Cynulliad Cenedlaethol Cymru

Yn ôl i Chwilio

Y Cyfarfod Llawn

Plenary

27/11/2019

The Assembly met at 13:30 with the Llywydd (Elin Jones) in the Chair.

1. Questions to the Minister for Education

The first item on our agenda this afternoon is questions to the Minister for Education, and the first question is from Bethan Sayed. 

Transport Options for Young People

1. Will the Minister outline how the Welsh Government's education department co-operates with the economy and transport department to improve transport options for young people in education and training? OAQ54767

Both departments co-operate in numerous ways, and I recently released a joint ministerial written statement informing Members of our intention to take forward a review identifying all issues involved in post-16 learner travel. Further updates on this review will be provided to Members as it progresses.

Thank you, and I welcome that particular review, because we are seeing worrying trends by cash-strapped local authorities to reduce support for options for learners in Wales. We've seen Neath Port Talbot council consult on changes to post-16 transport earlier this year, which they had to scrap because of the outcry, and now Bridgend council is consulting on abolishing free transport for post-16 learners in school or college, as well as abolishing free transport for nursery-age pupils. So, I do welcome this review.

But, I'm also sure you're aware of the fact that there are wider issues with regard to the affordability of those doing apprenticeships to be able to afford to get to their place of work, or to get to where they need to get to for their term in work. The current MyTravelPass scheme via the Welsh Government doesn't seem to have been as successful as you would have liked, with take-up dramatically less than expected. How are you going to liaise further with your colleagues in the economy department to address the serious and growing problem with regard to how young people are accessing education via the transport system here in Wales?

Well, I welcome the Member's support for the interdepartmental review on post-16 learner travel. With regard to MyTravelPass, although the responsibility for that scheme does not lie within my department, I take a keen personal interest because the impetus for that scheme was a budget deal struck between my party, when I was leader of the Liberal Democrats, and the then Welsh Government. So, I have a personal interest in its success. As the Member will know, that started off in 2014 as a scheme that was only available to 16 and 17-year-olds, and transport officials, after negotiation with the bus industry, have implemented an enhanced scheme. So, that now covers 16, 17 and 18-year-olds, 19, 20 and 21-year-olds. So, exactly the kind of individuals that I'm sure Bethan was alluding to—those people who are looking to combine study and work via an apprenticeship scheme. And I'm sure there's more we can all do to publicise the opportunity to use MyTravelPass. 

We will continue to work across the department to look to see what more we can do to support individuals with the cost of their transport, whether that is accessing training or more formal full-time education. 

Our green card policy, of course, would resolve the question of free bus transport for post-16 education, training or work. But, of course, I think the position of transport to faith and Welsh-medium schools does need resolving through primary legislation.

My question, though, is about the voice of young people in a local authority's decision on whether a route to school is safe or not. And until the active travel Act provides realistic options on this, because we are talking about journeys of two or three miles, depending on the school, we're still likely to be hearing from the children's commissioner that she's having to remind local authorities of their duty to consult children and young people about those school journeys. I'll suspect we'll also continue to get too much traffic at the school gate too. Would it be easier to press this point on due regard for article 12 of the United Nations Convention on the Rights of the Child if school transport were in your portfolio, and do you support extending that due regard duty to local authorities? I'm wondering if your review is covering that as well. 

Can I thank the Member for the question? I'm aware of the Conservatives' party policy with regard to post-16 travel. It involves scrapping the education maintenance allowance, which is financial support that helps our very poorest students. But the Member is absolutely right—one area we do need to tackle, and our departments are working closely on, is promoting active travel to school to reduce the number of cars that are driven to our school gates. We have a very good example of this just around the corner from this building in Ysgol Hamadryad here in Cardiff Bay, where people walk, cycle, scoot to school. So, there is always more we can do there. As part of our review, we are indeed looking at issues around safety and safe routes, so that will be part of the consideration that we are making, and I will review the comments the Member has made to see whether there are further particulars with regard to the rights-based approach that the review can look at. 

13:35

Can I very much welcome the review on post-16 education transport, but also the engagement that I know that is going on at the moment between the Minister and the Deputy Minister for Economy and Transport on active travel, on some imaginative thinking on that joint working? But could I ask, beyond those short journeys to school, for which we need to encourage more children to actually get on their bikes and scooters, or walk, quite frankly, and the family and parents as well, in terms of transport by bus, are we open in Welsh Government to thinking of different solutions, as they have in different countries? When I visited Finland last year, and when you look at places like Canada, who are doing this as well, where actually they develop the independence within young people, from a quite young age—and it's not appropriate for everyone, or in every situation—they actually travel to school on public transport. Now, this isn't for everyone, in every situation, particularly in rural areas, and it relies on a very good public transport network as well. But it is interesting that it can be done elsewhere. So, do we include that within our thinking, going forward, if people wanted to take up that option, or including local authorities, which I understand, in Scotland, as well, where, instead of school transport vouchers, or funding for an individual, they offer to actually buy the bike.

Given the Member's keen interest in active travel, and his very active lobbying in this regard, the Member will be pleased to know that we have revamped our consideration for active travel as part of our twenty-first century schools and colleges programme. And any application coming forward from a local authority that gives poor consideration of active travel to that new building will be rejected, and I'm sure he'll be glad to hear that. Can I say, the use of public transport is not novel in Wales—not even in rural areas? There are many children who catch the T4 bus, on the A470, to travel back and forth to high school, although I must say, sometimes, that does cause concerns for parents, who sometimes would prefer their children to be on a school-transport-only option. So, it's not the case that we have no children travelling on public transport to access education at the moment. Local authorities are looking to those models, where it is appropriate, and I'm sure that they will continue to do so.

Free School Meals

2. Will the Welsh Government make a statement on the effectiveness of the free-school-meals initiative for pupils in Wales? OAQ54750

Our free-school-meals policy rightly targets support towards the most disadvantaged children in our communities. As a result of our new eligibility criteria, by the time universal credit is fully rolled out—if it ever is—we estimate more children will be eligible for free school meals than under the previous system.

Thank you. TCC—that's Trefnu Cymunedol Cymru/Together Creating Communities—is a coalition of over 30 schools, community and faith organisations, and groups across north-east Wales. Last week, I attended the official launch of their all-Wales school hunger campaign at Ysgol y Grango in Rhosllannerchrugog, near Wrexham. Their research had found that many of the most vulnerable pupils aren't getting enough to eat during the school day, with pupils eligible for free school meals spending some of their free-school-meals money on breakfast, because they couldn't get enough resource at home, and, as a result, not having enough money left for the full balanced lunch the free-school-meal allocation was designed to provide. And I pledged there to raise this with you here. Forty-nine per cent of teachers told them that they sometimes had to provide food for pupils themselves, and they said they highlighted the issue not as part of a blame culture anywhere, but because those children need help. How do you respond, therefore, to the campaign's call to increase free-school-meal money to cover breakfast by 80p daily? They said that there were just over 29,000 school pupils affected, and, on current take-up, this was unlikely to cost £3 million per annum, which would address the call of this campaign. So, how do you respond to that call?

Well, firstly, I respond to the call by saying isn't it absolutely incredible, in a nation such as ours, that we have to have a school hunger campaign. Providing an allowance for breakfast for pupils eligible for free school meals in secondary schools is one course of action that I am actively considering at the moment. There are possibly other courses of action, and other solutions, that may be more appropriate to address this problem. What I want to make sure is that whatever we do is appropriate and provides a solution to the issues that the Member outlines. And now, having fulfilled his pledge of raising this issue with me, perhaps Mark Isherwood could do me the courtesy of raising the issue with his party colleagues in Westminster. 

13:40
Questions Without Notice from Party Spokespeople

Questions now from the party spokespeople, and the Plaid Cymru spokesperson, Siân Gwenllian. 

Thank you, Llywydd. I would like to discuss your recent written statement announcing the results of  the consultation to amend regulations on the Welsh in education strategic plans. Seeing specific movement towards change is positive indeed, and we do need meaningful planning in order to develop Welsh-medium education across the country, and there’s a long way to go.

The recent situation in Blaenau Gwent encapsulates this for me. The residents of the Tredegar area and Rhieni Dros Addysg Gymraeg have been battling for years for a second Welsh-medium school in that area. At last, the council agreed to do that after the campaigners had gathered the data that assessed demand. A number of cylchoedd meithrin were opened to prepare for this, but then, last month, there was a u-turn from the council and a decision was taken not to open these cylchoedd meithrin, which is certainly a mistake. How will the financial allocation within your portfolio change in order to allow the necessary changes to deliver the objectives of the reform to the regulations?

Can I first of all thank the Member for her support for the report on the way in which we are developing our WESPs in the future?

The situation in Tredegar is one that I am very familiar with. Not only is there clear demand from parents in that area for primary education through the medium of Welsh for their children, the Welsh Government has made available 100 per cent capital funding to build that school. The local authority bid into our capital programme. They have been successful in that. That money is available for the council to build that provision. 

However, as you have outlined, there now seems to be a different approach at the council. I have discussed this with both the portfolio holder for education at Blaenau Gwent and the director for education at Blaenau Gwent. It seems remarkable to me that a local authority would bid for that money, be successful in that application when other local authorities were not successful, and now find themselves in the position where they do not, it appears, at least, want to build that school. My officials are looking to consider the points raised with us by Blaenau Gwent council and looking to see if a solution can be found, because, like you, Siân, and like the local Assembly Member, we want to honour and to provide a service that parents and children in that area want. 

Thank you very much, and I am very pleased that you’re persevering with those efforts, and I very much hope that those discussions with the council will bear fruit very soon.

In turning now to the language charter, which is an innovative scheme that increases the use of the Welsh language outside the classroom, there is strong evidence that it is successful, but the 'Siarter Iaith framework' doesn’t have enough of a role in the new curriculum. It is crucial that there should be status for that framework. At the moment, it is described as part of the draft curriculum for 2022, but that is very soft. It is categorised under the heading of ‘further information and guidance’. I would like to see the framework being strengthened, and I’m sure you would agree.  Therefore, it would be good to see more of a reference to the language charter in the curriculum when the amended versions do arrive. And I’d like to hear from you, in relation to the charter, what amendments to the WESPs regulations will actually meet this need to strengthen the charter?

Again, like the Member, I believe that the siarter is a really important way of developing a culture across the school rather than in individual lessons, by actually ensuring that pupils and staff in that school, and parents and supporters of that school, have opportunities in a variety of ways to use the language. And I'm always very pleased to see a wide variety of schools embracing the ethos of that and looking to weave it into the daily life of their school.

It is in itself slightly bigger and broader than simply a curriculum issue. The Member will be aware that, following the substantial number of responses—very high quality and very detailed responses—that we had to the curriculum consultation over the summer, we now find ourselves in a refinement phase, where our practitioners, supported by our experts in HE, are looking to prepare a final draft. That will be available in January of next year.

What is absolutely crucial to me is that, beyond the curriculum, we find opportunities for children to use their language skills, both in Welsh-medium schools but also in our bilingual and our English-medium schools, so that the language is used not simply in lessons, but in the wider life of that school community.

13:45

Thank you very much, and I look forward to seeing the 'Siarter Iaith framework' given its proper place in the next version of the Welsh curriculum.

I must say that I am very supportive of some of the ideas of the consultation on the regulations—the move towards targets is to be welcomed, the shift in focus from reactive developments, namely measuring demand from parents, to being proactive in the approach, namely creating the Welsh-medium education places in the first place, and also the long-term planning of three to 10 years in order to be more ambitious—I welcome all of that.

But one issue that does need consideration is how to hold local authorities to account if they fail to create this development in Welsh-medium education that is so important in their areas. And would you agree with me that we now need to have that major discussion required on legislation in order to strengthen through legislation, and that that should be the next step?

Well, like you, I'm very keen that we allow the new reformed approach to Welsh in education strategic plans to develop and to bed in within our local authorities.

As a non-Welsh speaker myself who chose this option for my own children, I know how vital provision at meithrin or at Ti a Fi before that—Ti a Fi and meithrin, primary and secondary school, are crucial if we are to meet the Welsh Government's target of a million Welsh speakers by 2050, and simply reacting to demand is not going to be good enough. We have to be proactive in ensuring and promoting the benefits of raising bilingual, and, hopefully, in our new curriculum, trilingual, children. 

At this stage, within the timescales that we have in this Government, it would be wrong of me to suggest that we are actively considering legislation as the Member suggests, but I would not rule it out as a potential next step to ensure the success that everybody in this building would want to see for Welsh-medium education provision.

Diolch yn fawr, Llywydd. Minister, according to the Education Workforce Council website, Welsh Government has introduced targets for the number of students who enter the new PGCE courses in Wales with the intention of qualifying to teach certain subjects. Some of those subjects are identified as priorities, and they include Welsh and modern foreign languages, and I'm looking forward to your reply to Delyth Jewell's question later on.

A few weeks ago, I asked the Minister for the Welsh language how she thought the education system could bear most of the heavy lifting for the strategy of a million speakers by 2050, when only 12 teachers qualified to teach Welsh at secondary level, which stands at just a third of what it was five years ago.

Your target for new entrants for September for Welsh teachers this year was 75, which is very different from 12. Modern foreign languages—your target is 59, when only 18 passed last year, which is half the number it was five years ago. How did you arrive at these new targets and how many successful applications were made for entry this September?

Well, the Member is correct to identify an approach that clearly had not been successful in the past, and continuing that approach and hopefully, suddenly thinking that it might change the outcomes—well, somebody did say that doing the same thing and expecting a different outcome is the definition of madness. So, we need to try a different approach.

Now setting targets for our initial teacher education providers is important, but we need to reform how we're doing that, but also how we market teaching as a desirable profession has to change—the quality of our ITE is changing—but also, crucially, how we ensure that those people who train to be a teacher actually go on, then, to work in our schools, and not just for a period of one or two years, but continue to make an ongoing commitment to the teaching profession. 

I am currently considering an entire systematic reform of how we support initial entrants into our ITE provision and teachers through the first few years of their career, with specific mention of Welsh-medium provision in our secondary schools, which is of concern to me. The Member will be aware that, only this week, we launched a new scheme, where those who have qualified to teach in a primary school but have the potential and the skills to teach either the Welsh language or through the medium of Welsh in a secondary school but are not qualified can gain additional professional learning opportunities to allow them to transfer into a high school. Because what we do know is that, every year, we have a surplus of Welsh-medium primary school teachers who do not find jobs in our system. That's a huge waste of their talents and their resources. We can use those more cleverly, and therefore providing them with the opportunity to transfer into the secondary sector is just one of the new, innovative ways we're looking to address a problem that I'm not shying away from, is there, and we need to take action on. 

13:50

Well, thank you for that answer. Some of that was very interesting, but you didn't actually address the point on how many new applicants for these particular courses have materialised this year or how these targets were reached. Perhaps I can ask you if you're going to be dropping these targets. I imagine it's around now that you'd be sending a remit letter to the Education Workforce Council, so perhaps you can respond to that question when I ask you this next one. Because the Education Workforce Council also states that, and I'm quoting:

'If you are considering a career in teaching in Wales, from September 2019'—

that's this year—

'you will need to obtain qualified teaching status (QTS) by studying on an ITE programme, accredited by the Education Workforce Council (EWC) through its ITE Accreditation Board.'

Now, traditionally, qualified teacher status from England is automatically accepted here, but I recognise the changes to our curriculum, qualifications, and the method of assessment that QTS now goes through in England is quite different from in Wales. Nevertheless, you have said before that you don't want to prevent talented teachers from outside Wales bringing their talent to our schools, but I can't find any information about how those teachers can train up quickly, preferably in situ, to teach in our schools. Presumably, they'd still need to be accredited by the EWC. September has been and gone—how long do you plan to exclude newly qualified teachers from outside Wales from our Welsh schools?

There is no intention, as I've set out in previous statements, to cut off a pool of talented people who may be thinking about embarking on a teaching career or actually who want to come home and teach in our new system with our fabulous new curriculum. Therefore, there are plenty of opportunities for those wanting to come across the border or from other countries to teach in our system and there are training opportunities available, crucially in situ—you don't have to go back to a university to do it—to ensure that anybody coming into our system has the skills, knowledge and understanding of our approaches in Wales. 

With regard to numbers, the Member will forgive me, I don't have them in front of me, but I'm happy to write to her with them. 

Thank you. I'd really appreciate it. If you could do that, that would be great. Thank you very much. Perhaps you could also send us some numbers on the number of those training opportunities in situ that have been taken up by teachers from outside Wales.

You mentioned this in response to my first question, actually, that you want schools to be employing the new teachers that will be coming through the system as a result of all of this. How will you be making sure that schools can afford to employ more of these teachers and slow down the reliance on supply agencies, which, of course, comes with its own problems? How much of that £195 million education consequential coming to Wales as a result of this year's UK spending review will find its way to Welsh schools specifically? Thank you. 

Well, the Member is well aware of the Government's intention to publish its budget in the middle, now, of December—delayed, I'm aware of that. And it'll be clear to Members how the steps that this Welsh Government has taken to enhance not only the education budget—but also, crucially, the vast majority of school funding goes to schools not via my budget but via the local government Minister and the revenue support grant. And the Member will have a few more weeks to wait before those details are made available to all Members. 

