National Assembly for Wales

Diolch, Gadeirydd. Good morning, everyone, and happy new year to those I haven't yet spoken to. Clearly, the COVID pandemic has been traumatic for many people across Wales, and we notice there's been an uplift of the budget of £42 million. The question is: do you think that uplift is sufficient enough to deal with the increase—I anticipate it will be an increase—in the mental support that's going to be required by people across Wales as a consequence of the pandemic? There's a variety of reasons as to why that support will be needed, but it is a question of is it sufficient to deal with the anticipated increase in demand. 

Thanks, David, and thanks in particular for using that traumatic picture, because I think the trauma-informed approach to mental health is something we're going to have to take a lot more seriously in future years. It's something that already has an impact on society, but we still don't know how trauma is going to impact on society generally. But, if we look at the kind of direction of travel and the reports that we're looking at, then it was important that we did increase the amount of funding put into the support for mental health. There is a significant uplift in terms of the recurrent funding, and the point here is that this is going to increase the baseline. So, it's not just a one-off—we know that this is going to be a long-term issue that we need to address.

I think the other thing to underline is that mental health is not something that just should be restricted to health. We've got to understand that the causes of mental health are much broader. So, we need to consider the fact that the kind of money we're putting in to supporting the economy, making sure that there's support for housing, for debt, for support within education—all of those things will add to try to head off, really, the potential for increased need for mental health support. So, that cross-Government approach, that multi-agency approach, I think, is really crucial, but, you're right, we don't know yet what the final outcome of this is going to look like in relation to mental health. I had a very interesting meeting with the Royal College of Physicians the other day, and they were predicting that, actually, in terms of those front-line workers, potentially we won't see the impact on them in terms of trauma for a number of years, and so we will have to keep an eye on things.

One of the things I've done is to convene a new delivery and oversight board for mental health. So, we've got a programme, it's a very clear programme, it's been agreed, it's been discussed with lots of people in the sector, but I think we do now have to make sure that we're responding to what's going on. One of the things that that delivery and oversight board will do is to make sure that we are keeping an eye on those areas. If we find that we need more funding, then, obviously, there is this COVID fund that we can still apply for.

Thank you for that. I appreciate that you're highlighting the fact that there are many issues that will affect people's mental health, and therefore there is an important need to address some of those issues across Government, but that's something that perhaps could happen in the future as well, so it would be good to try to prevent mental health circumstances. COVID has, actually, probably, shot a hole through a lot of those points, and added to that. Families have been affected; whether it be individuals within families or families as a whole, there are a variety of things that could have affected a family. I won't talk about the children and schools impact, but, of course, that does have an impact upon your family. There's the bereavement question on families. There's the trauma of families having a loved one in hospital for a long period of time and not being able to see them. So, there's a huge range, and I totally appreciate what you said about the £42 million being a baseline added, and therefore you know that's going to be a long-standing issue. I also accept you talked about the COVID fund, but are you having discussions with the Minister for health and the Minister for finance to look at possible options of additional funding, not necessarily from the COVID fund, but from other sources, to actually, I would say, pick into, if you need to actually have it because there's a larger requirement than anticipated?

Well, let's not forget that there's quite a lot of money here already. There's about £783 million now that is being spent on mental health that's specifically within health and my budget. So, that's already a not-insignificant amount. But I will be having discussions and have had discussions—I've got a paper coming to Cabinet very soon—to talk about how we need to be moving this on together, understanding that this is a cross-Government approach that we need to consider, and, obviously, that everybody, then, should be marshalling the budgets within their own portfolios to try and address this issue as well. So, it's not just the £783 million, which is already significant, but there's all of those other things that we're putting in. The very fact, for example, that we've given more money to support businesses during this pandemic than any other part of the UK—that's all about trying to keep people's hope alive within those businesses. That is a mental health issue as well, and certainly the responses that I hear are from people who are, frankly, desperate, but we've manged to be able to go in there and give them some economic support. This is not over yet; we're still getting very difficult communications from people who are just on the brink. At that point, what they need is the financial support to support their business, but, at some point, they'll need mental health support, probably, to follow up, because of the trauma they've been through.

I take that as a 'no' and that you haven't had the discussions as of yet, but you believe that the funding you've got is, possibly, sufficient to deal with some of the expectations coming along the line. But, as you rightly point out—and I can tell you that mental health charities and organisations will tell you categorically that that £783 million is insufficient and it needs to be added to. We have had that on many occasions, I think; ever since I've been a Member it's been raised in the health agenda and the health budget that mental health has not always had the priority should have. So, I will leave that for the minute. But you just mentioned that some of that budget was actually shared between you, your own budget, and the health budget. How much of that budget do you control, and do you have to go to the health Minister to have him agree spending in certain other areas?

It's difficult to disaggregate the funding for mental health that sits within the health budget, and that's why the decisions on how that money is spent are taken jointly between myself and the Minister for Health and Social Services. What we're doing is that, within the money that's spent within health, there is a clear set of priorities that have been set out within the 'Together for Mental Health' delivery plan, so the priority areas where we are going to be spending within the health budget are already pretty set out. That's why that co-working with the health Minister is not going to be difficult at all, because those priorities are already there.

