will you confirm that the Welsh Government will use the Barnett consequentials arising from the Chancellor's pledges to match the UK Government's support?

Well, I've got bad news for the opposition spokesperson, of course, because austerity certainly isn't over. If you look at the documentation that supports the UK Government's budget, the Office for Budget Responsibility paints a pretty gloomy picture of prospects, even before taking into account COVID-19. And that's not surprising, given the UK Government's reckless approach to trade negotiations with our largest and most important trading partner, the European Union. At no point in this Parliament does the OBR suggest that growth will even reach 2 per cent, which is pretty poor by historic terms. So I don't think that we can say austerity is over. And even with the additional funding that comes to Welsh Government today as a result of the UK Government's budget, it barely takes us back to where we were 10 years ago. So, austerity, I'm afraid, is still with us.

Thank you, Minister. I was being mischievous when I mentioned the 'austerity' word—I knew that it would trigger a response similar to that. And some of what you say, in terms of growth, of course there's a basis there, and you're right to point those things out. But I do think that we need to look on the bright side as well. And there is good news in this UK budget, and hopefully the Welsh Government—key to my question—will actually be making use of the consequentials that are coming this way, to improve the situation here in Wales. Because Wales, of course, does have two Governments.

Minister, the Chancellor also announced a number of changes to national insurance and income tax, which, taken together, will mean that people who earn the minimum wage will now be £5,200 better off than they were in 2010. Moreover, beer duty and fuel duty are frozen for another year, so workers will see more money in their pockets in that way.

Here in Wales, we've been talking about the devolution of income tax, and the creation of new taxes. Do you feel that, often, the emphasis here is always on the creation of new taxes, and raising taxes? But there is also a tax-cutting agenda to be addressed, and the Welsh Government does have significant power at its disposal, in certain key tax areas, to reduce the burden on hard-working people in Wales, and to generate more income in the longer term by, of course, encouraging entrepreneurship, and providing businesses with more money to invest. We've heard about your view on taxes this year; could you tell us how you envisage using those tax powers in future, to reduce the tax burden on people in Wales, and to encourage economic growth?

I didn't hear anything from the UK Government today, actually, about changes to income tax. I know that there was an announcement in respect of the national living wage and the national insurance threshold, but I don't recall anything specific to income tax. Because that would be something that we would be keen to explore, particularly in case it had any implications for our Welsh Government funding. Actually, the Chancellor had very little to say on tax today. There was absolutely nothing on air passenger duty and there was nothing on vacant land tax. So those were two things that I was hoping to see in the budget today, but that was not mentioned. So, I don't think that the Chancellor has taken opportunities within his budget, particularly in relation to tax, because there's not an awful lot in it.

Thank you, Minister. You very cleverly chucked in air passenger duty there, knowing full well that this side of the Chamber do support fully the devolution of air passenger duty. So there are certain things we agree on, and there are other things that we do not agree on. The income tax changes mentioned were around thresholds, but that's aside.

Can I just, in terms of my final question, go back to something that Rhun ap Iorwerth raised, importantly, earlier, and that is the COVID-19, the coronavirus, situation? And this budget has contained within it an extra £30 billion or so—I think I'm right in saying—to the NHS, to deal with coronavirus in the UK, specifically in England. Have you had any discussions—? I know that officials in the Welsh Government have been having multiple discussions with officials in the UK—I know that with my public accounts hat on. Could you tell us if you've had any specific discussions with your counterpart in Westminster about the amount of money that will be coming to Wales over and above what we've got in the budget to deal with coronavirus? I think we would all appreciate that you're going to be potentially under massive pressure, and the NHS budget will be under massive pressure if you don't get that proper support for dealing with this extraordinary situation. So, if you could update us on that money in the budget and on any consequentials coming to you and to Wales—. And would you also confirm that that money will be ring-fenced and will be used within the NHS budget for the purpose that it is intended?  

I would welcome any support that the Conservatives can give in terms of ensuring that their colleagues in Westminster do ensure that Wales is funded as much as it needs to be in terms of the coronavirus. The Chancellor was at pains in his opening remarks to say that the coronavirus is something that is not a political issue; it is something that we all have to deal with, and we have to work closely across Governments on. And I would agree with him on that. 

In terms of the additional funding, the Chancellor announced a £5 billion emergency response fund for the NHS. So, we don't see any consequentials for that immediately, but what we do know is that that would be a figure of funding that might be available, should it become needed as the coronavirus progresses. So, we don't have a figure yet, and I think that's quite right that we don't have a figure yet, but what we do need is that agile working, that sharing of information to ensure that we do get the funding, as and when we need it.   

Brexit Party spokesperson, Mark Reckless.  

Diolch, Dirprwy Lywydd. Could I ask the finance Minister to explain how her strategy in terms of business rates relief in Wales differs from that being pursued by the UK Government? They announced today that the 50 per cent retail discount that they have next year is going up to 100 per cent and being extended to leisure and hospitality. Is that an approach that she is attracted to?

And the other efforts they have to support small business, some seem to be on the cusp of what's devolved and what's not. For instance, the British business bank start-up loan fund that they're increasing; by virtue of its name, I assume that businesses in Wales are eligible for that, but I do not know as a fact whether they are. And, what sounded like a rate relief measure in the budget is actually not under the business rates relief heading, but comes under a separate small business grant funding heading, but it seems to have been limited to England through making a £2.2 billion payment through English local authorities and then they give £3,000 back to every business that benefits from their small business rate relief. To extend that small business grant funding, is it right that that should be done by the UK Government on an England-only basis, given what's devolved here?

And I don't expect the Minister to announce her decisions for small business rate relief within an hour or two of the UK budget here, but I wonder if she could say something about her strategy and the outcomes and what she's trying to achieve through that and how that differs from Wales to England.  

We recognise how important non-domestic rates are in terms of our public services here in Wales. They contribute more than £1 billion to local government and to police services, and those are services that all businesses will benefit from in some way. We do take a different approach here in Wales, because our tax base is different. So, in Wales, the average rateable value is around £20,000, whereas in England, it's around £32,000. So, it's right, I think, that our rates and our reliefs do reflect those differences and the unique circumstances that we have here in Wales. 

More than 70,000 ratepayers in Wales receive rate relief, so that means that half of all businesses pay no rates at all, so that's where England are moving to. So, they're moving in our direction. And I do understand when businesses are looking across the border at different types of relief, they don't always do so in the context of their own situation. So, when their rateable value is significantly lower, it's important to reflect on the proportion of the support that we're able to offer. We have a wide range of reliefs for businesses and that's something I'm wondering actually if we need to start pulling some of those together. We do have the extension of the high street and retail relief scheme into next year. So, that was an announcement that I was able to make in January of an extra £26.6 million for NDR support and that's in addition to the £230 million that we already provide through our existing relief to help ratepayers with their bills. And that's about supporting all retailers with a rateable value of up to £50,000, and that scheme will support around 15,000 ratepayers. So, we have a variety of schemes targeted at different industries, but obviously, I'll be looking closely at any consequentials that might come and how they might come. 

Of course, there may be a case for doing it somewhat differently in Wales, but we have a £360 million consequential for next year just announced, and the retail but also the hospitality and leisure businesses are public-facing businesses that we may expect to be particularly affected by coronavirus and all the implications of that. And it does strike me that what the Chancellor has announced at the UK level for England seems a pretty effective way of getting money to those businesses, including those that you didn't mention any view on, those who get the small business rate relief in England, who get £3,000 channelled to them for each business through local authority. That's going to make a very significant difference in mitigating some of the impacts for many of those businesses. And I would encourage the Minister, as she absorbs what's happened in the budget at a UK level, but also when she considers the £360 million and how that pans out, compared to perhaps what she was expecting or not expecting to be in this budget, I do hope that those business rate reliefs will be an area where she can deploy some of that money.

I wonder, could I also ask about the Development Bank of Wales? I mentioned the British Business Bank start-up loans and can confirm actually that they are going to be eligible for all UK businesses—those start-up loans and the increase. But how do they interface with what's available from the Wales development bank? Is there a good deal of overlap? Can businesses benefit from both sources or do they have to choose one or the other? And what role does she see for the Wales development bank in mitigating the impact of the coronavirus? Presumably, for those businesses it has a relationship with already it should be in a good position to provide working capital support where that's necessary. But what's going to happen for its very substantial property development loans, which have been recycled again and again quite successfully to date, if developers find it difficult to sell on those properties? Isn't there a danger that that money will have a less positive impact for the economy at exactly the same time that coronavirus hits, if those developers aren't available to recycle and pay back the money as quickly as they otherwise would have? And can there be any role for the Wales development bank in supporting other businesses specifically for the coronavirus outbreak and working capital needs when it doesn't have that existing business relationship and knowledge of their working capital needs?

Well, the Wales development bank sits within the portfolio of my colleague the Minister for economy, but I do know that it has done really sterling work in terms of helping to support businesses prepare for Brexit. And in many ways, this is about helping businesses prepare for something difficult, so we can learn some of those same lessons.

It's been really important in terms of those property development loans, but also support for microbusinesses in terms of supporting them to grow, if they wish to grow. So, I think there are opportunities really to use those links that we have with those individual businesses to potentially offer support and advice, and this is one of the joys of being a small nation at difficult times, namely that you do have those individual relationships and you do have those opportunities to share information and advice.

But I know that Ken Skates will be looking closely at what role the Wales development bank can play in terms of supporting businesses as we face coronavirus. And I know that colleagues across Government will be having more to say about their own individual contributions to the effort in due course.

Homes affected during recent storms will receive up to £1,000 from Welsh Government. We are asking those impacted to contact their local authority emergency support teams in the first instance, to ensure they can access support as quickly as possible.

Thank you. As I've mentioned here numerous times, storm Ciara very sadly hit my constituency on 9 February 2020. Now an emergency funding relief scheme was announced on 18 February, and the First Minister stated, 

'We will make urgent financial support available to people whose homes have been flooded and, in particular, help families who do not have insurance cover'. 

Now, four weeks later, I am still being contacted by a number of my constituents who have filled in the appropriate forms and not heard a thing, and in a month, that's not good. So they've not received a penny. Now, on Sunday Politics, I was really heartened to hear you say that all those affected have now received their £500. Well, as I mentioned, I've got a number that haven't, so what I thought I might do, outside the Chamber, is write to you directly with details of those, so that maybe—. But are you aware of a problem in the processing of these application forms? And I have raised it with the local authority, who say, 'Well, we've done our part.' They've filled the forms in, we've sent them off, but there is this quite long delay, and I also have one lady who's not been offered the £500. She's been offered £80 but has suffered thousands of pounds' worth of damage, so I'm a bit worried about the criteria. Will you look into the processes? Because all I'm asking for is some fairness and balance for my constituents, so that they have something to help them get back on their feet after this awful flooding on 9 February.

I share any concern that people are waiting too long to receive their funding. Most applications to the discretionary assistance fund are processed within 24 hours, so individuals should have the funding within their bank accounts very quickly indeed.

I know that, as of 4 March, there were 278 awards made at £500, and 266 awards made at £1,000, so representing over a total of £405,000. So, I know that DAF is looking at verifying independent claims using data provided by local authorities, so what the individuals really need is for those local authorities to verify and to vouch for the fact that those individual homes have been affected by flooding, and that should be enough for the discretionary assistance fund. So, in the first instance, it would be about the local authority just confirming to DAF that those households have been affected, and then that should make things move more quickly. But of course, I'm keen to provide assistance if I can.

I was encouraged by the response of the First Minister yesterday, who indicated a willingness to consider adopting a scheme similar to the property resilience scheme that operates in England. This allows flood-hit homes and businesses to apply for up to £5,000 to help protect against future flooding. Yet, an answer that I had from the environment Minister this morning says that those households would not be getting a similar scheme in Wales.

I also asked the environment Minister a couple of weeks ago about help for homes and businesses with the cost of energy—dehumidifiers and industrial heaters, essential equipment when drying out a flood-hit property, are really expensive to run. She said that she would look at it, and I quote,

'as part of our ongoing response'.

Can you please let me know what discussions have taken place with regard to providing financial assistance, both for household flood-resilience measures, and for help with energy costs above and beyond what has already been announced to flood-hit homes and businesses? You will be aware, Minister, that there is a great amount of need out there, so can you tell us what additional resources you are making available to meet this need?

Well, I've had discussions with the UK Government about flooding, so you won't see announcements particularly related to Wales in the budget for flooding today. What you will see is an announcement of £120 million for repairs and £200 million directly to local communities for flood resilience. Now, we don't understand yet what the consequential funding might be that flows from that, but we've been really clear that our first and most important thought was dealing with the immediate crisis, and then there will of course be an ongoing piece of work in terms of ensuring community resilience in the future.

I'm hoping that there will be additional funding on top of what's announced in the budget today coming to Wales. That's certainly the discussion that we've been able to have with UK Government, and they've recognised that the situation here in Wales was exceptional, although I was disappointed not to hear Wales mentioned amongst the list of affected places in the Chancellor's statement today.

But these might be issues that the Minister for environment will prioritise in terms of the future, but we haven't yet got to the point where we're setting out the longer term stuff, so these will be discussions that I've yet to have, although the Minister might well be having those discussions with her officials.

Trefnydd, I wonder whether you could update us as to what the situation is with regard to the funding of major infrastructure problems. I know there has been an issue raised by the UK Government in terms of sending details and so on, but, of course, much of the infrastructure damage, some of it's below water, some of it isn't accessible and so on, but certainly Rhondda Cynon Taf is actually putting a lot of its reserves into actually carrying out that work, and, obviously, the Welsh Government is giving support as well. But, the key thing has to be that the money that we were told at UK Government level would be passported to Wales is actually quite vital now, in terms of the commitment that whatever the level of infrastructure damage is, we know that those major structure problems will have that additional financial resource from the UK Government. Have there been any further discussions? Has there been any indication that there will be a guarantee that the funds we need will be forthcoming when we need them in order to carry out those infrastructure reconstructions and repairs?

Well, the Prime Minister committed that funding would be passported to Wales to help us deal with the flooding, and we absolutely will hold him to that. Mick Antoniw is completely right to say that we don't yet know the scale of the challenge ahead of us, in terms of the recovery, because so much of that structural surveying work has yet to be done. Many of the areas that need to be surveyed are inaccessible at the moment. So, there's a lot of work to be done in terms of assessing and coming to an understanding of what the future figure might be.

We've let the UK Government know that we're probably talking about hundreds of millions, rather than tens of millions. I know I've heard figures around £180 million, but local authorities are all the time gathering further understanding. So, I think it will be several months before we can understand the full impact, in terms of spend for recovery, but we will be, certainly, holding the Prime Minister to account for his promise.

I am in regular contact with UK Treasury Ministers about a range of financial issues. Ahead of the budget, I wrote to the Chancellor setting out our priorities for Wales, including addressing regional inequality and responding to the climate change emergency.

Thank you for that answer, Minister. I think it's important that after 10 years we've seen austerity hit our local councils very hard. The Welsh Government has made tremendous efforts to actually minimise the impact austerity from Westminster has had on local authorities, yet we've seen local government in England continually suffering as a consequence of the cuts over there. In this budget, it's not quite clear yet as to how much of a consequential we will have as a result of the budget and the increase, if any, to local councils in England, but can you give assurances that if any consequential comes as a rise of funding to authorities in England that that will be passported straight to local authorities, because they are facing difficult times? We understand that coronavirus is among many other issues. They'll also face challenges as a consequence of coronavirus, because of the services—social services and community services—they often provide. It is important, therefore, that we support them as much as possible. If consequentials come, they should get it.

As David Rees recognises, we haven't yet understood the full picture in terms of where those consequentials might be. I would offer one word of caution in the sense that consequentials are given but they're also taken away, so that is an important consideration in terms of when and how funding is passported. But, as we come to a better understanding of the detail that we will have, then, certainly, there will be further announcements to be made. I have given a commitment that I will provide a written statement as soon as possible. So, after questions today, I intend to continue on that to give colleagues some further information.

In terms of the kind of figures that we have been provided with—we do need to check some of them, because they don't all match up—we're looking in the region of £122 million of revenue and around, or at least, £218 million of capital. But, of course, we have to remember that we had £100 million of capital taken off us just a few weeks ago, so £100 million of that new money today will have to go to plug that gap in our plans, which we have published and voted on for the year ahead. So, there is some of that to understand, and, also, we've had £3 million of financial transactions capital for the next financial year as well. So, as soon as we come to a better understanding, we will be able to make some further announcements on spend for next year. 

Minister, I know that the coronavirus will have affected any pre-budget conversations you've had with UK Ministers, but I wonder, when you were having those discussions, what you thought about the various trade sector deals that are important to UK Government, and from which Wales can directly benefit in some cases, notably the tourism sector deal. I think you mentioned the hospitality sector a bit earlier on. So, can you tell me a little bit about those conversations and whether you're expecting anything in this budget announcement in relation to any steel sector deal—whether you've got any heads up on that? A brief question from me, I know, but it's important. Thank you. 

There were several things that were obvious by their absence, I think, in the Chancellor's budget today, one of which was any mention of the steel industry. There was no clarity on rail spend. We had references to rail spend in Manchester, Leeds and other areas—Darlington—but nothing for Wales. And there were no real research and development commitments for us in Wales, and it was very unambitious, I think, in terms of tackling the climate emergency. So, there was lots there that I hope was obvious by its absence, steel being one of those areas, but we do continue to work with the UK Government. So, for example, on the future of the automotive industry, that's an area where we both have particular interests, and Welsh Government is particularly keen on developing that sector. So, Ken Slates is leading on some work in terms of how we can best ensure that investment that is brought to the UK does also feed through across to Wales.

I am in regular contact with UK Treasury Ministers about securing the additional funding we need to respond to the unprecedented impact across Wales of the recent storms.

Thank you for that answer, Minister, and thank you for the submission that you made to the UK Government regarding the budget. You made a number of important points regarding regional and national inequalities across the UK. You talked about welfare reform and the need for greater co-operation between the UK and Welsh Governments to deliver better social care in the future.

Could I, however, focus my question on the spending pressures from recent storms? In the preliminary information I've received both from Merthyr Tydfil and Caerphilly county borough councils, I can see that there is a need for significant spend in the constituency in order to overcome the impact of the storms, and I know from contributions from colleagues in the Chamber today that this is also true in other areas. Given the previous answers that you gave to other Members this afternoon, I think I'm right in assuming that you've not yet heard anything from today's budget that shows that the UK Government will finally actually step up to the mark and help us to invest in meeting both those current spending pressures and the future challenges facing Wales. Would you agree with me that, given the spending announcements from today's budget, this does finally confirm what we've always known, and that is that the last 10 years of Tory austerity and the hardship that that has brought to many of my constituents was always a policy of choice and not of necessity?

Finally, Minister, like me, do you wonder how the party of fiscal responsibility has managed to borrow £800 billion in the last nine years, almost double what Labour ever borrowed in its 33 years in Government?   

I thank Dawn Bowden for raising that particular issue, and allowing me the opportunity again to stress that austerity isn't over with this UK Government budget, and it's very much alive and well. The UK Government has ensured that our budget for next year is still only marginally higher than it was a decade ago. And I think that that does demonstrate that we are still facing some challenges as Welsh Government, but those challenges absolutely feed, then, into local government, and local government has been really keen to impress upon us that one better year of funding, which we've been able to provide them with, doesn't make up for a decade of austerity.

I will be carefully reviewing the budget to assess the impact for Wales. But as always, it will be important to look below the headlines, as the devil is always in the detail, and I intended to publish a written statement later today.