13:55
Carers who are Higher Education Students

3. Will the Minister make a statement on the support available to carers who are higher education students? OAQ54742

In Wales I have made available the most generous package of student support, which includes specific support to help those students with dependants. Last year, we issued £9.8 million as grants for dependants to full-time undergraduate students to help them remain in education.

Thank you for that response. There is excellent work happening in Bangor University, which is my local university, in order to ensure that carers can take university courses and that they are given the support to do that. The list of things done includes a bursary of £1,000; there is a residential course offered to carers between 16 and 25 to give them a flavour of university life and to see how they would cope with that; there is a wristband that's being offered to them, which is a good idea, so that they don't have to explain to various members of staff why they may need to take a phone call or leave early and so on.

I understand that the Welsh Government has asked the Carers Trust to provide a report outlining what universities could do to attract carers. I'm sure you'll be very interested in learning from what has been happening at Bangor University, but could I ask you what will happen as a result of that report? Is there an intention to provide more funding, perhaps, to support activities such as those taking place in Bangor in order, for example, to enable them to continue with their work but also to work closely with schools in order to show more clearly the routes into higher education for young carers?

Well, first of all, can I take this opportunity to congratulate Bangor on the work that they are doing to widen access and participation for this particular group of students? The £1,000 bursary was a really innovative intervention and a fantastic way to highlight National Carers Rights Day, which was the day they officially launched that and the other programmes that they have.

Can I just say that Bangor are not alone in this, in recognising the additional needs that carers do have? The University of South Wales offers carers bursaries of £1,000 for full-time students and £500 for part-time; Cardiff University makes a bursary available of £3,000 to carers over the duration of their course; and Swansea University offer a carers bursary of up to £500.

So, universities are aware of the challenges that this particular group of students meets. But I am concerned that we can do more, and that we should do more, to break down the barriers of pursuing further or higher education for those with caring responsibilities, hence the commissioning of this piece of work so that it can better inform us and the conversations that I have with the funding council and with our universities around what more they can do.

Can I just say—? This lunchtime—I'm not sure if the Member was able to attend—hosted by Hefin David, Cardiff University were here highlighting and showcasing some of their widening-access and participation work, looking to support asylum seekers, those children who are care experienced and those individuals with neurodiversity, who perhaps in the past have not felt that university was for them.

There is much good practice, but the report will give us the information and the suggestions of what more we can do. But I would like to congratulate Bangor on their hard work in this area.

The Deputy Presiding Officer (Ann Jones) took the Chair.

I would like to endorse the thanks that have been given here today to praise Bangor University for its exceptional efforts to support student carers. It just shows what can be done—in four years, the university has, for example, created a student carers booklet; as has been pointed out, they've introduced a red wristband to help lecturers identify carers; and they've awarded £1,000 bursaries to carers. Similarly, as the Minister has mentioned, the University of South Wales offers a carers bursary worth £1,000 and Swansea University a bursary of up to £500. These are excellent initiatives and they provide a much-needed model of support. Now, as the Minister here in the Welsh Government, will you consider introducing a Wales-wide student carer bursary?

Well, if the Member was listening to my initial answer to the Member, she will have heard me say that last year we issued £9.8 million to support 3,400 students with an average grant of £2,800 for those who have dependants, either children or adults, to allow them—[Interruption.] It is universal, for everyone. And, as I said, that was £9.8 million that we supported students with just last year. 

14:00
GCSEs and Other Qualifications

4. Will the Minister make a statement on the future of GCSEs and other qualifications taken by 16-year-olds in Wales? OAQ54739

Thank you, Andrew. On 18 November, Qualifications Wales, the independent regulator, published a major consultation setting out how it plans to ensure that qualifications at 16 reflect the new curriculum for Wales. This includes the proposal that redesigned GCSEs should form a central part of the qualification offer.

Thank you, Minister, for that answer. What we do know is that Qualifications Wales have said that there will have to be changes in the exams and the qualifications that people will take at the age of 16 here in Wales, irrespective of what that consultation will say. But what is really important, irrespective of whatever qualification someone takes, whether it's vocational or academic, is that there's good support for teachers and careers advisers in schools. Because we heard yesterday from the Member for South Wales West, Suzy Davies, about the gaming of the system within Wales, so that schools can push their academic credentials higher to be in the league tables.

Do you agree with me, First Minister, Minister—I gave you a promotion then—that what is really important is that, whatever comes out of the consultation also has a strong package of support and advice for teachers and career advisers in schools, so that our learners do take the right examinations, whatever they might be—whether they be academic or vocational—so that they reach their full potential? Because as a father of four children, one thing that has struck me as they've gone through the academic system is that, very often, that advice is lacking severely in our system. 

Andrew, I think you're absolutely right: what is crucial is that children, young people and their parents have access to great independent careers information and advice. We know that children as young as six are already beginning to form their ideas about careers, and what may or may not be available for them and, far too often, are closing down the choices to them. 

The Member, I'm sure, is aware that Rhondda Cynon Taf County Borough Council, which I believe is in the Member's region, is currently, on behalf of Welsh Government, piloting what is known as the Gatsby approach to careers advice. Only this morning, I was in Beddau in the secondary school there looking at their reformed approach to information, advice and guidance. Every child and every parent receives an interview on coming into the school; those interviews are repeated in year 9 before children take their choices for GCSEs. Each of the Gatsby criteria are being worked on in that school, developing relationships with local businesses, further education colleges and higher education colleges, and exposing those young people to the plethora of opportunities that are available. But the crucial thing is that each child is treated as an individual, it is not a blanket approach where people receive the same message; there is an individualised, personalised programme for each child. I would commend the approach that has been piloted, and I'm sure the local schools in his region would be very happy for him to visit to see it in action.     

Many of our students will, at some stage of their careers, seek employment over the border in England. It's only recently that England has diverged from our grading system by moving to one to nine, but I just wonder whether, over the longer term, the education Secretary sees any risks to Welsh students in that divergence getting their qualifications treated as they should be in England, particularly given the emphasis that the Department for Education in Westminster has put on the shift to one to nine being about ensuring greater rigour in their qualifications.  

Let me be absolutely clear. Just because England has decided to do something does not mean it is the right decision. I don't know why we basically start from that premise. Maybe the decision to keep A* to G, which is well understood by FE colleges, HE colleges and employers, actually is the right starting point. But the Member is absolutely correct: what is crucial is that any qualification that is sat by a Welsh student has portability and equal rigour, and there is nothing to suggest—nothing at all to suggest—that our GCSEs are any less testing, difficult and stretching than GCSEs across the border. And any suggestion that they are is doing down our individual students and our pupils. That portability will be crucial, and that's why we have an independent qualification system that works with qualification systems in Scotland, England and Northern Ireland to ensure there is that compatibility and that parents and students know that the exams they take in our nation are exams that will be recognised and valued anywhere in the world. 

14:05
Reforming Post-compulsory Education and Training

5. What plans does the Minister have to reform post-compulsory education and training in the next 12 months? OAQ54741

Officials are drafting legislation to establish the commission for tertiary education and research, and that will be published in the spring. 

I recently met with a representative of the National Union of Students Wales. They pointed out that the current legislation defines student unions and outlines how they should look, but it does not place a duty on post-16 education providers to actually have one. They say any reform of the post-16 compulsory education and training sector provides an opportunity to strengthen the legal footing on which student unions are placed. What plans do you have, Minister, to place a duty on all post-16 education providers to have a student union that is politically autonomous, structurally independent and fully-funded?

Student voice will be a central plank of our PCET reform legislation.

What are your plans—? As I said earlier—I mentioned apprenticeships. What are your plans in this regard to put apprenticeships at the heart of the PCET proposals? I know, of course, that this is an area that is in the economy and transport brief, but in my view—and I'm sure you would agree—an apprenticeship for young people should be viewed as an extension of an educational process rather than something separate from it, and when I speak to those in the apprenticeship world, they seem to feel a bit disassociated from the college set-up. So, I'm just wondering how you can use the PCET changes to make sure that non-work-based key skills and off-site education days can be properly made available to those particular students as well.

Well, it's important to recognise that our proposals to establish the commission for tertiary education and research will cover all post-compulsory education and training, including work-based learning and apprenticeship providers. It's also really important to recognise the significant growth in the diversity of apprenticeship programmes. Many people will continue, I suspect, to think about an apprenticeship as something that is undertaken by a young person at either age 16 or at 18. But increasingly, we are looking to develop our portfolio of higher-level apprenticeships and, indeed, this year, we have seen the first cohort of our degree apprenticeships, where students are learning on the job and in their university of choice. It's a really important development for students who don't want to make a false dichotomy about learning in an academic institution or developing an apprenticeship. We shouldn't make them make that choice; we should be able to provide an opportunity that allows them to combine both, and that's exactly what we're doing with our degree apprenticeship programme.

But, bringing higher education, further education, sixth forms and work-based learning all under the auspices of one organisation should allow us to see greater diversity of opportunity for students and for students to move more seamlessly through different sectors of post-compulsory education and training. 

Bullying in Schools

6. What is the Welsh Government doing to help prevent bullying in schools? OAQ54756

Thank you, Joyce. I have published this month a suite of guidance entitled 'Rights, respect, equality: Statutory guidance for governing bodies of maintained schools', outlining our new statutory guidance for schools and local authorities to help address and prevent bullying in our education system. These are supported by advisory guidance for children and young people themselves and their parents and carers on how they can help those affected by bullying.

Thank you very much. The impact of bullying on an individual's mental health can be devastating and can last for a lifetime. With one in 10 secondary school pupils in Wales experiencing bullying each week, it is crucial that everything that can be done is done. So, I am really pleased to see the launch of the new anti-bullying guidance from the Welsh Government that you've just mentioned. It does include a wealth of resources for schools, governing bodies, parents and carers as well as for children and young people, and I'm sure that it will help all those individuals or has a capacity to help those individuals move forward.

As I've said, there are resources there that parents and carers can access, and I think that that's of the utmost importance, and that the message that bullying is not okay needs to come from home as well as the school. So, I would be very interested to know if schools are actively encouraging parents and carers to access that information so that they can work on the resources at home with their children.

14:10

Thank you, Joyce. Obviously, these are relatively new resources that have been made available to schools, but it would absolutely be my expectation that schools should be able to signpost parents and carers to the resources that are available specifically for them to address behaviour in their own children, understanding what drives a child to bully in the first place and how to support that child. But also, if you are the parent of a child who is subject to bullying, which can be an excruciating position for a parent to be in, not knowing what to do for the best, this latest guidance is a really valuable resource for parents to help them navigate and negotiate that very difficult situation.

But we're not leaving it to schools. Members, if they choose to, today can look on the Education Wales Facebook page, where we are actively targeting parents to make them aware that this guidance is available to them. So, we're not leaving it to schools, we, as a Government, are trying to get out there, using a variety of platforms to draw parents' attention to these new resources.

Minister, Estyn's 'Healthy and happy' report, published in June, highlighted that only a minority of schools keep useful records about bullying, with schools often only recording what they regard as serious. However, by not recording carefully any allegation of bullying by pupils, schools are unable to effectively evaluate their policies, and are actually at risk of being unable to build up a picture over time about pupils whose well-being may be at risk. In light of this, what steps is the Welsh Government taking to encourage schools to record all incidents of bullying? As well as publishing the guidance you've just mentioned, how is the Welsh Government working with schools to develop whole-school approaches to tackling bullying, which has been proven to be the most effective approach to tackling bullying in our schools? 

Thank you, Paul. All schools must, by law, have a school behaviour policy in place, and the 'Rights, respect, equality' statutory anti-bullying guidelines outline the Welsh Government's expectation that all schools in Wales will have a specific anti-bullying policy, setting out how the school will record and monitor incidents of bullying to help take proactive steps to challenge that. So, a crucial part of our new guidance is exactly that. It includes mandatory reporting of bullying incidents, so that schools and local authorities are better equipped with the data that they need; they can monitor trends over time; and they can evaluate the impact of the policies that they have in place in their own school. So, we hope, as a result of this new guidance, there will be a more robust set of data and recording, going forward, which was—I'd be the first person to admit—missing in the old system.

I believe that we've all had an e-mail from a very concerned grandmother in Wrexham, who tells us that she feels her granddaughter's school is simply not following procedure on bullying, and, in fact, it appears to her that the school is actively obstructing any move to deal with the issues, regardless of the guidelines, past or present. Can you send any extra message that is loud and clear that bullying is not okay and that schools must take allegations seriously, ensuring that all voices are heard and logged?

Thank you for that. I am very glad to have another opportunity to state quite clearly that there is no place for bullying in any of our educational institutions: our schools, our colleges or our universities. As I said, each school is required by law to have policies in place. If a parent or carer feels that the school is not implementing that policy, in the first instance, that parent or carer should raise those issues of concern with the chair of governors, and there will be robust complaints procedures in place within the school and, indeed, within the local education authority for that parent or carer to follow.

The grandmother that the Member has just referred to may want to avail herself, again, of the new resources that are available for parents and carers, which will be able to provide additional information about what they can do in this situation.

14:15
School Funding

7. Will the Minister make a statement on the implications of delaying the publication of the Welsh Government's 2020-21 budget on school funding? OAQ54747

We recognise the implications deferring the publication of our budget will have for setting local authority budgets for 2020-21. The provisional local government settlement, through which the majority of Welsh Government funding for schools is provided, is due to be published on the same day as the draft budget.

You will of course be aware that many governing bodies are currently making very difficult decisions on their budgets for next year, including the dismissal of teachers and classroom assistants and so on and so forth. But they do that without knowing what their budgets will actually be for next year, and if you listen to some of the political parties in the general election, then money might not be an issue at all in the next financial year, but I will believe that when I see it.

But what I'm asking, of course, is: what are you doing to give earlier assurances to schools as to what they can expect for next year, and also longer term assurances, because working on a year-to-year basis is problematic, isn't it? You can have better strategic planning from providing longer term assurances in terms of funding, which, at the end of the day, would give you better value for money for the money that you give them in the first instance.

Like you, Llyr, I'll believe it when I see it too. It would make a welcome change.

The issues that you talk about are real and are recognised within the Government. We have been able to give as much reassurance to local authorities as possible without subverting the processes that are required by us, by this Chamber, that the Government has to go through. We have been trying to give a level of assurance to our local government partners.

I couldn't agree with you more: the ability to provide longer term funding forecasts would indeed allow for better planning and better decision making. The reality is, Llyr, I am not in a position to do that because the finance Minister is not in a position to do it either, given that the Welsh Government has only given us an indicative budget for one year as opposed to the Department for Education in England, which has been given an indicative budget for three years.

Modern Foreign Languages

8. What actions are the Welsh Government taking to reverse the decline in the number of pupils studying modern foreign languages for GCSEs and A-level? OAQ54763

Thank you, Delyth. Since 2015 we have invested over £2.5 million in the Global Futures programme to ensure that our learners experience the benefits of learning modern foreign languages. This includes funding consortia partners to develop centres of excellence with schools and universities and the student mentoring programme, specifically aimed at increasing uptake of language qualifications.

I thank the Minister for her answer. The British Council's latest 'Language Trends Wales' survey makes for stark reading for those of us who believe that learning modern foreign languages is important not just to increase the skills base of our young people, but to increase their empathy and to widen their understanding of other cultures. The research shows that the decline in pupils taking these subjects at GCSE and A-level since 2000 has continued unabated, which I'm sure you'll be aware of. This year there was a further 7 per cent decrease at GCSE and also an equivalent 5 per cent decrease at A-level.

The British Council concludes that the incentives and support for modern foreign languages at schools should go much further that what the Welsh Government is currently offering through the Global Futures initiative that you've referred to. Minister, they offer 11 recommendations, mostly based around developing a new multilingual approach in primary schools and supporting teachers to promote modern foreign languages to inspire and motivate children to take them at GCSE. Will you confirm that you will give due consideration to these recommendations when the full report is published, and think again about what needs to be put in place at primary level so that we can start to reverse this lamentable decline in modern foreign language teaching?

Can I say that I agree with the Member? We still clearly have a great deal of work to do to address the decline in modern foreign language uptake at GCSE level. The students that take modern foreign languages do exceptionally well at them, but those numbers are a worry to me and a worry, I'm sure, to everybody in this Chamber.

What was more heartening to read in that British Council report was that, actually, whilst there is still that challenge in the secondary sector, the picture is indeed improving in primary, and those initiatives within primary schools are absolutely crucial. I was pleased to read in the report that there is evidence of more primary schools embracing MFL within their own curriculum.

It is my intention, with the publication of the new curriculum for Wales, that we will be explicit that we would expect to see modern foreign languages being brought in as part of the curriculum at the upper age range of our primary schools to give children an opportunity to engage in those subjects early on. But indeed, in some of our pioneer schools—. I was recently at a new through school in the Valleys where the very youngest class was reading The Very Hungry Caterpillar—many of you, I'm sure, are aware of The Very Hungry Caterpillar, that icon of children's literature—and they were learning the fruits that appear in that book, they were learning the words for those fruits in English, yn Gymraeg, and en Español, in Spanish. And for those children, it was just the love of learning those different words that they were being given, and that demonstrates that it is possible to do this.

