Cynulliad Cenedlaethol Cymru

Croeso, bawb, i'r Cyfarfod Llawn. Jest nodi ychydig o bwyntiau, cyn cychwyn: cynhelir y cyfarfod hwn ar ffurf hybrid, gyda rhai Aelodau yn Siambr y Senedd ac eraill yn ymuno drwy gyswllt fideo. Bydd yr holl Aelodau sy'n cymryd rhan yn nhrafodion y Senedd, ble bynnag y bônt, yn cael eu trin yn gyfartal. Mae  Cyfarfod Llawn a gynhelir drwy gynhadledd fideo, yn unol â Rheolau Sefydlog Senedd Cymru, yn gyfystyr â thrafodion y Senedd at ddibenion Deddf Llywodraeth Cymru 2006. Bydd rhai o ddarpariaethau Rheol Sefydlog 34 yn gymwys ar gyfer y Cyfarfod Llawn heddiw, ac mae'r rhain wedi'u nodi ar eich agenda chi. A dwi eisiau atgoffa Aelodau fod y Rheolau Sefydlog sy'n ymwneud â threfn yn y Cyfarfod Llawn yn berthnasol i'r cyfarfod, ac yr un mor berthnasol i Aelodau yn y Siambr ag ydyn nhw i'r rhai sy'n ymuno drwy gyswllt fideo.

Yr eitem gyntaf ar ein hagenda ni'r prynawn yma, felly, yw'r cwestiynau i'r Gweinidog Addysg, ac mae'r cwestiwn cyntaf gan Suzy Davies. 

Thank you, Suzy. The review panel is currently gathering evidence and interviewing stakeholders. I will receive the interim findings, which will include key considerations for 2021, next month.

Thank you for that. It's just to raise the point that some in the sector have been contacted only this week, despite the review's findings due to be published by the end of October, so I'm not sure when the interim one is due. What they say does matter if preparations for the summer are to be practicable. Qualifications Wales have got their own summer 2021 stakeholder group to meet between now and December. So, could you tell us how that work and that of the review will relate to each other? And when will schools and colleges know exactly what they need to teach and how pupils' work will be assessed? Because that Qualifications Wales work won't be finished until a third of the way through the academic year. 

Thank you, Suzy. The interim report from the review body will be made available to me next month, and their final review will be given to me before the end of the year. Clearly, in the interim, Qualifications Wales are indeed carrying out their own piece of work, but they have already given evidence to the review panel, I believe, and they will need to be cognisant of any findings that the independent review panel make to me and any decisions I make as a result of the work of Louise Casella.  

Minister, you know I wrote to you in August, asking for a review of the system, following the results publication, and I am very pleased that the review is taking place. But I am concerned about next summer's examinations or possible examinations. We still don't know what will happen next summer, as of this point. I also know that many teachers and pupils are also concerned about what will happen with examinations next summer. Are you putting into place a plan B, which could be based upon teacher-assessed work again but, this time, moderated to ensure that there is fairness in the system and everyone receives grades that are equal and equivalent across Wales?  

Thank you, David. I recognise that practitioners, parents and pupils are concerned about what will happen in the examination series next summer. I have previously said that it is my sincere hope that examinations will be possible, but clearly we have to have contingencies in place if we find ourselves in the situation, for a variety of reasons, where examinations are not possible. As I said, in answer to Suzy Davies, the interim review panel is not just considering the examination series for this last summer, but will be making recommendations for next summer. And, as I said, the interim report will be made available to me in October. 

Thank you, Jayne. We have published guidance for post-16 providers to help them operate safely at this time. Colleges and universities must carry out risk assessments to ensure that appropriate measures are put in place to manage the risks of COVID-19 transmission in their institutions.

Thank you, Minister. Ensuring our young people are able to physically attend school or college is very welcome, and I know that the Minister and teachers across Wales have worked incredibly hard to ensure this has happened, and continues to happen, even in the difficult and changing circumstances we see. However, one concern that I've received from teachers and pupils is around post-16 education in schools. Those young people who are in school are more likely to work part-time and have social contacts from outside their school. However, the social distancing and guidance is the same as for 11-year-olds. There's a perception that sixth-form classes hold fewer pupils, however, I understand that, in some subjects, in some schools, there are over 30 students in a class. What discussions has the Minister had about the guidance for post-16 students in Wales and what has been learnt, following the first month, which could inform future planning?

Thank you very much, Jayne, for that. You're right—our sixth forms come in all shapes and sizes, with class sizes that can vary considerably, but it is correct to say that, sometimes, in popular subjects in large schools, sixth-form classes can indeed have a number of pupils. We have been very clear in our guidance to both schools and colleges that we should look to minimise contacts between groups of students at this particular time, and it is really important that practitioners are able to socially distance from their class. 

Clearly, we are keeping under very careful review the operation of both schools and colleges, following the first month, really, of operations. I'm pleased to say that the vast majority of schools have not had a case and, where we have had cases of COVID in pupils or teachers, that's usually a single case in a single institution. We have had cases in our FE colleges, but I'm pleased to say that, working with local test, trace, protect teams, the disruption to learning has been minimised. But, clearly, we're keeping under constant review the guidance to both schools and colleges as a result of the experiences over the last four weeks, and we'll be looking to review guidance in light of what we have learned so far. What's really important to remember is that the advice to date from Public Health Wales is that there is no evidence that schools or colleges are vectors for the virus spreading, and cases that we have seen in schools are a reflection of what we're seeing in our communities.

Minister, can I ask you what additional support is in place for learners who have extremely vulnerable people in their households who could be susceptible to COVID? I've got a learner in my own constituency who would like to continue with her post-16 education, but unfortunately her local college has told her that she must attend the college site in order to undertake the A-levels of her choice. As a result of that, she's not able to participate in education at present. Is there advice that you've been able to give to colleges to overcome this particular barrier that some young people are now facing as a result of having siblings or others in their families who may be extremely vulnerable?

Thank you for that, Darren. We have had regular discussions with both schools and colleges about what reasonable adaptations can be made to support students who may themselves be very vulnerable or feel very vulnerable at this time. It would be important for that student to have a discussion with her college, but if, Darren, you would like to write to me about that particular case, I will make further investigations.

Cwestiynau nawr gan lefarwyr y pleidiau. Llefarydd y Ceidwadwyr yn gyntaf, Suzy Davies.

Os gallech chi roi eich meicroffon ymlaen, Suzy Davies—iawn, dechreuwch eto.

Sori am hynny.

Yes, Minister, I was listening to your response to Jayne Bryant there and that observation that schools and colleges aren't vectors for the spread of COVID. Yet we've seen considerable numbers being sent home from some schools—200 in one case, and over 400 in another. You say you're monitoring what's happening at the moment, but have you learnt anything yet about why further education colleges seem to be doing a better job of minimising face-to-face teaching? They're losing fewer students than schools. Why is that?

Thank you, Suzy. As you said, we are keeping in close touch with our local education authorities and our directors of education. And in the case you've just mentioned—400 pupils leaving a school—I myself have spoken to the headteacher in those circumstances to understand why that situation arose. That's why, as I said in answer to Jayne Bryant, we are learning the lessons of these four weeks, where schools have worked incredibly hard to operationalise the guidance that we've made available to them. But clearly, in the light of those experiences, we need to understand what more we can do, how we can improve our guidance in schools, so that they can limit the number of direct contacts, and what other support we can give schools from our TTP teams, to be able to help them make decisions around which students can safely remain in school and not disrupt their education, and which students will, indeed, need to isolate. So, we're looking to review our guidance and, as I said, work closely with our colleagues in Public Health Wales and TTP to ensure that the advice given to headteachers is as good as it needs to be and that we have consistency across TTP teams in Wales.

Thank you for that. I think it would be helpful as well if colleges within a certain area might be prepared to speak to some of the headteachers in schools within their area about some of the good ideas that they've had.

Further education and higher education have both received over £20 million each from the Welsh Government COVID pot, despite a projected funding gap of more than £400 million for higher education. You signalled in the Welsh Conservative debate last week that that's one of the reasons why you don't support a partial reduction in fees for students who've lost out on the experience they've paid for. But, as we've heard, some students are having to stay in their expensive rooms to log in when they could have done that in a more familiar and cheaper environment at home—a home that many students will be leaving for the first time. None of the £27 million for HE is ring-fenced for student support. What are universities in Wales telling you now about how much of that money is going to unanticipated and speedy emotional and mental well-being support for students, and will they be coming to you for a top-up to the £27 million because of that?

Suzy, you'll be aware that the £27 million additional money that we've made available to the Higher Education Funding Council for Wales will be delivered to our institutions by the funding council. I met with the chair and the chief executive of our funding council just yesterday. And in my remit letter to them, emotional and mental health support for students is a priority for me, and I would expect part of that £27 million to be used to support universities deliver robust mental health and well-being support to students at this time, and also, potentially, to use some of that funding to ensure that financial distress that some students may experience is also taken into consideration. Obviously, Welsh students who are residing in Wales and studying—well, wherever they study—are entitled to our support programme. But I recognise that many students would usually supplement their income with part-time jobs, which may prove more difficult to come by at this particular time. So, both financial support and mental health support are a priority for me and a priority for the funding council, and we await bids from Welsh institutions to that pot of money, to ensure that that support is available.

Thank you for that. That's a good, strong message there to universities, so I certainly hope they're picking that up, because, at some point down the line, of course, we'll be scrutinising you on the spend of that £27 million, and I'm sure you will want that reassurance in the reports that you get back from universities in due course.

On a related matter—you'll know this—concerns have been raised with me, in my region and elsewhere, regarding some confusion about students living in large, off-campus houses in multiple occupation. Now, some set-ups are clearly single-person households in one building, but others can legitimately say that they're one genuine household of friends, sharing all facilities and costs like a family. This will impact on how the occupants of those buildings can respond to lockdown, and those in the latter situation are certainly at an advantage. I accept that this applies to non-students as well. But can you tell us how far down the road Welsh Government is to allowing solitary students to have a limited extended household in order to keep them sane? And, more generally, what concerns have you brought to the attention of the Minister for Housing and Local Government about what is understood by students to constitute an extended household, bearing in mind that they all have their own families, who may be happy to accept their own child in a bubble but not a whole household of friends?

Thank you very much for that. Can I assure the Member that I am not just seeking reassurances from individual institutions or the funding council about the levels of support institutions are putting in place for mental health? I met this week with the National Union of Students Wales to understand from them how their members are feeling. I will meet again with them next week, and I will continue to meet with them on a weekly basis so that I can receive reports from them as to how members are feeling. So, there are a number of checks and balances in how we are understanding what is going on on the ground.

I think it’s really important, Suzy, that we make clear that students will not be treated in a less favourable way than permanent residents of Wales. Wales is now their home. Our expectation is that they abide by Welsh regulations and guidance, but we certainly won't be putting additional restrictions in place. Indeed, in some cases, recognising some of the challenges around student accommodation—both on campus and off campus—the ability to share facilities has been made an exception to some of the issues around single households. But, clearly, we will continue to work with the housing Minister to ensure that those students who would be described as a single household are subject to the same consideration when we look at the wider issues related to individuals who find themselves living alone in the pandemic—some who might be vulnerable, some of them who are not vulnerable. But we all need that human contact and, as a Government, we're looking at finding ways in which we can allow that to happen safely, recognising that periods of isolation for those living alone can be particularly challenging.

Llefarydd ar ran Plaid Cymru nawr. Helen Mary Jones.

Diolch yn fawr iawn, Llywydd. Yesterday, Minister, the First Minister said in response to a question from Adam Price regarding students returning home for Christmas that he wouldn't treat students differently from anyone else. Now, I'm very glad to hear what you've just said to Suzy Davies—that you won't treat them less favourably—but I would suggest to the Government that this is a very distinct group of citizens. There can't be many other groups of citizens that will be moving in such large numbers from one community to another at particular times.

If a student is in a situation that they are in a university at Christmastime that is subject to a lockdown, does that mean that they can't go home? Everything that you've just been saying to Suzy Davies about the welfare of students and their mental and emotional well-being is very encouraging, but I would suggest to the Government that students do need to be treated differently, and perhaps what we need is a system whereby all students can be tested before they return home for Christmas, so that they could socially isolate when they get back home, if that's what they need to do—if they get a positive test. Otherwise, we will face, potentially, groups of young people or young people on their own over the Christmas holidays, and I know that you would not want to see that any more than I would.