I apologise, I missed some of that, because my internet dropped out a little bit, but can I just clarify one point? Your budget for mental health, well-being and the Welsh language has had an additional £9.4 million to improve support for the emotional well-being and mental health of children and young people. If that is purely for that purpose, and you take that out for the minute, is it fair to say that you had no additional funding to deal with the mental health of older people and disability and learning disability services?

No, I don't think that's fair at all, because we've had this additional funding of about £20 million for the service improvement fund, which will be spent within the health main expenditure group, and the point there is that the funding within that £20 million will be very clearly prioritised. Some of it, for example, will be spent on eating disorders, perinatal mental health support, psychological therapies, but also memory clinics and things, which, obviously, will be helpful for that older population that you were talking about there.

Just for clarification, is that your responsibility, or is it the Minister for Health and Social Services's responsibility? Who is actually prioritising? Who's in charge of that budget?

It's between us both, but we've both agreed that we will follow the guidelines set out in the 'Together for Mental Health' delivery plan, which is a broad approach to where we're heading. All of that's been very finely worked out, with the third sector, with the experts in this space. We know what our priority areas should be, and we're going to be making sure that we continue with those. Of course, we've had to adapt them somewhat, but I don't think we're going much further away from where we were before in terms of those priority areas that we'd already identified within that delivery plan.

So, it's a joint approach. 

It is.

Just out of curiosity—and I've gone a little bit over, Chair; it's one final point—I know the Minister for Health and Social Services is very busy and very focused on coronavirus, in that sense, and I fully understand that, and there's a need for that to happen, but does that give us some challenges to ensure that some of the other services that he has responsibility for are always in his focus and, therefore, basically, in a situation like this, you should take the lead and you should be the one taking care of mental health?

I think that's the understanding. That's why this role was created by the First Minister—because he recognised that this was an area that needed significant attention, and that the health Minister, clearly, needs to be focused at this point in time on fighting the pandemic. So, that's why there's an understanding that I will be taking a lead in those areas, which is why I've already had meetings with the vice-chairs of those health boards to talk about those priorities, to talk about the need for them to move quicker in certain areas. So, there is an understanding that when it comes to mental health, I'll be the one pushing within those health boards.

Just a final point: the understanding is, of that £780-odd million that is allocated to mental health, even though less is allocated to your own particular budget, you are taking the priority decisions on the delivery of mental health services across Wales.

Absolutely, yes.

Thank you.

Thank you, Chair, and good morning, Minister. This committee has been concerned about the ability to effectively scrutinise spend on mental health, and specifically the need for a detailed breakdown of the ring-fenced allocation and the inconsistent way that health boards collect information. Will you be publishing more analysis of health boards' spend, particularly on the ring fence, as well as benchmarking data to ensure transparency about mental health spend and performance?

Thanks very much, Jayne. I think first of all, it's worth emphasising that the NHS spends significantly in excess of the ring-fenced allocation. So, already we're going further than what is set out as a minimum requirement. We spend significantly more than other parts of the UK on this; about 11 per cent of NHS spend is on specifically the condition of mental health. And if you look over the years, there's been an increase—about a 9.4 per cent increase in expenditure since about 2009. So, proportionately compared to other conditions, this is getting, I think, the attention it deserves. 

We are working on a new allocation formula based on indicators of demography and health need. So, that's something—I don't know, Alan may need to expand a little bit on the detail of that. But just in terms of my area, I've set up this new oversight board to really keep an eye on where that funding is being spent, because it's been fascinating for me that the headlines are always, 'Look, we've spent an extra £10 million; here we're talking about an extra £40 million.' The question for me is, 'Look, are we actually spending the £783 million well?' And, I've got to say that my interest is not in inputs, it's in outcomes. And I'm much more interested in making sure that the money—it's not about the £40 million extra, it's about are we spending that £783 million well. And it's got to be done, I think, in a way that takes into account the patient experience, because there's a danger at the moment that we're chasing after deadlines and timetables and, 'Have we reached the timetable set out for patients to be able to see experts?' If the patient experience is dreadful when they meet the expert, that's not a good system. So, one of the things that I've asked my officials to do is to look at how we can take account of the patient experience. And I've asked, also, the third sector to help me with that kind of patient-experience approach. So that's something that I'm looking to improve on in future.

Alan Brace.

Yes, thanks, Minister. Just to come in with a little bit more detail about that, I think I mentioned last week, for all of our activity, we want to join up far better the way we're allocating resources, and not just to understand what we're giving to health boards, but to perhaps be able to drill that to a lot greater level of detail. And for us at the moment, that's the formulas that we're developing, and I'll touch on mental health. The building blocks are the 22 local authorities, and that's really important for partnership working and really important for the mental health agenda, and then we aggregate that up for health board allocations, but we can disaggregate it down to the 64 GP clusters as well. We are developing the population health measures for that. So, we're almost there on mental health. And that will be a really important addition to understand how resources are being allocated through the system, down to GP cluster level. That will allow us to move away, then, from, I think, the ring fence. The ring fence has served its purpose, in the sense that it's protected the budget for mental health. Local health boards particularly have invested more in mental health services than the ring fence, so that has given confidence to mental health services to plan on an availability of recurrent funding, but it now needs to develop a lot more in terms of a clearer line of sight about how health boards are allocating resources within their area.