I'm grateful to the Minister for her answer; I appreciate it was a very broad question. I don't know if the Minister has noticed that contained in the budget there is a commitment to a £30 million changing places fund. I'm sure that she would agree with me that the situation that so many of our disabled people face, where they can't be out of the house for more than a certain length of time because they can't access appropriate changing facilities, is something that none of us, I'm sure, across this Chamber would be content to see continue.

May I ask the Minister if she can make an assessment as soon as possible about whether or not we will get a consequential for this? I'm obviously probably one of the last people in this Chamber who would ever say to a Welsh Minister, 'Because they're going to spend this money in England on this, we ought to spend the consequential on exactly the same thing', but I have been very pleased to be supporting over some months the Llanelli changing places campaign in my own region, for example, and I'm sure she'd agree with me that it's absolutely unacceptable that a town of that size doesn't have a single changing places facility available for the disabled residents.

So, could I ask the Minister to find out as soon as it's feasible whether there will be a consequential and if she will consider having discussions with the appropriate Ministers—the Minister for planning, the Minister for social services—to see if it would be possible on this occasion, for this particular consequential, if we get one—and I really believe that we should—to be used? One of the disability charities has estimated that if we get the proper consequential for this we could provide 19 new changing places in Wales, which would obviously be of huge benefit to our disabled fellow citizens.

Well, the changing places fund wasn't one of the items that was mentioned in the Chancellor's speech itself, but I'm sure I'll find the detail set within the spreadsheets that accompany the announcement. So, I'll be taking the opportunity to explore in depth what has been offered through those spreadsheets and where those consequentials fall. So, at the moment, I don't have a full picture because it will take some time to get underneath the detail, but as soon as I do, I'll be able to make some further announcements. 

Question 7 [OAQ55200] has been withdrawn. So, finally, question 8, Mike Hedges. 

The budget strategy is agreed by Cabinet at the start of the year. Prioritisation is guided by the bilateral discussions I have with Ministers and wider engagement with the four statutory commissioners and external stakeholders. The budget improvement plan outlines our approach to improving the budget process over the longer time frame. 

Can I thank the Minister for that response? The amount of money spent on services is easily accounted for, but what's more difficult to identify is the outcomes achieved by that money. Does the Minister currently or does the Minister intend to set targets to be achieved with additional money provided to the different Ministers so that we can see that we're getting enough bang for our buck?

Mike Hedges's suggestion almost sounds attractively authoritarian, but I'm not sure that it is the view—. [Laughter.] I'm not sure that it's for the finance Minister to set targets across Government, but I do think that where they are appropriate, they should be developed by those Ministers and monitored closely by the individual Ministers as well.

So, there are some examples in our Welsh Government annual report, which was published in January, which show how we work against some sets of targets. One example, of course, would be the 20,000 affordable homes target during this term of Government, which we aim to build, and, of course, we're attaching £175 million of funding in 2020-1 to a diverse range of measures in order to help us progress our housing ambitions. So, whilst I'm not sure it would be for me to set targets, clearly, if colleagues set targets, then I'm keen to support them to achieve them.

Thank you very much, Trefnydd.

Item 3 on the agenda this afternoon is questions to the Counsel General and Minister for European Transition in respect of his law officer responsibilities. Question 1 is Helen Mary Jones.

The Welsh Government is committed to advancing gender equality in Wales. We have commissioned research to explore options for advancing equality and human rights in Wales. A firm commitment to promoting those rights is built into the Welsh Government's DNA and directly influences our policies, legislation and decisions.

I'm grateful to the Counsel General for his response. Does the Counsel General agree with me that we may be facing a situation, given the nature of the Government at the other end of the M4 and the pressure there to deregulate, and what many of us would be concerned about in terms of a potential lack of commitment to equality, where the current equality legislation and the Equality Act 2010—we may face it being amended, in a way that many of us would not like? Does he further agree with me that one route that we may be able to go down in Wales to provide a legal framework for equality issues, and particularly in this case, for sex equality, would be to incorporate the appropriate UN conventions into Welsh law? I was very pleased to hear him mention the research, and I wonder if he can give an indication this afternoon of—I know he's not directly commissioned it—when that research may be completed and when it may be appropriate to share that with this Assembly and the appropriate committees.

Certainly. Well, she refers to CEDAW, which is, of course, effectively an international Bill of rights for women and enshrines the principles of equality that we would wish to see upheld and advanced. And we would fundamentally oppose any attempt to weaken the Equality Act.

We have sought to ensure that when we look at questions in relation to conventions, we do so in a holistic way. CEDAW itself, and the reflections that came out of the examination on its compliance in February of last year—in which Welsh Government officials were directly involved in order to make sure that Welsh interests and Welsh issues were directly represented and raised during that examination process—those reflections have fed directly into the gender equality review, the interim output of which has been considered by the Cabinet. But the research to which she refers, my understanding is that that is intended to have concluded by the end of this year, so that the output of that would be available during this Assembly term, as I understand it.

We agree with the justice commission's recommendation to establish family drug and alcohol courts, and work is already under way to explore the feasibility of, and the mechanisms for, doing so.

Thank you. Of course, with regard to family drug and alcohol courts, during the Public Accounts Committee earlier this year, Albert Heaney, director of social services and integration, Welsh Government, advised that the judiciary regard them as being very positive, and a good approach that can be very helpful to families. Similarly, last October, the Commission on Justice in Wales called for the immediate establishment of FDACs in Wales. As I have said previously, I believe that the evidence indicates that the creation of FDACs in Wales could be, and probably is, in the best interest of children and parents. Could you provide an update as to how the Commission on Justice's recommendation is being progressed?

Well, we agree with the recommendation to establish the courts, as I indicated in my earlier answer. Officials have started work in this area through discussions about that particular recommendation, most recently at the family justice network meetings in November of last year, and again on 4 March of this year just gone. The president of the family division, as I think she was referring in her question, has stated that he is strongly in favour of FDACs, as they align well with the well-being legislation that we have in Wales, and fundamentally represent that preventative approach rather than a punitive approach. At that family justice network meeting on 4 March, a presentation was made about the functions and effectiveness of the FDACs, and it was agreed that local authorities would consider a pilot in relation to that issue.

I'm aware, of course, that permission to appeal has been granted by the Court of Appeal itself in relation to the pension challenge, and that the appeal hearing will take place in late July. Whilst the Welsh Government is not a party to that action, we have, of course, written to the UK Government on a number of occasions to express serious concerns that women who've had their state pension age raised without effective or sufficient notification are being prejudiced.

I'm grateful to the Counsel General for his response. Given that we now have a new Government at the other end of the M4, and that that Government talks a lot about levelling up and about fairness, would the Counsel General consider, perhaps with the Deputy Minister with responsibility for equalities, making further representations to the appropriate Minister at Westminster and perhaps looking again at whether or not there may be some contribution that we could make, perhaps by way of evidence, to the appeal that he mentions? It may be that, with a new Minister in place, and with this new emphasis on fairness, and a slightly more relaxed approach to spending, we may get somewhat of a better hearing. I don't think any of us would be sanguine, but I'm sure that the women affected here in Wales would be very grateful if the Welsh Government were prepared to try again.

I know he agrees with me that this is a very profound injustice, that these women were picked on, and we know they were picked on, because the then Chancellor of the Exchequer thought that he could get away with it. He thought that they wouldn't fight back. This may be an opportunity for the Government of Wales, on behalf of this whole Assembly, to make further representations on behalf of our fellow citizens who have been most foully treated.

The Member certainly is not sanguine, nor are we on these benches, as she generously accepts in her question. As she will know from our previous exchanges in the Chamber in relation to this, we have sought every opportunity to put our perspective on behalf of women in Wales to the UK Government and have frequently received responses that we have put in the public domain. She will herself, I'm sure, share our assessment of the gross inadequacy of those responses in tackling the injustice that we seek to represent women in Wales on on that matter.

I have already had reflections on how we can continue to make representations in relation to this new stage of legal proceedings and will be discussing that with the Deputy Minister. We should be absolutely clear that the women who face this injustice have faced a number of other injustices very frequently during their working lives, and the UK Government should do all it can to ensure that, in this respect, at least, it stands on the side of those women who have given so much to society and have found, later on in life, that the Government is not standing on their side.

Thank you very much, Counsel General.

Item 4 on the agenda this afternoon is questions to the Assembly Commission. This afternoon, all questions will be answered by the Llywydd. Question 1—Neil Hamilton.

The Assembly has four flag poles at three locations on the estate—two Welsh flags, one union jack flag, and one National Assembly for Wales flag, which are flown on the poles every day. There are established arrangements for varying the flags that are displayed, and the guest flags take the place of the Assembly flag, usually.

Thank you for that response.

I was very pleased to see the Catalan flag flying today, but, on a more regular basis, I wonder whether we could continue to fly the Commonwealth flag, which I saw earlier in the week. We have been members of the Commonwealth, obviously, since the inception of it. It has 54 member states, it encompasses 11 million square miles, spans all six inhabited continents, has 20 per cent of the world's landmass and a population of 2.4 billion people. The London declaration that established the Commonwealth member states as equal and free in 1949 states that its values are democracy, human rights and the rule of law, values that every progressive society should preserve and defend in the twenty-first century. And, of course, it has been presided over, as head of the Commonwealth, by Her Majesty the Queen for 68 years. So, I wonder if the Llywydd could tell us whether the Commission would look favourably upon this request either to fly the Commonwealth flag on a permanent basis, subject to special occasions such as today, or the flags of individual Commonwealth countries.

Usually, of course, on the fourth pole, it's the National Assembly flag that is flown. As the Member has said, the Catalan flag is flown today in recognition of the fact that the Presiding Officer of the Catalonian Parliament is visiting, and the Commonwealth flag was flown yesterday and the day before that to recognise the Commonwealth Day. That's what the policy has been in recent years: to fly the Commonwealth flag for two days per year during the period of Commonwealth Day.

I often have applications from Members to fly various flags to do with unions, states and different campaigns. I think it's very important that we do keep one of our flag poles available for the flags that reflect the special days or weeks or months to promote campaigns and recognised international days. That's my opinion on the issue. I don't expect every Member to agree with that. 

Huw Irranca-Davies. No?

My apologies; I didn't realise my name was down. But, yes, I would like to ask a question relating to—

Well, don't feel obliged. Don't feel obliged to. But you are down.

Thank you, Deputy Presiding Officer. My request would be, knowing that we have an international strategy now that is looking at our links with other regions that have Celtic connections—the Basque Country, Catalonia, et cetera—whether or not we can indeed look at periodically, actually, flying, as we have today, those flags on a much more regular basis, and echoing what Neil Hamilton has just said, because I think that would be a good indication of the fact that Wales is a very outward-looking nation.

I'm very keen to receive requests and suggestions from Members as to how we support our work here in the flying of flags and demonstrate our solidarity beyond Wales and with international organisations and countries elsewhere. If people have views—Members have views—on how our internationalist approach to our National Assembly can be reflected in our policy on flags, then I'm very keen to hear that, both from Members here and from the Government in its own international strategy.

Awareness raising is a key priority for the Senedd Commission ahead of the next Senedd election, particularly among 16 and 17-year-olds, who will be able to vote for the first time. This includes contributing to the development of appropriate resources, which will be available from May onwards. And we're also working with partners such as the Electoral Commission and the Welsh Government to raise awareness in time for the elections next year. 

I'm very grateful to the Llywydd for her answer, and it's extremely encouraging. I wonder if she can say a little bit more about how young people themselves are being involved in the discussion about how best we can communicate these messages to them? And, on a slightly different but related matter, can she tell us what partnerships are being developed to enable those foreign national citizens who will be able to vote in our Senedd elections to become aware? I just happened to have a conversation with a friend of mind who's originally from Romania, and she was very surprised, as well as very delighted, to know that she'd be able to vote in the next election, as would her husband, who's originally from Poland. So, those two points, really—how are we involving young people in the discussions about how best to get the messages across, and how are we enabling those citizens whose roots are elsewhere to understand that they can vote in this election?

Thank you for those two aspects of the question, relating to the two new aspects of the franchise that will be relevant to the elections next year. Of course, we have been preparing somewhat longer for the franchise to include 16 and 17-year-olds, assuming that that would be part of the legislation, and so our work certainly involves young people through the Youth Parliament, and through those partners who have collaborated with us in establishing the Youth Parliament, and who work directly with young people and with our work as a Commission in providing our support to schools in undertaking extra-curricular or outreach work to promote awareness among young people in Wales of democracy and the new right that they will have, and that work will intensify and continue in the months to come.

In terms of the second aspect of the question about the franchise expanding to include foreign nationals, of course, that's an aspect that's newer for us as a Commission, because it became part of the legislation during the scrutiny process, and so our hope is to work with the Government and the Electoral Commission to ensure that the citizens in Wales who have this new right to vote in the election next year will be aware of that. So, we will be, over the coming months, starting this important work to ensure that the Government and local authorities, of course, provide the correct information to people about their right to vote, bearing in mind, of course, that this has happened in time not just for the vote next year but importantly for the canvass this year to put people on the register for voting next year. 

Llywydd, I was in Garth Olwg school in my constituency recently, and I can tell you how enthusiastic so many of the young students are that they will actually be participating in the Assembly election votes next year. One of the things that was considered when the legislation was going through the Assembly was not only the issue of political education but also the idea of how we actually make voting easier—the digitisation, perhaps, of the electoral register, perhaps the automatic registration of 16-year-olds, because they are all either in school or in colleges, and that would be something that would be quite feasible. And also why shouldn't it be the case that we have ballot boxes in schools? So, all of these were new ideas that were suggested in terms of how to make voting easier and also to increase participation in voting. Are any of those things on the cards? Are they under consideration? Might you be able to enlighten us as to whether there has been any progress with some of these ideas?

Well, these, of course, are ideas and issues that were raised during the scrutiny process of the Senedd and Elections (Wales) Bill, as they are with the Local Government and Elections (Wales) Bill in its scrutiny process at the moment as well. I think it's a matter for Welsh Government to propose legislation on changing the way that we vote, rather than who votes for this Assembly, and I know that there is some discussion around that as part of the local government and elections Bill, and I know that these are issues that interest a lot of people, because making sure that we make voting accessible as well as interesting for people is something that should unite us all.

How we do that and when we do that are matters, I think, that we need to possibly discuss a little bit more here in this Senedd itself, and I'm up for having that discussion. We're not there yet, but I'm sure that these are ways that—the young people will lead us older, more traditionally thinking people along those routes. Myself, I wouldn't be against voting on my own phone. I could do it from here now, if I could. But I think we will move with the times. At this point, we're probably moving a little bit too slowly in order to keep up with how young people want to engage with us, but we need to be open to those new ideas that are coming from schools like Garth Olwg and other schools right throughout Wales. 

Commissioner, the expert panel advising on electoral reform, specifically extending the franchise to 16 and 17-year-olds, recommended a programme of proper political education as part of the curriculum. Has this education really been going on for long enough, as the new law has only just recently passed, and what representation has the Assembly Commission made to the Welsh Government to make this happen?

Thank you for the question. Yes, you're perfectly correct that the expert panel was very strong in its view that political education alongside the right to vote were two equally important measures to take in enabling young people to take part in the democratic process. The Commission is working with the Welsh Government, the Electoral Commission and others, but in particular, in this aspect of resources available to schools, to develop with Welsh Government resources that will be available as of September, the September term, to enable those 16 and 17-year-olds that are in school to access the most up-to-date information on their new right to vote at 16 and 17, remembering, of course, that not all young people with that new right will be in a school setting—also in a college setting and also in work settings—and we need to make sure that everybody is as equally empowered to know of their new right and how to exercise that right. 

The situation is constantly changing and, as a result, our considerations are also changing. Yesterday, an extraordinary meeting of the Commissioners was held to provide an update on the situation and to discuss the initial principles of our response. We continue to respond to advice that's changing on a daily basis, and careful planning needs to be done on the basis of different scenarios. The Commission provides all staff with information and advice about coronavirus that is as complete and up to date as possible. This information is available on our intranet.

If a Member suspects that they're infected, they should inform Members' business services immediately. In the case of staff members, they should inform their employer and the Commission immediately. Individuals who suspect that they are infected should contact the NHS helpline by calling 111 and isolate themselves at an appropriate place.

As the situation evolves, there may be implications for Assembly business, and we will ensure timely and appropriate decisions are made as a result of that. In the meantime, the Commission has taken proactive measures, such as placing guidance on thorough hand washing in the estate's toilets, and providing hand gel at all entrances to the building and public areas.

The situation is expected to intensify quickly, so we all have a responsibility in playing a part in preventing the spread of the virus. I'd like to assure you that the Commission is doing everything within its ability to safeguard staff, Members and visitors to the estate.

Thank you, Llywydd. With an increase in the number of confirmed cases, from 273 on Sunday to 373 yesterday, which is now an increase of 15 cases in Wales, I think it's reasonable for us all to be concerned about the potential further spread of this virus. The National Assembly for Wales and, indeed, our constituency offices are very much public facing, so I certainly welcome the fact that Members' business support issued e-mails on 28 February and again yesterday. One question I have: will there be notices provided to our constituency offices, because that's quite a good base for us to not only advise our own staff again, but to advise—maybe something for the windows of our constituency offices, just with some basic public hygiene advice?

I have reported in myself here some concerns, because I do know of one bathroom here on this estate where there is no hot water easily available and there is no soap, so it's as well that my concerns, when I do raise them, are taken quite seriously.

Now, as you are also aware, Llywydd, there are plans afoot to conduct a week of business in north-east Wales. I take you back to your comment you made earlier, that this thing could rise quite significantly on an imminent basis. So, what plans and considerations are in place now to think about the feasibility of continuing with that visit to north Wales? And, should there have to be a cancellation of this visit on an imminent basis, are we protected against any financial implications that may result as a result of that cancellation?

I'm very aware, as somebody who has a constituency office in Aberystwyth, that members of the public are going to constituency offices right throughout Wales to seek some advice from their elected representatives. I think it would be best if elected representatives look to Public Health Wales for much of the information that's on their website, which is easily downloadable, in terms of public health information, and to make that as available as possible in their local communities and, possibly, on window displays elsewhere, so that there's a consistency of messages that are reaching people in different ways. We're always very aware, of course, that people who are able to access, digitally, information from the Public Health Wales website are able to do that, but many of our constituents are not online and may well be visiting town centres and looking for other places for advice. I'm sure that we would want to make that as available as possible to them via Public Health Wales's most recent information.

The ongoing business of this place as our national Parliament is one that we will continue to review over the next few weeks. You make the point about Senedd Clwyd as well, which is meant to take place in June. You can be assured, as Members, that I and fellow Commissioners are very keen to look carefully and proportionately from day to day as we plan for the future business of this place, whether it's held here in Cardiff Bay or in Mold. 

Thank you, Llywydd. 

Item 5 on the agenda this afternoon is topical questions. The topical question this afternoon is to be answered by the Minister for Economy, Transport and North Wales. David Rees.

Yes, of course. First of all, Tata Steel did not make an announcement yesterday. However, the news articles did report on questions that were asked of staff and an internal memo from Tata Steel. I can assure the Member that we continue to engage with Tata Steel about how their transformation programme will impact on operations in Wales and, indeed, we continue to impress upon them the importance of standing by their commitment to seek to avoid compulsory redundancies and reduce job losses to an absolute minimum.