With regard to Global Futures, it is my intention to refresh the Global Futures plan, but I have to say, as I said earlier, if we carry on doing the same thing, we're going to end up with the same outcomes. So, I want to be convinced by my officials that, actually, what we're going to offer in a new version of Global Futures is really going to address the problem, because just simply carrying on with the same approach from the Government will not see the step change that the British Council is calling for and that you're calling for.

14:20
2. Questions to the Minister for Health and Social Services

Item 2 is questions to the Minister for Health and Social Services, and question 1 this afternoon is from Suzy Davies.

The New Health Board Boundaries

1. Will the Minister provide an update on the new health board boundaries in South Wales West? OAQ54765

Thank you for the question. The only health board boundary change that has taken place since 2009 is to move the Bridgend county borough area from Abertawe Bro Morgannwg University Health Board to Cwm Taf University Health Board and to form the new Cwm Taf Morgannwg University Health Board. The legislation making that change came into effect on 1 April 2019. 

Thank you very much, Minister. Two years ago, when we were discussing this, you told me that the change in the health board footprint in South Wales West wouldn't make any difference to services there. I recently had confirmation, though, from Cwm Taf Morgannwg University Health Board, that it's still thinking of closing the GP surgeries in Llanharan and Pencoed, and planning to replace them with a single new surgery in Llanharan, even though they're not able to say yet what those services might be. With the large increases in housing development planned—that's what I was told recently by Marcus Longley—it could mean that—. The main point of the question is that there's going to be quite a lot of housing development in that particular area, so I wonder if you could tell me, since the boundaries have changed, what update you have had from the new board about these particular issues on the very west of their boundary, and whether they're planning to do any new impact assessments rather than relying on those done previously by AMBU. Thank you.

I don't think this issue is affected at all in any adverse way by the change in boundaries. In fact, part of the challenge previously for this practice was having centres to operate in different health board areas. And in my conversation with the constituency Member, my understanding is different to the one you've set out. It may be worth you putting that in writing, then I can write to both the constituency Member, who's raised this with me directly, and you to get a clarified issue about it, because it's about planning to deliver the service and to take into account current and future need, and that is part of what we ought to see happening right across primary care.

As you said, the Bridgend area is now in Cwm Taf Morgannwg health board area. That means that Parc prison is now in Cwm Taf Morgannwg health board area. As you know, Parc prison is a private prison and the healthcare system, which is devolved, is operated privately under G4S in that private Parc prison and is meant to be under the overview of Cwm Taf Morgannwg health board. Now, evidence to the health committee last week from senior Cwm Taf representatives suggested they had little idea of the health situation going on within Parc prison. Is that acceptable?

Well, it's a consequence of the arrangements that have been put in place at a private prison, and that's not a matter that I can intervene on or actually undo. I would much prefer it if prisoner healthcare was run in a different way. I'd personally prefer it if there was an update to the formula to recognise the increase in prisoner population, and the needs that exist. I'd much prefer if we didn't have the private provision in Parc. That is not a matter that I'm in control of, although, obviously, come 13 December, I look forward to a significant change in the way that public services are funded and delivered.

I thank Suzy for raising this question, and I may be able to be some help, but I want to ask for some help from the Minister going forward as well. The changes to Cwm Taf Morgannwg University Health Board have indeed been helpful on two significant issues that I know he's been involved in over the last couple of years as well.

One has indeed been the issue of the provision of surgeries for people in the Llanharan and Brynna area. I want to put on record my thanks, I have to say, to Pencoed Medical Centre, who have reintroduced their surgeries back into Llanharan and extended the provision to four and a half days now there. But it does raise the interesting thing of the longer term issue that Suzy raised. We are going to have thousands of new homes within that area, from Pencoed to Llanharan to Pontyclun. There are probably five GP practices around that area, including Talbot Green and Pontyclun, as well as two within Pencoed and so on. At some point, we are going to have to shift the dial here and actually go beyond outreach surgeries, which is great, and thanks to Pencoed Medical Centre for reintroducing that, and onto that. So, I ask him if he will continue to keep engaged with me and with Cwm Taf Morgannwg University Health Board to explore that. Because they've done great provision in places like Mountain Ash where they've built new surgeries there. And I think they should be looking to the existing GPs to see which of those would want to be involved in this.

The second aspect that I'd ask him to continue his involvement with is Maesteg day hospital, and actually the wider facilities. It's great that, after a slightly scary consultation before under ABMU, Cwm Taf Morgannwg University Health Board have now gone out to actually co-deliver something on the basis of, 'How do we enhance the future of Maesteg hospital?' But the Minister has been integral to helping in this process, and I would simply ask him whether he's willing to keep an interest in this and to keep, where he can, giving gentle prods behind the scenes, so that we get the right solutions for people, whether they're in Llanharan in the east, in Maesteg in the Llynfi, or the Afan valley, I have to say, in the west.

14:25

I'm happy to confirm that, on the Pencoed issue, I remember not just the conversation with the Member but with local councillors and residents about the threat to the Llanharan centre being closed, and I'm pleased it's got a long-term future. And of course in thinking about the future, we need to think about where the need is and where the demand is, as well as the broader challenge that was set out in the primary care conference recently about how clusters work more effectively together so you have a greater partnership right across the primary care team. And I'm more than happy to stay engaged and involved with that. 

And the same with the future services to be based at the Maesteg day hospital site, because this is about where and how we deliver services in the future. And I'm sure, even if I wanted to no longer be engaged and involved in them, that the constituency Member would drag me back into doing my job and doing exactly that. 

Urgent Dental Surgery Provision in North Wales

Thank you, Deputy Presiding Officer. The Welsh NHS—[Interruption.] To be honest, if you really want to know—

Okay, well I'm quite concerned about the question I'm going to have to ask. The Welsh NHS saw the highest ever percentage—

2. Will the Minister make a statement on urgent dental surgery provision in north Wales? OAQ54751

Betsi Cadwaladr University Health Board has commenced a review of urgent and emergency dental provision, with the aim of providing a sustainable and improved service. As part of the process and in considering any change, staff and trade unions are being involved and will be formally consulted.

Thank you, Minister. The Welsh NHS saw the highest ever percentage of patient pathways waiting between 26 and 36 weeks to start treatment for oral surgery in September 2019. This is directly impacting on my constituents, such as one lady who has a seriously decayed tooth causing facial swelling, severe pain and high infection levels. She's already waited 33 weeks for a simple extraction. Numerous appointments for eye surgery that she requires have had to be cancelled because of the lack of oral surgery and given that she's carrying infection. This lady is 83 years old and, as I've said, she's already waited 33 weeks. The Welsh NHS is failing to meet the 26-week target for surgery. So, what assurances will you give me here today that my constituents will not have to wait so many weeks in agonising pain for urgent, urgent oral surgery again? And will you please perhaps, on this occasion, intervene in this case, and let's get this lady's tooth extracted?

As you know, I can't comment on an individual matter, which I'm certain I'm not aware of, but if you do write to me with the details, which I'm sure you will do, I'll happily investigate the matter in order to understand what has happened for your individual constituent.

In terms of the broader challenge about improving performance within the national health service, as you're aware, we've invested £50 million to help improve performance within this year. We currently have about 85 per cent of people being seen within the 26-week target for scheduled care, and you're also aware that there are, of course, a range of factors outside our control, including the direct impact of tax and pension changes. So, the Government continues to invest in the future of improving performance; you've seen performance improve in each of the last three years. I expect to be able to deliver further improvements again, bearing in mind the demands we face and we see coming into our system, and, of course, the challenge in investing across public services.

14:30

Constituents in the Bangor area have been in touch with me expressing concerns about the impossibility of accessing dentistry services. The NHS dentistry lists are closed, of course. They can't afford to pay to access private services, and there are families telling me that they haven't seen a dentist for over 12 months. So, can I ask you what you're doing to tackle that problem, and specifically what is the Government doing to ensure that we train dentists in north Wales, because, as with general practitioners, we know that if people are trained in north Wales, they are more than likely to stay in north Wales to practice?

Actually, we are looking at a range of training areas right across the country, including north Wales, for future service provision, and I'll have more to do with the faculty based in Bangor in the near future, to formally open that. But in terms of the specific challenges around Wales, we are actually seeing lots more people each year, compared to a decade ago, certainly across the country. In north Wales, the health board are about to retender a range of dental practices that have closed over the last 12 months. You should see more capacity within the north specifically, but more than that, of course, as I said before, the programme of contract reform is actually about delivering not just greater value, but greater capacity, in primary dental services, and I'm pleased to see that about one in four of our current dental practices in north Wales are engaged in that programme, and I expect more to come. So, that is partly about delivering capacity, but, actually, it's fundamentally about delivering a sustainable, high-quality services that I believe everyone, regardless of where they live, should be able to access here in Wales.

Questions Without Notice from Party Spokespeople

Turning to spokespeople's questions, and the first is from Angela Burns, the Conservative spokesperson.

Thank you very much, Deputy Presiding Officer. As a result of serious concerns about the quality and safety of care within maternity services at Cwm Taf, you commissioned an investigation into the provision of those maternity services. You asked the Royal College of Midwives and the Royal College of Obstetrics and Gynaecologists to undertake the investigation. This they did in January of 2019, and the royal colleges subsequently produced a report that the Welsh Government published on 30 April. It is a damning report. During the investigation, the royal colleges were so alarmed that they took the highly unusual step of making interim recommendations designed to secure immediate improvements in patient safety. The investigation found a service that was working under extreme pressure and under sub-optimal clinical and managerial leadership. The maternity services, Minister, were already in enhanced monitoring, warning bells were ringing, the field work on the unpublished colleges' report had been undertaken some eight weeks earlier. Therefore, do you think it was appropriate that you agreed Cwm Taf's integrated medium-term plan on 27 March?

'Yes' is the straight answer, because it's important that there is a plan and the plan itself makes sense. And having had the interim step from the joint royal colleges' report, of course I considered the matter fully, and whether it would be better or not to not approve that plan. I believe it's the right thing for the organisation, and I believe their capacity to deliver and continue to deliver in other areas should continue. But, of course, there is heightened scrutiny. So, I did take the step to raise the escalation status of the organisation, the targeted intervention. And as for the improvements on maternity services, well, Members in this Chamber have heard me say on more than one occasion, openly, where we are on the journey of improvement, with the work of the independent oversight panel, and that, indeed, the changes that the recent governance review recognised have taken place under the new leadership within that organisation.

Let's be clear: Cwm Taf was already struggling. There were reports from Healthcare Inspectorate Wales in 2015, which raised concerns about the quality of patient experience, the delivery of safe and effective care, and the quality of management and leadership. There was a report by the workforce and organisational development team in 2016, which identified significant issues, including the perception of a blame culture and a lack of time. There was a 2017 Wales Deanery visit that highlighted six areas of concern. There was a 2018 General Medical Council survey, which highlighted concerns, a 2018 Healthcare Inspectorate Wales report, which highlighted concerns, a 2018 internal report by the associate medical director, which produced a governance review and an implementation plan that wasn't implemented. May to September 2018 saw three deep dives into reported and unreported incidents on Datix, including the discovery of all those stillborn deaths, a September 2018 internal report by a consultant midwife that was ignored, a 2018 report by the Human Tissue Authority, which identified concerns in a number of areas throughout the health board, including maternity services. And a 2018 report by the Wales Audit Office, raising concerns over quality and governance arrangements. Minister, you did not sign off on the IMTPs of Hywel Dda University Health Board, Betsi Cadwaladr University Health Board, or Abertawe Bro Morgannwg University Health Board. So, can you explain to us what was so different about Cwm Taf that, despite all the foregoing, you felt you could agree their IMTP?

14:35

Well, I think it's important to recognise that, in the reports that the Member has quoted elements from, there are also a wider range of positive reports about the activity of the health board. Trying to recast in a wholly negative light the activity of the former Cwm Taf health board is not something that I think is either fair or balanced. The honest truth has been set out, in both the recent governance review, and indeed in the joint royal colleges' report that I intervened on and commissioned. Some of the areas that the Member has referred to were actually dealt with in my statement in autumn of last year, in requiring further improvement. So, far from the Government looking askance and ignoring the issues, we have intervened, we have taken steps and measures. And I look forward to further progress being not just made by the health board, but actually the independent oversight and assurance we will get not only from the independent oversight panel, but from the work both of the Wales Audit Office and Healthcare Inspectorate Wales. And more than that, in my recent visits to meet people in maternity services, I met staff on both sites; it was an honest and an open conversation, and a much more public one. And I'll be going back to meet families before the end of the calendar year, as indeed I promised to do. I think a balanced view is the one that I took when I approved the plan, and it's still the right thing for that plan to be approved today.

Well, let's be clear—the five operational objectives that provide a framework for Cwm Taf's IMTP plan include: to improve the quality, safety and patient experience, and to provide strong governance and assurance. Now, Dai Lloyd has already raised the evidence that we had from the director of community mental health and primary care at Cwm Taf over Parc prison. We're not questioning the fact that, in fact, G4S are supposed to be the ones running the community services; what he has responsibility for is governance, to ensure that those services are being delivered. And yet, his response to most of the committee questions was, 'I don't know. I don't know. I don't know', despite the fact that they've had that prison, not only in their care since the beginning of this year, but there's been an 18-month lead-in to it. So, it's all about the governance, and this has been brought out again by the joint Wales Audit Office and HIW report, which absolutely slates the lack of governance and audit control within this health board.

In your Cabinet paper, on 27 March, you said that all of the IMTPs of all of the health boards had been subjected to a robust assessment process. How, Minister, did you or your officials not pick up on this tsunami of concerns? Is the reality that, for the last few years, Cwm Taf has been held up as the grade A health board, the lodestar, the ones that all other health boards should try to emulate, and it couldn't be allowed to fail? Because there is beginning to smell a systemic issue throughout this health board. And before you come back with some quick quip on this, I'd like to remind you that even the maternity services oversight panel interim report is very clear, as is David Jenkins very clear about the fact that this is a cultural change that has to happen throughout the whole health board, that there are systemic issues, and the governance arrangements, if nothing else—which is one of the things in that IMTP that they waxed lyrical about, and say is absolutely spot on—are poor. Their audit committee hasn't met for ages, to discuss some of these issues. So, Minister, I'll just ask you this: did you look at Cwm Taf's performance robustly and dispassionately? Did you look but did not see? Did you look, did you see—did it not matter?

I think that's an appalling way to finish a question—as if it does not matter. Everything that I do in this job and the choices I make are about people in Wales who work in our service, people in Wales who need the health service. Far from there being a tsunami of unanswered concerns—. And, again, the overstated nature, in terms of the language you're using, I think really doesn't do you any credit, Angela Burns—[Interruption.] The reality is that having understood, following the joint report commissioned by the royal colleges, the nature of the concerns that existed, every organisation has looked again across the NHS at what it is doing and why. And if you look at the previous Wales Audit Office governance reviews, they don't reveal the same level of concern, and the detailed work they've done together with Health Inspectorate Wales doesn't reveal either.

There is a requirement for cultural change, and I've been very, very open about that and about the expectation that not just needs to take place but to be evidenced and to be felt by staff and the public. And, indeed, the new leadership in place within the health board, not just the interim chief executive, but the different approach being taken by the wider team, including independent members, is part of that as well. I'm looking forward to there being real evidence on where the health board is, and I will absolutely make choices about each and any NHS organisation dispassionately and with the interests of the public in mind.

14:40

Diolch, Dirprwy Lywydd. Minister, I'm really keen to understand why it was that the seven previous reports into the issues at Cwm Taf hadn't raised concerns with you, hadn't brought you to the point where you eventually did take the action that you took. And I have to bring you back to the question of the integrated medium-term plans, because there were some plans that you chose not to sign off, you chose to sign off the Cwm Taf plan—only a month after that, the Royal College of Midwives and the Royal College of Obstetricians and Gynaecologists report was made public. When were you aware, Minister, of the content of that report? And can you explain to us—? You've said to Angela Burns that you thought it was appropriate to sign off the plan, but can you explain to us, because I didn't really hear you answer Angela Burns in that regard as to—? Did you know what was in that report? You'd commissioned that report, you knew there were problems—did you know what was in that report before it was published, before you signed off the plan? If it was appropriate for you to sign off that plan, why was it inappropriate for you to refuse to—? Why did you refuse to sign off other plans for health boards where, apparently, there certainly were difficulties—don't let us talk about Betsi Cadwaladr—but, for whatever reason—? I suppose what I'm trying to get to, Deputy Presiding Officer—forgive me—is things were obviously in part of Cwm Taf in a very serious state. You chose to sign off their plan. Things in other health boards were—there were clearly other difficulties: you didn't sign those off. Could you please give us a bit of insight into what was the thinking behind saying, 'Yes, we'll sign off Cwm Taf's plan, but we won't sign off these others'? What were they doing, or failing to do, that was so terribly wrong that made what was going on in Cwm Taf appear comparatively acceptable?