But the other area that I think the Minister touched on is how well those resources are being utilised and what outcomes they're delivering. On the utilisation side, we have got a national efficiency, productivity, clinical variation framework, and within there is a population and health outcome quadrant as well. All health boards produce programme budgets, costing returns for mental health services, and we're part of the UK national benchmarking network, for mental health services but for all of our services. The problem with that is that it's primarily preoccupied with hospital and certain community services, and particularly when we come to mental health, we're a lot more interested in what is going on outside of those areas. So, we've been interested in the work in Aneurin Bevan and some of their outcome measures, their patient reported outcome measures work on dementia; I think that's really encouraging. That's given them a real insight into access to services and particularly areas of inequalities, and that's really important to inform their planning. In our own name as Wales, rather than as the UK, we've joined the OECD patient-reported indicator surveys project, which is led by a GP academic in Cardiff University, Andrew Carson-Stevens, and that is really to measure patient indicators outside of hospital and community services primarily focusing on primary care, and within there is a whole raft around psychological well-being, which I think will be really important in terms of some of the work that the Minister now wants to take forward.

And then lastly, the interesting element, as we've developed the value-based healthcare work and the PROMs measurement in some of our hospital specialties, the PROM indicators all capture something about well-being and psychological well-being; even though you may be measuring hip and knee services, within the PROM capture, there will be something on well-being and emotional and psychological well-being. And there is a growing wealth of data now in some of the health boards around how that is looking over increasingly more and more years, and I think we need to start capturing that in some of our mental health work a bit more.

So, there's still a lot of work to be done, but I think there is an intention now to put mental health properly into our resource allocation formula, and we'll achieve that quite quickly now, I think, subject to the Minister agreeing that, and then we really need to focus on utilisation and outcomes a lot more and strengthen a lot of our measurement and a lot of our data capture in that area.

Okay, Jayne?

Thank you, Chair. Good morning, everyone. Can I ask about the mental health service improvement fund? The Welsh Government released funding from the fund in 2020 to enable health boards to respond flexibly during the pandemic, but this year's funding is now baselined into the mental health ring fence. What are the funding implications of this, if any, in the way the fund is allocated in future years? And can I ask whether we have a clear understanding of what the flexible funding was spent on up until now, really? Because the last time I tabled written questions, there wasn't a great deal of clarity on what the health boards had used the money for.

Thanks very much, Lynne. Well, obviously, at the start of the pandemic, we made sure that mental health services were classed as essential services, and because we were concerned about the pressures that may happen, what we did is we allowed them to spend the £3.5 million to enable them to respond flexibly. Now, they were supposed to spend that on the priority areas as we'd set out, so it was kind of to boost up the priority areas that were already in place, but to give them slightly more flexibility within that.

With the remaining £3.5 million, we're expecting them to absolutely spend that in line with the priorities that we've set out within 'Together for Mental Health'. So, there was more flexibility initially during the pandemic, but the second amount of £3.5 million had to be in line with those priorities that you're very familiar with; things like eating disorders, perinatal, psychological therapies, those kinds of things. And just in terms of how it will be allocated in future years, it will be expected to be in line with those priorities within 'Together for Mental Health'.

And has that actually been monitored in terms of what health boards have spent that second £3.5 million on, and have they had to report to Welsh Government on that?

They've had to make sure that they spend it in line with those priorities. The detail of that expenditure, I think we're still waiting for. Tracey, I don't know if you could add to that. 

Yes, of course, Minister. Just to answer the question about the monitoring, yes, we did—it was lighter touch than in previous years, but we asked them to evidence to us, each of the LHBs, how that second £3.5 million would be spent in line with the delivery plan priorities, and we assessed that before releasing the money.

And is that information that maybe could be shared with the committee?

Obviously, we have that information, and we could summarise it, I would suggest. So, yes, we'll take that away and pick that up.

Thank you. Just still on the mental health improvement fund, then, is there a risk, do you think, now, that the fund is just going to be used for COVID recovery in terms of the mental health COVID recovery, as opposed to the service transformation that we know is really, really vital? We already saw some money diverted in the first part of the pandemic. I suppose what the committee is looking for assurances on, really, is is there any funding for COVID recovery in relation to mental health that's going to be additional to the transformation that we knew needed to take place anyway?

So, out of that £3.5 million in the second tranche, only about £400,000 was still being predominantly used for that COVID response, so £400,000 within that context of the £3.5 million. As time goes on, obviously we're hoping that that will be included in the mainstream of the response, and as you say, if we need some additional funding in terms of the COVID response, then we'll go back to the finance Minister and ask for that.

Okay, thank you.

Thank you, Minister, for your evidence so far. I'd just like to ask you some questions on the recovery fund that you've put together, and in particular the minimum service guarantee for low-level mental health services. Can you explain how you believe this fund will operate, and in particular how this initiative will deliver for people who require that low-level service intervention when it comes to mental health?