Thank you, Helen Mary, for that. I want to assure the Chamber and, indeed, I want to assure students and parents that it is a priority for me, and a priority for this Government, to ensure that students who are residing and studying at Welsh universities will be able to return home for Christmas. I say that as a Minister, and I say that as a mum who has just sent my eldest daughter to university on Sunday evening. Believe me, she might have views about coming home for Christmas, but I desperately want her home for Christmas with me.

So, we will be working with our health Minister, working with our individual institutions and, indeed, working with the UK Government to ensure that the circumstances can be put in place to allow that to happen. SAGE, in their advice to the UK Government, is very, very clear that this needs to be worked out on a UK-wide basis because of the student flows across our borders. Individual students will be wanting to cross county and country borders, so, therefore, Governments need to work together on creating the circumstances that will allow that to happen. I discussed this matter with the universities Minister in the UK Government yesterday. I will discuss it again tomorrow with Gavin Williamson, and we are determined to ensure that students, when they want to, will be able to return home. But, clearly, we need to put the circumstances in place where they can do that safely.

Thank you, Minister. So, what you're telling the Chamber today is that you will be treating students, potentially, differently from other groups of people. If that's the case, I'm very glad indeed to hear it. I fully support your point about trying to develop a UK-wide response to this, because, obviously, we have a lot of cross-border flow. I would put it to you, however, that if the UK Government acting as the Government for England fail to sort themselves out on this, I do hope that there will be a plan B from the Welsh Government.

If I can turn, then, to students who are currently at university but not receiving any direct teaching or only receiving very minimal amounts of face-to-face teaching, there will be some of those students who would wish to return home and to be able to do their remote learning from there. What's the Government's position on that at the moment? For example, if you're, let's say, a student in Aberystwyth whose home is in RCT, is it permissible for that student to come from Aberystwyth to RCT to study for a period of weeks if that's what they feel they need to do, and is it then permissible for them to return to the university when blended learning and face-to-face learning can start again? It is quite a complex situation, I think, for students, and I think they would appreciate more clarity.

I wonder if you can give us a sense as well this afternoon, Minister, because I know you'll have your finger on the pulse with this, as to how much blended learning is taking place, how much actual face-to-face learning are students getting. I don't support, as you know, the Conservative position that would have students having their fees repaid, simply because I don't think our institutions can afford it, but I do think that if students are only getting very minimal or none at all in terms of face-to-face teaching, they ought to be allowed to go home to be with their families, if we can do that safely, in order that they can get that emotional support. Many of them, especially first years, of course, will be self-isolating potentially with people they've never met before, and that's not a happy place for an 18-year-old to be.

Firstly, with regard to the suspension of face-to-face learning in Aberystwyth, that decision was taken late on Sunday evening; it will be reviewed on Friday and I know it is the sincere hope of the university to be able to move back to a blended learning approach. A quick survey of social media will demonstrate to you that our institutions across Wales are already delivering a blended learning approach, whether that be our medics back doing face-to-face learning in Cardiff University, whether that's engineering students at Trinity Saint David, whether that's history students at Swansea, or, indeed, something that is of particular interest to me, our ITE, our education students at Cardiff Met, who are out and about, actually, doing their learning outside as part of their induction into the university and developing their skills in delivering outdoor learning activities. So, universities are working incredibly hard to deliver that blended learning approach.

What's really important to me, Helen Mary, and I'm sure it is to you, is that it needs to be a quality experience. Lectures that are delivered online need to be good lectures and good experiences, as well as that face-to-face contact. That's why I've received assurances from HEFCW yesterday that they will be monitoring the quality of the blended learning approach very, very carefully. And let me say, blended learning and face-to-face contact is not just important in the context of learning. It is an important part of how universities can check in with the welfare of their students, by having an opportunity to see them face-to-face, and I know a great deal of time, effort and resources have gone in to, for instance, expanding university estates and creating more space to allow that to happen safely. So, for instance, in the case of Aberystwyth, they have actually recommissioned buildings that had previously been mothballed so that they can indeed deliver that face-to-face contact in small tutorial groups, and I know that they're keen to continue to do so as soon as is possible.

I have allocated funding of £400,000 to local authorities this year to provide support to home-educating families in recognition of the additional costs that these families may incur when providing resources and opportunities that are typically available free in school. This provision of funding is unique to Wales. 

I'm very grateful for that response, Minister, and very grateful for the funding that has been made available for home-educated young people. One of the challenges that many of those who have been home educated have faced over the past examination period is that obviously they're not at centres whereby grades could have been provided to them, and as a result, many are having to face the prospect, potentially, of examinations next year. Can you tell us what assurances you can give to the parents of home-educated learners that there will be an opportunity for them to sit their exams next year, so that they won't have to lose out when compared to their peers in terms of being able to have access to the grades that they believe they should have secured this year?

Thank you, Darren, for the recognition of the financial resources that have been made available. As I said in answer to earlier questions, it is my sincere hope that examinations will be able to go ahead next year. However, we know that this virus and the pandemic is unpredictable, so we do need to have other provision in place, and we will need to ensure this time—because we have more time to plan—that the specific needs of children who are not attached to a specific centre have the opportunity to be awarded a grade. So, I know that this is under consideration at the moment.

Minister, home education can be an informed and positive choice for families and children, so the additional funding from Welsh Government is really welcome. But in June, you announced that due to the pressures of responding to the COVID crisis, it wouldn't be possible to proceed with the proposals set out in the consultation on home education statutory guidance and draft database regulations. You wrote reassuringly to the Protecting Home Education Wales organisation explaining that you hoped they would be taken forward by the next Government at the earliest opportunity, and that new or revised proposals would be subject to public consultation. So, could I ask, Minister, would that consultation also take into account any further representations by the Children's Commissioner for Wales or by child and safeguarding organisations on how these proposals—recognising they're primarily focused on educational support—can also assist child safeguarding in Wales?

Huw, I can give you that assurance that any further consultation on these proposals will indeed take into consideration the views of everybody that has something that they feel that they can contribute. It is disappointing that we have found ourselves in the position where we cannot proceed in the way I had intended; it is regrettable indeed. But I should stress that despite the inability at this time, due to pressures of COVID, not to proceed with new legislation, local education authorities still remain under the legal obligation to ensure that all children are in receipt of a suitable education, wherever that education is delivered, and that hasn't changed. We issued guidance to local authorities earlier in the year about how they could continue to fulfil that function and support home-educating families during the pandemic, and we're looking to spread good practice across local authorities in that regard, so that where improvements can happen, and need to happen, there are examples of how that can be achieved.

I have remitted HEFCW to work with partners in the HE sector to address student mental health and well-being. To support this work, I allocated HEFCW £3.5 million last year to support well-being and health in higher education, including student mental health.

Thank you, Minister. I know that you are very well aware that I share the concerns raised by other Members about the mental health of higher education students at this very difficult time, and also that the committee has written to all vice-chancellors in Wales to seek assurances about support for students. But what I wanted to ask about today was specifically suicide prevention. I was very grateful to you for meeting with me and James Murray, whose son Ben tragically died by suicide at Bristol university two years ago. Can I ask, following that meeting, what update there is in terms of encouraging universities to embed Papyrus's excellent 'Suicide-safer Universities' guide in their work? Thank you.

Thank you for that question, Lynne, and also thank you for the opportunity to meet with yourself and Mr Murray, whose testimony was powerful indeed. He outlined, very clearly, the steps that all institutions can take to make them as safe as possible for young people. As you're aware, I gave a commitment, during that meeting, that we would be pursing the issue of Papyrus's advice, to see what steps universities were taking to implement that advice. I would like to reassure all Members that each university, prior to the start of the academic year, have been asked to prepare COVID plans, and one of the questions that we were asking in those plans is what steps they were going to take to support mental health at this time. So, whilst COVID brings new challenges, it is a particularly important aspect of universities' work at this time, recognising that people could feel additional vulnerabilities and additional isolation, worries and anxieties on top of what we would usually see at the start of the academic year. We will continue to monitor their progress via the funding council, and indeed with my regular meetings with NUS Wales.

Minister, in earlier questions you said that this has to be a UK-wide approach to get students home for Christmas, and I'd agree on that basis, given the cross-border flows that happen with students. The education Minister—the Secretary of State for Education I should say, sorry, in London, highlighted to the House of Commons yesterday that he could see that there'll be a formal suspension of face-to-face lecture time and tutorials, and everything would move online so that a two-week period of isolation could be undertaken by students before they left their universities to head home before Christmas. Is that a course of action you subscribe to?

Andrew, as you say, it's important that we have a UK approach, if at all possible; that is what has been recommended by SAGE. And, as you said, there are significant cross-border flows of students—Welsh students into England, Scotland and Northern Ireland, and vice versa, and therefore a co-ordinated approach, I believe, is best. I will be discussing a range of options with Gavin Williamson when I meet him later this week.

I published learning guidance in the summer, which set out our priorities for all scenarios, including blended learning. I have also announced a Recruit, Recover and Raise Standards programme and extra support for A-level students, and I have modified the curriculum requirements to take pressure off schools.

Thank you, Minister. Unfortunately, in recent weeks we have discovered just how hard it is to keep coronavirus in check. Future outbreaks are sadly inevitable. What we have to do is ensure that those outbreaks do not disrupt a single day of education. Minister, we have seen entire year groups sent home as a result of infections, and while we do everything possible to prevent the infections and stop such actions being necessary, we also have to prepare for the worst. Minister, what actions can you take to ensure a seamless transition from in-person to online learning, and will you ensure that schools are equipped to deliver classes virtually as opposed to providing self-paced learning?

Can I thank the Member for the supplementary question? Can I make it absolutely clear to the Member that whilst we have indeed seen disruption to education this term, 1,299 Welsh state schools have not suffered a COVID case to date? So, I think we just need to remember that, and give thanks to those teachers, support staff, governing bodies and local education authorities that are doing everything possible to minimise disruption to children at this time.

The Member will be aware that we have invested significantly in recent years in digital learning, both in terms of the infrastructure for individual schools, the provision of additional pieces of equipment for individual students and connectivity for students who don't have it at home. Just to give you an example of how schools are preparing to deal with disruption, during the month of September so far, since schools started back, we have seen the establishment of 25,000 Google classrooms; that is more Google classrooms set up in the period of one month than we have seen over a period of years. Teachers and schools are taking all steps necessary to be able to move to seamless synchronous and asynchronous learning should disruption happen to an individual group of students so that they can keep learning at this time.

Minister, good afternoon. I'm sure you'll join me in recognising the courage and resilience of our children as they return to school in what is a very worrying time for them and their parents. What thoughts have you given to providing more pastoral support and care to children in Wales, particularly in primary schools and nurseries at this time? In recent years, there's been an increasing demand for counselling services amongst schoolchildren, often discussed in this Chamber. Particularly now the COVID-19 pandemic is with us, we are seeing further disrupted children. So, how are you planning to increase counselling capacity in our schools, build resilience and support children? 

Good afternoon to you, Nick. Like you, I am in awe of the courage and resilience that have been shown by our young people at this time. Supporting them with their mental health and their well-being is important, and that's an important reason why we were determined to reopen schools fully for all children for this academic year and to keep them open, because we understand the impact that lockdown and not being in school has had on many children.

But, clearly, for some children, the return to school, whilst it is a happy one—they could, indeed, have anxieties as a result of the pandemic or the situation that they themselves or their families may find themselves in. That's why I have worked hard with my colleague the Minister for health to provide additional resources for school counselling this year, with a particular emphasis on being able to expand support in the primary sector, not through traditional counselling methods, which are not really appropriate for our younger children, but with a strong focus on family therapy and group work so that our youngest children can also be supported at this time. 

I just wondered if you could tell us a little bit more about the attendance rates at school, because I think that will give us an indication of how effective schools have been at reaching out to young people who may be feeling very anxious about returning to school and assuring them that they are going to be safe, and that they should be returning to school for their well-being.

Thank you, Jenny, for that. Overall, nationally, attendance rates run at approximately 80 per cent—just over 80 per cent—although there are some significant variations in that. Not surprisingly, those areas with a lower virus transmission are seeing higher levels of attendance. So, we see particularly high levels of attendance in Monmouthshire, in Pembrokeshire and in those areas, as I said, where we see lower levels of transmission. But even in areas of higher transmission, the vast, vast majority of children are continuing to attend school.