When you sign off a three-year plan you have to understand the nature of the narrative, what's being proposed and whether there's the ability to deliver on the change that is being described within that plan. And having a strategic direction is actually really important for organisations, regardless of their escalation status. And it's part of the challenge in north Wales that they've been living hand to mouth for far too long and they'll need, even if they don't move into normal monitoring, to have a plan for the future. It is part of the challenge they're facing. In Hywel Dda, they recognise that until they have further traction on their financial challenges, they're unlikely to have a three-year plan that the board can sign off and actually expect to be approved here.

The position in Cwm Taf was plainly different. Having had a three-year plan, having made progress on a range of areas, and the challenges about quality and some of the governance issues that have been highlighted—some of those were addressed through time with a range of criticism in the reports. But the idea that all of those issues were ignored or not highlighted or not considered simply isn't true. And in any of these judgments, it is a balanced judgment about what to do with and for that organisation. I made the judgment that I did. I think it was the right thing to do.

I actually think that having a plan in the here and now for Cwm Taf Morgannwg health board is actually really helpful about its future direction. But it does not underplay or move away from the challenges about quality and the ability to actually evidence that they are making the progress that they are plainly required to do, and indeed the heightened level of interest in and scrutiny of the organisation makes that very, very obvious. I have been open, and I will continue to be open about any choices that I make for any NHS organisation, including Cwm Taf Morgannwg University Health Board.

14:45

I'm struggling to understand this, and perhaps we're all suffering from general election fatigue and there's something the matter with my brain, but the Minister has just said that he was confident that Cwm Taf had the ability to deliver on that three-year plan that he signed off. Now, bear in mind, Deputy Presiding Officer, that this was before any of the interventions that the Minister has said will sort everything out. And let's be absolutely clear that the level of governance and management at that point, when he did that sign-off, was really, really poor. I still don't understand, from what the Minister has said, why he was happy to sign that off. Either he knew and he thought it could be overcome, or he didn't know, and that's a problem in itself, but he wasn't prepared to sign off those other plans.

Now, if we look back to the HIW and audit office report, they are being fairly clear that the Minister was measuring the wrong things. If these plans are only about the financial condition of a local health board, then let's call them that and let's deal with that, and I'm not for one moment saying that where local health boards are struggling with their finances, that shouldn't be addressed. But I cannot understand how the Minister felt that those individuals running that health board, who had allowed this appalling toxic culture to develop—and it's clear that it's not only in maternity services that that's really poor—when he signed off that plan, were in a fit state to deliver. That was long before he put his measures in. The measures he's put in may or may not work. I am just at a loss to understand that, and I want to know form the Minister whether he accepts that there are structural and systematic problems in the governance and leadership of the NHS that go beyond one health board at a time. 

Well, there's a range of questions in there, and, of course, I said before, you can't know what you don't know when you're making choices. I took measures to intervene in the health board once the report had been received and I then promptly published it. So, the intervention shows that we did act when the level of concern was there to do so. And indeed, putting in place an interim chief executive—that was an action that was fostered from the Government here as well. So, we've hardly been stand-off when it comes to the health board. And I don't think it is fair to put words into the mouth of HIW and the Wales Audit Office, in terms of saying that I or my officials were measuring or looking at the wrong thing.

If you look at the system reviews that have taken place within the national health service here in Wales, both before this term or at the start of this term with the parliamentary review, no-one has come up and said that there is a fundamental problem in the governance and structure of the health service here in Wales. Our challenge is how we make our structures work and how we hold each other to account in the different parts that are executive teams, independent members and, of course, in the scrutiny that I regularly face here as well. 

Now, ultimately, it will be revealed in the outcomes for people and in the facts and figures about what our health service continues to deliver. It is entirely possible to be a high-performing organisation and to get some things wrong. Our challenge is to recognise the scale of what needs to improve within Cwm Taf Morgannwg and to be open about whether that has happened or not and, if not, what further steps need to take place.

Well, well, 'you can't know what you don't know'. Well, Minister, you'd had seven reports before you signed off on that plan. You'd had seven reports from different parts of the health service that were telling you that there was a crucial service and that if you put all of that bad evidence together before you get the royal college's report, you can see that there are things seriously going wrong. 

I'm afraid that the Minister cannot stand here and say that he didn't know, or if he is telling us that he didn't know, then that takes us into a completely different area of competence, which is not where I want to go this afternoon. 

I think the Minister must accept—and it isn't us saying this; it is Health Inspectorate Wales and the audit office—that there are systematic structural problems with the governance, and Angela Burns is helpfully giving us the page reference—page 33. There are systematic problems not just in that health board. And isn't it time for the Minister to look again—to look at what the committee's report, which we discussed yesterday, said about some of the areas that the legislation that he's proposing will not address?

Isn't it time for him to consider a single, integrated, truly independent health and care inspectorate that can look at all these issues across the board? Is it not time for him to take steps to align the health and social care complaints procedures and make sure that they're rigorous and make sure, for all those families who were ignored again, and again, and again when they raised concerns in Cwm Taf, that that will not happen again. Isn't it time for us to have truly independent whistleblowing procedures for health and care services in Wales, because if the Minister believes there is one, he's probably the only person left in this country who does.

And is it not time, when it comes to quality of leadership—and this is so important—for the proper regulation of non-clinical NHS managers, including an agreed competence framework, consistent structures for training and development, and accountability procedures on a par with those to which clinical professionals are held? Will he today look at the seriousness of these issues and consider amending the quality and engagement Bill, as the committee has requested, to address all those issues, or, better still, withdraw and rewrite it, or does he expect us to believe that everything's fine?

14:50

Well, I've never tried to stand up and say, 'Everything is fine, look the other way.' That is just not the approach that I've taken at all. And I just don't think that an exercise in post-event justification is particularly helpful or useful in terms of taking forward our national health service.

The range of the issues that the Member raises—. She's entitled to have views that say she wants to reorganise parts of the health service. She's perfectly entitled to have those views, but in terms of trying to say that what is now required is to amend or withdraw the healthcare quality and governance Bill that the Assembly passed through Stage 1 yesterday I just don't think is the right thing at all. Because what the significance of what the Member has talked about is that this is entirely new legislation that takes us in a different direction, so in the parts on quality and candour that the Bill actually sets out—and we will go through the scrutiny of that Bill, through Stage 2, and I hope Stage 3 as well—that's a different matter entirely. And we've rehearsed before the issues around whether to have an entirely different management and registration system for managers within the national health service. I'm open-minded as to what the future could and should look like, but I'm practical about how we deliver that, and I don't think that a couple of speeches in the Chamber and a demand to change legislation is really an honest answer to how we could get there. 

Diolch, Dirprwy Lywydd. Minister, I was shocked to learn that, out of nearly 0.5 million calls to 999 last year, around a quarter of the calls were not serious. Welsh ambulance service staff were tied up with dealing with calls ranging from a stubbed toe to hiccups, instead of helping people in genuine need. The Welsh Ambulance Services NHS Trust has launched a campaign to encourage the sensible use of the ambulance service. Minister, what can we, here, in this Chamber do to support the Be Wise Save Lives campaign?

Well, the Be Wise Save Lives campaign sadly is run every year, or a version of it, because we regularly understand that there are people who don't make the best use of our emergency services and, in particular, in this case, the Welsh ambulance service. It's partly about equipping the public with information so that they can choose for themselves—the Choose Well campaign that we run each year—and it's also partly about asking people to have some common sense and to show some respect for the way in which they use the Welsh ambulance service. And all of us, regardless of our party perspectives, I think, could take some time to try to support and promote that campaign so that all of our constituents make better use of emergency services and those who are in real need of that emergency service are more likely to receive the help they will need at that point in time. 

Thank you for that answer, Minister. And, of course, as we enter the winter period, the pressure placed upon the ambulance service is enormous. We have seen record rates of sickness absence in the Welsh ambulance trust, putting more pressure on the service. Difficulty in accessing out-of-hours care continues to drive patients towards our overstretched accident and emergency departments, which has a knock-on effect on ambulance handover times. So, Minister, what steps has your Government taken to ensure the efficient handover of patients at emergency departments this winter in order to ensure our ambulance service is not stretched to breaking point?

Well, there is a range of measures that are already in place and  being introduced as part of the winter plans. Of the money that I previously announced, some of it went directly to health boards and some went to nationally directed services, and, indeed, £17 million was determined between regional partnership boards. Lots of it is about looking at the whole system. It's partly about taking pressure off the front door of an A&E unit, but it's much more than that. It is about keeping people well at home so that they don't need to go into an emergency department. It's also about getting people through and out of the hospital when it's no longer the right place for their care. And we are dealing with record demands being placed on our health service. It isn't just that October was the busiest month in terms of emergency department attendances but, for the ambulance service,  it was the busiest October ever, with the highest number of red calls ever—a growth of 35 per cent in the most serious calls to our ambulance service since the new clinical response model was introduced just four years ago. So, part of our challenge is delivering that capacity. I'll set out again in the future the measures that are already taking place and how that is helping us to try to deliver appropriate, compassionate and timely care even through the winter period.

14:55
Improving Communication between the NHS and Patients

3. Will the Minister make a statement on efforts to improve communication between the NHS and patients in Wales? OAQ54738

Our plan for health and social care, 'A Healthier Wales', aims to strengthen the voice of the citizen and ensure that we listen to and engage with the people of Wales. Information is provided to patients in a variety of ways to try to meet the varying needs and preferences of people across the country.

I thank the Minister for that answer, but not only is communication between NHS staff and patients critical, but, I'm sure we'd all agree, good communication throughout all NHS institutions can be crucial in patient care. We've had several instances brought to us by constituents that this communication is often not satisfactory, in particular communication between Nevill Hall Hospital in my area with other hospitals. In a specific instance, their communication with both the Princess of Wales hospital and the Royal Glamorgan has resulted in poor patient care. Is this the result of the patient being moved through different hospital boards?

This hiatus in communication between patient medical records is having a direct effect on quality and continuity in the care a patient receives. As has been alluded to, good information on patient treatment regimes is critical to the care and outcomes of that treatment. We've also been made aware that medical practitioners, strangely, including consultants, cannot directly access patient information from Velindre. Would the Minister please look closely at these apparent failures? 

We've had a real challenge in making sure that, as we've normalised the way in which we use information in our everyday lives, the health service catches up with that, in the way that we move some of the industrial-scale records that we create, with all of the different patient episodes that the health service provides—over 18 million patient interactions for a country of just over 3 million in one year. Our challenge is to make sure that that is available to people who require that information in front of them when they're actually providing care with and for that person.

We've made lots of progress in the last 10 years in doing that, but our challenge is that there is still much more to be done. That's why the announcements I've made on digital infrastructure and connectivity in the service matter so much, and it's why actually having a new fit-for-purpose system in primary care matters as well—to make sure that information is properly available to whoever needs it and, more than that, in the contract reform programme we have, to make sure we have a version of the patient record available to other healthcare professionals that we are directing and encouraging people to use, whether that's in ophthalmology on a high street in an optician or, indeed, in a pharmacy or other settings.

Minister, the Welsh Language Commissioner recently launched a campaign to raise awareness of the need for further development of a bilingual workforce in the NHS in Wales. He warned that Welsh-speaking patients are suffering and may even be put at risk if they cannot communicate with health professionals through the medium of Welsh. 

International research shows that people with dementia lose the ability to communicate in their second language after some time or later in age. Minister, what action are you taking to ensure that healthcare services are designed so that patients can receive treatment and care through the medium of Welsh or their own language? Thank you.  

We're making significant efforts to think about how we recruit and train people, and how we open up careers in healthcare at a much earlier age. For example, we've done some work with Welsh-medium schools about encouraging some of their students to consider a career in the health service, not just to be a doctor but the wider range of care services available.

When we think about what we're doing to support people, for example, we're retaining the bursary to make sure that people who study locally in a range of those nursing and wider associated healthcare professional roles are supported by the bursary. That means that people who are local to home are more likely to study locally and more likely to carry on working there, because a range of those people aren't traditional undergraduates at the age of 18 or 19. When they start, they're often people who have their own responsibilities.

So, where and how we train our staff, and where and how we recruit them, matters. Making sure that people have the idea that a career in the health service is open and available to them at a much earlier point is part of the work that we're doing to do just that.

Minister, I'm sure I'm not the only Member who's had problems of patients seeking help with getting their ears syringed from their GP, and being inaccurately referred to the private sector, where they charge up to £75. So, could you tell us how you're going to ensure that GP surgeries are communicating accurately with patients as to how they can access these services within secondary care, if they can't get that service from their own GP?  

15:00

The first point is just a point about language, because ear syringing is a particular method of removing wax that is no longer National Institute for Health and Care Excellence approved, and so we try not to refer to ear syringing—I know it's not just about changing language, it is a particular method itself—but to ear wax management, to try to make sure that, where people can, they can self-manage or, indeed, if they need intervention, have that provided. It is an NHS service, so people should not be referred into the private sector and be told that there is no NHS service available. There are a range of pilots taking place within the health service, some in north-east Wales, on having primary care audiology clinics available, but also within south-west Wales in the Cwm Tawe cluster. They've also got the same sort of approach in making audiology much more widely available. We will be re-communicating with colleagues in primary care about the range of services that are available, and to reiterate the message that it is an NHS Wales service and people should be provided with an NHS provider to do just that.      

Swansea Bay University Health Board

4. Will the Minister make a statement on the performance of Swansea Bay University Health Board? OAQ54748

I expect patients to be seen and treated in a timely manner and within our targets. We have made available £50 million to health boards to build on the recent progress and improve waiting times further by March 2020. Swansea Bay University Health Board has received its share of this national funding.

Performance data due to be discussed at Swansea bay health board meeting this week makes for difficult reading, as it shows significant problems in a number of areas. In October, ambulances waited outside A&E departments for 2,778 hours, and waits for planned care are also worsening, with 4,256 patients waiting more than 36 weeks for treatment, an increase of over 2,000 since April. Now, despite the health board being in targeted intervention since September 2016, the figures in many areas are getting worse, not better, and a reflection of a lack of capacity in both health and social care. So, what are you doing, Minister, to turn things around?  

Well, it is more than just the money that we've announced. Part of this is outside the control of the health board; we've discussed recently the tax and pension challenges, the fact that that has taken out capacity within each of our health boards, but that isn't the whole story and I won't try and say that it is. So, I've had correspondence recently from the interim chair of the health board about the steps they are taking on a range of these measures. They have now recovered protected capacity for some of their orthopaedic capacity to try to eat into that. They expect to improve to the end of this year, but there are challenges in both unscheduled care that make a real difference to scheduled care. Part of the reason why they've seen a movement backwards is because of the challenge of unscheduled care, needing to have bed space for unscheduled care patients. That's why I go back to the whole system because, actually, those medically fit people shouldn't be in a hospital bed; they should be in a different setting with the care and support they need. That's partly about the health service; it's also partly about the partnership with our colleagues in local government and housing in particular.

So, I do expect that he will see, by the end of the year, further progress; I expect, more importantly than that, the citizens of the Swansea university health board area will see further improvement in the delivery and the timely delivery of patient care.  

Minister, thank you for that answer and can I support Dai Lloyd's question? Because I've got a case of a constituent who actually last night phoned for an ambulance because their daughter required medical help. It took an hour and a half for a first responder, and that person then put a morphine injection drip in, eight hours for an ambulance, and when they got to Morriston Hospital they were sitting in the ambulance waiting outside. I visited Morriston Hospital A&E last week; there were 10 ambulances outside. There is a huge problem at this point in time, and we're not even at peak winter pressure yet. I appreciate that the ambulances are sitting there, they can't get out the people, people can't get off ambulances to go into A&E, can't get through A&E into beds in the hospital, because people can't get out of the hospital. There is a systemic problem somewhere in Morriston. Will you call in the chair and chief executive of the health board to actually ask them to explain to you directly how they are addressing this problem? We can't expect to go through winter, and our constituents can't expect to go through the winter, sitting in ambulances outside an A&E unit because they haven't yet resolved the problem of getting patients through the hospital.  

I'm seeing the chair of the health board in question on Monday to have this discussion. 

Social Care Provision in South Wales Central

5. Will the Minister make a statement on social care provision in South Wales Central? OAQ54760

15:05

Our ambition, as set out in 'A Healthier Wales', is to bring health and social care services together so that they're designed and delivered around the needs and preferences of individuals, with a much greater emphasis on keeping people healthy and well across all regions of Wales. 

Minister, I've had a very distressing e-mail from a constituent whose 90-year-old mother was first admitted into hospital on 8 August. The situation was stabilised, and she was physically well enough to go home a couple of weeks later. She's still in hospital. They still have not had a care package to keep her at home, and, as my constituent says, 'Until hospitalisation, mum was going out every day to lunch clubs and senior groups, which has been vital for her mental health and has been a major factor in preventing her deteriorating mentally'. They're now concerned that, even if she does get back home, she will just not have the skills to, even with support, continue what's left of her life—she is 90—and the institutionalisation that's gone on day in, day out, despite the care that she gets in the hospital, is just an illustration of how we do not combine this approach of social care and hospital services working effectively, even to the point, sometimes, that we're not getting the assessments made by the right team because there are arguments about whose responsibility it is—is it the hospital team or is it the community team—to do the primary assessment. It really is a mess and we must sort it out if we're going to do the best for our constituents. 