Thanks, Andrew. Just to be clear, I've been on a steep learning curve when it comes to mental health, and there are lots of things that I've learnt, and one of the things that is clear to me is that there's a real danger that we medicalise mental health issues, and we over-medicalise them. If you're about to lose your job or if you're concerned about losing your job, that's going to put some pressure on you, but it's not necessarily a medical problem that you have. You need some help with your anxiety. So, what I'm really keen to do is to make sure that we have a broader range of early interventions, which I think can be carried out by third sector organisations. So, increasing that tier 0 support, for me, is absolutely fundamental in this next phase. So, I'm very keen to spend a minimum of about £1.4 million of that improvement fund, that £20 million, on that early intervention, so that anybody who needs that early intervention can access support very quickly. Because the danger at the moment is that it's directed into the medical service, and it's not necessarily the appropriate direction.

Minister, sorry to cut across you when you're speaking, but could you give us an example or a taste of what you believe that low-level intervention might be? Because I agree entirely with your sentiment that, very often, mental health is medicalised and there are many other options out there that could prevent that medicalisation. Could you give us an idea of how this would be different from what's gone before it?

Okay, so, a couple of things that have been introduced during this pandemic—we've increased the support on the C.A.L.L. helpline, for example. What they've got there is a massive registry of organisations that can help people with particular issues, so obviously, Andrew, you've got a real interest in agriculture; there are organisations that can give specific support for people within that sector, and they will be directed to those places for support and then we can—. The plan is to give more support to those kinds of organisations who are appropriate to the different sectors. We've also increased our support for online behavioural therapies. So, we've got this new system called SilverCloud, where you can get support online that is backed up by professionals, psychological support therapists. But my hope is that we can get GPs to be more confident in directing people to that tier 0 support. I've already discussed this with the Royal College of General Practitioners, and I think what we need is a more consistent approach across the whole of Wales to give them the confidence that, when they are referring people, they know there's going to be a quality of service that they can be assured of. 

I particularly welcomed your comments earlier on in questioning, where you're not so much concerned about the quantum of money that goes in, but the outcomes that come out the other end. Very often, as politicians, we get fixated on the quantum of money, because that's the success story, but we don't necessarily follow through and see what the outcomes are. You've given us an example there of some online support, some referrals to telephone support. How will you confidently quality assure that level of support so that the outcomes do provide a safety net of support that is effective, rather than a ministerial note coming out, 'We've got 25 hotlines that people can ring, or we've got three websites that we can refer people to', which, actually, is just a tick-box exercise?

I think this is where what we need to do is to make sure that we're getting feedback from the service users, and that's going to be where we find out whether the process has been successful or not. One of the things that has been frustrating for me is hearing about, for example, in particular, young people who maybe go to their GP and then they have to wait a long time to get a CAMHS referral, whereas actually if they had been directed immediately to an eating disorder charity, for example, they could have had very quick support that would have been very useful to them whilst they were waiting for more specialist support. So, it's that kind of thing that I think would be quite useful, and would relieve a lot of the frustration that a lot of people are feeling at the moment. 

We know the third sector play a really valuable role in providing the services but I think, reading the budget, there's £20 million being set aside within the MEG budget to invest in third sector support for low-level mental health support and, in particular, trying to reduce the issues around loneliness amongst—[Inaudible.]—generation. Dai's just popped up on my screen. So, how is that £20 million going to actually be effectively used in purchasing those services and commissioning those services from the third sector, in particular the isolation fund, which you're hoping to establish in 2021-22? 

The whole £20 million won't be spent on that tier 0 support; we're expecting about £4 million of that to be spent on tier 0 support. On top of that, there'd be about £7 million for those priority areas within the 'Together for Mental Health' plan—so, those would be eating disorders, perinatal psychological therapies, CAMHS support. Then there would be probably about £6 million for crisis support, and then possibly about £3 million for memory clinics. So, that £20 million is not all for that tier 0 support. 

But I think this is another example where we need to recognise that this has got to be cross-Government working. So, if you think about something, for example, like poor housing, if you live in a house that's overcrowded, all of that is going to put pressure on people, increase anxiety, could create mental health issues. We need to be working with other sectors within Government. So, this cross-Government approach that is outlined within 'Together for Mental Health', which really needs to be driven now, is something that I'm determined to do. 

That's probably—[Inaudible.]

I can't hear you, sorry. 

Oh, they've muted me. I seem to be muted. Can you hear me now? 

I can now. 

I agree with the point about cross-Government support—mental health isn't just an issue for your good self—but I did ask specifically around the loneliness fund. 

Ah, okay. Yes, I'm sorry about that. 

And one final point—I appreciate there's a lot of ground we want to cover—when will the grant allocations for the voluntary sector organisations be finalised for this coming financial year? But, importantly, the isolation fund, I'd like some information on, please.

Okay. So, on the support for the third sector, we've postponed that slightly in order to make a better assessment of what is necessary now, because of the additional pressures we're expecting and the fact that we have this additional £4 million. So, we've extended the period that the current recipients of that funding are able to hold onto that funding for about six months, and we'll have a new bidding round now, in April, for that additional support. So, we've extended that for the current sector providers up until about September 2021.