I thank the Minister for that answer, and I thank him for his correction of my question as well. But clearly, we have mixed views on the news that came out yesterday, whichever way it came out. The 1,000 job losses that had been projected for the UK have gone down to 500, so that's a good bit of news. But of course there are still 500 job losses, whether they are compulsory redundancies or not, which we have been informed they will not be; they are still job losses and an opportunity for young people to move into careers in the steel industry.

We still have no detail as to where those job losses will be or what functions they would be within. It is important, I think, that we now get that detail, and I'm sure you agree with me that it is important that they respect that and that they respect the steelworkers and give them those details. In the original announcement, they indicated that by February we'd know where the functions would be. It's now March, and we just simply have information that the job numbers have gone down, but there's still no detail on where those functions will be or where those functions are located, and that's important.

Steelworkers have given continued dedication to Tata, maintaining and strengthening the steel industry over difficult times. They've faced challenges since the 2017 announcement, and there are global challenges as well. So, it is important that they are given that same respect back by Tata by giving them those details.

I also agree that it doesn't remove the challenges facing the steel industry in Wales and the UK, and the chief executive officer of Tata Europe, Henrik Adam, has himself indicated that there are serious financial challenges still facing the industry. Therefore, will you ensure that the Welsh Government looks at how we can support investment in the steel sector? And will you again—I know you've called upon them before—call upon the UK Government and the new Secretary of State to have a steel council meeting to look at how we can actually expand the steel industry?

They've just sold British Steel in Scunthorpe off to a Chinese company, with a commitment of £1.2 billion investment over the years. Tata have indicated some investment, but we need investment of that level to ensure that we have a playing field in which Tata in Port Talbot and Tata in Wales can actually face the global challenges that are coming down the line. Therefore, will you take that message back to London, to ensure that this is a twenty-first century business? It is modern, it's not old; it is a modern business. It has a strong future, and the UK economy needs a strong steel industry. We need to make sure that message is made loud and clear in London.  

Can I thank Dai Rees for his questions and the points that he's made, which are absolutely right? After I repeatedly called for a UK steel round-table to be convened, one was convened on 5 February. There were two major issues raised at that round-table: one concerned procurement and the need to ensure that we use steel produced in the UK on UK infrastructure projects, and then the second concerned the incredibly high cost of energy and the need for the UK Government to address this. 

Now, Dirprwy Lywydd, I haven't been able to check on the very latest announcements as part of the budget, but the message was absolutely clear at that round-table that the Government had to take an opportunity in this budget to announce measures to alleviate the high and volatile costs of electric. That is absolutely vital if the sector is to transition to a low-carbon position in the years to come, which will be assisted by, of course, development money from Welsh Government and UK Government. 

A lot has been said about funds such as the industrial energy transformation fund and the clean steel fund, but I think we need to bear in mind the scale of these funds compared to funds that are being rolled out elsewhere. It amounts to about £500 million in total over several years for the whole of the sector in the UK and, indeed, other sectors where energy-intensive operations are found—£500 million over several years. Compare that with the £5 billion that the Dutch Government is investing every year in decarbonisation of industry, and that demonstrates why the UK Government really does need to take more ambitious action in this regard, listen to the steel sector and implement change as necessary.

Now, Dai Rees is absolutely right that, whilst it would be inappropriate to discuss at length a leaked memo, it does give us heart that we're seeing a movement in the right direction insofar as Tata is concerned and the Welsh plants are concerned. I can inform Members that I, along with the First Minister, had a very, very productive meeting with Henrik Adam, CEO of Tata Steel Europe, just a few weeks ago where we discussed a number of issues, including their transformation plan. The company made it clear that they would be providing me with a formal update on the impact on the Welsh sites according to their transformation plans as soon as that information is available. They're still looking into issues concerning the identity of the proposed jobs that will be lost, but I pledge to update Members as soon as I have had that formal notification.

I'm very grateful to David Rees for placing this question, and to the Minister for his response. I fully appreciate that the Minister doesn't want to get drawn into detailed discussions about what turns out to be a leaked memo, but I would associate myself with what he and David Rees have said about how this looks as if it is travel in the right direction and that this is encouraging.

I'd also very much agree with the Minister that the UK Government's investment in supporting the long term future of the steel industry, and particularly in decarbonisation, is pretty woefully inadequate. I think that one of the opportunities that we were offered by Brexit, were we not, was that some key industries that perhaps could not be supported because of state aid rules could now be perhaps more strongly supported? I wonder if the Minister will undertake to raise that point with UK Ministers: that they've, in a sense, been hiding behind the whole state aid process and saying, 'We can't invest. We have to be really careful'—I'm not sure that either the Minister or I would have fully accepted those excuses. But now, of course, we're in a position where we're moving away from that and, in terms of medium term investment, we may be in a position where further investment could be made in ways that perhaps were not available to us before.

The emphasis is obviously here on the huge scale of the jobs in Port Talbot and the huge importance to that community, but I'd also draw the Minister's attention the 649 jobs in Trostre in Llanelli, in my region. Now, that isn't as many jobs, but in terms of the importance of those jobs to that community and the quality of the work, the stability of the work, we would obviously be very concerned in mid and west Wales if some of the jobs that are targeted to be lost were there, or if very many of them were targeted in Trostre. My understanding is that because it's a pretty specialised type of process that they are relatively not at risk, but will the Minister undertake today—and I'm grateful for him telling us that he'll come back to this Chamber as soon as he knows more from Tata—to specifically raise the case of the plant at Trostre and the workers there?

Because, just as David Rees has said, these are people who have worked incredibly hard; they've been prepared to make changes; they've shown a lot of loyalty and dedication to the company; and I'm sure that the Minister would agree with me that that loyalty and that flexibility deserves to be rewarded. 

Can I thank Helen Mary Jones for her question and her contribution this afternoon? I promise I will raise concerns about the numbers that could be lost from Trostre and every other steel site in the Tata family in Wales. The Member is absolutely right that the transformation planning is seeking to identify primarily white collar jobs that could be cut rather than blue collar. The numbers, as I understand them, of white collar at Trostre are not hugely significant, although there are obviously many backroom office jobs that could be affected. So, I will absolutely fight the case for Trostre and the retention of as many jobs there as possible.

I would agree with the Member as well that the state aid defence is a weak defence now, and it's also a weak defence, as we discussed yesterday, in terms of the support that could be offered to Cardiff Airport and many other sectors in the economy. Steel is strategically important in numerous ways for the UK. No other nation, as far as I can see, would be willing to allow steelmaking to be lost from their shores. Here in the UK, the UK Government must work with us in partnership. We wish to work with the UK Government. I'm determined to work with BEIS. I wish to see experience and expertise exchanged between Welsh Government and BEIS in order to ensure that we give the best possible fighting chance to the steel sector and many other areas of our economy for future generations. And that work should begin today with a concerted effort by the UK Government, through the budget, to address high energy prices.

Thank you, Minister. I think the fact that—this may be a leaked memo, but, obviously, you and the First Minister have been having conversations with Tata. There's an indication here, isn't there, that some granularity has been discussed here and that there must be some certainty on the part of Tata now about which parts of their operation they consider to be the most vulnerable and who's likely to be affected by them. So, the sooner we have that news, good or bad, the better, I think, not least because I think it needs to be shared with regional skills partnerships and colleges so that they can start the work on mitigation work, where, if we are going to have yet another flood of skilled people hitting our joblessness figures, then the opportunity for colleges and the regional skills partnership to plan for that would be, actually, very, very helpful indeed. And, of course, we're not just talking about employees potentially at Port Talbot, but their supply chains as well. So, my question is: what are you likely to be telling them, and when?

I agree with you that the underlying issues haven't particularly gone away. You mentioned the high energy costs; I'm not going to disagree with you on that point, but every time you mention energy costs, I'm going to mention business rates, which is something that is within the gift of Welsh Government to deal with. So, I wonder, on the back of that, if you can tell me whether—perhaps it's a bit early to answer this question, to be fair—the Bank of England announcement today about a reduction in interest rates will help Tata at all in any way, managing, at least, their cashflow, if nothing else.

And then, finally, somebody's got to mention coronavirus in this context. And we did raise it, or you raised it, actually, in your response to a question I raised at the last cross-party group on steel, about whether there were unforeseen circumstances that could be new hits on the global steel picture—obviously, coronavirus is one of those—and what steps can we take in terms of early conversations with Tata not to use this virus as an additional excuse to try and close parts of the industry that are located in the UK, actually, overall, but particularly in Wales. Thank you.

Can I thank Suzy Davies for her questions and the points that she made? Again, really important points, and I'd agree with pretty much everything that she's said. In particular, if I could just touch on the issue of coronavirus. Discussions are already under way with BEIS in relation to the impact that coronavirus could have on the economy, and particularly in those areas of the economy where we rely on quite considerable movement of people, or high dependence on goods from those territories where economic activity is either slowing down or seizing up as a result of the virus.

It's quite clear to everyone concerned that the damage to the economy could, in a worst-case scenario, be quite considerable, and therefore, it will require a concerted effort by the UK Government to ensure that as many businesses as possible can overcome what will be a temporary period of difficulty. I'm yet to receive full detail of what the Chancellor has announced today in terms of support for business through the coronavirus, but I very much hope that it will be a sufficient package to enable not just companies in the steel sector but across the economy to address the challenge of coronavirus in the months to come.

I think it's probably too early to determine the potential benefit of interest rate reductions by the Bank of England in terms of how that might assist with cashflow issues. However, the Development Bank of Wales, the high street banks I will be speaking with are already saying that they will be ready to assist many businesses, and that is very welcome indeed.

And I just repeat the point that, as soon as anything formal is available to me from Tata, I will share that detail with Members. And Suzy Davies is absolutely right, the RSPs need to know, at the earliest opportunity, so that plans can be made to accommodate those who could be left without work to ensure that they get the right support to get back into employment.

Thank you. Finally, John Griffiths.

Diolch yn fawr, Dirprwy Lywydd. Minister, thank you for your response to questions, and, particularly, stating that you will have in mind all the Tata sites in Wales in your discussions with UK Government and with Tata in general, because, obviously, for me, the Llanwern site in Newport East is still very, very important, having several hundred jobs and being very important to suppliers and contractors. Of course, we have a particular situation with the Orb site, which is idle at the moment, but, obviously, we still very much hope that that will come back into production and play a part in the steel industry in Newport and Wales.

So, within the general picture, Minister, I would welcome your reassurance, adding to what you've already said this afternoon, that Newport's steel industry will be very much in your mind, as you have talks and discussions, and make sure that steel has a very strong future in Wales.

I can assure the Member that Newport steel has been right there, right at the forefront of my mind, whenever I've spoken with Tata, whenever I've discussed these issues with counterparts in the UK Government. That will go on. I'm determined to ensure that as many jobs as possible within the steel sector in the Newport area are retained, and that we can actually build on the strength of the sector in Newport.

There was positive news recently in terms of the Welsh steel sector, and that came with the announcement of around 100 new jobs in the sector. I thought that that was particularly important at this moment in time, given the uncertainty that's being caused by a number of factors, including energy prices, ongoing uncertainty concerning Brexit, and, of course, coronavirus. That gave a very welcome shot in the arm of the sector in south Wales in particular, where the announcement was made, but for the whole of steel making across the UK.

Thank you very much, Minister.

Item 6 on the agenda this afternoon is 90-second statements. The first this week is from Jenny Rathbone.

Thank you very much. One in 10 women is affected by endometriosis. The causes of endometriosis are unclear, but retrograde menstruation, hormonal imbalance, surgical scars, problems with the immune system and genetics all play a part.

Many women suffer for years before understanding why they suffer with painful monthly periods, chronic lower back pain, pain during sex, diarrhoea, constipation, bloating and nausea, especially during their periods. Parents, teachers, employers and even the medical profession fail to spot the symptoms. It can take an average of eight years and 26 GP appointments to get to see an endometriosis specialist.

Endometriosis awareness training for GPs is now being rolled out across the Welsh NHS. And more endo nurses are being employed in line with NICE guidance. But there's only one specialist endometriosis centre in Cardiff for the whole of Wales, with a range of treatments to alleviate, but unfortunately unable to cure, this disease. Endometriosis costs the UK economy over £8 billion in healthcare treatments and lost employment, and the psychosocial impact is hard to put a figure on.

I want to pay tribute to the Endo March Wales co-ordinators: Nikki Dally, Samantha Hickson and Karla Edwards and all the other grass-roots campaigners who’ve raised the profile of endometriosis in Wales. It takes place every year on the last Saturday of this month. Last year, they were in Cardiff and Llandudno, and on Saturday, 28 March, they'll be in Cardiff and Mold. If you can, please join them.

On 8 March 1955, Dai Dower faced off in a boxing ring in the Earls Court arena against Nazzareno Gianelli. Dower beat his opponent, taking the European flyweight title. He was described as 'Boxing at his brilliant best'. He dazzled the watching crowd. This was the high point of the professional career of

'the fighting phenomenon of the south Wales Valleys’.

He claimed his third title, added to his British and Empire championships.

Life had started very differently for David William Dower. Born 20 June 1933, he started his career working as a miner in Abercynon colliery. A flair for boxing led to a successful amateur career, which he pursued alongside his grinding work in the pit. He was amateur flyweight champion, and competed in the 1952 Olympics in Helsinki. His professional career began the following year. When he took the European title, Dower was undefeated in the ring. In 1956, he was ranked second in the world. March 1957 saw him fail to claim the world flyweight title, and although he also lost the European title, he was undefeated British and Empire champion.

In 1958, Dower retired from professional sport at the ripe old age of 25. He became a sports teacher in a Bournemouth school, ending up head of sport at the town’s university. He died in August 2016, but his memory, as one of Wales's most successful sportsmen, and one of Abercynon’s most beloved sons, lives on.

This week is the hundredth anniversary of the death of Daniel James. Daniel James was a poet and hymn writer, but he is far better known by his bardic name, Gwyrosydd. Whilst being a prolific hymn writer, he is best known for composing the words of Calon Lân, which is normally sung to a tune written by John Hughes who was from Ynystawe in Swansea.

He was both born and buried in Swansea. He was a member of Mynyddbach chapel, the mother church for the Independent movement in Swansea, which now has the Calon Lân Centre attached to it. He started work in the Morriston ironworks as a puddler and he later worked in Landore tinplate works. In his middle age, the Landore works closed, and he found work successively at Tredegar, Dowlais, Blaengarw, and eventually in Mountain Ash, spending 15 years in one of Nixon's collieries, and finally, whilst in failing health, working for the local authority.

Much of his verse was unassuming and very popular, appearing first in periodicals and newspapers. He would also write a poem for a pint at the King's Head in Treboeth—perhaps the original 'poems and pints'. There has been a memorial tablet in Treboeth Public Hall since 1936, and a more recent one has been installed in Caersalem Newydd in Treboeth. The Calon Lân Society in Swansea have held several events and will be installing stained glass windows in the local school to commemorate the life of Daniel James, an ordinary working man with exceptional talent whose hymn, Calon Lân is the best-loved Welsh hymn. 

Thank you. 

Item 7 is a motion to amend Standing Orders, and I call on a Member of the Business Committee to move that motion, Caroline Jones. 

Formally.

Thank you. The proposal is to amend the Standing Orders. Does any Member object? [Objection.] Okay, so we vote under that item at voting time. 

Item 8 this afternoon is a debate on a Member's legislative proposal: equal opportunities audit. I call on Helen Mary Jones to move the motion—Helen.

Diolch yn fawr, Dirprwy Lywydd. This proposal is intended as a constructive contribution to the debate as to what will happen to equality policy here in Wales after Brexit. On these benches, we believe that equality law should be devolved in all its aspects, but we're realistic enough to understand that, given the current complexion of the Government at the other end of the M4, we're unlikely to get that devolution, as I'm sure many of us would wish, in the short term. We fully support full and unequivocal devolution, but if that isn't going to happen, we need to think about what we can do here in Wales within the powers that are currently devolved. 

I think many of us do believe that we are likely to see big changes in the equality environment at a UK or GB level. There are elements of the current Government in Westminster who are very anti-regulation and by inference, that makes some of them, I believe, anti-equality. I must be clear, Dirprwy Lywydd, that I'm not implying that of the Conservative benches here; we have great champions of equality on the Conservative benches, and I see Suzy Davies and Mark Isherwood here, and there are many others. But there is that tendency at a UK level. That was used, was it not, used as one of the justifications for Brexit—that so-called burdens could be lifted from business in the UK? I'm sure that the Deputy Minister will agree with me that that is not something that we would wish to see, but if it is going to happen, much of the structure of the activity that we take here in Wales around promoting equality is based in the GB equality legislation as it stands now, and if that is lost, we will need to take steps here. We've talked about a number of alternatives—the enshrining in Welsh law of the UN conventions, for example. 

I'm sure I don't need to set out, Dirprwy Lywydd, that we have a problem in equalities and employment in Wales. We know that women are traditionally found to be working in low-paid work, insecure work, part-time work, and I want to pay tribute to the organisation, Chwarae Teg, which I know, is an organisation that is very close to the Deputy Minister's heart, for the work that they've done in showing us what that costs the economy—not only what it costs the individual women, but what it costs the economy. We know, for example, that the access of black and minority ethnic people to high-quality and managerial jobs here in Wales is very poor and that that section of the population is more likely than anyone else to be overqualified for the jobs that they are doing. We know that 46 per cent of disabled people in Wales are in employment as against 78 per cent of the population as a whole, and I'm sure none of us believes that this is a satisfactory state of affairs. 

When Welsh Government is granting contracts or granting grants, we have strong current guidance. The guidance in itself I would acknowledge is good. I do have some questions about how effectively it's used and whether, when commitments are made by a business, that is actually then checked and the commitments on paper are actually checked out to see whether they're actually being delivered. But all of that guidance, or the vast majority of that guidance, though there are elements, for example, that come from the Well-being of Future Generations (Wales) Act 2015, falls out of the Equality Act 2010. If the Equality Act is amended and watered down, that guidance will need to be looked at again. 

I believe it would be right to put those requirements onto a legislative footing so that there can be no doubt about what is required. So, this proposed legislation could provide for: equality audits pre-contract; specific binding equality commitments tailored to whichever business it was as part of the contracting process; crucially, equality monitoring during the period of that grant or of that business arrangement; and penalties if those equality commitments are not met without good reason. Sometimes, of course, there will be good reasons why they're not met, but if they're not met without reason, then there should be a penalty. Of course, these requirements would need to be reasonable and proportionate, depending on the scale of investment and the size of the organisation, but they should apply to all, in my view. 

Now, this proposal builds, of course, on the work of the Fair Work Commission, which does, of course, call for the Welsh Government to legislate in some of these areas. I should say, Dirprwy Lywydd, that I don't think I've worded the motion perfectly because, in my view, this legislative approach should extend to all Welsh Government grants, loans and procurement contracts, and the legislation could be extended to include the whole public sector, including the health sector, local government, and so on. The same approach could also be extended to the third sector organisations contracting with or receiving grants from the public sector in Wales. 

I wouldn't want to give the impression, Dirprwy Lywydd, that we want to put disproportionate burdens, but I'm sure that while we can all be pleased that fewer of our fellow citizens now are out of work, we should all be concerned that so much of the quality of that work is poor. It's low-paid, it's zero-hour contracts, it's insecure. I know that the Welsh Government will agree with us on these benches that that isn't good enough, neither are the limitations on the access of those who get opportunities to better opportunities. We were discussing on the Economy, Infrastructure and Skills Committee just last week the great imbalance between males and females in taking up degree apprenticeships, for example, and how that might be tackled. I hope, Dirprwy Lywydd, that we can all agree that the Welsh public pound should not be spent in ways that perpetuate injustice or inequality, and I would ask Members to support this proposal today to allow for further exploration. I look forward to Members' contributions to the debate and to responding. 