Undoubtedly, where there is a case, that can have an impact. Yesterday afternoon I had the privilege and pleasure of talking to the headteacher at Ninian Park Primary School here in Cardiff. They started off the term really, really positively with high attendance. Unfortunately, they had an individual case, which did see their attendance immediately after that case drop. But as of yesterday they were back to attendance in the region of 86 per cent, and that's because the teachers, the headteacher and the governing body had worked really hard to provide the assurance to parents that they needed that even with a case it was safe for their children to be back in school.

We will continue to work with local authorities to ensure that the Welsh Government is supporting them and the teaching profession in providing reassurance. In some cases, we know that parents are being incredibly cautious and trying their very best. It's cold season, so I know that our chief medical officers are working together across the United Kingdom to be able to provide more advice to parents to help them make decisions about when it is right for a child to be sent into school and when a child, perhaps, should be kept at home and get a test, if necessary. I know that teachers are working very hard to have those conversations with parents and to provide the necessary reassurance.

Diolch yn fawr, Helen Mary. Local authority Welsh in education strategic plans outline how demand for Welsh-medium education is met. Our annual monitoring of plans suggests an increase in learners accessing Welsh-medium provision in the majority of Mid and West Wales. New WESP regulations set out a higher expectation of targets, and that is aligned with Cymraeg 2050.

I'm grateful to you, Minister, for the answer. I know that you will want to join me in congratulating Powys County Council, who have recently put out to tender again to build the 150-place Ysgol Gymraeg y Trallwng in Welshpool. As someone who grew up in Montgomeryshire and was educated there, albeit a very long time ago, I very much welcome this investment.

I'd like to ask you about the next steps for the new Ysgol Gymraeg Dewi Sant in Llanelli. I'm aware that there are still issues with regard to finding an appropriate site. In the meantime, my inbox is full of people who are concerned about the difficulties of providing distanced learning safely on the existing site. Can I invite you once again, Minister, to reassure the families and the staff at the school that, when a new site is identified, the funding will be available for a new build and that that won't be lost because of the very unfortunate, and we won't rehearse the circumstances, inability to proceed on the original site? 

Like you and many other people, Helen Mary Jones, the re-provision of a new school for that community remains a priority for me. I look forward to receiving an application from Carmarthenshire council so that we can proceed with that project.

Minister, a report by Estyn earlier this year showed that standards in literacy, numeracy and Welsh second language require improvement in around half of primary schools and all secondary schools inspected since 2017 in Pembrokeshire. Given that Pembrokeshire local government education services are causing concern and require follow-up activity, can you tell us what discussions the Welsh Government has had with the local authority and, indeed, regional consortia about raising standards and improving outcomes, particularly in relation to the teaching of Welsh as a second language?

Thank you, Paul. Improvements in teaching Welsh as a second language is important right the way across Wales, not only in Pembrokeshire, and it'll be an important part of our reformed curriculum, our professional learning opportunities and our new initial teacher education provision. I myself met with representatives, with my officials and with representatives of Pembrokeshire, prior to the summer recess, to talk about what additional support the Welsh Government can give to that local education authority to help improve standards across the piece. 

The Bill is currently being scrutinised by the Senedd and therefore I do not intend to make a stand-alone statement on this matter. Though, as I have already indicated to Members, I am open to discussions and will listen to concerns.

I was going to say, 'Thanks, Minister', but I don't think I can now, really, because it's a very simple question about evidence. What I would have appreciated would have been some interaction on the question of evidence so at least we can have a grown-up discussion about this.

I think, having spoken to professionals in the field—this morning, actually—again, one question that comes to my mind is, 'If it ain't broke, don't fix it.' I think what we need to have is an understanding of the Welsh language, the special conditions that it takes to learn a language in immersion circumstances. And I think we really need to pay at least some attention, some real attention, to the so-called figure of a million speakers, which I think is just paying lip service at the moment, because I see no evidence.

I'm disappointed with the lack of engagement with the question. All I was asking for was some evidence, and you clearly have none. Thank you. 

I can assure the Member, Presiding Officer, that there are plenty of grown-up conversations being had about how we can deliver the targets of Cymraeg 2050. I am perfectly aware of the success of the immersion model in helping children acquire Welsh. My own children have benefited from it. There is nothing currently in the Bill that will prevent immersion from happening, but I am aware of concerns about how the Bill might inadvertently make immersion, or the increase in immersion, more difficult and therefore, as I said, I am willing to listen to those concerns and to engage positively with those people who positively engage with me.

Thank you for your answer to Mr McEvoy and also your previous answers to the last couple of questions, because it's all along the same theme. But I think the real barrier to being able to provide and to meet the Cymraeg 2050 target is actually the difficulty of getting Welsh-speaking teachers in play. We need more of them and we need them in all the different areas of Wales. There are some parts of Wales where it's incredibly difficult to get Welsh-speaking teachers. Conversely, we also have young people who are training as teachers who don't yet have Welsh and they're finding it sometimes difficult to find jobs that are non-Welsh-speaking. So, how are you going to address that balance in order to meet the Cymraeg 2050 target? And how can we encourage more people to become Welsh-speaking teachers so that we can not only do immersion learning but actually learning in the non-Welsh schools?

Thank you very much, Angela. The first thing that we need to do is increase the number of students who are studying Welsh at A-level, because we know that that qualification is often a precursor for people to go on to study Welsh at a higher level and then converting then into teaching Welsh, and we are promoting a Welsh A-level take-up scheme to promote that subject so that more students take it. Within initial teacher education, we are indeed providing opportunities for those students who currently do not have Welsh skills to be able to acquire those skills as part of their initial teacher education, so, even if they don't intend to go and teach in a Welsh-medium school, they can deliver high-quality Welsh lessons within the English-medium sector.

For those teachers who do, indeed, intend to teach through the medium of Welsh, we have provided funding—although, I have to admit that COVID has created some disruption to this programme—that will allow primary school qualified teachers to convert to be able to teach through the medium of Welsh in the secondary sector, because that is where we have particular shortages—in the secondary sector. And, indeed, those wishing to pursue a career teaching through the medium of Welsh continue to attract the highest level of ITE financial incentives if they choose to go to study for a teaching qualification in Welsh. 

Last week, I met with Coleg Cymraeg Cenedlaethol to talk about what more they can do, learning from the expertise that they already have in expanding Welsh-medium provision in the HE sector—what more they can do to work with our individual higher education institutions and the Education Workforce Council to ensure that we can increase the number of people who are acquiring those skills necessary to teach Welsh successfully in a Welsh-medium school or in an English-medium school.

I'm pleased to say that we have an uptick in the number of recruits onto ITE this year, but one swallow doesn't make a summer and we need to continue to press on this agenda.

Finally, question 8, Rhianon Passmore.

I understand that, for the week 14 to 18 September, attendance at maintained schools in Caerphilly was running at 77 per cent.

Diolch, Minister. Thank you for that answer. The Welsh Labour First Minister, Mark Drakeford, has stated that keeping schools open was a top priority for the Welsh Government. For the parents and children in Islwyn, it is imperative for their social and mental well-being that they are able to continue their education in school with all the necessary precautions. From Risca Primary School in the primary sector to Blackwood Comprehensive School in the secondary sector, children have had to leave school to self-isolate for a period of time.

From Welsh Government data that I saw on Wednesday, eight out of 10 Welsh children were in school, compared to six out of 10 for the previous week. So, Minister, with attendance rising, how can the Welsh Government reinforce to our communities that, for our children to be educated, there needs to be, on public health grounds, reassurance? When will they be asked to stay away from school and what actions can the Welsh Government take to encourage the ever-increasing rise in school attendance by Islwyn's children?

Can I thank the Member for her question? And can I assure her that this Welsh Liberal Democrat education Minister is taking all necessary steps and actions to ensure that children, whether they be in Caerphilly, or, indeed, anywhere else in Wales, have the disruption to their education minimised?

Diolch i'r Gweinidog.

Yr eitem nesaf, felly, yw cwestiynau i'r Gweinidog Iechyd a Gwasanaethau Cymdeithasol, ac mae'r cwestiwn cyntaf gan Jayne Bryant.

Thank you for the question. Whilst we have seen a rapid increase in cases in some areas, the specific advice to people in the former shielding group has not changed at this point in time. They do not need to take the strict shielding measures at this time. The Chief Medical Officer for Wales is liaising with CMO colleagues across the UK on advice to this group on minimising their risk of harm, and we will be writing to those on the previous shielding patients list in the coming days ahead.

Thank you, Minister. I know that the measures put in place by Welsh Government to support the most vulnerable were greatly received. However, I'm now receiving correspondence from those who were shielding asking for further guidance. So, I'm pleased to hear that there will be some correspondence. Those contacting me are not asking to go back into shielding, but that, when announcements are made on any restrictions, communication is also made with those who were shielding. In particular, as the local restrictions are in place, people just want to have comfort that they're doing the safest and the right thing. While I appreciate that we're learning more about the virus all the time, what discussions are you having with others about the communication with those who are most at risk?

Thank you for the follow-up question. Of course, we had an opportunity to discuss some of this in the Health, Social Care and Sport Committee earlier this morning. So, as well as a direct contact that we expect from CMO correspondence with people in that former shielded category, we'll use the variety of our channels, and, to be fair, there's been such interest in the former shielded group that I expect we'll get significant pick-up in national and local media when we recommunicate where we are.

I think it is important to emphasise the lessons we've learned from the first six months. We do think we've prevented significant harm for people on that shielded groups list, but it comes at a cost. There was a cost in terms of people's mental health and well-being, because many of the people felt lonely, even with the support that was provided. So, shielding isn't an end in itself with no harm that attaches to it; it's always a balance. We also know that the previous approach of having a list of medical conditions doesn't take account of all the evidence of harm from COVID. We know that if you're less well off, you're more likely to suffer more significant harm—that point about health inequalities has been re-emphasised with a vengeance with the first phase of the pandemic. And, also, if you look like me, you're more likely to suffer harm, so the point about ethnic origin isn't taken account of in a medical conditions list. And, equally, if you look like me, and if I were to weigh three or four stone heavier, I'd be at a greater risk again as well. Not all of those things are picked up with a medical conditions list approach, so we're learning from what's happened. We're going to have to apply that, with the advice we get from the chief medical officers, in advising people how best to take care of themselves. But that will definitely involve direct contact with people on that former shielded patients list.

Good afternoon, Minister. Local coronavirus help and support groups, like Feed Newport in Pill, and the ones I set up in Wyesham and Usk, did a fantastic job during national lockdown at protecting vulnerable people, making sure they didn't feel isolated, and delivered food and prescriptions to those who were previously shielding and self-isolating. These vulnerable people are now at risk now the virus is on the rise again. Shielding for extremely vulnerable people was introduced at the start of the pandemic in March and only recently lifted. However, your Government's advice, as you've just stated, is that these people do not need to shield at present. Can you explain a bit more your reasons for that decision, Minister? And in what circumstances would you feel the need to reconsider this advice for those shielding, as it's confusing for people, as outlined by Jayne Bryant? There does need to be more communication and more detailed communication, and I welcome the fact that you're going to send letters out, but also for COVID groups to prepare to help those people shielding again. And, Minister, will you just take this opportunity now to join me in thanking all the fantastic work done by voluntary groups throughout this pandemic in helping those most vulnerable in our society?

I'm very happy to reiterate the thanks that myself and other Ministers, and other leaders of local authorities in every part of Wales, have given to all those people who've volunteered to help other people out, that's both in combating loneliness and isolation and helping with services, from the specific schemes we've had to delivering pharmacy medication to, if you like, the wider befriending and some form of social contact, albeit not the physical contact that we are used to and value. I know that this is also an issue where families and friends are taking care of each other outside organised activity as well. I have continued to do my mother's shopping, in the main, and to deliver that each week. I can't go into her home, because I present a bigger risk to her than my sister does, who has less contact, and all of those individual calculations about managing risk are taking place in families and communities around the country.

We need to take account, as I said in answer to Jayne Bryant, of the learning from the first six months of the pandemic, of our understanding of the benefits and disbenefits of a medical conditions list, and we will then set that out for people on the former shielded list, but for the country at large, because, whilst we're seeing coronavirus cases rise, we've been very clear that people on the former shielded list should be particularly vigilant in following the advice on restricting the number of contacts they have, because, actually, managing your own contacts, restricting them to as few as you need to have, obeying the rules, and, indeed, having good hand hygiene and following the whole-nation requirements, are especially important for that group of people with a medical vulnerability. But, as I say, it's a more rounded approach we need to take, and that comes from learning not just from the figures, but also from our direct contact with people who were formerly shielded, and I'm more than happy to keep not just the Chamber but the country updated about the changing advice and decisions that we make.