Just on the loneliness issues, we've got our Connected Communities strategy. The purpose of that fund is to test out innovative approaches and to really try and build on the sustainability of the voluntary and the community organisations for the long term. We originally had a £1.4 million fund for three years, but, because of the issues, the difficulties, of rolling that out, £400,000 of that funding for this year was repurposed, and that was used for the Friend in Need initiative. I don't know if you're familiar with that, but it was delivered by Age Cymru on our behalf, and I've got to tell you that this has—you know, it's been transformative for many people within Wales, in particular those people who are on their own. I know that some people have been provided with iPads and it has transformed their lives—really connecting for the first time. Obviously, now, we'll, hopefully, get back on track with Connected Communities and the broader strategy that we set out initially.

Thank you, Chair.

Thank you, Chair. Just going back to talking about some crisis care issues, you'll know that the committee's report on crisis care in 2019 called on the Welsh Government to better support patients going through mental health crises. What assessment have you made of the pressure on those services and how those services are adapting to the pressure that they're currently under?

Well, there's a huge amount of work being done in this space at the moment, and I've met with Emrys Elias, who is the chair of the concordat assurance group, who's bringing together all of these different organisations. You've got to think about where do people go when there's a crisis: the police, local authorities, the health board. So, there are lots of different organisations that we've had to bring together. Shane Mills I've also met, who is organising the access review. And I'm really determined to move on within this space.

What was interesting is that, during the pandemic, initially, referrals were reduced, but also, obviously, now we have the staffing issues because of the pandemic. We have made progress in terms of crisis care, because we've had about £3.4 million over the past three years, but I'm planning within this budget period to increase that significantly, probably to about £6 million. The key thing here, though, is that it's got to be about pathways that are not just health pathways. It's got to be about cross-Government work, and this is something that I'll be taking a paper to the Cabinet on in the next few weeks, really addressing this issue of how we can make sure that we can work cross-Government on this, including social and welfare issues. There is a pathway sub-group, and that's been convened to lead on this work, but already measures have been put in place. For example, if you phone 111 now, there is a crisis pathway already up and running. So, already, things are moving ahead in that space, but, obviously, I think there's a lot more work to be done.

Yes, thank you, Minister. We've talked a lot about the parity between physical and mental health. To what extent do you think the additional funding for mental health services will help to ensure that the mental health crisis, or a mental health crisis, is treated with the same urgency as a physical health crisis?

Well, this is something that I'm determined to set out. I think it is clear that, at the moment, if you phone 999, you understand that that's a crisis, you've got a physical crisis—you know, there is a system. We need to make sure that there is parity in terms of the system when it comes to mental health. So, that's why we've put this additional funding in place, to recognise that there is work to be done in this space. But, again, it comes back to this point that it's not just all about a medical crisis, it's got to be seen in the broader context. If you—I don't know—have taken drugs and you're homeless and whatever, then it's not necessarily a medical health crisis—you actually need to find a new home, you need that broader support that we need to put in place, which is why I think these pathways are critical.

Thank you. What progress has been made in improving waiting times for local primary mental health support services for all age groups?

So, local primary mental health support service waiting times are published quarterly, and it looks like we're showing good progress against the target, but I think it's fair to say that some of those figures have been volatile due to COVID, and I expect there to be fairly significant variations in that data in the next few months, particularly because we know the need to focus on the area of children and young people. So, there is still work to be done there, but there's definite progress within that space.

Thank you. And just moving on, back to psychological therapies, you mentioned the dangers of overmedicalising some of the mental health issues—are you satisfied that the investment you're putting into those psychological therapies will help to increase the number of people who can access that range of therapies and deliver a significant reduction in waiting times by the end of the next financial year? 

Well, I think we've got to recognise that, of course, there are lots of people who can be cared for through using that tier 0 support, but there are people who have more difficult issues that will need medical treatment, and that's why we need to make sure that that kind of psychological, more specialised support is in place. And that Matrics report has been published; the Matrics Plant report has now also been published, which is focused on young children and young people. The key element of the funding will be to support the national infrastructure to support improvements to the services, and that's going to build on the investment that we have put into psychological therapies over the past three years.

I think it's fair to say that we recognise that the bigger challenge for us is in relation to workforce, and that's not something that can be switched on and off. But there is a mental health workforce strategy that is being led by Health Education and Improvement Wales and Social Care Wales, so we're hoping that that is going to direct us onto a path. This is not going to be something that, when you're talking about more specialised care, you can deliver overnight. But what is important is that we have a very clear pathway for how we can address that.

You've given an example of some of the digital work that's been going on, and how important that is in terms of helping people with mental health issues. How will you ensure that those interventions, such as SilverCloud, that you've said, will reach those people in socioeconomic groups that are disadvantaged and culturally disadvantaged groups, such as those, perhaps, who don't have English as their first language?

Thanks very much. I think it'll be very interesting to see how SilverCloud is received. It's been interesting. There has been quite an impressive uptake in terms of people using that service. One of the great things is that you can use it when it's good for you to use, as a timing issue. There is an evaluation report that's been commissioned in line with that, and that will report in 2021. That includes a provision to look at the accessibility of those population groups. So, one of the things we're very concerned about is people, for example, from the BAME community who don't access mental health support and perhaps need to, which is one of the reasons why we've been working also with Diverse Cymru, to see if they can actually do some of this work promoting this work within their communities.