I thank David Melding for that question and I'm very sorry for the experiences that his constituent has had. Overall, there is a reducing trend in the level of patients who are delayed in hospital beds in the South Wales Central region. However, I am concerned about a variation between the different local authorities in the region, with some areas recently seeing an increase on last year's numbers and others a decrease. I'm very much aware that there are still too many patients who are awaiting packages of domiciliary care services to facilitate their discharge. We know that the demands for services have increased a lot recently, in recent years, and we are making great efforts to try to ensure that people are able to leave hospital at a timely pace, or are able to be prevented from going into hospital in the first place, by the services working together, and it's absolutely essential, as the Member says, that health and the local authority work together to ensure that this happens. We do have some very good examples, mainly funded through the integrated care fund, where this does happen, but I absolutely accept that there is a lot of work to do on this issue and the Minister for health and I will be going around and discussing this with the different local health boards in the near future.

Governance Arrangements for Health Boards

6. Will the Minister provide an update on the governance arrangements for health boards in Wales? OAQ54757

Health boards in Wales need to ensure they have robust governance in place and act in a manner that upholds the values set for the Welsh public service.

I'm sure that the Minister will agree with me that, ultimately, governance arrangements can't be separated from those appointed to perform the acts of governance themselves that are needed. The Minister himself, in the case of Betsi Cadwaladr, of course, plays a very active personal role. He's chaired the monthly accountability meetings since July 2018 and the chief executive, Gary Doherty, has made a couple of important appointments, in particular, turnaround director, Phillip Burns, who previously worked for the King's College hospital trust, in whose report for 2017-18 I see that a forecast deficit position of £38.8 million ended up at £142.3 million, forcing the chairman of the board, Lord Kerslake, to resign—hardly an endorsement in Mr Burns' skills at turning around any entity. He and Mr Doherty worked together in the Blackpool NHS board and he appointed also another staffer from Blackpool, Nick Varney, as a turnaround consultant. The Minister himself commented on Mr Varney in a special measures report in 2018, where he said:

'It has been disheartening and unacceptable that during 2017/18 issues have escalated in relation to the financial position and some key areas of performance'.

Blackpool itself at the time was under scrutiny from the Care Quality Commission during or just after the tenures of these three individuals. So, what investigative work did the directors at Betsi Cadwaladr and the Minister himself do to ascertain the quality of Mr Burns's and Mr Varney's work before taking them on as employees? Were the Minister and other directors aware that Mr Doherty, Mr Varney and Mr Burns were all networking buddies and staff at Blackpool NHS at the same or closely overlapping times? Does he agree that cronyism of this kind does nothing to increase public confidence in the governance arrangements for the NHS in Wales, and he and his party should be ashamed when these gold-plated appointments are persisted in being made at a time when nurses' terms and conditions in Bersi Cadwaladr have been eroded by scrapping—talks were going on to scrap their paid breaks?

15:10

I don't think the Member is in the greatest position to talk about cronyism in public life. When it comes to the position of the staff at Betsi Cadwaladr and the requirement to improve the finance function, our expectation is that staff are appointed in a manner that is consistent with our expectations and the requirements of the health board—it is not a nice-to-have, it is about them being objectively able to do their job.

In response to the point about the turnaround director's performance, actually, the initial view is that he is making a real difference to improving the finance function of the health board. That isn't just the view of officials here, it is the view expressed to us by officials in the Wales Audit Office too. There is significant distance to travel, but, actually, when he referred to Lord Kerslake, when he stood down from the King's College trust, he made it very clear that he did not think it was possible to manage with the sums of money available within the English system. He made the point about having a fair expectation for a fair funding settlement for the health service across the UK. You also highlight, of course, that the King's College trust, with a similar level of income compared to Betsi Cadwaladr, has a deficit of about four to five times the amount.

The challenges faced by the health board in north Wales are achievable to turn around, and it is my expectation they will do, but I'll be open and honest about whether they do so, bearing in mind the recent steps I've taken in setting out a renewed special measures framework for north Wales.

When it comes to governance, it's vital that the independent directors of health boards have a robust background, and understand how these large organisations run. Many have turnovers in excess of £1 billion. In the Cwm Taf case, report after report has indicated that there's been a breakdown in governance. What confidence, Minister, can you give us that your department, and yourself in particular, have learnt from mistakes that have happened in Cwm Taf to make sure that future appointments are robust, and the individuals that you put in place do have that intimate knowledge of how such large, intricate organisations work, so that we can get on top of some of these horrendous stories that come out of organisations such as Cwm Taf and the personal tragedies that have been inflicted in maternity services, sadly, on many expectant mums and families?

Well, there are some separate points there. The first is that I should remind everyone that independent members go through a public appointments process. It is a robust process, overseen by the commissioner for appointments, and that is not a devolved function, actually. The challenge then is about how they behave when they go to their organisations. There's a point about culture and leadership there, and that's part of the reason we've taken the steps that we have done, on not just induction, but the ongoing expectation for independent members and the way we expect them to behave. It's why David Jenkins's insight and report have been particularly helpful about the change in the nature of behaviour within Cwm Taf Morgannwg to properly recognise what they should be doing, to recognise that mistakes were made in the past, to recognise that insight, and then to be able to move on. But we're definitely changing where the induction takes place and the duties those independent members have throughout their period of time as a public appointment.

3. Topical Questions

Item 3 on the agenda this afternoon is topical questions, and the first topical question this afternoon is from Jack Sargeant.

Young people who experience violence in relationships

1. Will the Minister make a statement on how the Welsh Government is helping young people who experience violence in relationships? 369

I thank Jack Sergeant for that question. We provide a range of support to young people who experience violence in their relationships, either directly through counselling services, or indirectly via awareness-raising training for professionals who work with young people, to ensure that they respond appropriately to any identified support needs of the young people they come into contact with.

Diolch yn fawr, Deputy Minister. Violence in children and young people's relationships is a serious public health issue. Cardiff University recently undertook extensive research into this matter, and they found that there are gaps in support. Deputy Minister, if we do not address this issue, our future generations could fall between the gap of domestic violence support and child social services. What steps can the Welsh Government take to respond to the report's findings?

Minister, I know that you have long championed the cause of ending relationship abuse, and I was delighted to stand alongside you on Monday to mark White Ribbon Day at the vigil organised by our colleague and friend, Joyce Watson AM. Now, one area I think you'll be particularly interested in is the White Ribbon youth advocate programme, which encourages young people to sign the White Ribbon promise. Deputy Minister, will you explore how the Welsh Government can support this programme, particularly with online content, which is more likely to be accessed by our younger generation?

15:15

Thank you, again, Jack Sargeant. I was very pleased to be beside you on the vigil. What was good about the vigil was that it was a cross-party vigil and we had speakers from across the Chamber, but it wouldn't have happened without Joyce Watson, who has supported and initiated that vigil every day, and, indeed, earlier in the day, we were in the cathedral, which also Joyce initiated, 16 years ago. It was an important event.

Just in terms of the importance of your question, I joined one of the workshops where we heard from youth advocates from Gwent Police, and they were some of the first White Ribbon youth advocates in the UK coming forward. My officials are working with colleagues in education to design and pilot a health and well-being peer mentoring challenge for the advanced Welsh baccalaureate, which will also promote the Welsh White Ribbon youth advocate programme. Also, we'll be looking at the best ways to raise awareness of this programme online, with our communications and education colleagues, to ensure that we can reach as many people as possible.

I'd like to thank Jack Sargeant for raising this really important question today. I wonder if the Minister agrees with me that one of the issues that's key in the way that young people perceive healthy relationships and what's acceptable is the exposure at a very young age of so many of our young men and women to pornography, some of it of a very violent nature, which infects their idea of what is a normal or what is a healthy and respectful relationship. I'd like to ask the Minister today if she will have further discussions with the Minister for Health and Social Services about what more we might be able to do through the new curriculum, but also immediately, to work with schools, and also with youth groups, where some young people who perhaps find it harder to take a message in a classroom might hear that in a more informal setting to counteract some of these terrible misogynistic messages that our young people receive from, particularly, online content that is so difficult to control.

I do welcome that question, Helen Mary Jones, and I know that the Minister for Education is also joining me today in accepting that. There are a number of approaches that we're already taking, for example, I'm sure you'll be aware of the Spectrum project that we're funding, going into schools to teach about healthy relationships. We actually do have a 'This is not OK' communications campaign aimed at children and young people, and it has to take on board what they might also be facing and experiencing in terms of pornography and misogyny.

We're funding counselling in schools, as we've said, but also, most importantly, developing the new cross-curricula education on sexuality and relationships, and also, it is about working with young people more informally, as you say. That is where we have to also work with those volunteers as well as professionals who work with children and young people. Training professionals to ask and act so that they recognise the signs of violence and abuse is crucial in terms of signposting for support.

I have to congratulate Cardiff University for actually looking at this; for seeing the link between all violence and relationship violence, and doing some work underneath it. I think that there is more work that needs to be done. What we have here in this headline is just that: figures. But what we really need to start to understand is what's behind those figures, what is it that produces those figures? When we say that it's a public health issue, it is, but the emotional scars will stay with people for life, and the mental stress and the stigma will also potentially stay with those individuals for life. To experience that at such a young time, when you're first starting out on your journey as an independent individual, is really, really difficult.

Some five years ago, I did a very quick online survey of 100 young people under the age of 21, and I was shocked then by the responses to several questions, but one specifically:'Do you think it's okay to slap your partner?' Over 50 per cent said, 'Yes, that's fine', and there wasn't really a great separation between girls and boys, although there were more girls than boys who thought that that was okay. So, knowing that, then, and knowing this, now, I think the best thing that perhaps we can do, moving forward, is to ensure that all places where children are and where they congregate, whether that's a school, a sports club, a youth club, or any other venue, we have well-supported and funded programmes that teach them about control, and what control looks like. If they happen to meet somebody who says, 'I think it's great, you look lovely, let's have a nice meal at home', and every time, you're only ever being taken out to where they live, and being more and more isolated, individual young people will think that that's a compliment; they won't necessarily see that that's the start of a controlling, potentially highly abusive and dangerous situation for them to be in.

There are many organisations out there who offer this help, and many organisations who would be pleased to help us help those young people. So, my question here today is knowing what we know now, we can't afford to ignore it, we can't afford for any of those young people to become one of those statistics that I had, the candles here—163 women killed by men last year. So, we must intervene now, and we must, actually, now put our money where our mouth is.

15:20

Well, I also thank Joyce Watson for that question and for, obviously, the leadership she's taken. I agree that Cardiff University has produced a very valuable piece of work, particularly looking at our young people. I think on Monday night, many people in the Chamber today heard of those moving experiences of survivors—a young woman, a survivor, who talked about how she couldn't have come out of her experiences of abuse and coercive control without the support of New Pathways. Of course, there are a number of organisations, Women's Aid and  Bawso, who were all there on Monday, who are supporting, and Llamau and Hafan Cymru—so many. But also, I have to mention the young police officer from north Wales who told of his life when his mother was stabbed and killed, and the impact it's had on his life. He is now a serving police office in the North Wales Police in the domestic abuse unit. Survivors are crucial to the way forward, in terms of policy.

And I'm glad that we also launched a communications campaign during freshers' week this year, and those messages were targeted at university students. This was the third phase of 'This is Not Love. This is Control'. Diolch yn fawr.

Barry incinerator

2. Will the Minister make a statement on the status of the environmental impact assessment made of the Barry incinerator, given that testing at the plant has already commenced? 370

The written statement of May 2019 announced our intention to consult on an environmental statement that the developer of the plant was offering to prepare in relation to planning permission 2015/00031/OUT. That environmental statement has since been received and we have procured an independent consultant, WSP, to assist and undertake an analysis of the information submitted on behalf of the developer. I will undertake the public consultation described in the statement.

Thank you, Minister, for that answer, and I'm grateful for the organiser's update in the business statement yesterday over this evidence coming before the Welsh Government. Can you give us an assurance on two fronts, please? One, that the evidence that has been provided by the developer is of the quality that an environmental impact assessment would have had to have been at. And secondly, that no commercial operations will begin at the incinerator until the Welsh Government has formed its opinion, based on the evidence that the developer has given you.

I thank the Member. I know that the Member has a longstanding ongoing interest in this area. Clearly, the information that the developer will bring in terms of the environmental statement is in line with what we would expect. Clearly, this will be analysed by the independent consultant to look at any gaps and anything that we need to take forward, and we will consider everything carefully and with due diligence as the Member would anticipate and expect.

There is, of course, a wider question here, isn't there? Because we always hear these warm words from the Welsh Government about the need for a clean air Act, but you allow a technology that sees incinerators release various air pollutants, including nitrogen oxide, sulphur dioxide, particulate matter, lead, mercury, dioxins, et cetera, et cetera. You introduce the Well-being of Future Generations Act (Wales) 2015, with its emphasis on the preventative approach, yet you allow a technology that can have serious public health effects, including increased cancer risk through to respiratory illnesses, cardiac disease, reproductive, developmental and neurological problems. You declare a climate emergency as well, of course, yet the Barry incinerator, as we know, will add over 100,000 tonnes of carbon dioxide into our atmosphere, breaching the first, the third, the fourth and the seventh well-being goals, stemming, of course, from the well-being of future generations Act. 

So, is it not time, now, for a moratorium on such incinerators, or, at least, a moratorium until you address some of the underlying issues around waste that your proposed new zero-waste strategy should deal with, when we see it? But, if you are intent on pursuing support for this kind of technology, then should we not at the very least be banning incinerators from being built anywhere near schools, hospitals, residential areas and the like?

15:25

The Member does raise a wider debate in terms of actually how we deal effectively with our non-recyclable waste as a responsible nation. I know the Member agrees with me that we have a duty, as a responsible nation, to prevent it both from polluting the environment or seeing that problem exported to other countries. That's the reason why we have invested in infrastructure to extract electricity and heat from this material and to dispose of it safely and to the highest environmental standards.

However, I think it's important that we recognise that the incineration of waste for heat and power should, indeed, be a transitionary step. The long-term solution is to move away from single-use plastic and the use of fossil fuels, and that we move to ban some of those single-use plastic products, but also taking steps to ensure that responsibility for end-of-life costs of materials is placed more on the producer, and in line with the producer-pays principle. 

The Member refers to the upcoming new zero-waste strategy, which actually aims to not just focus on waste, but a circular economy and a move beyond where we have been before. An element of that is to look at actually what we do, and have responsibility for our own waste, and I would invite the Member to be part of that conversation in terms of actually how we deal with our waste that we cannot recycle at present but that we want to reduce in the future.

This is a very simple question: will you bring forward legislation to prevent incinerators like the one in Barry, like the one proposed in Trowbridge, like the one proposed in Usk—will you bring forward legislation to prevent such incinerators being able to be opened in Wales? It's a simple 'yes' or 'no' answer, really.

It's not. Deputy Presiding Officer, I'll refer the Member to my previous response to Llyr Gruffydd—that this is a wider debate to be had, and one that we need to have, going forward, when we discuss our future waste strategy.

4. 90-second Statements

Thank you, Deputy Presiding Officer. I hope the National Assembly will join me in marking Electrical Fire Safety Week Wales, which is taking place between 25 and 29 November 2019. Electrical Safety First is a charity that works to prevent electrical accidents and fires in the home in Wales. Whilst the overall number of accidental fires in Wales is in sustained decline, fires with an electrical distribution source have continued to rise. Furthermore, it's reported that 27,000 homes in Wales are at a real risk of electrical problems. The charity has recently produced a report entitled 'Improving Electrical Safety and Preventing Fires in Wales'.

As Assembly Members, we have the power to play a part in protecting vulnerable constituents from fires and electrical accidents in their homes. So, can I thank those Members of this Senedd who are sharing these important safety messages with their constituents as part of electrical safety week? Take pride in the fact that you are helping to prevent accidents and fires caused by electricity in homes. The evidence tells us that these messages are very important in those communities with concentrations of older housing stock, and that will include many Valleys communities like my own in Merthyr Tydfil and Rhymney.

As it happens, I do know from personal experience that electrical safety and preventing fires from electrical distribution is important. So, please take the chance to support Electrical Fire Safety Week in Wales, because, put quite simply, it can help save lives. 

5. Debate: Stage 4 of the Senedd and Elections (Wales) Bill

Item 5 on the agenda is a debate on Stage 4 of the Senedd and Elections (Wales) Bill. I call on the Llywydd to move the motion—Llywydd.

Motion NDM7208 Elin Jones

To propose that the National Assembly for Wales, in accordance with Standing Order 26.47:

Approves the Senedd and Elections (Wales) Bill.

Motion moved.

Thank you, Deputy Presiding Officer. In introducing this motion today to finally approve the Senedd and Elections (Wales) Bill, I wish to take this opportunity to briefly summarise the Bill’s background and its content.