Minister, thank you for your answers to the questions on this already. I think you'll agree with me that one of the major things that has been of assistance to people when they have been shielded is the priority delivery slots that supermarkets have offered to them. My understanding, from speaking to constituents, is that lots of those supermarkets are now bringing those priority slots to an end, at a time when we see coronavirus on the increase in so many of our communities. This is something that concerns not just my constituents, but me as well, so could I ask what discussions have you had with other Ministers around these protected delivery slots and just urge you to take some action on this?

That's an important point, I think, from Vikki Howells about the practical support that people have been provided with. The food delivery scheme actually didn't reach huge numbers of people, because they didn't need it. Everyone who needed it had a delivery from the free food scheme, but, once supermarkets had significantly expanded their own online delivery slots and prioritised people on that shielded list, the need for a free food delivery scheme was less than we had originally anticipated. So, that significant expansion in online slots needs to continue, and I'll certainly take this up and have a conversation with my colleague Lesley Griffiths, who has regular contact with supermarket retailers on a range of measures, and it's very helpful you've raised it with me today, because it's certainly something to take forward, as I've not previously had direct intelligence brought to me that there's been a reduction in slots. We absolutely want to see that continue, as we face up to what will undoubtedly be a very challenging winter and autumn.

Thank you. This winter, with the continued presence, indeed the resurgence, of COVID-19, we want to ensure that more people than ever receive the flu vaccine. That is why we have extended the eligibility criteria. We're working with key partners to maximise the uptake of the flu vaccine, and additional vaccine supply will be available to support anticipated increased demand.

I thank you for that answer. In his evidence session with the Senedd's health committee last week, Dr Quentin Sandifer from Public Health Wales said that

'in ordinary times, we would aspire to a 75 per cent flu vaccination uptake in eligible groups'

and that would 'maximise the protective effect'. So, clearly, we want to hit at least that this year. So, what, then, is being done to ensure that we achieve that maximum uptake? Has everyone eligible for the free flu vaccination been contacted by the NHS and are the stocks and the logistical arrangements in place to deliver a record number of doses on time? Given the spike that we've seen in coronavirus testing and absences at the start of the new school term and, given the increased danger of having both coronavirus and flu at the same time, where are we in terms of take-up and delivery of the nasal spray flu vaccination in primary schools?

Thank you for those questions. And it is a really important campaign, this year more than ever. In an average flu season, 8,000 to 10,000 people across the UK lose their lives as a result of flu, so this is a significant cause of mortality in normal times. Given the additional risk of corconavirus, it's even more important than ever that we have people taking up the offer of a free NHS flu jab, and indeed for other members of the public to protect themselves, if they can do so.

What we have done is we have, together with other UK nations, procured more of the flu vaccine than ever before—about 50 per cent more. That is to maximise take-up in the at-risk groups, and those people are regularly notified through their healthcare providers and will receive the same notification. We already see, though, positively, evidence of an increase in demand for the NHS flu jab, so that's good news. That does mean, though, that there is a need to make sure that people have ready access, whether in general practice or community pharmacies—our two main delivery systems for the flu jab for adults and adolescents—and it's important that continues.

On the nasal spray for younger children, both pre-school and in early school, we've actually, again, had increased supplies available to us, and that is rolling out within each health board as we speak. So over the coming weeks—. We've had a letter in my own household for our primary school age child to get consent for him to have the nasal flu spray as well during the season.

It's important that we get as much done, as far as possible, before we get into December. So we want as many people vaccinated as possible by November, if at all possible, because flu tends to circulate in larger numbers, in larger volume, from December onwards. So I am confident that the enhanced profile that this campaign has this year will lead to a continuing strong demand for uptake, and if we can have that high level of vaccination within our most at-risk categories, we'll then move to roll out another campaign for over-65s and, then, the over-50s.

But it's been a good start thus far and I do really think that, this year, we have seen a much heightened profile of the flu vaccine campaign. It normally receives a period of interest for a brief period of weeks and then largely rolls into the distance, but I think, with the additional threats of coronavirus, we will see more and more people wanting to take up the offer. 

The increase in demand, Minister, is very, very welcome, as is the extension of the eligibility criteria, but, unfortunately, I've got people in my own constituency who have been told they cannot schedule a flu jab appointment with their GPs until a month hence, which is clearly completely unacceptable, particularly for those in those vulnerable categories that you've already referred to. And, of course, it's not just the flu vaccine that some people need to access; there's also the pneumococcal vaccine to protect people against pneumonia, and I'm aware that there are shortages of that vaccine across Wales and, indeed, other parts of the UK at present. What action are you taking to make sure that there is sufficient capacity within the system to be able to meet the request for vaccination from all those who need it?

There's a mix in terms of the provision. So the UK Government normally procure flu vaccine supplies for across the UK, and that's where we've agreed to have an increased UK procurement exercise, and a range of GP practices also procure their own as well. We are aware of some challenges in supply and those are short-term matters, is our understanding. So, for example, one of the major manufacturers has decided to stagger the release of the flu vaccine this year, which is why some community pharmacies and some practices may experience a delay and a staging in the way they can deliver the vaccine.

In terms of what is and isn't acceptable, I think it's the case, as I said, that because flu circulation tends to take place later in the winter, through December, the important point is to use September, October and November to get as many people vaccinated as possible to provide that level of protection ahead of the peak of the flu season. We'll continue to work with both general practice and community pharmacy. And I would say that if there are real challenges in the supply, as opposed to a staggering of the supply, because the two are different, as ever we'll continue to work on this issue in a constructive way across the UK. It's one of the areas where all four Governments, regardless of political leadership, do have a very grown-up and, I think, effective way of working with each other.

I feel that Joyce Watson's question is hugely important, particularly in the light of the COVID crisis, where there are figures to show that the take-up of flu vaccines is much reduced amongst the most vulnerable. Perhaps this is because people are fearful of attending surgeries—a fact that may well be the result of doctors being reluctant to engage with all but the seriously ill. The low take-up is particularly worrying given the fact that in the last 14 weeks, the flu killed 10 times as many people as COVID. Is this part of the statistics that would prompt some scientists to say that the lockdown measures could kill 75,000 people? Minister, given the devastating effects lockdowns have on society as a whole, can you assure the people of Wales that the lockdowns will only occur once all available scientific advice is sought and that they will end at the earliest possible date that data no longer supports the lockdown?

I'm afraid, I think, that there was a large amount of misunderstanding in the first part of that question. Joyce Watson's question really is important because of the additional risks that we know come, not just in a normal flu season, where, as I've indicated, 8,000 to 10,000 people across the UK lose their lives as a result of the flu and its effects each year, but actually we're in a position where we are already seeing increased take-up. It isn't that there is a reluctance from people to have the flu vaccine this year—far from it. People are keen, not just in Wales, but my understanding, in terms of the sharing of information between all four nations, is that in all four of the nations of the UK people are keen to take up the flu vaccine and are looking to have it early, which is good news for all of us.

When it comes to the restrictions that have been put in place, both the current local measures we have and indeed the fuller lockdown measures that were introduced in March, they're only being introduced on the basis of the information we have available to us: on the medical and scientific information on the spread of the virus, on its impact and its likely impact if measures aren't taken to halt its spread. We will only introduce these measures where there is an evidence base to support them and it will reduce the harm from coronavirus, and we will lift them when the evidence is there that they are no longer a proportionate intervention in the way that people live their lives. 

We're acting now to avoid the sort of harm we saw in the first wave of coronavirus. I do not want to wait until our hospitals are full and I am having to report on significant increased death figures every day before we are prepared to act. Acting now is about avoiding even more draconian impositions on the way people live their lives, avoiding even more significant harm to families and communities across the country.

Cwestiynau nawr gan lefarwyr y pleidiau. Llefarydd Plaid Cymru, Rhun ap Iorwerth. 

Diolch, Llywydd, a gwnaf innau bigo i fyny ar y cwestiynau pwysig yna ynglŷn â brechlyn y ffliw. Gaf i dynnu eich sylw chi at astudiaeth ddiweddar yn yr Eidal sydd wedi nodi perthynas rhwng cyfraddau brechu'r ffliw a chyfraddau symptomau a goroesi coronafeirws? Mewn rhanbarthau lle'r oedd mwy o bobl dros 65 oed wedi manteisio ar y brechlyn ffliw y llynedd, mi oedd yna lai o farwolaethau neu bobl yn gorfod mynd i'r ysbyty oherwydd coronafeirws eleni. Gallwn ni ddim ond dyfalu ar y pwynt yma beth ydy'r rheswm am hynny, ond gan ein bod ni yn eiddgar i gyfyngu ar ledaeniad y ffliw beth bynnag, mi oedd yn fy nharo i y gallai gwneud yn siŵr bod y brechlyn ffliw ar gael i bawb sydd eisiau ei gael o, nid dim ond grwpiau targed, yn fuddsoddiad gwerthfawr iawn, nid yn unig wrth fynd i'r afael â phwysau arferol y gaeaf ar yr NHS, ond hefyd i leihau effaith coronafeirws. Felly, yn ogystal â'r ymrwymiad i gael mwy o bobl i gael y brechlyn, a fyddech yn fodlon ymrwymo i rywbeth pellach, sef ei ehangu fo i bawb gan y gallai hynny fod yn fuddsoddiad da?

Well, first, to plan and to deliver an effective seasonal flu campaign, and this will be our largest ever seasonal flu campaign—we expect to deliver more flu vaccines than ever before to the people of Wales this winter—we need to make choices in advance of the season to be able to do that, and we have chosen to target and to increase significantly the amount of flu vaccine that we procure for the people of Wales and that we then deliver.

The question about whether we should have whole-population coverage in terms of the NHS campaign is rather out of the scope of where we are at present, but it's something that we can consider in the future. It's not currently supported by the joint committee that advises the Welsh Government and all UK Governments on the delivery of vaccination programmes. But, as ever, as the evidence base changes, then we're of course prepared to shift and to change our position, because the objective here is how we protect as many lives as possible, and avoid as much harm as possible, whether that's from COVID, the flu or indeed a range of other infectious diseases and conditions that we know are a regular challenge for how we live our lives today.

Diolch. Mi symudaf i ymlaen. Wrth i fwy o gyfyngiadau gael eu rhoi ar bobl ledled Cymru, mae hi'n bwysig iawn dangos ein bod ni wedi dysgu gwersi o'r cyfnod clo llawn gwreiddiol. A dwi wedi gweld un adroddiad sy'n dweud bod cymaint â 50 y cant o bobl jest ddim eisiau mynd i weld gweithwyr iechyd proffesiynol ynglŷn â chyflwr meddygol yn ystod y cyfnod clo yna, achos yn syml iawn doedden nhw ddim eisiau poeni yr NHS. Rŵan, er bod y Pwyllgor Iechyd, Gofal Cymdeithasol a Chwaraeon y bore yma wedi clywed bod niferoedd ymweliadau at feddygon ac i adrannau brys, ac yn y blaen, wedi codi erbyn hyn—mae hynny'n beth da—mae Tenovus Cancer Care yn amcangyfrif y gallai fod yna 2,000 o bobl yn byw efo canser heb ddiagnosis yn dal ddim wedi mynd at y meddyg teulu eto o ganlyniad i'r pandemig. Pa sicrwydd allwch chi ei roi i'r bobl hynny—pobl sydd, wrth gwrs, yn teimlo'n fwy nerfus rŵan wrth i'r cyfyngiadau newydd ddod i mewn—fod yr NHS yn dal ar agor i bawb, ac annog y cleifion hynny sydd ar goll yn y system i fynd i chwilio am gyngor meddygol?

Well I think we've been very clear and consistent about the concern we had for the harm that is caused as a result of non-COVID conditions. That's both the harm that could have been caused if our health and social care system was overwhelmed—and it wasn't; it was under significant pressure in different parts of Wales, but it wasn't overwhelmed—and also the harm caused by non-COVID conditions because people are not undertaking treatment, either because they're opting out of treatment because of the concerns they have, and we definitely saw that, or indeed because it isn't possible because of the system being overwhelmed.

You'll have heard me say on a number of occasions over the past months the concerns we had about the fall in emergency admissions. That's partly because some people didn't really need and don't need—and we discuss this every year—to go into an emergency department, there are other routes for their care, but the much bigger concern was that there are people who really do need emergency care who weren't coming into our health service. And that's not just cancer; stroke, we know that there was a significant fall in people attending the national health service with stroke conditions. Now, I don't believe and there's no evidence to support the view that that meant that, suddenly, there was a significant reduction in the incidence of stroke across Wales. It's about how people were behaving, and their concerns.