Thank you.

Okay, Jayne? Back to Andrew R.T. for the next couple of questions, if they haven't already been covered. Andrew R.T., I'll give you the discretion there.

Thank you very much, Chair. Just briefly, if I may, the committee have done extensive work on taking evidence around mental health provision during the pandemic, Minister, and even outside of the pandemic period—I'm sure we can all recognise this as Members—we very often see people coming to us saying, 'What we're told is in our local health board area and what is being commissioned and what I can get are two very different things, they are.' Now, you as a dedicated mental health Minister, with a budget, have the ability to change that narrative, and I can see by your nodding head that you most probably agree with that sentiment. So, how do you propose to do that, to actually break that cycle of, 'This is what it says on paper, but this is what I get in reality'? You can drive that by this budget, so how are you going to do it?

Well, one of the first things I did, Andrew, when I came into this post, was to actually test the system, to be a kind of secret shopper. So, I called the mental health helpline to see, 'Does it work and am I being diverted to the right place?' And, thankfully, certainly that system worked very effectively and very efficiently. I've checked out the SilverCloud facility. But one of the things that was clear to me is that we needed more visibility, from the health board's point of view, in terms of where people can access support, because it was really difficult to navigate the health board's provisions. So, I've been pushing quite hard with the health boards to see if they can provide that information of what services are available, particularly in the middle of a pandemic, because it may be that they've been reconfigured in some way. Where can people go for this information? And you'll be aware that I sent information around on that to all Senedd Members last week just to make sure that they were aware where they could send their constituents to get access to that information. So, every health board now has to display clearly what support is available, and the children's commissioner was very pleased that we had delivered on that commitment.

During the early stages of the pandemic, about £2.2 million, I think, was released into the mental health field to try and create surge capacity. I think I'm correct in reading the budget to say that that specific budget line has dropped out this time round, it has, but yet we're most probably as deep in the pandemic now as we were back in March, April and June. How do you expect that capacity that was available in the early part of the pandemic to be continued, considering that budget line has dropped out of the 2021-22 budget?

So, I think, in the early stages of the pandemic, none of us really knew what we would be confronted with, but what we did know was that, because of things like the fact that you had to increase the space between beds and the fact that staff vulnerability may be a problem, there may be a need for that surge capacity. What we've seen is that that additional funding was helpful and it had been accessed by some health boards. But what we've put in place now is the national collaborative commissioning unit to make sure that there's consistency of approach across health boards in terms of getting access to beds, and that's been particularly true in relation to scouting around to find out where there is excess capacity. So, that surge capacity, which was used in the beginning, is no longer needed because we have this kind of bed-hunting capacity that has also been initiated.

And my final point, if I may, is from Hafal, the mental health charity, highlighting their concern about money being diverted out of the acute sector and into more low-level provision of mental health care. I'm not sure whether you've seen that letter, but are you aware of that? And their concern is about the monitoring to make sure that there isn't robbing Peter to pay Paul going on here, and the overall experience is it's not there to catch people who require it, either in the acute or the low-level sector.

Well, we're certainly not robbing Peter to pay Paul because this is additional funding, and I'm not going to apologise for the fact that we are very keen to make sure that we plug this missing middle gap, this low-level intervention that I'm very keen to support. I've been very struck by the Wolfson Centre for Young People's Mental Health who have made it clear that 80 per cent of mental health issues start when people are children and young people. So, it makes sense for us to focus our attention on those areas. Now, having said that, then, clearly, we can't step away from the very serious mental health issues that are still confronting people, and I know that Hafal is very keen to make sure that we focus our attention and retain our attention on those more vulnerable groups, perhaps—on prisoner mental health, on BAME community mental health, on those areas where we know that there's an issue. But we're not stepping away from that; we're just making sure we provide additional funding through that tier 0 support.

Thank you.

Okay. Diolch. Right, moving on to Lynne Neagle.

Thanks, Chair. I'd like to ask about suicide prevention, Minister. What is your current understanding of the impact of the pandemic on suicide rates and the risk of higher suicide rates in Wales? And how has that assessment affected your allocation in the budget?

Thanks very much, Lynne. Well, at the beginning of the pandemic, we commissioned the NHS delivery unit to work with Public Health Wales and Professor Ann John to chair an advisory group into the review of deaths by probably suicide. Part of the problem we have is that, with suicide, you can't be sure of the outcome of an inquest until quite a long time afterwards. But that's not to say that we shouldn't be keeping an eye on things, and that's why we have had more focused surveillance during this time. I was quite surprised to find that the British Medical Journal, for example, is suggesting that there's emerging evidence that, despite the fact that it's perhaps too early to conclude definitely that overall suicide rates have increased, there is definitely some reassurance in the reviews that they have seen. So, we haven't seen the increase that we feared. Now, having said that, you know, we're not through this, and the trauma that people are going through, we don't know how long that's going last. 