Thank you. I don't have any speakers for the debate, so I'm going to go straight to the Deputy Minister and Chief Whip, Jane Hutt.

Diolch yn fawr, Dirprwy Lywydd, and I do thank Helen Mary Jones for tabling this motion and also say that I welcome this debate on how we can improve and encourage equal opportunities, particularly addressing the private sector as well as the public sectors, which we so often focus on, because this is clearly linked to our wider approach to tackling inequality. We know that better, fairer opportunities for everyone, right across the Welsh economy—. You referred, of course, to the Fair Work Commission, and we are acting on the recommendations. Delivering fair work is a cornerstone of our policy programme. We know, of course, that a fairer society where diversity is valued and respected and where people can participate, flourish and fulfil their potential, is the society and economy that we want. 

So, equality and inclusion are integrated and mainstreamed through all six characteristics of fair work, but different approaches—and you've acknowledged this, Helen Mary—would have to be taken into account considering sector context and, for example, size of employers and how they could engage. But I do absolutely understand Helen Mary Jones's call to look at and to consider legislation regarding how we ensure that firms in receipt of Welsh Government grants could then move forward by, helpfully for them and constructively for them, providing an equal opportunities audit.

We will, and we will always, consider legislation where we have the powers to do so, but I think it's right that you focused as well on the fact that we do have other levers. We have procurement levers and non-legislative grants, which can, actually, drive change. We try to drive that change through working in partnership with business, but also with trade unions and with public bodies, to ensure that Government policy is working so that everyone benefits. 

We know that simpler, stronger social partnership arrangements do actually deliver that ambition for better, consistent outcomes, and they do ensure that Welsh workers across all sectors in the economy share in economic growth, but most importantly in fairness in the workplace.

Actually, trade unions, of course, through collective bargaining, have been critical to advancing many workplace equalities. There are employers who also recognise these benefits of a diverse and engaged workforce that is fairly rewarded. So, part of our implementation work of 'Fair Work Wales' involves scoping how, for example, we might be able to include conditions on fair work and equality in funding agreements. 

We already have the scope to attach a range of additional conditions to grants and other forms of financial assistance. We have to strike balances, of course, in terms of what this would mean. It's about developing an approach where employers embrace that change to deliver fair work and greater equality outcomes. That's where we have to, as the Government, manage this process.

So, we've accepted the six priority recommendations in 'Fair Work Wales', we've accepted others in principle and we've begun our journey to becoming a fair work nation. But, I also want to just mention today that this is alongside the commencement of the socioeconomic duty that underscores our commitment to a fairer society, with diversity valued and respected.

This morning, I issued a written statement to Members. I'm glad to have the opportunity to say to Members to look at the statement, because it regards the socioeconomic duty commencement date. We have to ensure that all our public bodies are fully prepared for this, and they are going to be engaged with partners in developing the guidance. We've had good consultation. The duty will now be enacted on 29 September of this year.

Just finally, Dirprwy Lywydd, I think it's important that we're looking across the equality strands. So, last September, I published 'Action on Disability: The Right to Independent Living—Framework and Action Plan', and that requires action across every Government department, including economic development. Yesterday, I published the 'Advancing Gender Equality in Wales Plan', which came out of the Chwarae Teg gender review. It's setting out priority areas for the coming years, focusing on equality of outcome.

I think key to all of this, particularly in terms of the levers we have, is the economic contract, because that's a real tool for change. In fact, the economic contract has to ensure that businesses are making change and demonstrating responsible business behaviours. We have a great deal of soft power, but it is about how we move forward, when we need to legislate and how we can take account of evidence.

So, finally, I'd just say that, particularly in the context of leaving the European Union, the important work that we're carrying out in terms of research on wider options to strengthen and advance equality and human rights in Wales, I think, will help us get the evidence to see whether we need to move forward in terms of legislation in Wales. I'm very grateful for this legislative proposal, and I look forward to working with you and other Members in full on taking this forward. 

Thank you. I call on Helen Mary to reply.

I'm very grateful to you, Dirprwy Lywydd. I feel that the Senedd may be rather tired of me by the end of today, because this isn't my last planned contribution—I thank Dr Dai Lloyd for his kind words. I'm very grateful to the Minister for the tone of her response. I fully endorse a great deal of what she said. She is right, of course, to say that there are some employers who are embracing this agenda very effectively, but I'm sure that she'd agree with me that there are others who are not and that, sometimes, we will inevitably, in Government, need carrots as well as sticks.

I very much welcome her statement today around enacting the socioeconomic duty. I think some of us may be a little bit disappointed about the decision to push it back, but I do understand the context of that, and that it is better to do it a little later and do it well than to rush and do it badly.

I think there are many levers, as the Minister has said—the procurement levers and so on—to promote this agenda in the private sector. But the truth is that many of those levers rest on legislation that I do not believe, and I don't think she believes either, are secure. The very existence of the definition of the six protected characteristics sits in the current Equality Act. If that is watered down, if that is amended in ways that we find unhelpful, I submit that we will need legislative responses, as well as all the other things around partnership and the very important role of the trade union movement and so on that the Minister has mentioned today.

Finally, I'm very grateful again, as I've said, for the very positive response, and I commend this proposal to the Senedd.

Thank you. The proposal is to note the proposal. Does any Member object? No. Therefore, it's agreed in accordance with Standing Order 12.36.

Item 9 on our agenda this afternoon is the Member debate under Standing Order 11.21 on early cancer diagnosis. I call on David Rees to move the motion. David.

Diolch, Dirprwy Lywydd. I move the motion, tabled in my name, this afternoon. I'd like to put on record my thanks to all Members who supported this debate, and particularly to Angela Burns, who will be closing the debate this afternoon.

Cancer Research UK have identified that one in two people in the UK born after 1960 will be diagnosed with some form of cancer in their lifetime. Presently, around 19,000 people are diagnosed with cancer every year in Wales. We all know someone who has received a cancer diagnosis. Some will be cancer survivors, but others are sadly no longer with us, having battled cancer with strength and dignity.

Over recent years we have seen meaningful progress in diagnosis, treatment and survival rates, with just over half of people with a cancer diagnosis living for 10 years or more, compared to one in four in 1970. However, Wales persistently lags behind comparable countries for cancer survival.

There is a direct correlation between the chances of survival and the stages of diagnosis across both year 1 and five-year survival rates. Cancer survival decreases when early diagnosis is not available. And that's something we need to remember: cancer survival decreases when we do not have early diagnosis. 

In Wales we have seen one-year survival rates increase, along with five-year survival rates. It is clear that early diagnosis is fundamental. This becomes evermore present when we look at harder-to-diagnose cancers, such as lung cancer or pancreatic cancer. Cancers like these have little to no stage 1 symptoms, or symptoms that are non-specific. It is therefore important that any strategy for cancer treatment must include a strong emphasis on early diagnosis. 

At the end of this year, the Welsh Government's cancer delivery plan, which was published in the fourth Assembly, comes to an end. The World Health Organization recommends that every country should have a cancer strategy, no matter what resource constraints it faces. As the current plan comes to an end, we need to ensure that Wales has a new, fit for purpose in a changing world, comprehensive cancer strategy, which will be in place when this current delivery plan ceases at the end of this year. A new comprehensive cancer strategy that meets patient need and, most importantly, improves patient outcomes.

Many of the cancer charities that I speak to on a regular basis feel that this is an opportunity for the Welsh Government, and for this Senedd, to set a new vision to improve patient outcomes, covering prevention, early diagnosis, access to treatment and cancer research that benefits patients. And they and I believe that the new cancer strategy must be underpinned by increasing diagnostic capacity, for faster diagnosis and treatment to improve patient outcomes.

At this point I want to praise the rapid diagnostic centre in Neath Port Talbot Hospital. It's a great example of how to use diagnostics at an early stage, and it's working well, with patients being referred by GPs upon suspicion of a possible cancerous condition, when a red flag is raised through non-specific symptoms. I visited the centre last week to see the fantastic work the team is actually doing in diagnosing cancers at an early stage. But it does two jobs. Whilst it can diagnose a cancer at an early stage, it can also reassure those who do not have cancer at an early stage as well. And we have seen a reduction for that team from an average wait of 84 days to an average wait of six days. What a dramatic change. And it's a primary-led function.

Now, as the motion states, early diagnosis is key to improving cancer survival rates, and we know that there are certain cancers that are more difficult to diagnose. We've mentioned them already: ovarian and pancreatic are just two examples of those diagnosed at a later stage. For the eight most common cancer types combined, survival is more than three times higher for those that are diagnosed at an early stage, compared to a late stage diagnosis. Diagnosing people at the earliest stage is critical to giving patients the best chance of survival. One of the major factors behind how likely someone is to survive lung cancer, for example, is how early they are diagnosed— 

Will you take an intervention?

I will.

Thanks for giving way. You mentioned that some cancers are harder to diagnose than others and it's reminded me of a constituent's case that Angela Burns, our health spokesperson, has been involved in with me as well. The constituent that we saw, his wife sadly died of ovarian cancer; I don't think it was diagnosed until stage 4. Certain cancers like ovarian cancer are incredibly difficult to diagnose because they masquerade as other conditions quite early on, whatever those might be. So, would you say that—I'm delighted that you're bringing this debate forward—part of this means that the Welsh Government does need to look at some of those cancers that are harder to diagnose and maybe look at some of the evidence out there, particularly algorithms, for instance, which my constituent was looking at with an expert in Cardiff University, which can make that diagnosis process a lot easier so that you can get to these cancers a lot earlier?

I fully agree with Nick. Ovarian cancer is an example of where it is difficult, and very often, we find that patients with ovarian cancer are diagnosed at stage 4. Friends of ours were similarly in that position and unfortunately, she passed away. It is a situation where we have to address how we tackle the hard-to-find cancers. And I was just about to highlight one example of such a hard-to-find cancer, but it is important that we put the emphasis on that as well to ensure that we look at new and innovative measures and techniques that'll do that. I'll give one example, because one of the major factors about lung cancer is that 27 per cent of lung cancer diagnoses are made at the earliest opportunity—27 per cent—so that's three quarters that aren't, which means that three quarters are diagnosed at stages 3 or 4.

Now, the publication, actually, only this year, January 2020, of what is known as the NELSON study—a study undertaken between researchers in the Netherlands and Belgium—confirmed that evidence supported that targeted lung cancer screening can actually help identify it sooner. Now, it's new and it's a pilot scheme that is being operated, but perhaps we in Wales could take on such new, innovative schemes such as this where there has been research that has shown that, actually, this is an approach that can work. And this approach is actually early screening by CT scanning. That is one of the ways that are suggested are better; we used to do it by x-rays, but now CT scanning can actually do it better. Could we look at a pilot approach and at that example and take it on in Wales, and be leading on tackling the situation, be leading in the UK and be leading in Europe, looking at how we can use innovative techniques and modern technology to actually help us do that early diagnosis? I'm sure that we're going to find similar areas, whether it be ovarian, pancreatic and others, that have very late diagnoses as well.

So, since the introduction of the cancer delivery plan, the Welsh Government announced in 2018 its decision to implement a single cancer pathway, which came into operation in June last year. As a result, every Welsh health board is now developing a plan to ensure that the majority of their patients, from the very first point that cancer might be suspected, receive cancer diagnostic tests and start their treatment within 62 days. Equally, for those patients who do not have cancer, they will be reassured promptly, reducing unnecessary stress and worry for those individuals and their families. The single cancer pathway is the culmination of more than three years of work to change our health boards' identifying and reporting of cancers, and to improve patients' cancer experiences. For the first time, health boards record how long patients wait from the point when cancer is first suspected regardless of the way they enter the healthcare system. The next cancer strategy must build on this to identify areas of improvement under the single cancer pathway to diagnose and treat as many patients as early as possible. So, we have started, but we need to do more.

Additionally, we need to ensure that the screening uptake is improving. Now, cervical cancer is clearly one that we often talk about, or maybe not in this case, and we should do more. But when the Jade Goody effect took place, we saw a surge in screening requirements following her death. Unfortunately, that has now waned, despite the tremendous work of cancer charities, such as Jo's Cervical Cancer Trust. We must ensure that these vital tests are taken by all those who are eligible. Cervical cancer screening every five years has led to a 70 per cent reduction in deaths from cancer. So, we need to do more to undertake and get screening accepted by wider people. We often talk in this Chamber about bowel cancer screening and the low take-up on that and the high take-up on breast cancer screening. We need to press this and a strategy to address this far more.

But we can do more by moving with the times and using technological advancements for the benefit of patients, and ensure that all have access to the most up-to-date and most accurate test to ensure that those who are affected by cancer are treated swiftly and in the best manner for their diagnosis.

Dirprwy Lywydd, I'm watching my time and I'll make sure that Angela has sufficient time to respond. So, I'll close a little earlier than I would have, but I want to close by reminding Members of the fantastic workforce we have in the NHS here in Wales. It's a workforce that works tirelessly to ensure that all patients have the best experience, no matter what their diagnosis. But we must recognise the pressures they're under. One of the things that we often heard in previous questions on the current cancer delivery plan was identifying the key worker in this whole thing, because that key worker is crucial to the patient and to the outcomes for that patient. Again, we must support both the patient and the workforce because they support the patient, and we must support the patient during diagnosis, during treatment and after treatment. Let's not forget when they survive as well. I look forward to the contributions this afternoon, Dirprwy Lywydd. Diolch yn fawr iawn. I hope that Members will support this motion.

I just wanted to pick up on that idea of innovation in all this and mention the rapid diagnosis centre at Neath Port Talbot Hospital, which I visited a couple of weeks ago—I know that David has as well—and to thank Helen Gray and Dr Heather Wilkes for the time they've given us there. They're pretty inspirational women, I've got to say. This facility just shows what you can do if you have the resolve to do something rather than just being presented with an expectation. I think it's worth mentioning as well that, certainly when I was there, we met a Macmillan doctor as well, and it was this getting all the medics in one room together, right at the beginning of a patient's journey, that seems to be the key factor in what turned out to be a completely surprising service.

I call it a surprise because it is a primary care service through which it takes just five to six days to diagnose and instigate the first steps to appropriate treatment. And that's to compare with what was there before, which was a process that took over 80 days to diagnose and instigate. Just think of the uncertainty and the worry for those individuals waiting for those 80 days, let alone considering the disease progression, which is to do with early diagnosis, of course. All that is swept away if you can get all this sorted within one week. Even if the diagnosis is one that you fear, you get that assurance very early on in the process that it might even be possible to survive this and to believe that early on.

The centre was opened just two and a half years ago to take action to reduce Wales's rather unhappy record on Wales's outcomes. Even within the developed world, the UK as a whole really, but Wales particularly, was quite some distance behind some much poorer eastern European countries. The Wales cancer network bid for a pilot after spotting a really good idea in Denmark, which was to do with vague symptoms, which we were mentioning earlier, and how those were treated there, which had resulted in early diagnosis and an impressive result on lowering mortality as well.

The key to Denmark's success lay in their different attitude to vague symptoms. So, to compare, in Wales where GPs refer a patient on with very common cancer signs, they will start on the familiar cancer pathway that we already know about. However, where those symptoms aren't so obvious—David Rees has mentioned a fair few of those—where they're not conclusive, those cases get downgraded in the system so that even when a GP has a gut instinct that an individual has cancer but no definite symptoms, they get lost in the system much more quickly. In Denmark, through setting up—I'll just call it a vague symptoms clinic, if you like. Thirty per cent of the people who came through those doors were there because of a GP's gut instinct, and I think that's something worth considering as we move more closely towards technology in healthcare. Because artificial intelligence may be able to do an awful lot of work with the discovery of those 50 per cent of cancers that present without prominent symptoms, but patients need to get into the system in the first place. They need to get that referral in the first place from a GP, even to get—

Will you take an intervention?

Yes, I think I've got time.

Thank you. I think, what you're talking about, it really is important, because people who are generally well are amongst the worst. I think of our colleague Steffan Lewis, who was a very fit and well person. It's only when he got very seriously ill, at stage 4, that he was diagnosed. Getting it early is so important.

Well, I can—. You pick perhaps one of the saddest examples of precisely that point there, Mike, because people will feel just unwell at various points, and just think, 'Oh, this must be a passing virus' or whatever, rather than taking this opportunity to get into a system that might actually save their lives.

One good thing as well about this system that they've got in Neath Port Talbot, apart from the fact that you get called in, is you get tested and you get your results interpreted and a diagnosis made within a week—a week, imagine that—and that's done because we have radiologists and nurses and GPs, perhaps other relevant medics, in the room right early on in the process. That's what seems to be the key to unlocking the delay problems, as I say. The fact that they're being done in such short order in Baglan—why on earth can that not be done elsewhere? Because, again, you know, I just draw that distinction between seven—well, six days actually—and 80 days. If it can be done there, why on earth can't it be done anywhere else?

Of those who are discovered to have cancer at whatever stage, 85 per cent of them will get their primary cancer identified within that six days. That's amazing. Not all people presenting with vague systems, of course, end up having a diagnosis of cancer. At the moment, it's about 11 per cent in addition to the more obvious cases. But for every one of those people, it's an earlier diagnosis and a route to treatment—a faster route, I should say—than anywhere else in Wales.

I just want to finish—. Will you give me a little extra?

You carry on, and I'll tell you when you—.

That's great. Thank you. 

This does pick up other diseases as well, which then get differently treated, but also more urgently. But the one thing I wanted to bring to bear on the Deputy Minister is that this short road to diagnosis is considerably cheaper than the long one. It costs £500 to get this six-day diagnosis and referral to treatment, and five times that much on the 80-day road. So, if that alone is enough to persuade you to start rolling this out across Wales, then I hope it's done its job. Thank you very much, Dirprwy Lywydd.

I'm very pleased to take part in this debate. Can I commend David Rees, leading off in this debate—a very important issue, and I agree with all parts of the motion—and just make three basic points in terms of, obviously, as David outlined, we need a new cancer strategy this year now to take over from the current cancer plan that's coming to an end? That's a given, I would have thought, although we would like to see confirmation of that. World-wide experiences recognise countries have to have a cancer plan, so let's make sure we have one going forward, because the current one stops this year.

The second point I would make is that lots of this is to do with diagnostics—the most recent developments, they tend to be expensive but they're good—and also workforce elements. Obviously, with the health committee, we've done several reviews over the last few years that have highlighted workforce concerns. We don't seem to have enough staff in whatever specialty, from GPs upwards, but particularly diagnostic staff as well—not just the lack of kit, now, but the lack of diagnostic staff. We saw that with the endoscopy review that we did. There are not enough specialist endoscopists. They don't have to be all medics; specialised nurses can do that. But whoever has got the endoscopy in their hands, we need more of them to be able to diagnose cancers, be they early or late.

And, obviously, it is important—. Sorry, Huw.

Dai, thank you for raising that very important issue. Would you note, in amongst this, the fact that one in eight of the population now are likely to be diagnosed, particularly as they age in years, with prostate cancer, and the work of Prostate Cymru, which actually works on that issue of diagnosis with medical professionals of all types at all stages of their career, to actually make sure that they're not only aware, but they're aware of how to actually do the diagnosis correctly—so, working with students and consultants to upgrade their urological knowledge so that they can do that diagnosis? Practical things like that really matter.