We have definitely learnt from the first six months. And so we now have streaming in terms of COVID-light or COVID-green zones, and COVID-red, COVID-positive or COVID-possible zones. That's important to give people confidence, and the way that we manage patients who are coming into our health service through either one of those routes, primarily for hospitals, but also we've had to change the way that primary care has worked. So the ability to consult and to see people virtually, to speak to people on the phone, there's been a significant increase, and that should give people more confidence. But the message from me, and from our whole national healthcare system, is we're open for business, we've learnt from the first six months, and if you have a serious healthcare condition, you should continue to come forward, you should continue to seek advice, support and treatment, whether via primary care or indeed hospital care, because the NHS has certainly not closed up and we look forward to people returning in larger numbers. The case for reform in our healthcare system will be remade about the need to change the way that we work, but that does mean people need to present at the earliest opportunity to allow us to intervene in the least invasive way possible.

But there are people though who are already in the system and who've faced a journey that's much, much longer than it would have been. And you'll have heard me make repeated calls about the need to structure services in a way that will allow treatments to resume, diagnosis services to resume, and so on, at a much faster rate than they are currently. Again this week I've heard concerns from surgeons—one of the royal colleges—that this isn't happening still to the extent that it's needed.

It might be understandable that the publication of referral-to-treatment data was suspended at the beginning of the pandemic, but here we are now on the last day of September and the last available data was published in March, and those were figures for January. RTT data provides a crucial insight into how long people are in the system, how long they're waiting, across all health boards, all specialities. And with elective services across Wales, we know, decimated by the outbreak, without the data we have no way of knowing the scale of the backlog problems we're facing within NHS Wales. And every statistic is a patient, waiting in pain, quite often. So, now that we're over six months into the pandemic, will you urgently make this data publicly available?

In health committee this morning, I and the chief executive of NHS Wales, Dr Goodall, provided a range of information about the scale of the backlog that has built up and the range of that backlog. I'll certainly look to see how and when we release information to provide more detail on that. I think returning to publishing RTT figures and percentages would be incredibly unhelpful, because it would give the impression that the NHS is somehow failing, when actually it is about how we're managing to cope with the demand that is coming through and a very different way of working. We're not in a position where we're going to be able to eat into that backlog through the winter. We're still in the mode of surviving the pandemic and maintaining as much activity as possible, but I've been very upfront about the fact that that means that we won't undertake the same level of activity. It would be wholly unrealistic, and set an impossibly unfair task for the NHS, to demand that it both prepares for and manages the pandemic, which is not finished, and eats into the waiting times that have built up. That's not just the picture here in Wales; it's right across the UK, and I'm sure you'll have noticed comments from the Royal College of Surgeons in response to the NHS Confederation report about England and the challenges they face, where they've been sharply critical of an attempt to eat into the backlog when actually their staff haven't had a rest following the first phase of the pandemic.

So, I still believe it will take pretty much a full Welsh Parliament term to get back on top of the activity that has not taken place, about the fact that people wearing additional PPE cannot undertake the same amount of activity as we would have expected in February this year. So, I'll happily go away and look again at how we provide information to inform people about the scale of where we are, not just people who want to read the transcript from this morning's evidence session with the committee, but to see how we do that in a way that is regular and reliable for members of the public and, indeed, of course, elected representatives. 

Llefarydd y Ceidwadwyr, Andrew R.T. Davies. 

Thank you, Presiding Officer. Minister, in the news today we've seen the outbreak at the Royal Glamorgan Hospital, and tragically eight people have been reported as losing their lives. We send our condolences to the families of the ones who have lost their lives. There are 83 cases of COVID at that hospital. Earlier in the year, we had an outbreak at Wrexham Maelor Hospital. Both hospitals have major accident and emergency departments for their particular areas, of which we have 13 across Wales. Can you highlight today if there are any similarities between the two outbreaks and, if there are similarities, how will you ensure that this doesn't occur in other A&E receiving hospitals? Because as we go into the winter months, obviously we know what winter pressures do, but with the disruption an outbreak like this causes, as well as the tragedy of loss of life and the general upset that it causes, this is something that we want to avoid at the other hospitals across Wales. 

I think there are differences as well as similarities. So, we picked up the issues in Wrexham Maelor, and we definitely learnt from what happened in Wrexham Maelor, about the need for clear executive leadership and for buy-in across the staff group for the measures that would need to be taken, about prompt isolation and reinforcing enhanced infection prevention and control measures. So, our whole system learnt a lot from what happened within Wrexham Maelor, and those lessons are being applied within the Royal Glamorgan. That is why we are, for example, testing staff who work on that site, it's why a number of wards have been closed, it's why there's an early diversion of activity away from that hospital, to allow the hospital to manage and to recover, and it's why there's been a reinforcement of the need to test patients on admission, whether emergency or elective.

It's also the case that some of the transmission in the Royal Glamorgan, as with Wrexham Maelor, came from transmission within the hospital, whether between patients or staff. What is different, though, about the Royal Glamorgan is that we have a higher reservoir of coronavirus within the surrounding community. So, a number of people have come into the hospital and needed treatment because of coronavirus, and we also know that some transmission has taken place within the hospital itself. There are risks for every hospital and closed environment if coronavirus takes hold within the staff or the group of people who are either being cared for or living within that environment. It's why we continue with our testing programme in care homes. I expect that we'll not just have more information from the health board, but there'll be a continued focus on whether the infection rate peaks, as it did in the Maelor, and recovers, and how long that will last for. So, I'm expecting to have regular updates from the health board themselves about the picture within the Royal Glamorgan each day. And I know that the chief executive of the health board is expecting to make further statements to the press about the measures that have been taken and the action, including, as I said, the diversion of patients away from that site. 

Thank you for that answer, Minister. As you highlighted, the reservoir in the local community is obviously one issue that does need to be understood, and the transmission into the hospital as well as in the hospital itself. Just this afternoon, we've had information from Public Health Wales that they've become aware of 2,000 test results that they were completely unaware of, and, obviously, when you're trying to understand local data, being able to understand the test results is a critical component of being able to track the virus in communities. Today, I welcome the news, obviously, that Rhondda, for example, and Merthyr have got their own local maps now that show the level of infection rates in those communities—something that I've been calling on you to bring forward for the rest of Wales. So, clearly you have that information. There are two parts to this, if I may seek assurances from you: can you enlighten us more as to these 2,000 results that Public Health Wales have been made aware of, as to why the system didn't alert Public Health Wales to the outcome of those test results, given their importance; and secondly, will you commit to making that data available that Merthyr are highlighting today and Rhondda are highlighting today about infection rates in local communities so that people can understand the prevalence of the virus within their communities?

On the second point, I have already indicated that I am looking to see how we can regularise the provision of that information so that it's not just ad hoc. And we're looking at what Public Health Wales already publish to give people the understanding of what is taking place on a local level. And it's not just the Rhondda area; it's actually the whole of Rhondda Cynon Taf where I think they're producing maps showing the rates that exist, together with Merthyr. I think it would be useful to provide that information on a regular and predictable basis. So, I am already looking at how we do that and to see what is already provided by Public Health Wales.

On your first point, unfortunately this has been a data glitch with lighthouse labs. The data haven't come in to NHS Wales Informatics Service to provide to Public Health Wales, and so Public Health Wales have alerted us to the fact they're awaiting those some 2,000 lighthouse lab test results. It's a matter that has been taken up through our normal management and information arrangements with colleagues in the UK testing programme. As soon as those figures are available, we'll need to make sure we understand where they are and how far back those test results go as well, because we have had some improvement in the turnaround delays in lighthouse lab test results, and so I'll want to understand how that tracks back and changes our understanding of the shifting picture of positive coronavirus cases across Wales. So, it's certainly not ideal, but, as I say, I expect us to resolve that with the people responsible for the lighthouse lab testing programme. 

Earlier in the response to my questions, you highlighted, and I highlighted to you, the disruption that's been caused by the outbreak at the Royal Glamorgan Hospital to services, and today in the news we're hearing that a million breast cancer screening appointments have been lost because of the COVID outbreak across the whole of the United Kingdom. What's really important is when GPs, obviously, have concerns and refer patients into the health system, people get the diagnostic tests that they require and then the treatment within the NHS. In Neath Port Talbot, there is already a rapid diagnostic centre that is available for such a service, but obviously we need such centres across the rest of Wales. Can you commit today to the rapid expansion of the rapid diagnostic centres, so that GPs do have that option and so that when patients are suspected of having further inquiries required when it comes to cancer procedures, they can get into the system, have the diagnosis and either get the all-clear or progress within the health service, in whatever part of Wales they live? Because we all know that, when it comes to cancer, time is of the essence, and if we do have disruption in the service, as we do because of COVID, then we need to use the best practice that's available to us, and I would suggest that rapid diagnostic centres are one of those avenues that need to be opened up. 

Two points: the first is that we have already restarted screening services, as I've previously reported back to Members. The second is: you may not have picked this up, but Tom Crosby has confirmed that there has been agreement within NHS Wales to roll out a national programme of diagnostic centres, following the trials that have been undertaken in Neath Port Talbot and, actually, at the Royal Glamorgan, at the diagnostic hub there as well. So, I will be providing proper detail to Members on the detail of that roll-out programme, but it's a good opportunity to say that the trial that we've been running in Wales has been successful, and we expect that to take place in a national roll-out. So, I think perhaps we're already half a step ahead of the question that's been asked today. 

Yes. We recognise the challenge of delivering essential services and routine surgery during the COVID-19 pandemic. Management information indicates that treatment activity is around 40 to 50 per cent of that pre the COVID pandemic. Face-to-face out-patient activity is around just over half but it is increasing each month. We continue to see changes in the delivery of services, with virtual review in both new and follow-up out-patient appointments significantly increasing by a factor of 700 per cent, when comparing March 2020 to our current understanding of September 2020 figures. 

Minister, I'm pleased, of course, to hear that the resumption of services is actually increasing, but I have been contacted by a constituent who is desperately waiting for her son to receive dental treatment and has been told by the local health board that the approximate waiting time is 81 weeks, despite being added to a priority theatre list. Now, I'm sure you'll agree with me that an 81-week wait is just completely unacceptable. Therefore, can you tell us what discussions the Welsh Government is having with health boards about exploring other avenues for patients to receive treatment, such as outsourcing, so that constituents like mine are not facing an 81-week wait? 

In terms of the specifics, I think it would help—and I'd be happy to look at this—to have the specifics of the matter that the Member raises from his constituent, to understand the detail behind that and to be able to provide a more useful answer about that constituent. I want to be helpful in being able to do so. 

On the broader point about the waits that exist, there isn't huge capacity within the independent sector here in Wales, and the challenge is, as we move through the pandemic, how the independent sector is already looking to maximise the work that it undertakes individually, and, indeed, we still have provision with the independent sector to help us as part of our winter protection plan and the ability to have surge capacity. It will take a significant period of time to recover all of the activity that has been delayed as a result of the COVID pandemic. As I said in answer to earlier questions, the NHS Confederation report for England sets out a very similar picture in that nation about the range of activity and the length of time it will take to recover.

I think that the objective view would be that everyone would understand that that is what has happened, with the significant loss of life that has already taken place and the risk for even more significant loss of life if we don't take measures to ensure that we don't suffer in the next phase of the coronavirus pandemic. But that does have a consequence for the rest of our national health service activity. The objective view may be on the one hand, but if you're somebody who is waiting a long period of time, and living with discomfort, for activity, that may not be of much comfort to you individually. That's why, in terms of recovery, once we get through the survival part of the pandemic and understanding of what we're going to be able to do to provide, hopefully, a vaccine or effective antiviral treatment, we will then have a significant task ahead of us in Wales and in every other UK nation to understand how we successfully recover that. And that's why, as I say, I think it will take pretty much a full Welsh Parliament term to get back on top of that. That's not scaremongering; that's me being straight and honest with people about the level of challenge we can all face up to. 

Thank you for the question. Data produced by the Office for National Statistics report that there were 460 deaths involving COVID-19 registered in Betsi Cadwaladr University Health Board residents in hospitals by 29 September. Those are the most up-to-date figures I have available to me. 