The other thing that I'm particularly concerned about is bereavement support during this time. A lot of people have not been able to grieve in the way that they would hope to during this difficult time. So, that's another area where we've made sure that we have put support in place.

So, are you satisfied, then, that the funding you've allocated, which is the same as last year, is going to be sufficient to deal not just with what we know about the existing suicide risk, but with what we know about the link between economic deprivation and suicide, and given that the economic fallout from this is going to take a bit longer to kick in?

I think that's right. It's just, I guess, that what we're doing is we're making sure—. The best thing to do in this space is to try and prevent suicide from happening in the first place. So, giving more support on things like debt and job loss and housing issues, I think, is probably at this point the best way for us to try and fend off problems within this area. What we are doing is we've convened a group to look at real-time suicide surveillance. So, although we can't have the official figures, we've now got a policing-led group to—and I think they're meeting for the first time today—provide an update for us on a more regular basis so that, if we see that trend changing, then, obviously, we'll have to respond to that. But, at this point, we don't think there's a need to do that.

Okay, thank you. Can I ask about dementia, then, and how the funding decisions you've taken in the draft budget will help deliver services for people with dementia, particularly in the light of the fact that we know that dementia services have been very badly hit during the pandemic?

Thank you. Well, you'll know that we're going to continue to spend about £10 million in order to support the Welsh Government dementia action plan, and the majority of this funding will be allocated to the regional partnership boards, because we know that this is about a close relationship between health and social services. But we recognise that there has been an impact on those services, and that's why, I think, there will be a need to do some catch-up work in relation to memory assessment services, and that's why, in that service improvement funding, we will be earmarking maybe £2 million or so specifically for that, to make up the lost ground.

Are you satisfied that the regional partnership boards are best placed to take forward this work? Are you confident that they're going to do it? We have seen a lot of variation, as you know, in the way regional partnership boards operate.

I think that is something that we need to keep an eye on. Some are far more mature in terms of their working relationships than others, so we'll keep an eye on that, but I guess, in terms of the memory assessment services, then a lot of that we will be able to manage within the NHS and perhaps keep slightly more control over it.

Chair, if it's okay with you, I'd just like to ask about perinatal mental health. Minister, as you know, we passed a motion in the Senedd before Christmas calling for ring-fenced funding for perinatal mental health. As you also know, people who've had babies during this pandemic have suffered greatly, really. Is there any money in the budget for ring-fenced funding for perinatal mental health?

Well, we haven't ring-fenced it yet, but we haven't made any firm decisions on how we're going to spend the £7 million that has been earmarked for the service improvement fund. So, we'll look at that, Lynne, just to see if there is any scope to do that, because, obviously, that is one of the priority services that we've asked people to look at within mental health. So, let me take that away and have a look at it, Lynne, because, as I say, I think we're still really assessing what the balance is between eating disorders, psychological therapies, perinatal. I'm quite keen to make sure that we look at where the biggest issues are and the biggest strains are on the services. But I absolutely accept that, for people who have given birth during this pandemic, it's been a really tough time for them, and I was really pleased to be able to share some additional support suggestions given by Liz Gregory recently on how people can help themselves during this time.

Thank you.

Thank you, Chair. Has the Welsh Government's substance misuse delivery plan been refreshed in response to the pandemic, and particularly in terms of the impact that it's had on our most deprived communities?

Thanks very much, Jayne. The delivery plan has been updated and it's going to be published imminently, so we've allocated about £28 million into this. I think it's fair to say that substance misuse services have really adapted quickly to ensure that the needs of that population, including the homeless, are met and that guidance is in place. I think one of the really interesting things about this pandemic, and you'll know, is that initially we got everyone off the streets, and for the first time, we were able to give that kind of wraparound care to people who needed to access those services. So, I think there is probably a lot we can learn from that experience, and we need to make sure—. It's quite difficult to get to some of these people very often, and so, it's been really heartening that we've been able to step in, and I think there have been some quite innovative things that we've done also as a nation.

That's really helpful. Do you think there's a need to repurpose funding within the substance misuse ring fence for 2021-22 to better meet the needs of people with co-occurring mental health and substance misuse issues? And are you anticipating new and exacerbated demands for these services in the forthcoming year?

Thanks very much. Certainly at the beginning of the pandemic, we did publish specific guidance to make sure that we could respond to the situation. I think one of the areas where that flexibility was used was in relation to opioid substitution therapy and family support. So, we increased the support there and one of the interesting kind of innovations that we led on in the UK was—and we introduced this pretty quickly—the introduction of injectable buprenorphine, so that's a new form of opioid substitution therapy. And the point here is that you could inject and then you didn't have to go back for a long time. And remember, initially, during the pandemic, nobody was going out; we didn't want to encourage people to go out. So, that was actually really useful, but actually it's been really helpful to those service users, and we're feeding that information back, because it's something that the UK Government is really interested in learning from us on. So, there is flexibility within the budget to repurpose if necessary, but that's an example of where we repurposed and we've learned quite a lot, so we'll hopefully be carrying on with that.

And are you anticipating the new demands for these services as well in the forthcoming year?

We've got to keep an eye on it. We don't know how this is going to track into the future, and obviously, we will keep an eye on it, but at the moment, I don't think we've seen a significant increase in demand.