Absolutely. And there are some exciting things going on. You know, it's exciting times to be both a specialised medic, and a nurse as well, these days. It is an absolutely exciting field, in the diagnosis, the management and in the treatment of cancer. But, obviously, there are lots of challenges, and that's why we need a new cancer strategy going ahead, because one of the big issues as regards early diagnosis is uncertainty. This new rapid diagnostic centre in Neath Port Talbot is absolutely transformational, because, prior to that, as GPs, we needed to have at least one red-flag symptom. You'd come to see me, you'd have to have either rectal bleeding, pronounced weight loss, anaemia or specific pain to tick a box—that's a red flag—to justify a two-week referral. Even if I had a gut feeling that there was something dreadfully wrong with you, but you didn't have one of those tick-box things, I couldn't refer you within two weeks. Obviously, you end up having a cancer then, and people look back saying, 'Ah, those GPs—rubbish.' Daily Mail headlines: 'They just can't diagnose people in time'. But we couldn't, we were not allowed, to refer within the two weeks unless there was a red-flag symptom.

If I thought you were ill, yet you didn't have a red-flag symptom, I couldn't do anything about it. Now I can. That's the beauty of this rapid diagnostic centre. It realises and it makes much of that gut feeling that we've always had as GPs. You know, by and large, after we've been in general practice for quite a while, we can tell whether there's something wrong with you, basically because we've known you for years—No. 1—and even though your symptom might not come up on some chart as being a red flag or the blood tests haven't changed yet, 'You don't look right', and that justifies—. That gut feeling, for the first time, has enabled us to make an urgent diagnosis. That is the leap forward that we've been asking for for years in GP land, to get early diagnosis. It's absolutely transformational.

Because ovarian cancer—we talk a lot about ovarian cancer—one of the earliest symptoms for that is bloating—bloating. Well, most of the adult middle-aged and elderly population are bloated at any one time. Yes, I could refer you all, but that wouldn't help the diagnostic rates of early ovarian cancer. But there's something additional with ovarian cancer—you are non-specifically not looking well to me, and I would get you seen. And it's only recently have we as GPs in the Neath Port Talbot area had that ability. We need it all over Wales, because in other places we're still waiting for those red-flag boxes to be ticked. We need that service now rolled out and we need a new cancer strategy. Diolch yn fawr.

I'd like to thank David for bringing forward this extremely important debate. As a cancer survivor, I can attest to the fact that early diagnosis saves lives, because, without an amazing consultant, backed up by a team of nurses and diagnostic staff at Neath Port Talbot Hospital, I would not be here today. Because having had a mammogram, after which I was dancing out the door because they said there was nothing that had shown up on it, an eagle-eyed consultant called me back and said, 'Can you come back, because something just doesn't seem right, even though it is clear?' And this was because the tumour I had in the breast was a translucent tumour and couldn't be shown up then at that time.

So, I'd like to thank that eagle-eyed consultant for saving my life, as well as all the friends, family and my fiancé then, who has now become my husband—we had a wonderful wedding to celebrate that, and Suzy Davies can vouch for what a happy, wonderful occasion that was, and a celebration for surviving cancer, Suzy, as you can say. So, I thank everyone that was involved in helping me to recover, and it's been 13 years since, so I think this should give an awful lot of people confidence to go forward in the early stages.

Unfortunately, not everyone is as lucky as me, and I don't take any day for granted. In Wales we see just under 20,000 people diagnosed with cancer each year, and, sadly, only 50 per cent of those diagnosed with cancer survive more than 10 years. We perform poorly for cancer survival rates compared with other nations, which is why it is vital that we have a comprehensive and ambitious cancer strategy that addresses our shortfalls in the route to early diagnosis.

Early diagnosis is essential for long-term survival and detecting cancer early enough means that survival rates are around 90 per cent. Late diagnosis results in those rates dropping to under 10 per cent. We have an amazing opportunity to do something about that, but changes won't happen overnight. The current cancer delivery plan comes to an end this year, and we can therefore ensure that its replacement is more ambitious, meets the needs of more patients and improves survival rates. There have been amazing developments in cancer diagnostics, such as multiparametric MRI for prostate cancer and the faecal immuno-chemical test, or FIT, for bowel cancer. Both of these improve detection rates and therefore aid early diagnosis, but, due to staffing shortages and regional variation, they're not as effective as they could be. In the case of MPMRI, not every health board provide an MPMRI with dynamic contrast enhancement.

My husband went through two invasive and painful biopsies, twice contracted sepsis and twice went through weeks of painful recovery to try and stave off the increase in sepsis diagnosis, if you like. My husband was told that he had prostate cancer. The words used were, 'It is definitely malignant', after the MPMRI scan, 'and it is located in the right-hand side of the prostate'. Now, nearly two years later, we are still unsure whether he has cancer because, after yet another biopsy, we were told good news—it's not cancer after all. So, he is still going through the diagnostic stage, which—. This is almost—I think it's 18 months to two years now. Sadly, his case is far from unique.

So, we have some slow progress, but efforts are hampered due to a lack of trained radiologists. The Welsh Government have put more money into improving MRI provision, and have created a Welsh imaging academy that will lead to improvements, but does little to improve survival rates in the short to medium term. The lack of strategic workforce planning has also impacted bowel cancer survival rates. The new FIT test has the potential to revolutionise bowel cancer care, but, due to workforce shortages, we have set the testing threshold much lower than other parts of the developed world. It is therefore little wonder that, for bowel cancer, we are 25 out of 29 in Europe, behind many poorer former Soviet bloc countries.

We have to ensure that our new cancer strategy has more ambitious targets, better workforce planning, and strategies to improve screening, uptake and end the postcode lottery. After all, the statistics I have quoted are not entries on a spreadsheet—they are real people: our husbands, our wives, sons, daughters, mothers and fathers, friends and colleagues. So, we owe it to them, to every person with cancer, to do better, and I urge Members to support this motion. Thank you.

I also welcome greatly this debate brought forward by David Rees AM. It is factual that we are making real advances in this country, but it still remains the case, as has been said by many, that Wales is behind comparable countries for cancer survival, despite a decline in death rates. Late detection of many cancers is thought to be the main factor around this lag, and it has been stated by Cancer Research Wales that late diagnosis is both complex and multifactorial, and can result from the lack of awareness of symptoms, patients embarrassed to see their GP, or, commonly, having to make several visits over a large period of time before the GP refers the patient for specialised examination. The red flag system, as has been mentioned by Dai opposite, will aid that medical profession doing that particular task.

The Welsh Government and its health Minister, Vaughan Gething, have understood the importance of this area of delay and also will act to address this very real challenge. The important single cancer pathway introduced in June 2019 as a new metric to measure cancer waiting times will also be an additional factor. But it is imperative that we do build underlying systems and diagnostics within the single cancer pathway to diagnose and treat as many patients as early as possible, and a new cancer strategy, as has been outlined by many, will supersede the current delivery plan—it's a point in time where we could focus on and emphasise this critical early diagnosis as well, and, equally, specialised workforce planning and training around specialised cancer routes, for example, endoscopy and many others.

The new focus on prevention and early diagnosis will be key in catching symptoms of disease early, treating early and improving survival rates, and the new treatment fund and the implementation of the specialist key worker to support cancer patients will aid and improve, again, those current survival rates. But this debate today is not about statistics. As others have stated, this is about real people, like my Dad, who was recently with early-stage bowel cancer. Due to this early diagnosis and an excellent patient-centred care plan, he is now in remission. He is lucky, and his journey must now be further replicated through all new approaches across Wales. 

The Deputy Minister, Julie Morgan. 

Diolch, and thank you to Members for bringing forward this very important debate. I think one thing we can all agree on is that cancer needs to be a priority for any Government, given the number of people affected by cancer, as David Rees said in his introduction, and of course the often devastating impact of a diagnosis and the wider impact on our NHS. 

Members will be aware that we've had a cancer delivery plan in place since 2014. This has a significant focus on earlier detection, and we have for some time met the World Health Organization's call for its members to have in place a cancer control programme. But you will be aware, and several of you have referred to this today, that a number of national disease-specific plans are due to come to an end in December this year, and we've been giving significant attention to what should replace them. So, I am pleased to confirm today, perhaps somewhat earlier than intended, that the Minister has asked officials to press ahead with developing a successor approach to the cancer delivery plan. The Minister has also asked for the successor approach to heart disease and stroke to be developed and, for those other plans coming to an end in December, that a one-year extension is granted in order that we can phase in successor arrangements. So, I'm pleased to be able to respond to you with that information today.

An important consideration has been the development of a number of commitments in 'A Healthier Wales' that have implications for how we approach improving outcomes for major conditions such as cancer. These include the development of the NHS executive, the national clinical framework, the quality plan and the introduction of quality statements. It's very important that these commitments link together robustly in the context of cancer so that we can deliver improvements in services and outcomes at a greater pace and with greater impact in the years ahead.

It will be the case that the successor approach to the cancer delivery plan will have an enhanced focus on the earlier detection of cancer. The current plan recognises that earlier detection is likely to improve survival—and lots of Members have made that point today. The two key components of this primary care referral practice and access is access to diagnostic care. We have significant amounts of activity in place targeted at these two components, but we want to go further and faster in the years ahead. It's been very pleasing to hear the praise of the Neath Port Talbot rapid diagnostic centre here today, and the dramatic drop in the waiting time. 

We also want to ensure our screening—

Just on that particular point, we've heard how successful that particular diagnostic hub is. I'm sure you'd agree with me that it would be great to have more of them, especially in north Wales. Will the cancer care plan—will that be looking at that particular aspect as well?

There will be an enhanced focus on the earlier detection of cancer. That is going to be part of the new plan. 

We also want to ensure our screening programmes are optimised. Many people have mentioned the screening programmes here today. I accept that more needs to be done to encourage those who are eligible for screening to take part. Public Health Wales has a dedicated screening engagement team, whose role is to raise awareness of screening and promote informed choice. 

It's important, I think, to remember that the target uptake for each screening programme is not a target for the number of people we'd like to see screened; these are standards that the programme must achieve in order to be viable and provide overall public health benefit at a population level. Obviously, taking part in screening is a matter of individual choice, because screening is for people who don't have symptoms of the disease, and nearly all participants won't have cancer who take part in screening. So, it is important for each person to consider the balance of potential benefits and harm from having a screening test and any subsequent investigations and treatments. We must always be mindful of the potential for harm and particularly the need for robust evidence of overall benefit when considering the introduction of any new screening programmes, but we have had significant successes in screening in Wales.

Breast Screening Wales was the UK's first fully digital mammography service. We're also the first UK country to introduce the more accurate human papillomavirus test into the cervical screening programme, and uptake has since increased to 73 per cent. We've also fully rolled out, as Caroline Jones said, a more accurate test for bowel screening, and will this year take the first in a series of steps to optimise the programme in line with national guidelines. Uptake has improved to 57 per cent, and I'm hopeful that we will meet the standard of 60 per cent for the existing age cohort. 

Our ambition remains to deliver cancer outcomes that are comparable with the best in Europe. We have made significant progress in recent years in outcomes and in service delivery, and I would like to point to the—[Interruption.] Yes, certainly. 

That's very kind. Caroline Jones also made reference to prostate cancer, and during business statement yesterday, in calling for a statement, it was suggested I raise this with you during this debate today by the Trefnydd. 

Prostate Cancer UK have used freedom of information to access data on the current situation. Three of the seven health boards in Wales have not yet introduced services equivalent to the National Institute for Health and Care Excellence recommended standard for multiparametric magnetic resonance imaging scans. There is a plan to have that in place across Wales by 1 April, but they say that radiology units will need resources to enable them to do that. I wonder if you could comment in light of Caroline's comments and that data from Prostate Cancer UK. 

I thank Mark Isherwood for raising that important point and, certainly, I will go away and look at what is causing that delay in those health boards. So, thank you for raising that. 

I would point, as I think David Rees highlighted as well, to the fact that the single cancer pathway is the standout achievement, a platform for improvement that is unique in the UK. But I would also point to the development of a new cancer informatics system, to our investment in new radiotherapy equipment, the impact of the new treatment fund, and many more things beside. Perhaps most of all, I should point out the dedication and professionalism of our managerial and clinical staff, who work day in and day out to provide excellent patient care. 

I think the important point in terms of today's debate is that we ensure that we build on the success and momentum built up in recent years—a lot has been done, but there's a lot more to do—that we realise the potential of what has been developed through the cancer delivery plan, and we go even harder at the systemic issues that hold back our cancer outcomes. This means, as has been repeated in this debate: prevention, earlier detection, high-quality care, better service planning and workforce provision, as well as new service models and harnessing the potential of geonomics, digital and research. 

So, the Minister and I do look forward to updating Members further on progress later in the year, but once again thank you very much for bringing forward this debate to give us the opportunity to discuss these very important issues. 

Angela Burns to reply to the debate. 

Diolch, Llywydd. I'd like to thank everyone who took part in today's debate, and I'd particularly like to thank David for drawing us all together, cross party, to make representations. I think we have to be crystal clear about that word 'cancer', it is something that still today strikes fear and panic in most people's hearts. We still see it as 'the big C', the thing that can come out and get us. And yet, as both Caroline and Rhianon very clearly have shown, there are opportunities out there, there are success stories, there are pathways that lead to better outcomes than we used to have. So, it's not just a gloomy story; there is real progress being made.

I would just like to give a quick shout out to some of the researchers that we have at Cardiff University. I would particularly like to name Professor Andrew Sewell and the Cardiff University team, because they've discovered this T-cell inside blood that has the ability to cruise around your body and go, 'Aha, that is not a good cell heading our way.' And if they can just harness it—and they think they can—then they can use it to really target in a highly specific way a wide number of cancers, in a way that the current immunotherapy can't do. And so, we've got great scientists here in Wales who are really working on positive outcomes for Welsh citizens, and I think that we need to, Minister, really try to support these people and make sure that they have funding. 

I'd also like to briefly talk about immunotherapy, because it is one of the modern medicines. Dai, in your contribution, you referenced modern techniques, modern medicines, but unfortunately you can still have situations where the National Institute for Health and Care Excellence will say you can only access immunotherapy once you've gone through chemotherapy. Then, your consultant will say things to you like, 'But I can tell you now, because you've got a very nasty bladder cancer and we've only just discovered it and you're T4, you've got to go through the chemotherapy to get to the immunotherapy, which can probably prolong your life, but the chemotherapy's not going to do anything for you.' That's nonsense. We need to really work on that, so that if there's something that can help somebody they get access to it without having to jump through a useless, painful hoop of chemotherapy. So, Minister, I'd be very grateful if you might take that one away as well and talk about it. 

I was delighted with your response about the cancer delivery plan. This is wonderful because, actually, the questions I was going to ask you were about the NHS exec not being formed; were we going to have to wait; what was the gap; and of course coronavirus pulling officials away to concentrate on this and not being able to concentrate on that. So, it's very good news, not only that the Welsh Government's going to start it, but, actually, that it's also applying to the other delivery plans. And those that you haven't been able to work on yet will be extended for one more year. I think that gives real comfort to people. 

There were some great contributions. Dai, again, you made that point about the rapid diagnostic centre, and about the fact that GPs who have trained for years and years and years, and then have loads and loads of experience in their clinics, don't get that kudos; they don't get that, 'Right, Dai Lloyd, if you say that this person needs to be looked at, I'll go and have a look at them.' It's this form filling, red box ticking. But a rapid diagnostic centre: six days, as Suzy said, as opposed to 84 days—what a difference.

And, of course, Suzy went on to look at best practice in other European countries. And not only did she make the point that that best practice saves lives because you can get in more quickly; you can get your result quicker; you can start your treatment more quickly; but, of course, when you've got that kind of NHS service offering, you've got more staff who want to come and work for you. I think you were saying that, in Denmark, which was one of the areas that they were looking at, they were actually having staff queuing up wanting to work, wanting to work at best practice. So, we can do that. We're small enough and agile enough.

And thanks to the Welsh Conservative secretary for finance, in his budget statement today, there will be more money coming to Wales. So, Minister, I would really ask that you consider deploying that extra money in things like rapid treatment. Because, again, Suzy made that point—if we can help somebody, make them well, give them a good outcome—actually, long term, it's going to save the state so much more money, and they will have a so much better quality of life. 

The other great cry of the heart was not enough diagnostic staff, and that is something we absolutely need to address: our workforce shortages. David, you made that point with passion and conviction, and it's very, very key. So, again, Minister, I would urge that, when you go back from this debate, you work with Health, Education and Improvement Wales and that they really plan the shortfalls that we have. 

I'm very keen to end, because I'm sure the Llywydd is very keen that I should end, but I just wanted to say one comment, just to put that into context. The cellular pathway workforce: 36 per cent of the consultants in Wales will be retiring in the next five years. We've got to replace them. We've got to make the plans, implement the plans, and get the new blood coming through.

So, Minister, thank you for your very positive response. David, thank you very much for, as I say, collecting us all together to debate this. But I do look forward, Minister, to you perhaps confirming back to us—and what I think we'd really like to have is a Government debate on this issue, about how we can really get to grips with something like the diagnostic workforce. Thank you.

The proposal is to agree the motion. Does any Member object? [Objection.] I will defer voting under this item until voting time. 

The next item is the Plaid Cymru debate on A&E services at the Royal Glamorgan Hospital. I call on Leanne Wood to move the motion. 

Diolch, Llywydd. I move the self-explanatory motion. We've rehearsed the argument that people require an accident and emergency service within reasonable distance of their homes here on many occasions. The clinical evidence is clear that there's a relationship between distance and mortality in emergency situations, which is even clearer for respiratory conditions; in other words, the sorts of conditions prominent in the poorest areas of Wales like my constituency of the Rhondda.

But the Welsh Government is deciding now not to engage. Rather than taking responsibility and  making the case as to why Wales should have fewer accident and emergency units, which would at least be the honest policy position, this Government is hiding behind the notion that they can't do anything: 'It's not possible', we are told. But we were told it was impossible before. My colleague Helen Mary Jones—who literally wrote the legislation that says they can intervene and stop this under the One Wales Government, which was the coalition that ran between 2007 and 2011—will explain later how Plaid Cymru changed the impossible once before.

But I want to add a further argument to the overwhelming case for retaining accident and emergency services at the Royal Glamorgan and every other existing hospital that has that facility. That argument is that we are highly likely to need all the capacity possible in the coming weeks to deal with COVID-19. Wales lacks critical care beds. It lacks the workforce necessary for staffing those critical care beds. It makes absolutely no sense to argue that now is a suitable time to allow more capacity to be lost. We should be planning on the basis of maximising what capacity we do have, and being prepared to adapt wards if necessary.

But such is this Government's ideological obsession with moving services into the community—a euphemism for closing wards—that they've become incapable of seeing the importance of having secondary care when it's needed. Yesterday's statement on the COVID-19 illness was such a classic example of how embedded this obsession is that they probably don't even realise it. The statement yesterday made no reference to critical care beds. Surely, critical care beds can't be seen as less of a priority than having an online symptom checker, community testing facilities, or protective gear for GPs? Five per cent of people who will contract this virus will become critically ill, and that is not something that is likely to change with these measures. We need capacity to deal with ill people.