As large parts of the north move into local restrictions tomorrow, of course, we need assurances now from this Government that lessons have been learnt from this summer's outbreak in hospitals, such as Wrexham Maelor. Thirty two COVID-related deaths in six weeks—now, that isn't a criticism of front-line staff who have worked tirelessly throughout this pandemic, but it does raise serious questions about the Welsh Government and senior management's handling of the issue. People need to know why staff on COVID wards were sent back to work on other wards without being tested, why patients admitted to A&E were placed on wards before their COVID test results were back, why patients were released back to the community before their test results were known, why COVID-positive and COVID-negative patients were placed on the same ward. You go into hospital to get better, Minister, but that certainly wasn't the case for some people in Wrexham Maelor over the summer. So, given that Betsi Cadwaladr health board has been under your Government's direct control for the past five years, will you accept your part in this failure, and what steps are you now taking to make sure that that isn't repeated?

Well of course I have responsibility for the national health service here in Wales, and I'm proud to do so. When the health service gets things wrong, I'm the Minister responsible for the health service, just as when the health service makes a huge difference in saving lives and caring for people in the compassionate way that we've come to expect as a normal everyday reality of what our health service does the overwhelming majority of the time.

As I indicated in answer to Andrew R.T. Davies's questions earlier, we definitely have learned from the outbreak in Wrexham Maelor earlier in the summer, and those lessons are being applied in the Royal Glamorgan at present. It's important we continue to learn as the coronavirus pandemic continues. So, the leadership from Gill Harris in particular, as the nurse director, now acting chief executive until the new chief executive arrives later in the year, was particularly important, as was the way that stakeholders were brought together—not just the leadership team, but also the staff and trade union representatives—and the communications with families.

The risks for this particular virus are real and significant, and every one of these particular outbreaks—whether in a care home, a hospital or in community transmission—highlights the risks and why it's important for our healthcare professionals to adhere to the best infection prevention and control advice, and also why members of the public need to help them in doing so. So, there are, of course, lessons to learn, and I think it may be helpful, in terms of not just the Member's question, but, potentially, in dealing with the committee, to set out and highlight what we think some of those lessons learnt are as we go through the Cwm Taf Morgannwg challenges in the Royal Glamorgan at present, and to understand where we think there is room for improvement and what that means. You'll already see, though, that the chief medical officer's department has already written to all health boards reiterating a range of guidance and advice, and indeed the chief nursing officer has also reiterated the advice and expectations on infection prevention and control across the whole service.

I've been contacted by ambulance staff in north-east Wales concerned that the lack of ambulance staff testing could contribute to deaths due to COVID-19 in hospitals in north Wales. When I pursued this with the Welsh ambulance NHS trust, the chief executive stated that for asymptomatic ambulance personnel, testing is deemed neither appropriate nor reliable. Their deputy chief executive said, 'If and when the scientific evidence supports repeated testing of asymptomatic individuals, then it will become Welsh Government policy and will be adopted by us at that point'. How, therefore, do you respond to the statement to me by these ambulance staff that although it's of paramount importance that ambulance crews are protected from the transmission of the COVID-19 virus, most ambulance crews have not once been routinely tested, and only symptomatic staff have been given tests? Surely the scientific evidence that necessitates testing for care home staff would apply to ambulance crews, who also work in close proximity to the elderly, the vulnerable and patients with serious underlying health issues who could die in hospital?

The statements of the chief exec and the deputy chief exec are correct. The current scientific and medical evidence does not support the wholesale testing of asymptomatic ambulance staff. If it did, we would shift our position and make sure that we have the capacity deployed in accordance with that advice. The surveillance testing of care home staff has been something that has provided confidence in the sector, and meant that we have been able to deliver not just the testing for people that go into residential care, in particular when discharged from hospital, but that the staff themselves feel protected and we've been able to understand where outbreaks are taking place. The special vulnerability of care home residents is a different factor to the way that paramedics undertake their jobs and the range of people they come into contact with. It’s also a fact that we don't see the same level of staff change within direct contact when it comes to the ambulance service and dealing with people within the community. That isn't really a comparable position to the regular teams of people that need to care for people in care homes. It is the case that if the evidence changes, we will, of course, be happy to shift our position. There's nothing inconsistent with the current policy decision and the best, most up-to-date scientific evidence and advice.

The Deputy Minister to respond.

We have provided £400,000 to Age Cymru to establish a national telephone befriending service to provide emotional support to older people. We've also worked with local government and the third sector to ensure that wider practical and emotional support is in place, such as digital inclusion and buddy schemes. 

Can I thank the Minister for her response? Many older people, especially those living alone, are suffering from loneliness. Will the Government promote Zoom sessions for those who are living on their own so they can see and talk to their friends when they have access to ICT? And also, can more be done to increase the number of people getting the benefit from Age Cymru's excellent telephone befriender service?

I thank Mike Hedges very much for that question. I know that many people, including older people, are lonely. There are also many people not confident digitally, don't use the internet and don't have access to the appropriate devices, and that is why we did fund Age Cymru to establish a telephone befriending service, and as I said, we've given them £400,000 for the fund. We feel that the Friend in Need service is an excellent service, as Mike Hedges says, and our Welsh Government officials have worked with Age Cymru to ensure that links are made in each local authority to ensure that what Friend in Need supplies fits in with what the local authorities are doing as well. And then, through Digital Communities Wales, we are coordinating initiatives in local communities for people, including older people, to access skills and to have the motivation and the confidence to take part in Zoom meetings, as Mike Hedges says. But I think he's asked a very important question and we're certainly working on those ends. 

Deputy Minister, they say that often the loneliest place to be is in a crowd and you will know of the older people's commissioner's report that was issued earlier on care homes and loneliness, isolation, the whole blanket bans that we're having on care homes and how difficult it is with all the lockdowns. Before we go back down that road again, how can the Welsh Government ensure that this time around we can be far more compassionate and more targeted with how we treat each of the individuals that are involved in this scenario? Because we may have people in care homes, but there are an awful lot there who simply find it incredibly difficult to engage with the staff, incredibly difficult to engage with fellow care home residents—people who have got faculties, who do understand what is going on, it's that their bodies are not strong; their minds are absolutely fine. I've had distressing tale after distressing tale told to me of people who just felt so abandoned during the last lockdown and the blanket ban saying, 'You can't see the people you love, that's the end of the discussion', when they were locked up, or felt they were locked up, in their rooms on their own, with very little social contact with anyone.

Thank you, Angela, for that question. Certainly, we're very well aware of this very important issue about how we enable older people in care homes to have access to their loved ones. It's really treading a very difficult line between the protection of the health of the older people in the care homes and the staff and their mental health in terms of having the contact with their loved ones that they need and desire. So, we certainly don't support any blanket bans; we're looking to local authorities to try to approach this on an individual basis and to see where safe visits can be made. We also think it's really important to use all the technology that's available for residents of care homes to keep in touch with their loved ones. We did, of course, provide £800,000 for digital devices for care homes and hospices to enable that to happen, but I absolutely accept the point that there are many residents who won't be able to take advantage of those digital devices. So, we've given guidance about visiting outdoors, and during this very brief period of time—certainly not today—but some time before the winter comes, outdoor visits could still continue. Obviously, it's up to the provider and the local authority, but with our guidance, we want to encourage as much flexibility as possible and we absolutely accept that it's really important for residents of care homes to see their loved ones whenever it's possible for them safely to do so.

Minister, your microphone.

There we are. It's normally the other way round.

We continue to monitor the impact of the pandemic on mental health and well-being through a range of surveys and other evidence, both in Wales and across the UK. I will be making a detailed statement on our actions to respond to changing mental health needs in the near future. 

Minister, we look forward to that statement, because the longer the coronavirus is with us and the longer we have to adjust our lives, then the more profound the potential impact on mental health and well-being is. But some have been more severely affected because of enforced social isolation and shielding, because of financial loss or job loss, and the ever-present worry of exposure to infection, not least those who work in our health and our care sectors and our retail sectors too. Add to this the daily onslaught of social media and traditional media—this means that even when you relax in the comfort of your own home, the virus seems to seep into your living room too. Clubs and organisations like choirs, rugby, knitting clubs, community bingo, sports and arts, which normally provide a safety net of friends and support for all ages, have fallen quiet, too. So, Minister, as the COVID restrictions threaten to stretch into the months ahead, how can Welsh Government and partners provide resources and support to counter a gathering storm of loneliness and isolation and mental health problems that face us?

Thank you. We'll continue with the implementation of our all-age loneliness and social isolation strategy, which we published in February, but more specifically, we do take account of surveys and evidence from ourselves and partners about the direct impact upon mental health and well-being of loneliness and isolation, which is part of the reality of the measures we've had to take to keep Wales safe and to protect the maximum number of lives. The measures we've taken in local restrictions, where we've had to unfortunately take apart the extended household bubbles—I recognise that there's a consequence to that. So, what we have done in terms of working with partners is both on the immediate response to the pandemic and actually planning for the future. Our work has focused in the immediate stage on access to tier 0 and tier 1 support—that's the low-level intervention and support—and the current improvements include strengthening the core mental health helpline, the launch of the young persons mental health toolkit, and SilverCloud, which is an online cognitive behavioural therapy programme. We're also providing additional funding to the third sector to help fill gaps in this time of provision.

We're also looking ahead to the future and understanding that we expect an increased level of anxiety within the public at large that we may need to do something about, what we're going to be able to do in terms of access to specialist mental health services, but also, we need to actively think about what we're going to be able to do in terms of the mental health and support needs of our staff, in particular front-line health and social care. The impact of what our staff have had to do to keep people alive, safe and well is something that affects some people now, but we all know there's a well-known evidence base that some of that impact won't manifest itself for a period of time. So, during the next stage, the next term of this Welsh Parliament, we're going to need to have planned for and to understand how we can help to support our staff, and that's why we've already introduced additional support mechanisms across Wales for staff within health and social care.

Thank you for the question. Following a sharp increase in cases in Rhondda Cynon Taf, new restrictions were introduced on 17 September to reduce the spread of coronavirus and protect public health. Welsh Ministers reviewed these restrictions on 24 September, and at that time we agreed to retain the restrictions for at least another seven days.

Minister, thank you for that answer. Residents in my constituency will be extremely concerned by the news of the major COVID-19 outbreak at the Royal Glamorgan Hospital, which has sadly led to the death of eight patients, with a further six in intensive care, Minister. I'd like to express my sadness and shock at this news, but, of course, our thoughts are right now with their families.

I met with the health board chair today, and support the action being taken by the health board to ensure this outbreak is fully contained. Minister, could you update me on the latest position from the Welsh Government perspective, and in particular, can you give details of the support being provided by the Welsh Government to help control the outbreak? Could you also provide any details of the implications for those who have had operations postponed? And finally, Minister, I'd be grateful for a general update on how the local lockdown in Rhondda Cynon Taf is progressing in respect of infection rates, and with the Royal Glamorgan outbreak in mind, do you see a need for further testing resource to be targeted on RCT?

Thank you for that series of questions. In terms of the actions that the health board are taking, my understanding is they had a meeting with local partners, crucially the local authority, yesterday, where they discussed and agreed the range of measures being taken, and I do think it is a sensible safety precaution to minimise routine care when they are experiencing an outbreak of infection. That does mean that people will have procedures delayed and rescheduled at a later date, but that is in the best interest of those patients—not to admit them onto a sight for routine procedures where we understand there is an outbreak where harm is being caused. And that is a temporary measure while the outbreak is being brought under control.

At this point in time, the chief exec of NHS Wales is in regular contact with the health board to have a proper understanding of the measures that are being taken, and the oversight, as indicated earlier, for the measures and the control measures to understand what is happening, with both the staff testing that's in place, to understand if there's a need to do more. As a result of the staff test results, we get to see where the outbreak actually is, and to see how well contained it is. So, we're learning and applying the measures from the Wrexham Maelor Hospital. 

In terms of your broader point about measures within the community, I think it's important to reflect that whilst we haven't seen the same reduction in cases that we have seen, fortunately, in Caerphilly—and Newport is also making good progress—there is some cautious evidence to think that we may be seeing a plateau. It's still at a very high level, but we'll want to understand if that really is the case, and that will give us some further hope for the future. But the evidence of Caerphilly is that it is possible to see a reduction in rates, and that this is not a one-way escalator to further and further restrictions. We'll continue to measure and weigh whether there is a need to do more to help control the spread of the virus across the RCT area. 