The Bill has many facets: renaming the Assembly as 'Senedd', changing the franchise, reforming the categories of people who are disqualified from standing for election to the Assembly or from serving as a Member. Today, we will be voting on a Bill that requires at least 40 votes to pass. This is a constitutional Bill, and the powers to create such legislation were only devolved to this Assembly in 2017. This is one of the few occasions in our Senedd when a supermajority is required to pass legislation. The last such occasion was a vote on holding the 2011 referendum on primary law-making powers. In accordance with Standing Order 6.21, the Deputy Presiding Officer and I will have an opportunity to vote on this Bill, and both myself and the Deputy Presiding Officer are likely to exercise that right this afternoon.

Today, we will be voting on extending the franchise to 16 and 17-year-olds for the Senedd elections in 2021. It was the Representation of the People Act 1969 that lowered the voting age from 21 to 18, and, so, the provision to extend the franchise to 16-year-olds is long overdue for some. In May 2013, a clear majority of Members of this Senedd voted in favour of lowering the voting age. Ten thousand young people participated in a Commission consultation in 2014 on the voting age. Most of those young people are now in their mid-20s. This is an opportunity to realise their aspirations back then, and to make voting a reality for young people today.

The recommendation to reform the legislation around disqualification arose from the work of the constitutional committee in the fourth Assembly, and the desire to rename the Assembly to reflect our parliamentary responsibilities emanated from a vote by ourselves here back in 2016. The fruit of this work and these decisions are at the root of this legislation today.

I’d like to thank the Laura McAllister expert panel for the work and recommendation on votes at 16 and 17, and I would also like to thank the Assembly committees for their detailed scrutiny of the Bill, which has influenced the Bill before us today. A personal word of thanks for the excellent staffing team who have worked with me on the development of this Bill. We can be confident that the Commission has people of the highest possible quality supporting us as Members on legislative matters. And I'm particularly grateful to the professional and enthusiastic team of staff who worked with me on this legislation. Likewise, to the staff within Government who contributed towards aspects of the Bill too. I would like to thank them.

Now, of course, the Bill we will be voting on today, in November, is different to the Bill that I introduced in February of this year, in many ways. First of all, the Senedd will have a bilingual name—Senedd Cymru and Welsh Parliament. Also, the franchise will include qualifying foreign nationals. Councillors will be disqualified from being Members of the Senedd, and the Electoral Commission will be funded by, and will be accountable to, the Assembly for Welsh elections.

I know that not all political groups are satisfied with all of these elements. The Plaid Cymru group and some other Members, including myself, as it happens, are unhappy with the change to a bilingual name. The Conservative group is satisfied with that change, but is dissatisfied with introducing votes for qualifying foreign nationals. A Bill does evolve over the scrutiny period, and I would ask Members, as they vote, to bear in mind that this Bill is greater than the sum of its parts. It’s a Bill that gives our legislature a name that truly reflects its constitutional status and improves public understanding of the Senedd’s responsibilities. It’s a Bill that also creates a Senedd that is more inclusive, diverse and effective, and that will strengthen our democracy for the twenty-first century.

It’s true that further reform is needed for our Senedd, and that will require further legislation in the near future, I hope. But, for today, let’s take the step to vote to strengthen the foundations of our parliamentary democracy here in Wales.

15:30

Thank you, Deputy Presiding Officer. Can I say that I'm very disappointed indeed not to be able to vote for the Bill, and indeed to be voting against it actively? And the reason for that is there are very welcome things in the Bill, which the Presiding Officer has outlined. Although we have a free vote on the issue of extending the franchise to 16 and 17-year-olds, it's something I've been very keen to support for many years, and I do believe it's an idea that its time has come, and it would reshape a lot of our political discourse if we did have 16 and 17-year-olds on the electoral register. And it really is quite devastating to me that I'm not going to get the opportunity, for reasons I will outline in a moment, to vote for that really powerful extension of the franchise.

I think it's also important that we recognise this institution as a Senedd, and in English as a Parliament. I think this is a great step forward. Devolution—as, well, lots of people claim to have said it; it may have been Ron Davies—is a process not an event. But we've had a sort of nearly 20-year constitutional convention working out what sort of form of devolution we really wanted. And we started as a sort of county council on stilts—although I have to say our Presiding Officer then made sure that we acted always much more like a proper Assembly. But we have become what I would say is a classic Westminster-model institution, and the name Parliament, or Senedd, is appropriate recognition of that.

I also welcome the Bill because it clarifies and streamlines the rules on disqualification. And Members may recall that I did chair the Constitutional and Legislative Affairs Committee in the fourth Assembly, when that report was drafted.

However, in introducing the right for foreign nationals to vote, this Bill, in our view, becomes unsupportable. It's a major change to a Commission Bill that the Commission did not want. And I do remind people that this novel idea is not common practice anywhere else, as far I'm aware, and it also brings with it the right to stand for this institution, and presumably hold office in it. It's been completely unscrutinised, introduced by the Government without scrutiny, introduced at Stage 2. It's really quite a shocking thing to do on a constitutional Bill that requires, as the Presiding Officer said, a supermajority. It's quite insulting, frankly, to those who have genuine concerns about the lack of scrutiny.

So, the Conservative group, in voting against this Bill, will not be voting against a former Commission Bill, but a Bill that, unfortunately, has been hijacked by the Welsh Government. And I have to say, Presiding Officer, I think you've been singularly badly served by the Government on this occasion.

15:35

Today's vote is an important milestone. Twenty years after it was established as an Assembly, with very few powers, we are passing a law today, hopefully, that formally notes the Assembly's flowering into a national Parliament for our country, but that also invites more of our citizens—our young citizens—to be involved in the political and democratic processes that underpin our existence as an institution.

By extending the right to vote to our 16 and 17-year-old citizens, we are showing that we trust our young people, that we are willing to listen to their views, and take their aspirations seriously. I am confident that it will change the way that we communicate our messages with electors generally, and, more than that, change the way in which we make policy and come to decisions about legislation in this place.

It has been a great source of pride for me—and I speak on behalf of all of us, I'm sure—to see how our brand new Youth Parliament has made such an impact in its first year. It's proof, if anyone needed it, that our young people have a huge contribution to make to shaping a world and shaping a future that is, after all, their own.

There are other important elements to this Bill, in relation to the Electoral Commission's work regarding Senedd elections, for example, in respect of eligibility to stand for election. It is a technically important Bill in that regard, as we take responsibility for our own electoral arrangements.

But let me turn now to the other element that has been the subject of much debate over the last few weeks and months, and one that has disappointed me and my fellow Members on these benches greatly in terms of the Welsh Labour Government's approach. I'm talking about the name of this institution.

Let me explain again: I'm not talking about the description. The Bill describes this institution for the first time as a 'Senedd' in Welsh, and a 'Parliament' in English. That's important because we were given the name 'Assembly' to give us inferior status to the new Parliament that opened in Scotland at the same time. You can argue that it doesn't matter, that it isn't the name that's important, but what we do, and of course that’s true. But it is important. People's perception is important and becoming a Senedd, a Parliament, reflects the fact that this is now a vastly different institution—a legislature with taxation powers.

But there was an opportunity here to make another point of principle, to tell the world that this is not just any senedd, not just any parliament, but that we are a distinctly Welsh body. The proposal was to call us a 'Senedd', officially. A name for everyone, a Welsh language name, bilingual in its use. Like so many other words, like our national anthem, a way to show that the Welsh language belongs to everyone, that we are confident in our heritage, united in our future, and that we celebrate what makes us unique as a country.

I and Plaid Cymru are very pleased that we have been able to work with a number of backbench Labour Members on this. But, there we go, we lost, as the Labour Government and the Liberal Democrats voted en bloc to stop that, and voted instead to go for Senedd Cymru/Welsh Parliament.

There was no legal obstacle. All advice confirms that. It was a lack of confidence, perhaps. Was it fear? Fear of what or whom, I'm not sure, given that an opinion poll during the week of the Stage 3 debate showed that the people of Wales supported the name 'Senedd'. A Government that is ready to aim for 1 million Welsh speakers, but, even in this small way, is unwilling to give one platform to the Welsh language that normalises it for all of us in legislation. 

We have won by default, in a way, because in a written answer this week the Counsel General said that the 'Senedd' was the term that the Welsh Government would be using, including in some legislation. 'Aelod o’r Senedd' and 'Member of the Senedd' will be our titles as Members. So, we will be a Senedd.

Yes. 

15:40

You know that I'm pretty sympathetic—. Thanks for taking the intervention. You know I'm pretty sympathetic to the name 'Senedd' and I think it's actually a very appropriate name for this Parliament. On the issue of the poll that you just referred to, perhaps on that day the majority of the people who responded did say that they would rather a monolingual name in Welsh rather than English, but the consultation, which the Commission undertook, actually came up with a different result, where many people actually wanted a bilingual name. So, a lot of that depends on the question you ask, doesn't it?

I'll share the question that was asked, and it was a very straightforward question that was asked and it came back with a very straightforward answer too. And I happen to find on many issues that people's choices and people's opinions on very important things do change over time and that the more current we can measure people's opinions the better it is. 

In closing, it is disappointing that the Government has decided that the name 'Senedd' is fine to use on a day-to-day basis, but not good enough to use in the piece of legislation that gives our Parliament its new name. Wales is seeking leadership, and on this issue the Government failed to provide it.

But here in our Senedd this afternoon, we will vote for this Bill. We will vote to celebrate becoming a Senedd in any language, and we will proudly vote to extend the vote to young people, to 16 and 17-year-olds. This is a Senedd for all of the people of Wales, and our young people, more than anyone, are the future of that Wales.

I thought there was an instructive divergence between how the two previous speakers described what the institution was becoming. Rhun referred to our flowering into a national Parliament, while David referred to our becoming a classic Westminster-model institution. In either event, I think it's important that we call ourselves what we are and since we now have primary law-making powers and we have tax-raising powers it is appropriate for our name to develop from the National Assembly for Wales to a Welsh Parliament/Senedd Cymru and we support that.

We oppose the changes in the franchise. However, I would like to say I think a number of Members have made compelling speeches around 16-year-olds having the right to vote. Mine remains open on the issue. Our group is not convinced of the case for that, and we oppose it. However, I will look with great interest as to how schools develop, in education, and the appropriateness of how that's dealt with and how we, as politicians, respond in terms of campaigning and canvassing and involving school students below the age of 18 in our processes. I hope it works well, albeit we are not convinced.

We are also opposed to the issue of prisoners voting. I recognise that Welsh Ministers and, arguably, the Llywydd, as chair of the Commission, as public authorities, have a separate legal obligation in respect of judgments from the European Court of Human Rights, albeit not one that we, as individual Assembly Members, are required to vote for.

Most worryingly, though, as David Melding has very ably set out, is the hijacking of this Commission Bill by the Welsh Government to push forward and use Wales as a test bed, a guinea pig, for a policy announced barely two months ago at the Welsh Labour conference to, according to the conference, at least extend free movement to much of the world and to give pretty immediate voting rights to foreign nationals. The word 'qualifying' foreign nationals is used, but I'm not sure there's much in the way of qualification. It seems to be pretty much all foreign nationals who are resident, or considered to be resident, without a specified qualifying period. I think that is wrong. And the way it has been done has been particularly wrong. It has been done without consultation. It has been done without serious scrutiny. It's been done without reciprocity for people from Wales to vote in any of these countries for which we are giving these voting rights, and I'm not seeing any example of anywhere else in the world where this is done.

I have some sympathy for the Llywydd in terms of how the Bill has been hijacked. However, she and her deputy now face the choice between allowing a Bill, which she has piloted, to fall, or supporting a Bill that includes deeply divisive and highly partisan clauses around foreign national voting. I've spoken before about the importance of the chair being impartial; today's voting record will show if they are.

15:45

Thank you very much, Deputy Presiding Officer. In asking Members to vote in favour of this Bill, I would like to start by paying tribute to the Llywydd in her role as Member in charge of the Bill for bringing us to this point. The process of developing the Bill was lengthy and complex and the guidance of the Llywydd has been crucial on that journey, and we are much indebted to her for that.

Secondly, I would like to emphasise that, in many ways, this Bill represents a compromise between very strongly held views. To that end, I'm of the view that it deserves the support of Members in general.

There have been different views expressed on the name of this institution, and Rhun ap Iorwerth mentioned that in his contribution. That issue was discussed at Stage 3 specifically. But through this Bill, we will be giving a title to the institution that is appropriate to its new powers. Those are the powers of a real legislature and parliamentary body. The statutory name reflects the view of the public in the Assembly's Commission’s consultation before the Bill was introduced. Of course, in terms of day-to-day usage, the Welsh Government will use the shorter name, Senedd, and hopes to see others do likewise.

We've also achieved a compromise between competing positions as to how the Electoral Commission should be funded in respect of its work on devolved elections. The Welsh Government is working with the Assembly Commission and the Electoral Commission to ensure that the new arrangements can work effectively, and we will continue to do so. They'll be brought into force once we can be confident of that and these new arrangements represent an important element in the development of devolution.

So far as the provisions relating to disqualification are concerned, I pay tribute to David Melding who chaired the committee in the last Assembly, which recommended that we distinguish between disqualification from candidacy and disqualification from membership of the Senedd. We've pursued that recommendation, although, again, there have been differing views as to exactly how that distinction should be applied in particular instances.

The Bill also provides for extending the Senedd franchise to 16 and 17-year-olds and to qualifying foreign citizens. The Welsh Government has long advocated the involvement of young people in the democratic process, which we believe is essential to achieve a vibrant democracy. Similarly, it is our view that people, regardless of their citizenship, who contribute to the economic and cultural life of our community should be able to have a say in the future of that community, and that is why we brought forward amendments to extend the Senedd franchise to qualifying foreign citizens and were pleased that that attracted support beyond—well beyond—the Welsh Government benches. And, indeed, relating back to the comments that have been made in earlier contributions, Members will remember that, when asked whether all legal residents in Wales should be allowed to vote in Assembly elections regardless of nationality or citizenship, 66 per cent of respondents agreed that they should. There are equivalent provisions on the franchise in the Local Government and Elections (Wales) Bill. We believe it's appropriate that the franchise for all devolved elections in Wales are aligned.

Dirprwy Lywydd, this is an important Bill. I believe it's right that we use the new powers conferred by the Wales Act 2017 to make our democracy more accessible and comprehensible and to open it up to more members of our society. That is what the Bill achieves and, in reiterating my thanks to the Llywydd as Member in charge and, indeed, echoing her thanks to all officials and lawyers who have worked on this Bill, I urge all Members to vote in support of it.

15:50

Thank you, Deputy Llywydd, and just to reply to some of the points raised during that debate. And may I first of all thank the Counsel General for the collaboration throughout the development of this Bill, and may I also recognise the contributions of David Melding and Mark Reckless? And although many Members will vote against the Bill today, I was pleased to hear the Members who did contribute confirm that there are some aspects within this Bill that they, even in voting against it, are in favour of—votes at 16 and 17 in some cases, and the naming of this institution as a Senedd or Parliament at last. So, thank you for putting that on the record.

Also for the record, if I may say, I’m not of the view that this Bill had been hijacked by Government. If I may say, this Chamber voted in favour of changes to the Bill during the scrutiny period, so it was a democratic vote rather than a hijacking, whether you’re happy with the outcome or not.

And in conclusion, therefore, and in accordance with Standing Orders in this Assembly, it will be a pleasure for me to use my rarely exercised right to vote this afternoon in favour of strengthening our Senedd.

Thank you. In accordance with Standing Order 26.50C, a recorded vote must be taken on Stage 4 motions, and Business Committee decided that the vote on this item will take place immediately.

In accordance with section 111A of the Government of Wales Act 2006 and Standing Order 26.50A, I have made a statement relating to protected subject matter and the supermajority requirement of this Bill. As the Bill does contain protected subject matters, the motion requires the support of at least 40 Members for the Bill to be passed. And unless anybody wishes for the bell to be rung, I now want to proceed directly to the vote. So, we open the vote. And close the vote. For Stage 4 41, no abstentions, 19 against. Therefore, the Bill passes.

NDM7208 - Debate: Stage 4 of the Senedd and Elections (Wales) Bill: For: 41, Against: 19, Abstain: 0

Motion has been agreed

6. Member Debate under Standing Order 11.21(iv): Pancreatic Cancer

Item 6 on the agenda this afternoon is the Member debate under Standing Order 11.21 on pancreatic cancer, and I call on Lynne Neagle to move the motion. [Interruption.] Can we settle down, please? Thank you. Lynne.

Motion NDM7191 Lynne Neagle, Dai Lloyd, David Melding

Supported by Delyth Jewell, Joyce Watson, Mark Isherwood, Neil Hamilton, Neil McEvoy, Vikki Howells

To propose that the National Assembly for Wales:

1. Recognises that one in four people diagnosed with pancreatic cancer in the UK do not survive the disease beyond a month and three in four do not survive beyond a year, many because they were not treated quickly enough.

2. Recognises in Wales there are around 500 new cases of pancreatic cancers every year, and that, in 2015, some 508 people were diagnosed with pancreatic cancer and in the same year some 451 people died of the disease.

3. Recognises pancreatic cancer is the deadliest common cancer with a dismal prognosis that has hardly changed in the last 45 years.

4. Welcomes Pancreatic Cancer Awareness Month (November) and the work Pancreatic Cancer UK does to promote awareness around the lowest surviving and quickest killing cancer.