Now, there's no doubt we want to see investment in the health services that keep people healthy and enable people to avoid needing to stay in hospitals; this is in just the same way that we want to see fires prevented before the fire service has to be called. But we still need the fire service for when a fire does occur; and we still need an accident and emergency unit for when accidents and emergencies happen. With the best will in the world, many of my constituents already have chronic conditions that can't be prevented, and some of them will inevitably, from time to time, need emergency treatment. They will be put at risk from having to travel further.

Staff shortages have of course been cited as the chief problem—and this is real—but the board hasn't even tried. And why would they? The south Wales programme was approved by Labour and given the go ahead, and nobody was ever going to work in a unit that they knew was being run down. This is exactly why the Government needs to take responsibility, change course, and announce the south Wales programme no longer applies and the health needs of today support the Royal Glamorgan retaining its accident and emergency unit. You can do this. You've done it before. Do it again.

Thank you. I have selected the five amendments to the motion. If amendment 1 is agreed, amendment 2 will be deselected. Can I call on the Deputy Minister for Health and Social Services to move formally amendment 1, tabled in the name of Rebecca Evans?

Formally.

Thank you. I call on Andrew R.T. Davies to move amendments 2, 3, 4 and 5, tabled in the name of Darren Millar.

Thank you, Deputy Presiding Officer. I welcome the opportunity to speak in this debate again. It was only some three or four weeks ago that we were debating this very subject with a Conservative motion before us and that motion, after amendments, did find favour. And it's regrettable that the Government haven't moved on this particular position, when the Assembly speaks in such a positive way. I would like to see a more positive reaction from the Government. 

I formally move the amendments that are laid in the name of Darren Millar. Obviously, amendment 2 reflects on that debate that was held, as I said, some three or four weeks ago that had a positive outcome for retention of A&E services at the Royal Glamorgan. Amendment 3 and amendment 4 touch on the engagement process that the health board should always undertake when discussing any major proposals, and to be fair to the health board, to a point, they have done that. And obviously, the south Wales programme did that in its time as well. But what is a fundamental flaw here is the flaw of the south Wales programme when it talks about delivering services for this particular part of the community that I represent as a regional member for South Wales Central.

The Royal Glamorgan is not an old hospital; it’s a relatively new hospital. The surrounding area is expanding rapidly. I’ve heard the Member for Pontypridd talk of about 20,000 new houses being erected in that particular area. The whole surrounding area is a growth area—it’s not a diminishing area, it is a growth area. And then you couple that with amendment 5, which was the evidence put forward by Cwm Taf themselves at the Health, Social Care and Sport Committee, where the health board had not been actively looking to promote jobs at the Royal Glamorgan Hospital. And today, there’s a story in the local papers highlighting that freedom of information requests have identified that there’s been no positive action to attract full-time—and I use the word 'full-time'—consultants. There has been action to try and attract locums to fill the gaps. Well, you cannot build a sustainable service, as everyone knows, on locums. And so, everything points to this need to retain the accident and emergency provision at the Royal Glamorgan Hospital—a modern hospital, with a growing population surrounding it and growing demand.

And yet, the health board, over the last several years, has been hellbent on delivering the south Wales programme, which, to a point, they are mandated to deliver, because it’s a programme that obviously the Government has endorsed, and ultimately has said to the health boards that are signatories to it, 'This is the blueprint for health services within the area.' I don’t think there’s a person who believes that that blueprint is a sensible way to deliver accident and emergency provision within the Llantrisant and the Valleys areas. And indeed, the medical professionals at the Royal Glamorgan Hospital have said so much themselves. They identify that, obviously, there are gaps in the rotas—no-one’s disputing that fact—but when you take the point that the health board has not been proactively promoting availability of employment on that cycle of consultants, and to take themselves forward in their careers, is it any wonder that there are vacancies that have struggled to be filled?

And so, on all fronts, there is a positive case to be made for the retention of A&E services at the Royal Glamorgan Hospital. And the Government’s amendment saying that this is all the fault of the health board is ridiculous, I have to say, because the Government is in a position to give direction to the health board over the overall strategic direction of health provision here in Wales. Yes, I accept that, day-to-day running is delegated to the health boards, but the overall strategic direction of health provision here in Wales is at the door of the Minister of health. That’s his role, or her role, depending on who occupies that office. And so, it is incumbent on the health Minister to listen to the representations that are being made in this Chamber, made wider by the communities that are served by the Royal Glamorgan Hospital, and ultimately by the evidence that supports the retention of the A&E service at the Royal Glamorgan Hospital. And I do hope that we will get a positive response from the Deputy Minister this afternoon that it builds on the vote that was held some two or three weeks ago in this Chamber, rather than, ‘This has nothing to do with us. Pass it back to the health board’. That just will not do and I hope that the motion, with amendments, will be supported this afternoon.

Thank you. Can I just gently remind Members that in a half-hour debate, it's three minutes—each contribution is three minutes, apart from the Minister's? I've got a number of speakers who I'd like to try and get in. Delyth Jewell. 

Thank you, Diprwy Lywydd. I'm speaking in this debate, because I'm concerned that if the A&E and the Royal Glamorgan Hospital is not kept open as it is, that will have a negative impact on many other hospitals, including the Prince Charles Hospital in Merthyr, which is in my region.

In response to an FOI, Cwm Taf Morgannwg University Health Board acknowledged that, in 2017, there were 60,072 instances of patients attending the A&E in Prince Charles, whilst there were 63,691 who attended the Royal Glamorgan. By 2019, 63,341 patients went to Prince Charles, and 64,649 attended the Royal Glam. So, what do those figures mean? It stands to reason that if one of those A&E centres closes, those tens of thousands of patients requiring emergency care don’t dissipate or disappear—they'll need to go elsewhere. They'll need to travel a greater distance, at greater expense to themselves and at a greater risk to their health.

Thank you, Delyth. I didn't want to cut you in your flow there, but those figures also show that we need all those A&Es as well. If there's going to be any removal of the south Wales programme, that cannot be an excuse to start looking at closing other A&Es.

I would agree entirely. With the point, absolutely.

Now, I know from personal experience how long waiting times in A&E already are in Prince Charles. The staff do an excellent job under tremendous strain, but patients are routinely left waiting for hours and there aren't enough beds. My grandmother passed away last year after a number of years of ill health. During her final year, she attended Prince Charles A&E on a number of occasions with my parents, and later with carers after she'd fallen. On one occasion, my grandmother was waiting for nine hours on a trolley in a corridor because there weren't any beds. She was 99 at the time and suffering from dementia. Now, again, the staff did everything they could, but it was not appropriate for a woman of that age to be without a bed for that long. Imagine what impact an influx of new patients will have on this already struggling A&E.

Now, time is short, so I'll say one other thing. I am going to echo what's already been said in this debate. I am dismayed with the Government's amendment that implies, in some way, that responsibility for the NHS lies ultimately not with the Welsh Government, but with health boards. That isn't true, and the Government's amendments is almost a slight of hand in that way, and it will confuse voters.

The main argument of those who seek to undermine the Senedd is that it has failed to deliver, but this plays on people's confusion between the legislature and the executive—that is the Senedd that is an institution and the Government that sets the policies. I'm afraid it is in the interests of the Welsh Government to feed this confusion in this instance in order to avoid accountability, and this is what they've done with the Royal Glam. A Labour backbencher recently went as far as to claim publicly that the Welsh Government is not responsible for managing NHS, only for its funding. Now, that's simply isn't true, and Labour, I'm afraid, should be ashamed that they are attempting to paint the whole of this Senedd with the brush of a failure that is purely their own.

Now, the Welsh Government has here decided to delete the first clause of the Plaid motion, and in doing that, the Government has failed to acknowledge its own role in overseeing and ultimately managing the NHS. Now, worst still, it's actions like that that feed an atmosphere of distrust in politics and a general confusion over what areas are devolved and who controls what. Now, I am finishing now. It might not seem like a lot—this 'delete all' from the Government—but it's actions like this that are more damaging than we can realise. Trust matters, and we should all care about that.

My support for the retention of a 24-hour consultant-led A&E at the Royal Glamorgan is total and is unwavering, and I believe that it is the only viable option. The community I live in is galvanised as perhaps never before in fighting for this outcome, and I'm pleased that this campaign also has the support of the main hospital trade unions—Unite, Unison and the GMB. I've attended both recent local health board meetings; I've spoken at the rallies and public meetings in support of the retention of 24-hour A&E at the Royal Glamorgan. And I'm also pleased that the motion that I moved in the Assembly several weeks ago, with the support of my colleagues and with cross-party support, in support of keeping the A&E at the Royal Glamorgan was successful, and supported by all parties. I want to reiterate that motion for the record, because it calls on the health board to rule out the closure of the accident and emergency service at the Royal Glamorgan Hospital, or the replacing of the existing accident and emergency service with a 24-hour minor injuries unit, and to reinstate the option of maintaining a full consultant-led accident and emergency service at the Royal Glamorgan.

I am sad that, on an issue as important as this, Plaid have chosen only to allow 30 minutes for debate, which really seriously limits the ability of Members to participate, and I'm limited to three minutes. The Plaid motion tabled today is inaccurate and misleading, and that is why I will not be supporting it. It refers to rescinding a decision by Welsh Government, which has never existed—there is nothing to rescind. It also calls for the health Minister to take action, which he cannot take until the health board has actually taken a decision. Now, that situation may change, but only once a decision has been taken and that is why all my efforts until that time is reached will be focused on persuading the local health board and its members that 24-hour A&E must be retained and I believe that we are winning the argument and that we will succeed.

The motion, I believe, takes our eye off the ball, and it diverts our focus from where the key decision is going to be taken, and that is where I and my colleagues will concentrate our support. I will, however, be supporting the two Conservative amendments 2 and 5, because they do make an important contribution to this debate. Firstly, unlike the Plaid motion, they reiterate the important motion already passed by this Assembly—this is important.

Secondly, they highlight the key issue of this campaign, which is the failure of the local health board for the past seven years to recruit consultants, and, in fact, the failure to advertise for full-time consultants until recently. It is no wonder the A&E has been blighted. Commitment to a 24-hour permanent A&E is fundamental to being able to recruit.

Llywydd, my colleagues and I are concerned and committed to ensuring that 24-hour A&E will be retained at the Royal Glamorgan Hospital. Our strategy is based on actually winning this campaign and I believe that we will.

I'd like to place on record again my support for full 24-hour A&E at the Royal Glamorgan Hospital. This is such an important topic, so I'm a bit mystified, really, as to why Plaid Cymru have only used 30 minutes for this debate. I hope it's not an attempt to stifle the voices of Labour backbenchers, who represent areas affected by this. I'd have thought that they would have wanted to give more time for a full and sufficient discussion.

I'm also disappointed because to my mind, this motion isn't really truthful. Plaid Cymru know all too well that decisions about local delivery are made and have to be made by health boards on a day-to-day basis. Now, other parties may disagree with the way that that system operates, and that's a perfectly valid position, but then they need to bring forward a plan to change the system, rather than simply to point score. 

The motion also fails to consider the bigger picture—

Are you taking the intervention? No.

—that was addressed in the amendment a few weeks ago that I co-submitted with Mick Antoniw, Dawn Bowden and Huw Irranca-Davies. That was much more thorough wording that holistically considered service provision throughout Cwm Taf and didn't just try to set communities against each other. For example, our amendment called for the retention of a full A&E service, not just at the Royal Glamorgan, but also at Prince Charles and the Princess of Wales Hospital and it is vitally important that we have that wording set down there, so that we don't just protect A&E at one hospital to the detriment, possibly, of another—[Interruption.]

Will you take an intervention?

No, she's not.

Our amendment also called for improvements to GP out-of-hours services and to extend minor injury unit opening times, for example, at Ysbyty Cwm Cynon—a practical solution to improve performance by A&Es by removing some of the pressure.

So, to close, I would just like to reiterate my support for a full 24-hour service of A&E at the Royal Glamorgan Hospital, and to place on record my disappointment that, in tabling this motion, Plaid Cymru have shown that they don't want to offer solutions or innovations; all they want is political point scoring.

Thank you. Can I now call on the Deputy Minister for Health and Social Services, Julie Morgan?

Thank you, Deputy Presiding Officer. Unfortunately, the Minister for Health and Social Services is unable to be here in person this afternoon, as he is required at the UK-wide COBRA meeting in relation to our response to coronavirus, but I'm pleased to be here to debate this here today.

Members will be aware that the Minister spoke in the Conservative debate on this matter on 12 February, and similarly, I'd like to start by thanking all the staff on the front line that many Members have referred to today, because they worked tirelessly to provide the care and treatment that patients need, day in and day out.

We all recognise the importance of the NHS, and the public attachment to it continues to be reflected here in the Chamber, and rightly so. We can assure you and the public that the safety of our NHS now and in the future is of paramount importance. Members will also be aware that the safety and transparency of the service is crucial. I'd like to take this opportunity to clarify, as has been already said here today, that health boards have a statutory requirement to deliver safe and sustainable healthcare services for their local population. In that context, Cwm Taf Morgannwg University Health Board is currently considering the most appropriate model for the future delivery of emergency care at their hospitals.

Will you take an intervention?

Yes, certainly.

Do you accept that the south Wales programme is actually preventing the recruitment of consultants? If you do accept that point, do you think that the Government can intervene to get that changed?

At the point we're at, the health board has not yet made a decision about what its plans are. [Interruption.] I'll go on to the south Wales programme now, when I speak. But no decision has yet been made. I think that is the very important point. It has to be made locally, but no decision has yet been made.

So, to turn to the points about engagement that are made in the motion, we don't recognise the issues raised in relation to previous health board restructuring exercises, and the principles on public engagement. There are clear protocols in place that set out our expectations on engagement with the public. If this is specific to the Bridgend boundary change, I can assure Members that there was significant engagement, and the Government will therefore oppose amendment 3. The health board is currently undertaking an ongoing engagement process with staff, local representatives and the public on their A&E proposals, and it would not be appropriate for Ministers to intervene by directing or attempting to direct any health board or trust to run an unsafe service as long as it's local.

We've been clear that the health board, in any change of this nature, has to be open and transparent. I know that a number of events have already taken place. The health Minister has also made it clear that evidence underpinning proposals for change and their impact should be made publicly available or an explanation of why not. The Government will therefore support amendment 4. There is a clear mechanism in place for escalating concerns about public consultation on significant changes to the Minister for Health and Social Services.

I'd also like to reiterate that the south Wales programme was not determined centrally by the Welsh Government. It came from engaging over 500 front-line clinicians who live, work in and serve communities across south Wales. This was NHS-led, and rightly so. In considering a way forward, I understand that the health board are reflecting upon the outcome of the programme, the changes made in the delivery of healthcare, and the healthcare needs of the current and future population in the area—so they are looking at the future population in the area, as Andrew R.T. Davies referred to.

Thank you, Deputy Minister, for taking an intervention. I appreciate you've gone through the amendments. The one significant amendment that the Member for Pontypridd drew attention to as well is amendment 5, because that is a statement of fact, that the health board have not over the last 12 months actively recruited consultants to the A&E department of the Royal Glamorgan Hospital. I take it the Government will be supporting that, because that is factually correct, as confirmed by the health board to the Health, Social Care and Sport Committee here in the Assembly. Could you just confirm that? Because I notice you didn't speak on amendment 5.

On amendment 5? I'm going on to amendment 5 now, yes.

So, I understand, as I said, that the health board are reflecting upon the outcome of the programme, and they are looking at the current and future population in the area, and of course the reality of staff recruitment. Members across the Chamber will know simply calling for the south Wales programme to end doesn't really answer the problem—it avoids the problem. The health board is responsible for ensuring that they have sufficient staffing to deliver safe services for patients, and it's not for Ministers to intervene in local operational matters. The Government will therefore abstain on amendment 5.

While I understand some concerns have been raised about the health board's attempts to recruit, it's important that we recognise that the health board has been actively recruiting to ensure that there is sufficient consultant support, but that has been through a reliance on locums, and more recently utilising some consultants from the Princess of Wales, but this is not a sustainable position going forward. The health Minister has also discussed at length on a number of occasions the challenges of attracting and retaining emergency medicine consultants in what is a shortage profession across the UK. The immediacy of the current position in Cwm Taf Morgannwg has arisen because of staffing shortages, and it would be wrong to ignore the challenges the health board is facing.

Health Education and Improvement Wales is already developing a joint health and social care workforce strategy. Four doctors in training are expected to achieve their certificate of completion of training in emergency medicine this summer and take up posts as consultants across Wales. Between 2021 and 2025, a further 62 doctors are expected to achieve their certificate of completion of training. The national unscheduled care board has been established and has reviewed the workforce requirements for emergency medicine and the further expansion of the consultant workforce, supported by Health Education and Improvement Wales. However, that in itself isn't an answer to all the concerns of Members and the public. There are no quick, easy fixes.

We know that people care deeply about the future of our NHS, and everyone here does as well. We expect all of our decision makers in the NHS to listen to what their public and their elected representatives have to say, to be open, honest and transparent with the public and their staff. We expect our NHS to make choices and deliver a robust, safe service.

The health board will be receiving a further update on the exploratory work being undertaken on the future proposals, including the feedback received during the engagement process, at their next public board meeting at the end of March, where they will decide the next steps. I repeat: no decision has yet been made. 

Thank you. Can I now call on Helen Mary to reply to the debate?

I'm very grateful to you and to all the Members who have taken part in this debate. I won't have time to fully respond to everybody's points, but I do want to respond to some of them. 

I would say to Mick Antoniw and to Vikki Howells that I completely accept that their commitment to this cause is genuine, but if they want more time to debate it, perhaps they should ask their Government for that. It is not the business of the opposition to make time for you to make your points. That's up to the party that you represent. 

I'm grateful for the tone of the response—[Interruption.] If anybody wishes to intervene, I'm more than prepared to take an intervention. 

Just briefly, in fairness to my colleagues, this is a debate set by Plaid Cymru, and you have 60 minutes to debate; you decided to give it 30 minutes, not the Government. This is your decision. 

No, we absolutely did and my point, David, was that it's up to us to decide that and if your colleagues want to seek further time, they've got other opportunities to do that, but it's up to us how we use that time. So I'm not taking any lessons on it. But that's not the main substantive point. 

I need to make a correction to my colleague Leanne Wood, because she said that I wrote the legislation to which she referred. That's not true. I supported the then Minister, Edwina Hart, in writing that legislation, but I do know what it contains. The Government either knows or it should know that the legislation that they referred to, the National Health Service (Wales) Act 2006, has been, and was during the time of the One Wales Government, amended. I want to remind Members of the tone of that debate at the time when we made those decisions. There was a legitimate debate about whether the health service should be managed by arm's-length bodies, like the old trusts, or whether it should be directly accountable to the democratic process. It was a legitimate debate, and I will quote what the Minister said at the time. During the course of that debate, Edwina Hart said that she fully understood the case for arm's length, which is what the Government amendment is suggesting, but this is what she said: the decisions about health need to be made by the people that people can sack, and those are the politicians. 

I am not disputing the point that, now this process has begun, the point at which the Minister might be able to intervene is after a decision is made one way or the other, but the context of this is that the Welsh Government appoints all the non-executive directors of the health boards. The Welsh Government sets its budget, the Welsh Government sets the policy context within which it operates, and it is simply disingenuous to say that this is a matter for the health board in isolation. It is not. The Government needs to take responsibility. Leanne Wood said that there is a tendency to centralise these emergency services. If that needs to be done, then let it be done, but let it be done openly and honestly and let the people who are responsible take the responsibility for those decisions.