The key point is that it's in the hands of people in their communities to look after each other, and the rules are there for the benefit of everyone. If we get a high level of adherence to that, then we can expect to see a reduction in the spread of coronavirus and the harm that we know it has already caused and is likely to cause. We'll continue to review matters on a regular basis; that includes a provision of testing services. We've actually seen a fall in the number of people taking up the testing services available, so the concern that the health board have is not that we don't have enough access to testing, but that actually there are people who should be getting a test who are not. So, again, it's an appeal for people to use the testing resources that are available within RCT, and we'll continue to review how and where they're provided to make sure they're readily accessible for the communities that need to access them. 

Minister, it's obviously a very serious event in the Royal Glamorgan. This is September—when we face the pressures of winter in late November, December and January, we could be under more severe pressure yet. Now, I know, throughout Wales, part of the management of the COVID risk has been moving some operations to other facilities—cancer operations, for instance, to the Vale Hospital and in Cardiff to Spire. And cancer treatment is going on, as I understand it—emergency treatment will continue at the Royal Glamorgan, but all other elective care has now stopped. Cancer patients in particular have to be protected from infection—you can have a very bad outcome if they've been operated on and are under immunosuppressant drugs. So, can you assure us that zoning hospitals, or moving certain care to specific sites, is going on and will be a way of ensuring that higher levels of cancer care can be delivered than otherwise when we face these sorts of emergencies?

Yes, I'm happy to provide that direct assurance—that is exactly what the health board are planning for with their partners. They've not just worked with the local authority partners about the need to have people leave the hospital to create more space in general terms, but in terms of your broader and more specific point about cancer services, they're already working with other partners too to see what can be moved to make sure that treatment continues as far as possible. So, I'm happy to provide the direct assurance the Member looks for.

I'm deeply concerned about the outbreak of, and the deaths from, COVID-19 at the Royal Glamorgan Hospital and what this will mean for both patients and staff. My sympathies, obviously, go to all of those who've been affected.

Many elective surgeries have already been postponed during the pandemic, and now the backlog is set to get worse. Emergency patients will now be transferred by ambulance to other hospitals, thereby adding a potentially crucial delay to them receiving life-saving treatment.

I want to know what the Government can do to bring this crisis within the hospital to a swift end and create a safe environment for patients and staff. You can improve on testing. Can you boost testing capacity on site so that we can track and trace the virus better? Can you improve the turnaround time for results so that people get those results quicker? The staff need improvements in testing and faster testing, so what can you do to help with that? Finally, do you have any confidence left in the lighthouse labs now? 

I think there's a range of things to run through, hopefully to provide some reassurance to the Member and any people watching. When it comes to outbreaks and outbreaks management, you'll have seen from the previous outbreak in Wrexham Maelor that we actually ran the tests through for the staff and for patients when an outbreak had been declared through our Public Health Wales labs, and they provided a very fast turnaround. The tests for an outbreak are prioritised, so they do have very, very fast turnarounds, so you can expect the 90 per cent plus that we achieved in Wrexham to be turned around within a day.

So, we're actually using NHS Wales tests for this, for the management of the outbreak, and that's exactly what they're intended for, with that additional capacity and the surge capacity that exists in our system. That should provide reassurance for staff and, indeed, for people going onto the site as well. If they do still require treatment and that is the right place for them to have their treatment, then they should be tested. Again, they can expect that to happen through Public Health Wales labs as well.

When it comes to the assurance about people being transferred to other sites, then people will be transferred by professionals within our Welsh ambulance service trust, and they can expect to receive a high quality of care. We're in the fortunate position that there are hospitals that are relatively near to the current site for the Royal Glamorgan, and I don't think that there's a basis for people to be concerned that life-saving treatment could be unduly delayed by that transfer. It's, as ever, a balance, in that if people need to be transferred away from that site, it's because there's a risk to those people in otherwise admitting them, and that's the risk that has to be balanced and the judgment that has to be made. I'm confident in the leadership of the health board; I'm confident in the way they have worked with partners to do so. I believe that we can look forward to the outbreak being brought under control. Certainly, there is no lack of testing or the availability for testing on site for people who really do need to get tested, and I think we demonstrated that with the previous response to the Wrexham Maelor outbreak.

Yes, I welcomed the recent Audit Wales report on the redevelopment scheme at Ysbyty Glan Clwyd. As recognised in that report, improved governance and assurance procedures for capital projects have been introduced and are now embedded into health board and Welsh Government processes.

That remains to be seen, Minister, because in 2012 the Welsh Government approved a project to remove asbestos and refurbish Glan Clwyd Hospital. The project was completed in 2019, at a cost of £170 million—55 per cent more than the original budget. Now, in the Auditor General for Wales's report, the findings are scathing: the Welsh Government never formally approved the health board's outline business case; auditors issued a 'no assurance' opinion on the health board's arrangements for governing and managing the project; and when approving the business cases, the Welsh Government did not sufficiently consider the risks associated with their advisers; concerns too that project design and costings were underdeveloped. Now, I do appreciate, as you mentioned, that steps have been taken to improve arrangements for approving business cases, but let's be honest, you are and were the Minister responsible. So, what assurances can you provide this Senedd with that you will not allow such bad financial management in this health board again? Thank you.

Well, when the project was agreed in 2012, I wasn't a Minister in the Government. It's important to make that factual point of accuracy. Actually, the characterisation of the report is partial from the Member. The comments I made in direct answer at the outset come from the conclusions of the Wales Audit Office report itself. It recognised weaknesses at the time, it recognised that the rationale for that was a desire to see the remedial work undertaken, it also recognises there is a significantly better clinical environment for patients and staff to work in as a result of the work that's been undertaken, and it also recognises there are improvements in the process and in the governance arrangements for capital projects, not only within Betsi Cadwaladr for north Wales, but, indeed, across the service as well. That is a more honest and rounded review of the report, rather than the partial version provided by the Member in her second question.

Diolch i'r Gweinidog.

Yr eitem nesaf nawr fydd y datganiadau 90 eiliad, gan nad oedd yna unrhyw gwestiynau amserol wedi cael eu cytuno.

Felly, y datganiad 90 eiliad cyntaf y prynhawn yma yw'r un gan Mike Hedges.

Diolch, Llywydd. At approximately this time each year, Senedd Members from all parties don pink items as part of the Wear it Pink for breast cancer campaign. These photographs end up on social media and in local papers. This year, due to the pandemic, we cannot take part in an event in the Senedd, but I do not wish to miss the opportunity to show my support for the breast cancer campaign. I think it is very important. 

While we have a COVID pandemic, breast cancer has not gone away. Since launching in 2002, Wear it Pink has raised over £33 million for breast cancer research, which I believe is a remarkable achievement. I urge everyone to support Wear it Pink and help to make possible life-saving breast cancer research and life-changing support for those affected by the disease. 

Each year in Wales, around 3,000 women are diagnosed with breast cancer and over 550 women die of the disease. That's why I'm encouraging everyone today to support breast cancer awareness day. We cannot dress up and meet with breast cancer survivors, but we can show our support for breast cancer charities, and I'm trying to do that today.

Thank you. Now, with particular pleasure, I call Elin Jones, the Presiding Officer. 

Radio Bronglais yw gorsaf radio ysbyty Bronglais, yn darlledu drwy'r dydd, bob dydd, a'r wythnos yma mae Radio Bronglais yn dathlu ei phen-blwydd yn 50 oed. Dechreuodd yr orsaf yn 1970 pan gyflwynodd aelodau o glwb ieuenctid Bow Street raglen geisiadau ar nos Sul i'r cleifion. Ers hynny, mae'r orsaf wedi mynd o nerth i nerth. Agorwyd stiwdio barhaol gyda chefnogaeth y loteri yn 2001, ac ers 2013 mae Radio Bronglais yn ffrydio dros y we i bedwar ban y byd.

Mae'r orsaf yn cael ei rhedeg gan dîm mawr o wirfoddolwyr ac yn cynnig platfform i dalent newydd lleol. Y mwyaf adnabyddus o'r rhain, siŵr o fod, yw Aled Haydn Jones, a gyfrannodd yn gyntaf i'r orsaf pan oedd e'n ddisgybl 14 oed yn ysgol Penweddig. Mae Aled bellach newydd ei benodi yn bennaeth ar BBC Radio 1. O Radio Bronglais i Radio 1. Da iawn ti, Aled, mae Aberystwyth yn browd iawn ohonot ti.

Mae'r orsaf wedi'i henwebu am lith o wobrau ar hyd y blynyddoedd. Mae rhai o'r cyfweliadau anoddaf, ac yn sicr rai o'r rhai hiraf, dwi wedi eu cael erioed wedi bod ar Radio Bronglais. Ac, wrth gwrs, mae'r orsaf yn cael ei gwerthfawrogi gan gleifion a staff yr ysbyty.

Yn nwyster y pandemig iechyd yma, dewch inni ddiolch a dathlu cyfraniad pob radio ysbyty, ac yn benodol dymuno pen-blwydd hapus i Radio Bronglais.

Diolch yn fawr. There'll now be a break for 10 minutes to allow changeover in the Chamber. 

Order, order. The Senedd is back in session.

We move to item 5, which is a debate on the Health, Social Care and Sport Committee report on the impact of the COVID-19 outbreak, and its management, on health and social care in Wales, and I call the chair of the committee to move the motion. Dai Lloyd.

Diolch yn fawr, Dirprwy Lywydd. Dwi'n falch iawn o gael agor y ddadl yma heddiw ar adroddiad y Pwyllgor Iechyd, Gofal Cymdeithasol a Chwaraeon ar COVID-19.

Cyn imi siarad am ein canfyddiadau, hoffwn dalu teyrnged i ymrwymiad ac ymroddiad pawb sydd wedi cyfrannu at y gwaith o sicrhau bod ein gwasanaethau rheng flaen yn parhau i weithredu o dan amgylchiadau anodd dros ben. Er y byddwn yn meddwl yn awtomatig am y sector iechyd a gofal cymdeithasol, rhaid cydnabod hefyd ymdrechion diflino cynifer o sectorau a phroffesiynau eraill, a hynny'n aml y tu ôl i'r llenni.

Mae'r cyhoedd hefyd wedi aberthu llawer, ac mae angen cydnabod hynny. Cafodd teuluoedd a chyfeillion eu gwahanu, a chafodd y rhai mwyaf agored i niwed eu hynysu oddi wrth eu rhwydweithiau cymorth ehangach. Mae eu hymdrechion i gadw at y cyfyngiadau symud wedi atal y feirws rhag lledaenu'n sylweddol. Yn anffodus, rydyn ni'nawr yn wynebu heriau tebyg eto, ac rydyn ni'n gofyn i bobl Cymru ddangos yr un ysbryd eto i gyd-ymdrechu i helpu i ffrwyno'r feirws llechwraidd yma unwaith eto.

Pan gadarnhawyd yr achos cyntaf o'r coronafeirws yng Nghymru ym mis Mawrth eleni, ychydig iawn ohonom, gredwn i, oedd yn sylweddoli y byddai'r feirws yn cael effaith mor ddinistriol a hirhoedlog arnom ni i gyd. Mae wedi bod yn greulon ac yn ddidostur ac mae wedi cipio cyfeillion ac anwyliaid oddi arnom. Fel pwyllgor, roeddem yn teimlo ei bod yn bwysig ystyried effaith y coronafeirws, a'r modd y cafodd ei reoli, ar y gwasanaeth iechyd a gofal cymdeithasol yng Nghymru. Rydyn ni wedi ystyried ymateb Llywodraeth Cymru a chyrff cyhoeddus perthnasol, yn ogystal â’r effaith ar staff, cleifion ac eraill sy'n cael gofal neu driniaeth yn y gymuned neu mewn lleoliadau clinigol. Ein diben wrth ymgymryd â'r gwaith hwn oedd ceisio helpu i ddangos beth weithiodd yn dda a beth na weithiodd cystal, a hynny er mwyn dysgu gwersi a'u cymhwyso'n gyflym, efo'r cynnydd yn y gyfradd heintio sy'n digwydd nawr.

Rydyn ni wedi cael tystiolaeth gan amrywiaeth eang o weithwyr proffesiynol ym maes iechyd a gofal cymdeithasol, cyrff cyhoeddus a rhanddeiliaid, ac rydyn ni'n parhau i wneud hynny. Cynhaliwyd arolwg o staff rheng flaen, cleifion, gofalwyr, a'r rhai sy'n derbyn gofal neu driniaeth, i ddeall yr effaith y mae'r pandemig wedi ei gael arnynt. Hefyd, roedd gwahoddiad agored i unrhyw rai a oedd yn dymuno rhannu eu profiadau efo ni. Hoffem ddiolch i bawb a roddodd o'u hamser i gyfrannu at ein gwaith.