5. Calls on Welsh Government to take action to improve survival rates for people with pancreatic cancer in Wales through:

a) faster treatment, by learning from fast-track surgery models in England that have shown promising results;

b) earlier diagnosis, by learning from Rapid Diagnostic Centres being rolled out in England and piloted by Swansea Bay University Health Board and Cwm Taf Morgannwg University Health Board; and

c) holistic support, through timely dietary and nutritional support to enable patients to better tolerate treatment.

Motion moved.

Thank you, Deputy Presiding Officer. I'd like to thank my fellow Assembly Members from across—

15:55

Hang on a minute. Can we settle down, please? This is as important a debate, I think, as the rest of the agenda this afternoon, so if we're going out, can we go out—? Lynne needs to have our full attention. Thank you. Lynne.

Thank you. I'd like to thank my fellow Assembly Members from across the Chamber who have supported today's pancreatic cancer awareness event and those who jointly brought forward this debate. I'm very pleased that the Chair of the health committee, Dr Dai Lloyd, will be closing the debate today. Dai will, I know, voice the concerns that many of us have about how different solutions are identified for different cancers in the context of the new single cancer pathway, because for the patients we are discussing today, more than almost any others, time is of the essence.

In almost every way, the world has changed beyond all recognition in the last 50 years. In November 1969 the world watched and wondered at the successful Apollo 12 moon landing. Technology was changing, and fast, and so was healthcare. In the early 1970s only one in four cancer patients in the UK could be expected to survive their disease for 10 years or more. That figure is now two in four. In 1969 infant mortality in this country was at 18.32 per 1,000 births. It now stands at 3.7.

Why this context—this long, 50-year view of the world and medical advance? Because looking back from here to that black-and-white age, it is the things that haven't changed that serve to shock us the most. Over that period, one thing has not changed: survival rates for pancreatic cancer have not changed. Despite all the progress we've made in technology, communications and in healthcare, for nearly the entire lifetime of the NHS the dial has not shifted when it comes to this lowest surviving and quickest killing cancer.

The statistics—the unmoving statistics—are plentiful and shocking. Pancreatic cancer is the tenth most common cancer in the UK, but receives just 1 per cent of research funding. Due to late diagnosis, seven out of 10 people with pancreatic cancer will never receive any treatment, and only one in 10 will receive surgery, which is the only curative solution. Fewer than 6 per cent of those affected in Wales will survive for longer than five years—take a moment to reflect on that.

In the shadow of these numbers are real people, real stories and very real suffering. So, I want to use the remainder of my remarks today to give voice to three stories—a bereaved relative, doughty campaigners and a leading clinician. Three stories that combine to make one point: we must do better.

First, I want to tell the story of my constituent Linda. I want you to imagine what Linda's Christmas was like 10 years ago. Having lost her cousin, Noel, and her uncle, Robert, to pancreatic cancer in recent years—both died within weeks of their diagnosis, despite being given years to live—Linda was now faced with the uncertainty of her seriously unwell mother. She'd gone through two years of poor health, various treatments and uncertain diagnosis. Then, 10 years ago, she suffered a rapid decline over the Christmas period, only to be told in January 2010 that she too had tumours on her pancreas, liver and stomach. The discovery was too late. There was nothing the doctors could do—that dreaded phrase: 'We'll make her as comfortable as we can.'

Linda pays tribute to the care given by nurses when her mum got home for her final three weeks, and to her own daughter, who held it together for her nan until she was out of sight and off the ward, when she could safely break her heart in her mum's arms. Linda is still angry—rightly angry—that her mum heard her diagnosis alone, that she didn't hear about the trials available, that no-one thought, through those crucial months, about the possibility of a family connection, but, most of all, that she hears the same stories today. Linda has turned her hurt into a campaigning zeal that would put any politician in the shade. Linda and her family deserve to hear about more progress than we've made in the last five years, let alone the last 50.

The second story comes from Bilal Al-Sarireh, the clinical lead in Wales on pancreatic cancer, and I want to thank him for working with my office to give a detailed update on the challenges that exist today. Professor Al-Sarireh says that, having seen such huge progress since establishing Wales's first specialist centre a decade ago, he now worries that he is letting patients down because they cannot access treatment fast enough, regardless of how quick or how urgent their diagnosis. I'm sure the Minister will agree with me that we never want to hear clinicians express those feelings of guilt and regret for circumstances they cannot control. I hope that the Minister will look seriously at the concerns being raised by the professor about the challenges facing Wales's national centre, where the numbers of patients being offered curative surgery is dropping from around 20 per cent to under 15 per cent, and where palliative bypasses are now on the increase, a reflection of two challenges.

The first is the question of ensuring that funding is matching increased demand, and, secondly, in terms of logistics, Wales is currently an outlier when it comes to having standalone centres for specialist treatment of liver and pancreatic disease. Can the Minister therefore consider establishing a single hepatopancreatobiliary cancer centre in Wales? According to experts, this will help recruit, retain and sustain the right specialists and bring the right skills to Wales to make real progress on reducing waiting lists. Time is of the essence: that is the message you hear time and time again from all those touched by pancreatic cancer.

And, finally, I want to pay tribute to Nick and Wendy Horler, who run Blaenavon post office in my constituency. Once again this year, they have lit up their premises in purple lights to mark Pancreatic Cancer Awareness Month. Like many campaigners we will hear about today, they have done this year in, year out. Like Linda and her family, like Professor Bilal Al-Sarireh and his team, and so many others gathered here today, the Horlers are waiting to see what the years of campaigning and raising awareness will deliver. Three stories with one point: we must do better. For sufferers of pancreatic cancer, time is always of the essence. Too much time has now passed with too few strides made in treatment, survival rates and awareness. I urge all Members to support today's motion to give more time, more hope, to the people impacted by this terrible disease. Thank you.

16:00

Can I pay tribute to Lynne Neagle for that speech, but also for the work you've done in this area? I also want to put on record my thanks to Pancreatic Cancer UK for the information drop-in that they organised today, which I know many Members attended and we found the information there to be particularly valuable.

Deputy Presiding Officer, over the past 50 years, diagnosis and treatment strategies for cancer patients have evolved rapidly, transforming patient outcomes. Yet, despite the major advancements witnessed in other areas of oncology, improvements in pancreatic cancer patient outcomes have largely stood still. In sharp contrast to the remarkable growth in the survival rates observed in other disease areas like lung, breast and prostate cancer, the overall five-year survival rate for patients diagnosed with pancreatic cancer is just 5 per cent across the globe, and that's not really improved substantially since the 1970s.

Earlier this year, analysis positively suggested that cancer survival in the UK is improving, but it still lags behind other high-income countries, so we've got that part of the problem as well. Indeed, despite the improvements we are seeing, the UK still performed worse than Australia, Canada, Denmark, Ireland, New Zealand and Norway in the study published in The Lancet. Cancer Research UK says that the UK could do better and called for more investment in the NHS and the systems and innovations that support it, and that would be really important for pancreatic cancer and the prospects of improving outcomes.

As we've heard, one of the problems is that the early stages of the disease can be silent and symptoms are often not picked up, and therefore the disease is discovered late in its course. And also I think there is a general poor public perception of pancreatic cancer and awareness, and this, added to the standard diagnostic tools frequently leading to delays in identification, and that they're not as advanced as some other areas of cancer treatment—the outcomes are that, by the time someone knows they have the disease, curative surgery, for instance, is not any longer viable.

But, despite these rather daunting statistics, there have been signs of improvement and we need to build on these achievements, and obviously we've got great organisations that I've referred to campaigning actively in this area, as well as those that have the disease or their families, and we know what powerful political force is brought by those that come and give witness of their personal experience and that of their loved one. So, I think it's really important we build on this to increase the wealth of established research that we have and ensure that incremental improvements are valued and then seen across the field, and then combined with other advances so that we have a holistic approach. There are many, many things that need to be got right and improved to give an overall advance in prognosis and also to extend the treatment options available. So, I think that really is key to what we need to do, but, above all, I think it is this drive to get earlier diagnosis, and that leads to improved treatments, and we need to ensure that that applies in the field of research but also that we take patients and the public with us so that their awareness is improved also.

I was very pleased to read earlier this month that Dr Catherine Hogan at Cardiff University's European Cancer Stem Cell Research Institute had been awarded £373,000-worth of funding by Cancer Research UK to understand how pancreatic cancer cells develop, with the aim of developing diagnostic tools for the future. So, we have a proud record also in Wales and in our universities and medical schools, and that's something, I think, that we need to contribute and ensure that we take that to its maximum extent and back it as well. But getting those major funding sources and bringing them into Wales is important.

But I finish, really, with this plea that we all get more aware of pancreatic cancer, both in terms of where it is as a public health issue—the tenth most common cancer, as we've heard—but also it will ensure that we drive this up the political list of priorities so that we see the advances that have been pleasingly achieved in many areas of cancer treatment come to pancreatic cancer. Thank you very much. 

16:05

November is Pancreatic Cancer Awareness Month. It is a disease that too few people are aware of in any detail, but, if it's something that's touched your family, you will be acutely aware of how devastating it is. I know that many of us contributing to this debate will be indebted to organisations like Pancreatic Cancer UK for sending us statistics, and I'd also like to put my thanks on record to them. Of course, those statistics are damning, particularly the statistics that illustrate how the odds are stacked against someone once they've finally been diagnosed with pancreatic cancer. As we've heard, seven in 10 people with pancreatic cancer will never receive any treatment, and only one in 10 will receive surgery. But we have to remember that behind all those statistics are people, families who will be traumatised by the swift onset of this disease. It is too little understood, and, by the time it is diagnosed, it's usually too late to do anything.

Pancreatic cancer is the quickest-killing cancer and the cancer with the lowest survival rates. The figures are stark, but what's starker still is how doggedly static those figures are, that there has been so little improvement for decades in survival rates. Of course, there is no hierarchy of pain. Every cancer can be devastating, and every cancer can have seemingly miraculous stories, but there is a feeling that pancreatic cancer, the silent killer, also has the weakest voice when it comes to funding considerations, to research and to public understanding.

I support Pancreatic Cancer UK's call for there to be a national plan for pancreatic cancer to improve diagnosis rates, to raise awareness of the symptoms amongst the public and GPs, to get critical investment into research, so that diagnosis rates can be improved and the chances of survival increased for thousands of people.

The public awareness element of this is critical. My grandmother died of pancreatic cancer in January 2005. She'd been a little off-colour at Christmas, but, like so many patients who don't know that these symptoms are masking something deadly, she put off going to the GP. When she did go, no-one had recognised the symptoms. She wasn't alone in that—16 per cent of pancreatic cancer patients actually visit their GP seven or more times before getting a diagnosis. A few days after Christmas, she went to the GP again, and they didn't know exactly what was wrong but they sent straight to hospital. It was over the new year period, so the disease still wasn't spotted for too long. My grandmother was left calling out in delirium because of the pain, and when the symptoms were finally understood and the fantastic palliative care team came on board, she died three days later. She'd been in agony for weeks. It was incredibly distressing, for my mother, especially, because the disease seemed to come from nowhere, and yet, within days, nurses had to cut off her wedding ring because of the pain. She had only really been ill for three weeks. It was cruel, it was all-consuming.

I know that other members of my family, including me, are at a greater risk, because my grandmother died of pancreatic cancer, and her mother before her. We have to improve diagnosis of this horrible disease. More funding is urgently needed for research, as well as a dedicated awareness campaign about the tell-tale symptoms of the disease. Please, let's make this investment so that fewer people have to die like my mam-gu.

16:10

I thank Lynne, Dai and David for tabling this important debate. As the other contributors have pointed out, pancreatic cancer is the deadliest of all the cancers, yet the majority of people have never heard of it. I became acutely aware of pancreatic cancer over 30 years ago, when doctors discovered a tumour on my pancreas. Thankfully, in my case, the tumour was benign, but the symptoms that I had were awful: it was falling down, it was fainting without any awareness at all, because the level of insulin had been totally disrupted. I didn't know what was wrong, and it took two years to diagnose. I had insulinoma, rather than cancer, but, until that point, I was unaware of pancreatic cancer.

Sadly, 93 per cent of people diagnosed with pancreatic cancer will die within five years, and a quarter of those diagnosed die within the month. Unfortunately, this is mainly as a result of lack of awareness of the signs and symptoms of the disease. Over two thirds of adults in the UK are unaware of the symptoms of pancreatic cancer, according to Pancreatic Cancer UK. Because of this and the fact that the disease has non-specific symptoms, early diagnosis is almost impossible, and, as with all other cancers, early diagnosis is key to long-term survival.

This is why I'm happy to support this motion today and play a small role in promoting awareness of the disease. However, we have to do more. We need a dedicated public awareness campaign. There have been national public information campaigns for lung cancer, breast cancer, bowel cancer and bladder cancer, but no such campaign for pancreatic cancer. There is no simple screening test for this awful disease, so we have to rely on members of the public being aware of any symptoms and trying to seek help. Thank you.

I'd like to thank everybody moving this today—Lynne Neagle, Dai Lloyd, David Melding, and the supporters Delyth Jewell, Joyce Watson, Mark Isherwood, Neil Hamilton, me and Vikki Howells as well. I really didn't realise what an aggressive cancer pancreatic cancer was until earlier this year, unfortunately, when an old colleague of mine, my first ever head of department in my first full-time job, Phil Davies, was taken far too young. Phil was a great manager and I learnt a lot from him, and it was shocking for every one of us who knew Phil, and, of course, more shocking for the family that the cancer was so aggressive and that it takes over so quickly. So I wanted to pay tribute there to Phil Davies.

I note that the fast-track surgery in England, on a more optimistic note, is having promising results, so that's really, really pleasing, and I welcome the early diagnosis centres that are being rolled out. This is something that, for once we can all agree on, and I really hope that this being brought forward today brings positive results. Thank you for giving me time to speak.

16:15

Thank you very much. I call on the Minister for Health and Social Services, Vaughan Gething.

Thank you, Deputy Presiding Officer. I'd like to thank Lynne Neagle and Members from all parties who have supported today's debate in raising what is an important and poorly understood issue by the wider public. Now, I recognise the devastating impact that pancreatic cancer can have on people and their families, especially so given its poor diagnosis. For anyone in any doubt, in particular in hearing the opening of this debate, and indeed the contribution from Delyth Jewell, they should be left in no doubt about how aggressive a form of cancer this is.

The motion recognises that one-year net survival rates for pancreatic cancer were around 28 per cent between 2012 and 2016, when the most recent data was available, making it a cancer with one of the worst survival rates. We've seen around 520 new cases, and sadly, around 480 deaths a year. One-year net survival for stage 1 pancreatic cancer is higher than 60 per cent based on the data for 2011-14, so whilst time-to-treatment is a factor, a key issue appears to be that pancreatic cancer tends to present in a much more advanced stage when treatment options are more limited. Now, the Government will be abstaining, but I'm largely supportive of the motion. I'd like to offer a couple of corrections about the record, and of course all Members will have a free vote, outside the Government, on the motion itself.

According to our statistics from 2015, we saw 531 new cases of pancreatic cancer. It's also really important to recognise that outcomes have improved over the past 20 years for pancreatic cancer, and particularly so in the past decade. One-year net survival has improved by over 7 percentage points and five-year survival by over 4 percentage points between 2007-11 and 2012-16. So, there are real improvements that have been made by our NHS. However, the basic point that Lynne and others make in moving this debate is correct: this is a cancer with very poor outcomes, and there is a real need to make progress.

Surgery is a curative option for a range of cancers. I was please to hear Lynne mention this in her opening contribution, because regularly, when we talk about cancer services, we have a debate around drugs, when actually, surgery is much more likely, in most cases, to be the curative option. It's part of the reason why there's a focus on improving surgery rates across a range of cancers, and that, of course, includes pancreatic cancer. That goes back to having earlier diagnosis so that curative surgery is a real option.

On the proposal about having a specific centre, I've listened and I will ask the clinicians at the Wales Cancer Network to consider that further, to give me advice to go into our cancer delivery plan for Wales and the work of the implementation group to understand what that would mean and the benefit that could provide for people in Wales.

But I do want to also recognise the work that Pancreatic Cancer UK does in raising awareness of the impact of pancreatic cancer, and, of course, they get to take part as a member of our Wales Cancer Alliance. I meet that third sector campaigning alliance on a six-monthly basis, and they are represented on our national leadership group for cancer services. The motion called for us to learn from fast-track surgical models in other countries and I'm happy to commit to that and to see what lessons there are for Wales. It's work that we regularly do in looking at other parts of the world, including, of course, other parts of the UK. It also calls for us to learn from the rapid diagnostic centre pilots in two of our own health boards, and I can certainly commit to doing that. That's funded through the cancer delivery plan for Wales, and I look forward to the evaluation that is being provided and discussed by the network.