People have made comments here and outside about playing politics with the NHS. Well, Dirprwy Lywydd, the NHS exists because of politics. The NHS is a political decision and, at the time of the One Wales Government, we made a very clear commitment to the people of Wales that the Government, whatever Government it was, would stop hiding behind the semi-independent trusts, that we took out the market mechanism and we created the larger health boards, and those health boards are directly answerable to the Government. Now, you can dress it up whichever way you like, you can quote outdated legislation if that's what you want to do— 

Will you take an intervention?

I will happily—

No, sorry, you're out of time. 

I do apologise, Mick Antoniw; I would have taken the intervention if I could. 

You are accountable, you are responsible. If you want to change that, change the legislation, but don't keep hiding behind an independence of the health boards that simply doesn't exist. 

Thank you. The proposal is to agree the motion without amendment. Does any Member object? [Objection.] Therefore, I defer voting on this item until voting time. 

Item 11 on our agenda this afternoon is the Plaid Cymru debate on coverage of the six nations. I call on Rhun ap Iorwerth to move the motion. Rhun. 

Thank you very much, Deputy Presiding Officer, and I’m pleased to be able to move this motion today. It is presented and written in a way that we hoped would have been able to attract cross-party support, quite similar to the last debate. I do understand that the Government is intending to support our motion as well, so we have an opportunity today to make a united statement as a Senedd as to how important the six nations are to us as a country.

The motion says it all: sport is important to our cultural and civic identity in Wales; we need to make sport as accessible as possible; we are concerned about the reports that Wales might have to pay for six nations games in the future; and we are concerned about the impact that that could have on the interest of young people in the game.

Rugby is very important to me personally, as it is to many of us. I’m very proud to play for the Senedd rugby team, and we’re in the middle of our own six nations championship at present and we’re unbeaten in that. I’m still a part of the coaching team in Llangefni Rugby Club youth section, and I get great pleasure in teaching the game to young boys and girls, but I also appreciate the role that the club plays within the community. We are going through a very prosperous period in the club in Llangefni at the moment. There are literally hundreds of players in the youth section at the moment and it is great to see; there is no room for us in the club at present. It’s great to see women’s and men’s rugby growing in Holyhead too, and the club in Porthaethwy is still very important.

But what creates or what generates that interest, particularly among young people? Well, without a doubt, the ability to watch and look up to and wanting to emulate their heroes, whether they are men or women. As it happens, I asked the boys on Sunday morning in the team that I help to coach—the under-16s—I asked them how many of them watch international rugby in Wales. All of them said that they watched—the majority of them wearing Wales shirts and so forth. I asked how many watch club games regularly, either on tv or watching our own first team in Llangefni. Well, very few of them were doing that. I wasn’t very happy about that, but that’s another problem. But that response told me that it was through watching the men’s national team, for these boys—watching Alun Wyn Jones, Dan Biggar, Leigh Halfpenny and George North, of course, for us in Anglesey particularly—that’s where the interest is generated. The same thing is true, as I said, in terms of the way in which coverage of the women’s team generates interest among young girls as well.

I’m very concerned therefore what would happen if those games couldn’t be an intrinsic part and a natural part of our cultural life by being broadcast on free-to-air tv. I’ve never had Sky tv in my house—that’s my own personal choice—and many people can’t afford Sky tv or can’t afford to pay to watch sport. Going to a pub or another location doesn’t work for everyone either. [Interruption.] Yes. 

I'll be voting for the motion this afternoon, and I have huge sympathy for the merits of this motion. I, like you, don't have Sky tv whatsoever and never have had that, but the financial model of the Welsh Rugby Union is predicated on international rugby. If they can't bring the revenues in, what's the alternative to make sure that the grass-roots game and the professional game in Wales can have those revenues to be competitive? 

These are core questions. Cricket has been through a period of looking at itself and how it pays for itself, and look what's happened to audiences for cricket. I'll quote from the author Gideon Haigh, who asked, 

'Does cricket make money in order to exist, or does it exist to make money?' 

It's always about finding the balance. 

I’ll continue. Going to a pub isn’t always an option for everyone, and certainly not for young people, for example. It’s not for people with mobility problems and people who don’t want to be in big crowds of people. Yes, in rugby clubs around Wales we do show the game and we can carry on doing that, but that’s for people who already have an interest in the game.

We, as a party, have written to the Secretary of State for DCMS in the UK Government, arguing the case for adding the six nations to the category A events that have to be shown on free-to-air tv. There was a review in 2009. That was the last review of that, and it came to this conclusion:

'Wales matches in the Six Nations Rugby Championship should be listed in Wales only…The Panel was persuaded of the "special national resonance" of rugby union in Wales.'

And we only need to look at the viewing figures, not just for specific games, but how many people generally who watch six nations games—82 per cent of the population of Wales. That figure is astonishing, and it does show how much this game is integrated in our specific culture in Wales.

I could talk about another specifically Welsh issue—the threat to Welsh language broadcasting of the games. What would happen to those in the future. Broadcasting has been a part of the lexicon of rugby in Wales over the years and we can't afford to lose that.

As I said earlier, cricket has been through this experience, and we can't afford to see ourselves in a situation where we would lose that access for people to a game that's so important to us.

I love sport. I love taking part in sport and watching it. I love following and watching our national football and rugby teams. We in Wales love our sport. It permeates deep into our national psyche, our culture. Football—Euro 2016 was a wonderful experience, and I look forward to many similar experiences through football again. But as an annual competition, there's something about the six nations that really binds us like nothing else—that amazing figure of 82 per cent of people watching it. And take access to it on free-to-air tv away from the population, you rip away not just a television programme, but a core part of our nation's culture, and you threaten directly the health of rugby as a participation sport. So, let's vote together on this today, and make a clear and unambiguous statement as our national Parliament.

Diolch, Dirprwy Lywydd. There are few issues that actually do conjoin us with our different politics in this place. So, this is an important debate for the people that we all represent to have here in this Welsh Parliament. And as has been said, here in Wales, rugby is so much more than just a game. Six nations matches are etched in our national psyche. They are part of who we are, and part of our shared Welshness. And in clubhouses, pubs and living rooms across the nation, people gather to watch the six nations in a way unlike almost any other sporting event in Wales. And it is greater than its subject matter, so it is absolutely vital that we do keep this highlight of the Welsh sporting calendar accessible to the majority.

We need only to look at the example of cricket, as has already been mentioned, which has seen a substantial drop in participation and viewing figures since moving to pay-per-view services in 2005. And this is not to discredit for-profit channels such as Sky or BT, which have, over a number of years, provided some very high-quality rugby coverage. But the fact is that these are simply not accessible for the same number of people in Wales.

When Wales claimed a grand slam victory over England last year, 8.9 million people viewed this on BBC One. That is more than the most-watched football match on the BBC in 2018-19. This should signal how important it is to keep these games on free-to-air tv. It is also a signal as to why others want it.

I wish to take this opportunity to promote the women's six nations, which will now be unified with the men's tournament in terms of television rights. As the women's game continues to grow in participation, ensuring greater, not lesser television coverage is a vital next step. Unfortunately, this weekend's Wales women's fixture against Scotland has been called off due to the coronavirus affecting one of the Scottish players, and I'm sure members across this Chamber would like to join me in wishing her a full and speedy recovery.

Dirprwy Lywydd, if we are to ensure that the next generation are inspired to play and support rugby, we must keep it accessible to them. The six nations is enjoyed by avid rugby fans and social observers alike. This will not be the case if it disappears behind a pay wall. In Wales rugby has always been a sport for everyone, not just a privileged few, and we must all work together to keep it that way.

'I was there',

said Max Boyce. Well, we can't all be there, can we? And so it's important that we all have an opportunity, through television, to share in that experience. I remember where I was when Ieuan Evans scored that excellent try in 1988 against Scotland. I'm sure we all remember where we were when Scott Gibbs scored in Wembley in 1999, or when Gavin Henson kicked that wonderful kick to beat England in 2005. It's part of our national memory, isn't it, it's part of our heritage, and it's part of our culture.

People say, 'Well, go to the pub to watch the game. If we have to pay, you can watch it in the pub.' But that doesn’t work for everyone, as we've already heard. My children couldn’t have watched Wales play England on Saturday if we'd had to go to the pub to watch the game. And neither would they have spent hours in the garden playing rugby, emulating Dan Biggar and Hadleigh Parkes, with me with a little white tape on my ears trying to look like Alun Wyn Jones. And I'm surprisingly similar, if truth be told. [Laughter.]

But six nations matches are national treasures, and they should be safeguarded. If it's good enough for the Grand National, then surely it's good enough for Wales rugby matches in the six nations. We've heard reference to cricket, and the experience that cricket has been through over the past few years. Well, 9 million watched Freddie Flintoff and the team in the Ashes matches back in 2005—9 million people. But soon after that, cricket went behind a paywall, and people had to pay to watch those games. By the world cup, there was barely a million. Indeed, it was 0.5 million people watching some of the England games in the world cup. And when it came to the finals, Sky decided that they had to show it free of charge on Channel 4, and even then, only 4.5 million people watched. So, that was a decline of half the audience in 15 years watching the England cricket team. Now, that's an admission of failure that they had to broadcast on Channel 4. And in the same summer, of course, there were still almost 10 million people watching Wimbledon, free to air. Over 8 million people watched the England women's football team in the world cup at the same time.

We've heard already that the income of selling broadcasting rights to invest in the game at the grass-roots level would make up, perhaps, for the audience loss. Well, participation figures in cricket show now that those playing cricket regularly has almost halved in the last two decades, which corresponds to that period that I mentioned earlier, of course, when it hasn't been available free to air. Now, that isn't the future we want for rugby in Wales, and that isn't the future that Plaid Cymru wants for rugby in Wales. And that is why we are eager to see everyone supporting our motion today, to ensure that everyone, whoever they are, in Wales can access and share in the celebrations, hopefully, every time that Wales plays a game in the six nations championship.

I think this is an important debate, and we in the Welsh Conservative group will be enthusiastically supporting the motion.

Can I start by paying tribute to Peter Jackson, the highly respected journalist who first wrote about this story, in The Rugby Paper—it's not a very original title, but it was a very important story. [Interruption.] And it's a good paper, indeed. I think the key point here is the exclusion of joint bids. The BBC and ITV seem to be getting ready to make another joint bid, and a very valuable bid; of course, they outbid in the last round. But no reason has been given by Six Nations Rugby Ltd for the approach of now excluding joint bids. And it does seem to me that this is anti-competitive. There's also a remarkably quick timescale to these negotiations—they end this week. And it does smack of the whole process being forced and controlled.

We've already heard from a couple of speakers now that there is a real risk of losing millions of viewers behind a paywall, to generate millions of extra revenue. But what do you gain with that extra revenue if you've lost your grassroots, and the love of the game that is shared by so many in the population? And this seems to me something that really has to be reflected on.

Can I welcome the action of the Westminster committee on digital, culture media and sport, and their demand from Six Nations Rugby for an explanation of this situation? And the chair of that committee, Julian Knight, said, and I quote:

'We cannot allow this to be a deal done behind closed doors. Fans have a stake in this and a right to know what's going on.'

And I completely agree. There is something not right about this in the way its governance is being conducted. And this game is of huge importance culturally to us in Wales—it's a mass sport in Wales; it's not so much in England or in France, indeed. And I do believe that it's England and France that are driving this process and they, I think, will bitterly rue the day that they did that.

But I think that if the rugby authorities do act unreasonably, then the Government should consider making six nations rugby matches in the UK listed events. And I would say to the UK Government that there are some actions you must take to strengthen the union, and this will be one of them, recognising the strength of rugby in Wales, and therefore we must have a national, i.e. a UK approach to this regulation. Thank you.

I'm pleased to be taking part in this debate, albeit not for very long—obviously the time does not allow me to wax lyrical about my own somewhat less-than-dazzling rugby-playing career back in the day on the wing—left wing, obviously. [Laughter.] But, obviously, prior to devolution, the Wales rugby team, the Wales football team, and the National Museum Wales—it was sport and culture that gave us a political identity in the absence of politics in this place. So, prior to devolution, the Wales rugby team was supremely important, particularly in that glorious decade in the seventies when we were very successful as well—amazingly successful on the sporting field, not quite so successful in the political field in that century. But it has allowed us to define ourselves as a nation, even before we could politically in this place. And it is a grass-roots sport. 

I'm a member of Dunvant Rugby Football Club—I might as well give them a mention—and they run loads of age-representative teams from under-eights upwards: boys and girls. It operates like a youth club, basically. It is volunteer-based. It doesn't get much funding from the Welsh Rugby Union or anybody else. Volunteers locally and families together club together—it keeps children occupied. It occasionally wins rugby matches as well at the higher level. But, yes, it's under threat, if anything like this happens.

Television has given rugby that coverage; it's also given the women's game that coverage. Women's rugby in Wales is now on television and we've seen women's rugby take off at a grass-roots level. Siwan Lillicrap, the Welsh rugby captain, is from Swansea—I'm guaranteed to give her a mention.

But I wear a Glamorgan cricket tie because I'm a bit of a cricket freak as well, but what we've seen in the last 15 years is, as we've heard, a 30 per cent decrease in grass-roots playing numbers in cricket. We've seen village cricket teams here in south Wales, which traditionally supply Glamorgan County Cricket Club team with players—we've seen that supply dry up and those cricket teams disappear. And, yes, there's supposed to be lots of money at the top end—it doesn't help our village cricket teams here in south Wales. So, yes, there is a special national resonance for rugby in Wales—that's why we need to keep it on terrestrial television. Diolch yn fawr.

Can I thank Plaid Cymru for bringing this important debate this afternoon? We will be supporting all of Plaid's motion.

Rugby is the national game of Wales and unlike England, where much is based on its public school system, it is a sport of the working classes and it is a grass-roots sport in Wales. 

If the BBC is to be a true public service operator, it is incumbent upon the institution to retain certain sporting events for the general population. We should note here that it's taken steps to retain Wimbledon, the boat race, a share with BT of the FA Cup and other institutional gaming events. The BBC licence fee raises £3.7 billion annually, but is supplemented by another £1.2 billion raised from its commercial operations. So, that's a total of £5 billion annually. It is reported that the rights bid for the six nations tournament is around £50 million, or—if I'm not to be wrong, as Diane Abbott might have been, that's just 1 per cent of the BBC's annual revenue. But as of now—. This cost, of course, was shared with ITV. But, as has been pointed out by David Melding, that may not be allowed in the next bid phase.

So, whilst we have to accept that there are many other programmes—and I use that in the broadest sense of the word—the popularity of the six nations is witnessed by the fact that 41 per cent of the UK watches the tournament, and, as Rhun pointed out before, that figure rises to something like 82 per cent in Wales. So, the six nations tournament is one of the most anticipated and watched events in the sporting calendar. Indeed, for Wales, it is probably the most popular event. The loss of the Pro14 championship to pay television undoubtedly impacted on the watched coverage of that competition.

Being exposed to sport through all media, as has been pointed out, is the best way to inspire young people to engage in playing that sport, and, as Dai Lloyd mentioned, we can see that in the fact of the numbers of women now playing rugby because of the exposure on television. So, Dirprwy Lywydd, we call upon this whole institution, led by the Welsh Government, to use every lever available to influence the BBC to retain the six nations tournament for terrestrial television.

Thank you. Can I now call on the Deputy Minister for Culture, Sport and Tourism, Dafydd Elis-Thomas?

Thank you very much, Deputy Presiding Officer. I’m pleased to confirm that we as a Government will be supporting this motion, and I therefore expect the support to be unanimous, as all contributions have been.

You will recall that we had a topical question and I responded to that as robustly as I could last week. I won’t rehearse anything that I said last week, but I do want to inform you of what I’ve been doing in the meantime, namely that I have written to the UK Government, not only to convey the feelings and views of this Chamber, but I’ve also sent a digital version of our Record of Proceedings so that the Secretary of State can read something from a Parliament that is worth reading—this Parliament as opposed to the Parliament that he’s a Member of, perhaps. And I’ve also sent a copy to my colleague, Gareth Davies, the chair of the Welsh Rugby Union. I haven’t yet received responses.

But the fact that we, once again today, for the second week on the trot, are discussing this issue—and I am grateful to my colleagues in Plaid Cymru for tabling this motion and I will be doing something similar after this debate to ensure that, once again, the UK Government is aware of the views of this Parliament and that they do consider what should happen in terms of the listing. The fact that we have seen cross-party support from Plaid Cymru, the Conservatives and, of course, from David Rowlands—thank you to you, David, from the Brexit Party—and quite a serious contribution from Andrew R.T. Davies, as well as David Melding from the Conservative side—.

The only word of warning that I would give in agreeing with everything that’s been said in this debate is that this question is not going away. The funding for international rugby, working on a commercial or partly commercial basis, is going to be an issue that we will have to find a solution to, both in Welsh rugby and international rugby, and we who are unhappy about the solution that’s been put forward to date are duty bound to see what kind of solution could be acceptable to us. So, I have one other invitation to make to this Senedd, as I invited the Senedd last week: it would be most useful if one of the committees of this Senedd were willing to consider this issue further, to call for evidence and produce a—

Thank you very much for taking the intervention. We, in the committee that I’m chairing instead of Bethan, are intending to make comments on the subject before us today, but we will certainly consider the points that you’re making about looking at the subject in its entirety, if that’s appropriate, because, as you said, this problem is not going to go away, even if we are successful in this campaign to keep the six nations on free-to-air.

Thank you very much for that. On the basis of that pledge, you will know how much I enjoy appearing before your committee, particularly under you as Chair, perhaps. So, thank you for that invitation. I’m pleased to confirm and ask everyone to support this motion today. Thank you.

Thank you very much. Can I now call on Rhun ap Iorwerth to reply to the debate?

Thank you very much. There’s not much else to say, in all truth, but thank you very much, everyone, for your comments, and thank you for the support that you will be giving today. I’m very grateful for the commitment by the Minister that he will send a copy of the Record of Proceedings of this meeting, and the unanimous vote, hopefully, to the UK Government, as well as to the WRU.

In terms of the point about the problem not going away, there is a solution here, namely to allow, for example, for more than one free-to-air tv company to do a joint bid, which would bring matched funding, possibly, in order to ensure that the source of funding would continue to flow. But I also welcome greatly the commitment to look more deeply at this issue within the Senedd.

We’ve had a test of what would happen, in truth, when the England home games went to Sky back in 2001-02. There were half a million people watching Wales against England at Twickenham and then, the next year, on free-to-air, Wales against England at the Millennium Stadium, 6 million people were watching. It would be detrimental to the game if we lost those figures.

I close with a quote from Alun Ffred Jones, as the culture Minister in 2009, who gave evidence to the review on which sports should be on free-to-air tv. This is what he said:  

'The public is the most important part of the jigsaw when it comes to viewing rights. We must act in the best interests of the people of Wales.'

Amen to that. Let’s vote unanimously on this.

Thank you very much. The proposal is to agree the motion. Does any Member object? [Objection.] You object. Right. Thank you. 

So, we go to voting time. Unless three Members wish for the bell to be rung, I will now move to the first vote. Yes. Okay, fine. So, we now move to a vote. The first vote this afternoon is on the motion to amend Standing Orders, and I call for a vote on the motion tabled in the name of Elin Jones. Open the vote. Close the vote. For the motion 39, one abstention, nine against. Therefore, that motion is agreed.

We now move to vote on the Member debate under Standing Order 11.21 on the early cancer diagnosis. I call for a vote on the motion tabled in the name of David Rees. Open the vote. Close the vote. For the motion 36, 12 abstentions, one against. Therefore, the motion is agreed.