Mae ein hadroddiad yn cynnwys 28 o argymhellion, ac mae 21 ohonynt wedi'u derbyn yn llawn, a hoffwn ddiolch i'r Gweinidog yn fawr am ei ymateb manwl. Ni fydd gennyf amser i ymdrin â phob argymhelliad, ond byddaf yn ceisio ymdrin â rhai o'r negeseuon allweddol, gan droi yn gyntaf at gyfarpar diogelu personol, PPE. Nawr, yn ystod dyddiau cynnar y pandemig, rhoddwyd cryn dipyn o sylw i'r pryder ynglŷn â sicrhau cyflenwad digonol a pharhaus o gyfarpar diogelu personol. Roedd llawer o'r dystiolaeth gynnar a gawsom yn tanlinellu ofnau a phryderon staff rheng flaen ynghylch cyfarpar diogelu personol priodol. Yn ôl arolwg a gynhaliodd Cymdeithas Feddygol Prydain, nid oedd 67 y cant o feddygon yng Nghymru yn teimlo eu bod wedi'u diogelu'n llawn rhag COVID-19 yn y gwaith, ac roedd 60 y cant ohonyn nhw wedi gorfod prynu eitemau o gyfarpar diogelu personol yn uniongyrchol, neu wedi derbyn cyflenwadau fel rhodd allanol, oherwydd nad oedd y gwasanaeth iechyd yn gallu caffael cyflenwadau digonol.

Dywedodd y Coleg Nyrsio Brenhinol hefyd fod nifer fawr o'u haelodau, yn enwedig timau nyrsio cymunedol, wedi ffonio am eu bod yn poeni nad oeddent yn gallu cael gafael ar gyfarpar diogelu personol. Dywedodd fod 74 y cant o staff nyrsio wedi dweud eu bod yn poeni am brinder cyfarpar diogelu personol, a bod dros hanner wedi teimlo dan bwysau i ofalu am glaf heb amddiffyniad digonol. Yn wir, dywedodd y Gweinidog iechyd wrthym fod y sefyllfa yn peri pryder gwirioneddol i'r Llywodraeth hefyd ar y pryd.

Mae'r sefyllfa hon wedi gwella, ac rydyn ni'n falch iawn o hynny, ond ni allwn orffwys ar ein rhwyfau. Mae angen sicrwydd arnom y bydd cyflenwadau PPE yn parhau, yn enwedig o gofio'r cynnydd yn y gyfradd heintio'n ddiweddar. Gwnaethom, felly, argymell y canlynol: rhaid i Lywodraeth Cymru fynd ati ar fyrder i gyhoeddi strategaeth i sicrhau cyflenwad gwydn o gyfarpar diogelu personol; i gasglu ynghyd lefelau digonol o gyfarpar diogelu personol priodol ar gyfer unrhyw achos yn y dyfodol; i adolygu’r cyfarpar diogelu personol y mae wedi’i gasglu ynghyd i sicrhau ei fod yn parhau i fod o ansawdd digonol a’i fod yn addas at y diben; i gyhoeddi strategaeth ar gyfer sicrhau gwydnwch y trefniadau dosbarthu; i weithio gyda phartneriaid i sicrhau bod canllawiau ar gyfarpar diogelu personol yn cael eu diweddaru yng ngoleuni’r cyngor gwyddonol diweddaraf, a chyfathrebu’r cyngor hwn yn glir i’r staff. Dyna argymhelliad 1. Dwi'n falch iawn o ddweud bod yr argymhelliad hwn wedi’i dderbyn a bod cynllun strategol ar gyfer caffael cyfarpar diogelu personol ar gyfer iechyd a gofal cymdeithasol yn cael ei ddatblygu.

O gofio bod Cymru, yn draddodiadol, yn dibynnu’n gryf ar gyflenwadau o Tsieina a gwledydd eraill yn Asia, mae’n hanfodol ein bod yn cefnogi cynhyrchwyr yng Nghymru i ddatblygu ein cyflenwad cartref ein hunain. Gwnaethom argymell felly fod Llywodraeth Cymru yn adolygu ei systemau i sicrhau bod y mecanweithiau ar waith i alluogi gweithgynhyrchwyr yng Nghymru i ymateb yn gyflym wrth gyflenwi cyfarpar diogelu personol priodol pe bai unrhyw achosion yn y dyfodol. Dyna argymhelliad 2. Wrth dderbyn yr argymhelliad hwn, roedd y Gweinidog yn cydnabod rôl bwysig busnesau Cymru yn y gwaith o gryfhau ein gallu i wrthsefyll ail don o COVID-19. A dywedodd y bydd y cynllun caffael PPE ar gyfer iechyd a gofal cymdeithasol yn gyfuniad o gyflenwadau lleol a rhyngwladol.

I droi at gartrefi gofal rŵan, roedd cynnal profion mewn cartrefi gofal yn fater dadleuol, a chafodd Llywodraeth y Deyrnas Unedig a Llywodraeth Cymru eu beirniadu, fel rydym ni'n gwybod, am fethu â chynnal digon o brofion mewn lleoliadau gofal. Mae ffigurau’r Swyddfa Ystadegau Gwladol yn dangos y bu 663 o farwolaethau oherwydd COVID-19 yng nghartrefi gofal Cymru.

Yn ôl Fforwm Gofal Cymru, roedd y drefn o ryddhau cleifion o’r ysbytai i gartrefi gofal wedi cyfrannu’n sylweddol at y ffaith bod yr haint wedi lledaenu mor frawychus o gyflym mewn cartrefi gofal. Dywedodd Comisiynydd Pobl Hŷn Cymru ei bod yn pryderu nad oedd hawliau pobl hŷn wedi’u diogelu’n ddigonol. Roedd nifer y marwolaethau yn gysylltiedig â COVID mewn cartrefi gofal yn peri pryder mawr i ni. Rydym ni'n credu bod agwedd gychwynnol Llywodraeth Cymru tuag at gynnal profion mewn cartrefi gofal yn ddiffygiol ar y dechrau, ac roedd ei hymateb i’r argyfwng cynyddol yn rhy araf wedyn. O ganlyniad, roedd nifer y marwolaethau mewn cartrefi gofal yn cyfrif am 28 y cant o’r holl farwolaethau cysylltiedig â choronafeirws yng Nghymru.

Roedd argymhelliad 9 yn ein hadroddiad yn galw ar i Lywodraeth Cymru sicrhau bod pob claf sy’n cael ei ryddhau o’r ysbyty yn uniongyrchol i gartref gofal wedi cael prawf, yn unol â’r arfer gorau diweddaraf, i sicrhau bod preswylwyr a staff yn cael eu diogelu cystal ag y bo modd. Cafodd yr argymhelliad hwn ei dderbyn mewn egwyddor. Dywedodd y Gweinidog fod yn rhaid cael canlyniadau’r profion cyn rhyddhau cleifion o’r ysbyty. Hoffwn ddiolch i'r Gweinidog am y sicrwydd hwn ac am dderbyn ein hargymhelliad.

I droi at brofi, olrhain a diogelu yn olaf, cyn imi orffen ar y dechrau yma, hoffwn sôn am y strategaeth profi, olrhain a diogelu—system olrhain cysylltiadau Llywodraeth Cymru. Mae gan y rhaglen profi ac olrhain o dan y strategaeth nifer o ddibenion allweddol, gan gynnwys: gwneud diagnosis o'r clefyd; cadw golwg ar iechyd y boblogaeth; olrhain cysylltiadau; a pharhad busnes, gan alluogi gweithwyr allweddol i ddychwelyd i’r gwaith yn gyflymach ac yn fwy diogel.

Mae nifer o dystion wedi tynnu sylw at bwysigrwydd dychwelyd canlyniadau profion yn gyflym er mwyn sicrhau llwyddiant y strategaeth profi, olrhain a diogelu. Fel y dywedodd Syr David King, aelod o SAGE Annibynnol, mae’n hanfodol bwysig bod canlyniadau’r profion ar gael yn gyflym.

Dwi'n dyfynnu: 'Os daw’r canlyniad bum niwrnod ar ôl cynnal y prawf, ac mae’r person hwnnw’n dal yn crwydro o amgylch ei gymuned, dychmygwch faint o bobl y gall eu heintio yn ystod y cyfnod hwnnw.'

Rydym ni'n cytuno y bydd cyflymder y profi, yr amser mae’n ei gymryd i brosesu canlyniadau, a chywirdeb y canlyniadau hynny yn hanfodol i lwyddiant y strategaeth profi, olrhain a diogelu. Po hiraf yw’r amser prosesu o’r dechrau i’r diwedd, o gasglu sampl i roi canlyniadau i unigolion, po fwyaf yw’r oedi ar yr adeg pan mae’r clefyd ar ei fwyaf heintus, neu po fwyaf tebygol yw hi y bydd pobl—[Anghlywadwy.]

[Anghlywadwy.]—argymell felly fod yn rhaid i Lywodraeth Cymru, gan weithio gydag Iechyd Cyhoeddus Cymru, geisio sicrhau bod canlyniadau pob prawf yn cael eu dychwelyd o fewn 24 awr. Dyna argymhelliad 19, a chafodd yr argymhelliad hwnnw hefyd ei dderbyn mewn egwyddor.

Clywsom hefyd y byddai cefnogaeth y cyhoedd yn allweddol i lwyddiant y strategaeth. Mae angen i bobl fod yn barod i fod yn onest wrth rannu manylion am eu symudiadau a'u cysylltiadau, a hunanynysu os gallent fod mewn perygl, a hynny er budd y gymuned ehangach. Gwnaethom argymell, felly, fod yn rhaid i Lywodraeth Cymru, gan weithio gyda’i phartneriaid, sicrhau ei bod yn cyflwyno negeseuon cyhoeddus clir, a’u hailadrodd yn gyson ar lefel genedlaethol a lleol, yn tanlinellu cyfrifoldeb unigolion i hunanynysu os oes ganddynt symptomau a phwysigrwydd gofyn am brawf ar unwaith. Dyna argymhelliad 25, a derbyniwyd yr argymhelliad hwnnw.

Wrth gwrs, os bydd y broses o olrhain cysylltiadau yn llwyddiannus, mae’n bosib y bydd yn rhaid i bobl hunanynysu sawl gwaith, ac mae hyn yn bryder arbennig i bobl sydd mewn swyddi cyflog isel, gan na fyddant yn gallu fforddio aros gartref o'r gwaith. Yn ôl y canllawiau presennol, mae gan unrhyw un sy'n hunanynysu hawl i dâl salwch statudol, sef £95 yr wythnos, ond nid yw hwn yn gyflog cynaliadwy nac yn gyflog byw. Mae’r demtasiwn i anwybyddu symptomau a chyngor a mynd i’r gwaith yn bryder gwirioneddol, felly, ac yn faes y mae angen i Lywodraeth Cymru roi sylw brys iddo, yn enwedig o ystyried nad yw trefniadau tâl salwch statudol wedi’u datganoli. Rydym felly wedi galw ar i Lywodraeth Cymru fynd ati, fel mater o frys, i holi Llywodraeth y Deyrnas Unedig am y trefniadau tâl salwch statudol ar gyfer gweithwyr gofal cymdeithasol ac eraill yng Nghymru sy’n gorfod hunanynysu. Rwy’n croesawu’r ffaith bod y Gweinidog yn derbyn yr argymhelliad yma a’i sicrwydd ei fod yn parhau i dynnu sylw Gweinidogion y Deyrnas Unedig at y pryderon am effaith ariannol hunanynysu.

I gloi, hoffwn gydnabod bod maint yr her sy’n wynebu Llywodraethau a’u partneriaid wrth iddynt ymdopi ag effeithiau COVID-19 wedi bod yn ddigynsail hollol. Gwnaed ymdrechion aruthrol yn gyffredinol a llwyddwyd i gyflawni gwyrthiau. Yn anffodus, mae cyfraddau heintio yn codi unwaith eto. Rhaid inni ddefnyddio'r profiad a gawsom a’r cyfan a ddysgwyd wrth frwydro yn erbyn y don gyntaf o'r clefyd i sicrhau bod unrhyw fesurau newydd a gyflwynir i reoli'r feirws yn effeithiol yn amserol ac yn gymesur. Diolch yn fawr.