Finally, it calls, of course, for holistic support for patients to prepare them for surgery. I've made it clear on several occasions that I expect health boards to be doing this as a routine part of surgical pathways, and that is absolutely part of the improvement work that we need to do to make the best use of the surgical skills of our staff, but, importantly, to improve outcomes. So, we're committed to doing all that we can to build on the progress made. Our approach has been to focus on improving services and outcomes for all cancers rather than to focus on those with the poorest outcomes. We think it's important on the point of equity, but also because many of the things it will improve in the outcomes for pancreatic cancer are applicable to improving outcomes for most cancers too. Our medium-term approach is set out in the cancer delivery plan, taken forward by the implementation group, and supported by more than £5 million of annual investment.

One of the key focuses has been on detecting more cancers at an earlier, more treatable stage. That's underpinned by new referral guidance and a national programme working together with primary care and the piloting of the two rapid diagnostic centres for people with vague symptoms. It also includes the optimisation of screening programmes, an important ally of work in our diagnostic programme to provide streamlines access to investigations for cancer. The aim of all of this is to ensure that people are investigated promptly, and in the small minority of people who do have cancer, that their diagnosis is made quickly.

A key area of focus for us is the introduction of the single cancer pathway. That is much more than just a new way of measuring cancer waiting times. This is a UK first, and it means that patients will no longer be artificially divided into those who present in primary or secondary care. They'll all be measured against the same pathway, and most importantly, from the point of suspicion, rather than the receipt of referral or the decision to treat. As well as being a clearer way of measuring waits, it means that people's investigation and treatments have to start earlier to meet the 62-day time limit. Within 62 days, clinicians can treat patients according to their clinical priority. I know that Pancreatic Cancer UK have called for a 20-day treatment target from diagnosis, but the 62-day single cancer pathway includes a diagnostic phase and the start of treatment.

In order to support health boards to deliver the single cancer pathway and to reduce variations across Wales, and to deliver care in line with the best professional standards, we are also introducing nationally optimised tumour site pathways. These are descriptions for each tumour site to set out how health boards should plan to deliver their services. The first of three tranches of these pathways was published through a Welsh health circular in October this year, and I expect pancreatic cancer to be included in the next tranche early in the new year. These pathways are highly ambitious, and health boards will work towards them over time, supported by the national peer review programme for cancer.

Further developments, such as the cancer research strategy and the replacement of the cancer informatics system will also play a role in helping us to deliver the improved outcomes and excellent services that every Member who has spoken and listened to this debate today will want to see. Once again, I want to thank Members for bringing forward this debate, and I hope and expect we can continue to make real progress in the years ahead.

16:20

Diolch, Dirprwy Lywydd. Can I start off, first of all, by congratulating Lynne Neagle on her leading work here as regards bringing this motion before us this afternoon, emphasising, critically, the fact that pancreatic cancer needs a particular focus? As a GP of 35-years standing in Swansea, I know that pancreatic cancer is tough to diagnose, but, 'Always ask about the family history', I always say. But it's tough to diagnose, it's tough to treat, it's tough to research, and ultimately, it's tough to survive it. 

Now, Lynne, in opening this debate, has made the case, both coherently and brilliantly, really, as regards we have to step up to the mark here in Wales. Survival rates for pancreatic cancer have largely not changed. I take on board what the Minister has just said about some percentage changes, but when you hear the diagnosis in primary care that somebody has pancreatic cancer, it is not a cause for celebration.

Now, huge strides have been made in medicine, as Lynne outlined, and in other cancers like childhood leukaemia, Hodgkin's disease and many other cancers, as outlined, survival rates have been dramatically, radically transformed over the years. All of those conditions did have a particular focus at the time, though, in terms of we said at the time, 'Childhood leukaemia: why are children dying? Let's have a particular focus on that. Let's sort it out.' That was 25 years ago, now. But, it hasn't happened for pancreatic cancer, and that's why we're having this debate today.

The distressing case studies that we've heard from Lynne, from Delyth, from Neil McEvoy and others demand action and a focus on pancreatic cancer. And by demanding focus, we mean that 'focus' means increased funding for this particular cancer, and it does actually mean serious consideration, and I would be campaigning to set up this specialist tertiary surgical centre. I think that is the transformational element that needs to happen. As the Minister said, surgery is curative, so let's enable the very best surgery targeted at this hugely malignant cancer. That single hepatobiliary pancreatic surgical centre needs to happen. That is the transformative action; that is the fast-track surgery; that's the early diagnosis; that's what needs to happen.

Because it is really tough to diagnose this. People present with really vague symptoms that could be anything or nothing, as Delyth said in her distressing case involving mam-gu. It is hugely difficult to pick up the signs, because we can't, as GPs refer everybody who comes along with a bit of tummy pain and not feeling well and feeling a bit off colour, otherwise our hospitals would be full—[Interruption.] They are. And diagnostic tests to improve research have worked for other conditions that we thought never had a diagnostic test. That's why the emphasis is on research here, as well, to find that test. 

So, I'm grateful to David Melding as well for paying tribute to Pancreatic Cancer UK, a tribute to their great work. Much research is going on and it's research that will transform the field. People say, 'You're always talking about research, it's a bit tedious', but that's where all these medical advances have come about. Tremendous research enables medical technology, medical treatments, and medical advances to truly take off. Cancer Research UK, Cancer Research Wales—everybody is doing a phenomenal amount of innovative research. And Delyth reminded us that November is Pancreatic Cancer Awareness Month, and again, emphasising the trauma of the diagnosis, and the need for a national plan, as we're already saying—this national focus uniquely for pancreatic cancer. 

I'm grateful also to Caroline Jones for her personal experience and her support for this motion, and also for Neil McEvoy's words on the fast-track surgery, and his personal experience. I'm grateful to the Minister as well, before closing, in terms of, obviously acknowledging the excellent work that is done by our excellent staff in the NHS at the moment. Improvements are happening, but, uniquely for pancreatic cancer, we still haven't seen that step change in survival rates. So, we have to have that focus on funding, on that setting up of a single hepatobiliary pancreatic surgical centre; I look forward to the day—the Minister could even open it. We need a focus. I hear the words about the single cancer pathway—absolutely fantastic—but within that, there needs to be a particular emphasis on what we can do about this silent, and not-so-silent killer, that is pancreatic cancer.

So, cancer of the pancreas—in closing, Deputy Presiding Officer—demands a particular focus. It's had a particular focus here in the Chamber this afternoon. I am grateful for the contribution of all Members. Yes, we can learn from other countries, other centres, we can learn from the rapid diagnosis pilots. We need to take all that on board but also work and step up to the challenge and support the motion. Diolch yn fawr. 

16:30

Thank you. The proposal is to agree the motion. Does any Member object? [Objection.] Therefore we defer voting under this item until voting time. 

Voting deferred until voting time.

7. Welsh Conservatives Debate: Welsh Government Funding

The following amendments have been selected: amendment 1 in the name of Rhun ap Iorwerth, and amendment 2 in the name of Rebecca Evans. If amendment 1 is agreed amendment 2 will be deselected.

Item 7 on our agenda this afternoon is the Welsh Conservatives' debate on Welsh Government funding, and I call on Nick Ramsay to move the motion. Nick. 

Motion NDM7206 Darren Millar

To propose that the National Assembly for Wales:

1. Believes that Wales benefits from being part of the United Kingdom.

2. Notes that, as a result of the Fiscal Framework agreed between the Welsh and UK Governments, Wales currently receives £1.20 per head for every £1 spent per head in England on devolved matters.

3. Welcomes the additional £790 million over and above the Welsh block grant which has been committed by the UK Government towards Growth Deals across Wales.

4. Recognises that the funding available for the Welsh Government is at record levels.

5. Calls upon the Welsh Government to:

a) use any additional resources which arise as a result of increased investment on the NHS by the UK Government to improve the Welsh health service;

b) use any additional resources which arise as a result of increased investment on education by the UK Government to improve the Welsh education system;

c) rule out any tax rises or new taxes in Wales between now and the next elections to the National Assembly for Wales.

Motion moved.

Diolch, Dirprwy Lywydd. I'm pleased to move this motion today in the name of Darren Millar.

The fiscal framework agreement between the Welsh and UK Governments was a groundbreaking agreement that really moved the funding situation in Wales on. It was welcomed by all sides and I think it's to the credit of both Governments involved in that that we ended up with that agreement. As a result of the fiscal framework, Wales now receives £1.20 per head for every £1 spent in England. That's a really good news story. It's even a good news story for the Welsh Government, given their involvement in it. You don't often talk up the benefits of co-operation with the UK Government, for obvious reasons, but it is—

Will you take an early intervention? Do you genuinely mean to say—and thank you for taking the intervention—that Wales needing additional funding because of our poverty is something to celebrate and is good news?

Well, I would say, if I'd got a bit further along, he might have heard a bit more, but there you are. No, I'm saying that the fiscal framework is to be welcomed, and I'm sure that you welcomed the fiscal framework—I think you did anyway, and I think your party did. [Interruption.] Go for it. 

I'll come in. You said it's good news that more money is coming to Wales. The reason more money is coming to Wales is because of our poverty. That can never be good news. 

If you're actually saying that you don't want more money to come to Wales and you want us to suffer from the poverty that we've got, I don't think you really mean to say that. [Interruption.] I'm not going to let you in again. I don't know whether you're trying to get up again. 

Look, I welcome the fact that the fiscal framework means there is an uplift in the money that we receive and I think that is better than the previous flawed Barnett funding formula that was given to us. I will be frank—I probably would agree with you on this, actually—I think that, on the Barnett formula, longer term, there would be a better way of funding Wales and many of us have had those discussions in this Chamber. But as things stand at the moment—and I'm afraid to say it again, in case you jump up again, Rhun—the fiscal framework is delivering more money. And I hope that that—. [Interruption.] I'm sorry this has worked you up so much. I hope that the additional money will be invested in Wales in a way that will make the economy more sustainable and will deal with poverty. There you are, you see, I was getting there eventually, so I hope you're happy now. 

The UK Government has committed an additional £790 million over and above the block grant for growth deals across Wales. The Welsh Government's budget will increase by £593 million above the 2019-20 dateline. The latest spending round also includes an increase of £80 million to the capital budget, which has already been set for 2020-21. As a result, the capital budget will be 2.4 per cent higher than in 2019-20, and funding from the UK Government is actually at record levels.

And yet, when you look at the funding situation in public services in Wales, such as the NHS, that money doesn't seem to be being passed on. Wales is facing a deficit of £97 million in 2018-19. Demand pressures continue to increase and also, of course, there are new demands on the NHS, such as mental health services. That's putting extra pressure on the workforce, who do an outstanding job under challenging conditions. I think we need to see in the NHS a more sustainable, longer term, multi-year funding plan. We often talk about the importance of that, but it doesn't actually seem to happen in practice. 

Welsh Conservatives welcome the £385 million that has been pledged to the health service, as well as the £195 million to education and £20 million to capital projects, which has been pledged recently during the election campaign. And we know that there's going to be—if there is a Conservative UK Government after the election, at least—over £30 billion extra for the NHS across the UK, which means that here in Wales we will receive a significant uplift in that part of the budget.

But, of course, getting that money isn't enough—it has to be passed on. We know that in the case of the NHS particularly that hasn't happened over a considerable length of time. If you look at the details of NHS spending, taking oncology, for instance, there is a serious shortage of cancer specialists in Wales—I've just been listening to the previous debate, of course, on pancreatic cancer. We've only had a 7.7 per cent increase in consultants since 2013, compared with a 25.4 per cent increase in England and a 25.4 per cent increase in Scotland as well. Vacancy rates here are persistently high.

So, it's all well and good for the Welsh Government to say on the one hand, 'We don't receive enough money from the UK Government', and on the other hand to say that they are investing here, when we know that in the past the NHS did see an increase but it was only a cash increase at one point in time, when, of course, you need to safeguard the increase against inflation as well.

On a more positive note, I mentioned the north Wales growth deal, and that is a step in the right direction. Through the projects identified in the proposition document, the intention is to create over 5,000 new jobs, to lever in £3 billion of private sector investment and to increase the value of the north Wales economy from £13.6 billion to £26 billion by 2035. This investment is to be welcomed and will provide major benefits to the Welsh economy.

If I can turn to the issue of tax, which is also mentioned in our motion, Welsh Conservatives supported tax devolution. It was, of course, a UK Conservative Government, in coalition, that brought that in at the UK level as a way of making this place and the Welsh Government more accountable to the people. But, it is vital that tax rates in Wales remain fair and competitive. That is absolutely essential. Wales simply cannot afford punitive tax rates that take money out of the pockets of those people who are going to invest in new businesses, in small and medium-sized enterprises and in expanding existing businesses, and invest in the entrepreneurial economy.

So, we are calling on the Welsh Government, in this motion, to reassert its previous commitment to not raise income tax before the—

16:35

Mike Hedges rose—

I will in a moment, I'll just finish this.

—the next—I was going to say Assembly election, but I suppose Senedd election is more appropriate, isn't it—the next Senedd election in 2021, and to come clean with the electorate in advance of that election if the intention is to significantly raise income tax after it. Mike Hedges. 

Can I thank Nick Ramsay for taking this intervention? Can I also thank him for being the first person to use the name Senedd for this institution? Nick, the question I really want to ask you—I hope you can answer it—is: in the command paper it says 'no detriment'. Does that mean that if actions take place at Westminster that cause a reduction in the amount of money coming into Wales that the Westminster Government will underwrite it?

I think I understand. Your point being that in the case that there was a reduction in money coming here from the UK Government, then would that mean that the Welsh Government would be able to increase it?

No, a reduction in income tax collected because something happened that was the decision made by the Westminster Government, over which the Welsh Government had no control.

Yes, I wouldn't be averse to a no-detriment principle there, so you can infer that, but I think that that would have to be very carefully considered, and I think that, over the medium term at least, if that was done, there should be mechanisms within the Welsh Government so that tax rates are seen to be competitive.

I know that we've often had these discussions, Mike, about volatile taxes like land transaction tax—of course, all tax is volatile, to a certain extent—and what would happen if there was a major shock to the economy. Borrowing, of course, could be used to cover any shortfall in the short term. But, I think, yes, no detriment over the longer term should be the aim.

In conclusion, Deputy Presiding Officer, and returning to the first part of the motion, the Welsh Conservatives believe that Wales's membership of the United Kingdom has been beneficial to the Welsh economy over many years. If you just look at Wales's estimated fiscal deficit alone in 2017-18, estimated at around £13.7 billion, that is currently supported, of course, largely by the UK Government. That wouldn't happen if Wales was independent.

You're asking for it. [Laughter.] I'm sure you will have read, of course, the work that was done around that, and I'm sure you will have noted as well the strong caveat that that analysis in no way reflects the fiscal situation of a potentially independent Wales. That is the narrative around the current settlement that we have within the United Kingdom, which you tell us is a union of equals, but which you've just proven is absolutely not.

16:40

I chose my words carefully, actually. I didn't say 'union of equals'; I said that our membership of the United Kingdom has been beneficial. I feel that this speech has been more of an intervention on everyone else, to be honest. [Laughter.] I don't dismiss your point, Llyr; I am, of course, talking about the current situation and, currently, that is estimated to be our deficit, and it is underwritten by the UK Government, the UK as a country, and the union as a whole. Now, if we had not been members of the United Kingdom over the last 500 years or whatever, then perhaps we might be in a different situation; I'm sure you'd agree with that. We will never know that; we are where we are now.

I will say to you in closing, unless anyone else intervenes, Deputy Presiding Officer, that I actually think it's a minority of people who support independence in Wales, but it is a significant number of people, and you represent that part of the electorate. That is your right in a democratic system to do that, and I think that those people deserve a voice and you're giving that voice, particularly in your interventions today. But you must come clean with the electorate in advance of an election if independence is your goal, then this is the economic price that Wales, at least in the short to medium term, will pay. Get it out there, be clear about it, and let the people of Wales decide what they want to do. I'm sure you wouldn't disagree with that.

I have selected two amendments to the motion. If amendment 1 is agreed, amendment 2 will be deselected. Can I call on Rhun ap Iorwerth to move amendment 1, tabled in his own name? 

Amendment 1—Rhun ap Iorwerth

Delete all and replace with: 

To propose that the National Assembly for Wales:

1. Believes that successive Westminster Governments – under both Labour and the Conservatives – have presided over intergenerational poverty and chronic underinvestment in Wales.

2. Believes that having the economic and fiscal levers of an independent country is the key to Wales’s future economic prosperity.

Amendment 1 moved.

Diolch, Dirprwy Lywydd. 

There is a wonderful predictability about debates like this on funding for Wales. The Conservatives slam Labour, Labour slam the Conservatives, Tories say it's all about how Welsh Government spends money, Labour say it's all the UK Government's fault, and it's a cycle of blame that suits them both. Both can sling political mud at each other, Wales gets spattered in the middle, its financial and economic position unresolved, poverty unaddressed, inequalities entrenched, both UK parties seeking plausible deniability about their own culpability by arguing that it's the other's fault: 'It's not us, guv, it's them.' Yes, carry on. 

It's incredible that he wants to heap all of this stuff on the shoulders of the Conservatives and the Labour Party, but, of course, your former leader, Ieuan Wyn Jones, was the economy Minister for four years in a previous coalition Government here in Wales, and yet the situation was even worse under his tenure than you describe. Do you accept your responsibility for the failures that we see today because he was the economy Minister? 

The Llywydd took the Chair.