We now move to vote on Plaid Cymru's debate on the A&E services at the Royal Glamorgan Hospital. I call for a vote on the motion tabled in the name of Siân Gwenllian. If the proposal is not agreed to, we vote on the amendments tabled to the motion. Open the vote. Close the vote. For the motion 23, one abstention, 25 against. Therefore, the motion is not agreed, and we vote on the amendments.

If amendment 1 is agreed, amendment 2 will be deselected. I call for a vote on amendment 1, tabled in the name of Rebecca Evans. Open the vote. Close the vote. For the amendment 26, no abstentions, 23 against. Therefore, amendment 1 is agreed and amendment 2 is deselected.

We now vote on amendment 3. So, I call for a vote on amendment 3, tabled in the name of Darren Millar. Open the vote. Close the vote. For the amendment 23, no abstentions, 26 against. Therefore, amendment 3 is not agreed. 

I call for a vote on amendment 4, tabled in the name of Darren Millar. Open the vote. Close the vote. For the amendment 49, no abstentions, nobody against. Therefore, amendment 4 is agreed. 

I call for a vote on amendment 5, tabled in the name of Darren Millar. Open the vote. Close the vote. For the amendment 31, 18 abstentions, nobody against. Therefore, amendment 5 is agreed. 

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

Open the vote. Close the vote. For the amended motion 11, 20 abstentions, 18 against. Therefore the motion is not agreed. 

We now move to vote on Plaid Cymru's debate on the coverage of the six nations and I call for a vote on the motion, tabled in the name of Siân Gwenllian. Open the vote. Close the vote. For the motion 49, no abstentions, nobody against. Therefore, the motion is agreed. 

We now return to the agenda for this afternoon. We now turn to the short debate, and I call on Vikki Howells to speak to the topic she has chosen. Vikki.

Diolch, Dirprwy Lywydd. I've agreed to give a minute of my time to my colleague Mick Antoniw today. 

The inspiration for this short debate came from the publication of 'The State of the Coalfields 2019'. The report was an investigation into the economic and social conditions in the former British coalfield areas, and it was commissioned by the Coalfields Regeneration Trust, produced by a team at the Centre for Regional Economic and Social Research at Sheffield Hallam University, and this was comprised of Christina Beatty, Steve Fothergill and Tony Gore. 

The report has been critical in shaping the structure of my debate today. Of course, inspiration for the debate also comes from two important coalfield anniversaries occurring this year. March 2020 marks 35 years since the end of the 1984-85 miners' strike, and 2020 also marks 25 years since the reopening of Tower Colliery in my constituency as a workers' co-operative: two events in my lifetime that were so crucial in shaping politics and identity, and that's both personally for me and more widely for many other members of my community too. One was a moment of defeat, yet nevertheless marked by a spirit of defiance; the other a crowning moment of victory. Both are important motivating factors behind today's debate. 

The report itself was an update on a piece of work produced in 2014. I've mentioned the miners' strike. It's important to remember that the original report was published to mark 30 years since the start of that dispute. The aim was to capture the experience of coalfield communities, explore how effective regeneration schemes have been and to ask, 30 years on, had coalfield communities caught up with regional and national averages, were they in robust economic and social health. Well, the 2019 report brought that research up to date, and my contribution owes much to the evidence it presents. Crucial additional information is taken from the last meeting of the cross-party group on industrial communities, which I chair. I do hope that the Deputy Minister for the economy will be able to meet with the secretariat of that group to discuss its contents in detail.

At that February meeting, Professor Fothergill shared unique data to the former south Wales coalfields area. Some of this isn't published in the report, but I will be making use of it today. He also explored the arguments made in 10 priorities for the former coalfields. That is the policy statement produced by the Coalfields Regeneration Trust and the Industrial Communities Alliance. It offers a valid programme for coalfield communities, to which I'll also make reference, and sets out a platform to ensure that the future of the Valleys is vibrant and prosperous to transform their fate and to help determine a positive identity for coalfield areas and their residents.

I'll spend a little time later on outlining these recommendations, but first I want to briefly explore some of the key definitions within the report. Most importantly: what are coalfields? Well, the authors explain that coalfield communities are defined as those where, in 1981, at least 10 per cent of male residents in employment worked in the coal industry. Coalfield areas have been matched to their constituent lower super-output areas and principal constituent local authorities. In the latter case, for Wales, that is Flintshire and Wrexham in north Wales, and Blaenau Gwent, Caerphilly, Merthyr Tydfil, Neath Port Talbot, Torfaen, and my own local authority of Rhondda Cynon Taff. But it also includes large parts of England and Scotland. Altogether, across Great Britain, 5.7 million people—that's 9 per cent of the population—live in those coalfield areas. Professor Fothergill rightly made the point that they should be a pressing concern for UK policymakers.

If the coalfields were a single region, their population would be equivalent to the west midlands. It would be higher than Scotland and nearly double the size of Wales. In Welsh terms, coalfield communities make up one in four of the Welsh population. Indeed, the south Wales coalfield is the home of 768,000 residents—the second largest coalfield community after Yorkshire. We're talking about a large area here, containing substantial numbers of Welsh citizens.

There's lots of data within the report, and I just want to draw out a few particularly pertinent points. Firstly, in terms of that population in the coalfield areas, it is older than the British average. In coalfield areas, one in five of the population is over 65 years of age—that's above the British average. Moreover, the coalfield population is getting older and the gap is widening. Furthermore, the share of young adults in coalfield communities is lower than the British average. It's also much lower than comparative figures for major regional cities like Cardiff. While overall population figures in coalfield areas are increasing, this is happening at a slower rate than the British average—2.5 per cent rather than 4.5 per cent. This gap is even further pronounced in the south Wales coalfield where population growth is just 1.5 per cent—a third of the British average. So, our population is older and it's not growing as quickly as in other parts of Wales.

Secondly, there are significant health challenges in our coalfield communities. Life expectancy is lower, there are challenges around lifestyle choices, and more people report long-term health conditions. This is underlined by the numbers claiming disability living allowance or personal independence payments. Across the coalfields, nearly 0.5 million people—that's 9 per cent of the entire population—are in receipt of either of these benefits, and the British average is just under 6 per cent. The disparity is starker when we look at the south Wales coalfield where 11.2 per cent of the total population are receiving either DLA or PIP— that's nearly double and equivalent to one out of every nine people. So, our population faces significant health challenges. 

Thirdly, job growth in coalfield communities is nowhere near the level we would like. There have been increases in the number of jobs, which compares well to average levels, but the data is not so impressive when expressed as a percentage of the working age population. Indeed, for the south Wales coalfield, the figure was just 0.2 per cent. Coalfield areas export workers, so job growth that is impressive in terms of the initial stock of jobs is less significant in terms of the workforce size. Compared to the south-east England's full-employment rate, an extra 38,000 jobs would be needed in the south Wales coalfield.

The job density of the coalfield also compares badly. Job density is the number of employee jobs per 100 people of working age in a given area. The British job density is given as 75, so that's 75 jobs per 100 people of working age. But for the coalfields, it's just 55. For north and south Wales, it's just 42. This is no surprise to the large numbers of my constituents who commute to Cardiff or further afield to work. I hope that initiatives such as Better Jobs Closer to Home bear fruit in changing this.

A further interesting angle is the nature of employment. Former coalfield areas have higher percentages of their workforce engaged in manufacturing. The figures are 13 per cent as opposed to a British average of 8 per cent, or 5 per cent for a city like Cardiff. The importance of the foundational economy to coalfield communities is clear. In other coalfield communities, warehousing and call centres are employers that have seen major growth, but that's not the case for south Wales, where such ventures are often the jobs to which coalfield residents commute elsewhere. So, jobs growth is a challenge in the coalfield areas, manufacturing plays a more important role, people are less likely to be self-employed, and residents are more likely to commute for work.

Fourthly, unemployment rates in coalfield areas compare well with averages. Indeed, unemployment has fallen faster in these communities than overall. However, this is masked by the increase in people receiving incapacity benefit. Beatty et al note that this is a common trend in older industrial areas, but coalfield communities are prime examples. The British average in November 2018 was 5.7 per cent, 2 per cent less than the figures for coalfields. Whereas the north Wales coalfield is in line with other coalfield areas, in south Wales, the figure is a shocking 10.4 per cent. More families are also in receipt of in-work benefits as average earnings are lower.

This is rendered all the more important when we factor in the impact of welfare reform. Coalfield areas are expected to lose out with an estimated loss in the south Wales coalfield of £770 per working age adult per year. It's a loss, moreover, that falls disproportionately on the poorest households, and renders a lie of 'all being in it together'. This has terrible consequences for family budgets. It also signifies an extraction of resources that would otherwise be spent within the local economy.

Perhaps the net impact of all this taken together is that 42 per cent of all coalfield neighbourhoods are within the 30 per cent most deprived in Britain. In reality, this figure is lower than that for main regional centres, excluding London. This suggests coalfield areas aren't actually doing that badly. This is an important point as it emphasises that the fate of the coalfields isn't necessarily so bleak. Whereas 52 per cent—greater than one in two—of south Wales coalfield's lower super-output areas are among the 30 per cent most deprived, some of the coalfields are doing quite well. Why is that the case?

Well, Professor Fothergill has posed one interesting explanation in his presentation. Some coalfields like south Staffordshire, Kent or Lothian have done well, but they are much smaller than the coalfield in south Wales. An interesting comparison is provided by the only coalfield that's larger, which is Yorkshire. Many similarities exist between the two, but Professor Fothergill noted one important difference: this is that the south Wales coalfield is in many ways peripheral to Britain with less developed transport infrastructure. The coalfield is split into narrow valleys rather than being a single labour market. Cities like Leeds and Sheffield are integrated into Yorkshire, but Cardiff, from the Valleys, can seem a long way off. Perhaps the city region will have a critical role to play here.

Professor Fothergill also explored a clear set of objectives that could be used to tackle the challenges facing the south Wales coalfield. These included: a replacement for the EU funding that communities in south Wales receives; better support for industry; better quality jobs; investment in education, skills and health; growth rooted in coalfield areas; investment in local connectivity; better support for local authorities; support for community infrastructure; more spending in coalfield communities on arts and sports so that funding inequalities are rebalanced; and a better deal on miners' pension surpluses. I know many of these are already key goals for the Welsh Government and that policies have been developed and put in place to ensure their delivery. Indeed, many of these interventions have been reinforced through this Assembly term and through last week's budget here.

We rightly have a Cabinet Minister specifically holding a portfolio for north Wales. This is to ensure the needs of that region are at the top of the Welsh Government's agenda. I sincerely believe we also now need a Cabinet-level Minister for the Valleys. Their purpose would be to lead on fulfilling these objectives and ensuring a bright future for these areas and their communities, placing coalfield communities at the heart of our policy making and at the heart of our country's future prosperity.

Can I thank the Member for a really impressive and comprehensive analysis of the serious challenges affecting many of our coalfield communities? Can I first of all, though, say that I think we need to put on record our thanks for: the work that the Coalfields Regeneration Trust actually does in supporting enterprises, business regeneration, community facilities; and CISWO, the Coal Industry Social Welfare Organisation, which provides social help to families formerly connected with the mining industry: and also the National Union of Mineworkers, who give so much assistance in terms of pensions, in terms of industrial disease, and other parts of the legacy of the mining industry?

What the report highlighted to me is that, although employment is improving in numbers, a third of the people in work are part-time, there is a high level of low pay and a growth in self-employed and zero-hours contracts. Would you agree with me that this really highlights the importance of the social partnership Bill that the Welsh Government is planning to bring, in terms of bringing ethical standards of employment? Because it's not levels of employment that is the issue, it's the quality and the security of employment.

Thank you. I now call on the Minister for Education to reply to the debate. Kirsty Williams.

Thank you very much, Deputy Presiding Officer. Could I begin by thanking both Vikki and Mick for their contributions this afternoon? Many of the issues facing our Valleys communities are deep-seated and longstanding, as outlined by Vikki in her speech. They are the result of generational changes and will take time to reverse, and part of the challenge is to think about how we can futureproof our economy for the challenges of tomorrow.

This Government signified the importance of the old coalfield communities when, in 2016, it established the ministerial taskforce for the south Wales Valleys under the leadership of my good friend Alun Davies, the Member for Blaenau Gwent. I remember many conversations at that time with Alun about the role of education, lifelong learning and skills, and I will touch upon aspects of my portfolio later on in my remarks.

The broad aim of the taskforce was to lead a long-term piece of work to deliver real change by creating good quality jobs closer to people's homes, improving people's skills and bringing prosperity to all, with local communities and local people at the heart of that work, finding solutions for themselves rather than having solutions imposed upon them. It wanted to build on the strengths of the Valleys, including its unique and breathtaking natural surroundings—and of course, Deputy Presiding Officer, I see that every day as I travel down from Brecon to the Senedd.

What many people perhaps will fail to realise is that, even in my own constituency, which many people would regard as a rural constituency, actually, I have ex-coal-mining communities in Brecon and Radnorshire in the upper reaches of the Swansea valley, in places like Ystradgynlais and Coelbren and Abercrave. But we are aware that, within that beauty, there is still the challenge of renewal, of economy, of culture, of democracy and debate. I know that the current Deputy Minister is adamant that we also include the environment, the culture and green spaces in this work, as they have the potential to boost community well-being in the widest possible sense.

If I can now turn to specifics of investment, the Deputy Minister has announced funding worth £650,000 in Caerphilly. Williams Medical Supplies, for instance, will see 91 new jobs created in Rhymney. This funding has secured and created really good employment opportunities, and the company has shown its commitment to our economic contract and invested in improving its green credentials. William Hare Ltd, an international company that engineers steel solutions for innovative construction projects worldwide, are putting in over £10 million for the acquisition and the development of their Risca site, with the Welsh Government providing £350,000 to support the company's plans. This will result in the creation of 100 new jobs over the next two years, alongside the expansion of facilities, improved manufacturing capabilities, more apprenticeships and using local suppliers, which will be a real boost to the foundational economy, which, as Vikki rightly said, is hugely important.

And a key part of our approach to enabling long-term change is the Tech Valleys programme. Our aim was to encourage the adoption of digital technologies and developing high-value advanced technologies that support cutting-edge industries. Now, it's true to say that the global slow down in the automotive industry in particular has meant that progress has not been as extensive as we would have hoped. Two key strands for the future delivery of the Tech Valleys programme have been identified: (1) to continue to attract and develop cutting-edge global technology organisations and (2) to assist existing local businesses to improve their processes, apply technology, and to develop higher-value products and diversify their customer base so that they are futureproofed.

On the first strand, in 2018, we invested £100,000 in Dennison Advanced Materials Centre, a state-of-the-art engineering training facility at the Blaenau Gwent learning zone. The centre is one of only a handful of FE colleges in the United Kingdom that can provide advanced composite training as part of its aeronautical and motorsport engineering courses. Since then, the first advanced composite apprenticeship course in Wales has started and it has attracted 60 students to date, including, I'm very pleased to say, Deputy Presiding Officer, a number of female applicants. Last year, 30 per cent of the engineering applications were from women.

As you know, we're also working with the global technology company, Thales on a £20 million National Digital Exploitation Centre—the NDEC—in Ebbw Vale. We are match funding Thales's £10 million investment, and the NDEC has already injected £1 million into the local economy with 20 of its 53 local suppliers based in Ebbw Vale, and has employed over 90 per cent of its start-up staff from the local area. The initial capability is now open for business with a state-of-the-art cyber range and business facility, and a growing education programme with links to local businesses.

On the second strand, we've developed a focused programme of support to assist grounded firms in the Tech Valleys area to increase productivity. The productivity enhancement programme will utilise the combined resources of our regional relationship management team, the smart innovation programme, the Blaenau Gwent economic development unit, and the Upskilling@Work project led by Coleg Gwent. And it will also lever additional specialist resources, such as the ASTUTE programme, where appropriate. Furthermore, Coleg Gwent are leading on our personal learning accounts pilot. This is already making a difference in supporting employed individuals aged 19 and over and earning under £26,000 to gain higher level qualifications or skills in these sectors where a shortage of skills has been identified by the regional skills partnership, such as engineering, construction, ICT and health. That will enable them to progress into employment at higher levels of wages.

But we're also raising attainment and aspiration earlier in the education journey. Earlier this year, the brightest and best students from the Massachusetts Institute of Technology, the world's No. 1 university, spent time in our schools supporting maths and science teaching. We are only the seventeenth country in the world to take part in the scheme, and schools across Rhondda Cynon Taf benefited from this as well as schools further afield in the coalfield area, such as Neath and Bridgend. 

Our reforms to student support mean that more students from low participation areas are studying full time, part time, and for Master's degrees. Just yesterday, I was speaking at a lifelong learning conference and was able to confirm an 80 per cent increase in new Open University students in Wales. And nearly half of OU in Wales students now come from our most disadvantaged communities, including a significant uplift from students from the coalfields. This year, we've also seen an 8 per cent increase in university applications from our most deprived areas and that is the best record anywhere in the United Kingdom. 

The Valleys taskforce also has as one of its priorities the further development of the foundational economy, which Vikki again highlighted as being a crucial part of work. It has provided £2.4 million to fund 27 Valleys projects as part of the foundational economy challenge fund, enabling them to experiment with novel projects in their local areas. So, for example, the Rhondda housing association has been given funding to acquire a vacant department store and manage it as an enterprise hub to help revitalise the high street. Blaenau Gwent council has received support to examine how it can increase spend with local businesses, up from a baseline of 17 per cent of its procurement expenditure. 

The successful spreading and scaling of the outcomes from the foundational economy challenge fund projects will support policy objectives that complement the priorities of a range of Welsh Government departments. And this Government, together with our partners in the WLGA have adopted a town-centre-first principle. This will see Government, local authorities and wider public sector business and communities consider a town centre location in their decisions to put the health and the vibrancy of our town centres at the starting point for their location strategies and location investment-making decisions, and that includes the twenty-first century schools and colleges programme. 

Our transforming towns regeneration programmes are also providing or enabling £800 million-worth of investment to support over 50 towns across Wales to rebuild and refurbish buildings and public spaces, as well as tackle empty properties. In January, we announced a further package of support for town centres with nearly £90 million, and the package includes extending our capital grant programme for a further year to March 2022. And this will deliver additional regionally prioritised town-centre regeneration projects worth £58 million.

Our transforming towns agenda supports investment to create well-connected, vibrant, viable and sustainable towns, with a strong local economy where people are proud to live, work, play and invest. And for our children, we chose Rhondda Cynon Taf as the area to pilot our new approach to independent careers advice as part of the Gatsby programme. Recently, I was in a school in the constituency of Mick to see the aspirations of those children there and the advice and the work experience opportunities and mentoring that that pilot is bringing to children in those communities. Deputy Presiding Officer, I asked one student where he was applying to go to university, and he said to me, 'I want to go to the best—why not? I'm applying to the Massachusetts Institute of Technology.' And I have every confidence that that student will get there.

I hope that this gives the Senedd, those of us that are left, a flavour of the many different areas of work across the Welsh Government that is focused on, or is contributing to implementing the long-term sustainable changes needed in the south Wales Valleys. And as always, the Government is grateful for the dedication that Vikki has in ensuring that these matters are discussed on a regular basis here, on behalf of her constituents and those across the south Wales Valleys communities, for which we are grateful. Diolch yn fawr.

Thank you. And that brings today's proceedings to a close. Thank you.