Thanks, Minister.

Thank you, Chair. If I could ask you, Minister, what we've seen through the pandemic, regrettably, is a widening of the inequalities gap, for various reasons, and it will take a whole-Government approach to try and shrink that gap down, almost trying to erase it, in an ideal world. Do you think it is reasonable to expect Government budgets to actually specifically target that gap and use that resource to shrink that gap in the way that money is determined, especially around mental health provision?

I think it's important we don't waste this crisis. There are opportunities here, and we need to respond to the situation we're in, and we're determined to do that within the health sector. So, we're working with Public Health Wales and the WHO to look at the Welsh health equity status report for Wales, and as you will know, this is an area where Wales is trying to lead in terms of health inequities—what is it that we need to do to try and address those inequities in relation to health? And what we know is that it's much broader than just a medical problem. This is a poverty problem, this is an inequality problem, and so the key thing for me is that we need to keep this focus on a cross-Government approach to inequality and to address those issues where possible. Something certainly I'm determined to do is to see—. The sooner we can intervene in relation to children and young people's mental health, the easier it will be for them in future. So, that focus for me on early intervention and on children and young people—so, the tier 0 support and focusing on children and young people—for me, those are potentially the game changers in this place. 

The final point I want to make, as I appreciate we're up against time, is: how has your position in Government—? Because I've been in the Welsh Parliament now for 13, 14 years, and mental health has been a priority, and rightly so, for every Government Minister and every Assembly Member or MS, and the same soundbites come out time and time again, but here we have a Minister sitting in Government—you touched on it a little earlier in response to questions, that it has been difficult to aggregate the budget out, because obviously it transcends portfolio boundaries, it does—but how can you leave a thought with the committee that your role in this budget process has made a key difference in the provision of services for mental health provision here in Wales, and will not just revert to the soundbites that all politicians of all colours have used when it comes to mental health?

I think the proof of the pudding is in the eating, and the fact that we've had quite a restricted budget this year and yet we've found an additional £42 million for mental health should tell you something about the priority that this Government puts on it. But I've got to come back to this point that it's not just about the health budget; it has got to be a cross-Government approach when it comes to mental health. I think part of my role in Government, and it's a unique situation—I'm not aware of any other Government in the world where they have a mental health representative at the top table. It means that there's an understanding that this is something that we need to address now, but the crisis in relation to this, and the perceived crisis, is not something that is inevitable. There's already a problem, but early intervention could save us a huge amount of grief in the future if we are able to step in and support people at this time. We've got to remember that those things, like the interventions in relation to the economy, are as important as some of the interventions that are happening within my budget.

Thank you.

Good morning, all. It's nice to see you all. Before I go on to specific questions on this particular draft budget, I just want to look back a little bit, because the COVID pandemic has impacted upon all areas of life, including sport, and sport has not been exempt from this; we've seen a lot of huge impacts upon our grass-roots sports in particular. Fourteen million pounds was allocated to the sports and leisure recovery fund, could you just give us an update as to how that fund has been allocated and is there anything left to allocate in the remaining months of this particular financial year?

Well, what we do with our budget is work with our statutory partners. And of course, in the whole area of sport policy—and that, of course, also includes the overall responsibility that I have for physical activity on behalf of the Welsh Government—that is delivered through Sport Wales, and that's £12.5 million out of the £14 million figure that I released. And the intention of this is also to support local culture and sport activity through a £1.5 million spend. And of course, there is support for sporting events through the £64 million cultural recovery fund. So, it's to look for protection for organisations and facilities and to protect jobs in the centre. And Sport Wales has invested over £6.2 million from the sport and leisure recovery fund and further payments are due before the end of the financial year.

Okay, thank you for that. I know that there's a question on it a little bit later, but I just wanted to clarify something. I understand what you're saying—that £12.5 million is allocated to Sport Wales; what processes are in place for you to monitor how that funding is distributed and to ensure that they're delivering on the priorities of the Government?

It's because we have a weekly contact, and more often between officials as well, with our nominated bodies—in this case, Sport Wales—and we are aware, in detail, of what they have invested. They've invested over £6.2 million from the sport and leisure recovery fund, as I said, and there has been a commitment to invest in, I think it's 842 community clubs through the active Wales fund, and the remainder is allocated to the national partners. Because I've mentioned Sport Wales already, but the other parts of the equation here for activity in sport are the national governing bodies, and they're also eligible to benefit from the allocations that we make.

So, just to clarify, there are weekly meetings between Sport Wales and officials to ensure that the allocations of the finances from Sport Wales meet the priorities of the Welsh Government.

Yes.

How much additional funding do you think you'll be needing for sport in the next budget year, 2021-22, as a consequence of COVID-19, because I've also often raised the concerns of grass-roots sports, tier 2 and the lower level, making sure that they're able to get back up and running because they have struggled in getting income in during these periods of time? So, how much additional funding do you think you're going to need from the COVID-19 fund to be able to ensure that we do not lose those clubs, associations or organisations who are delivering grass-roots sporting activities?

I find it difficult to give you a figure on that, and I'll ask my colleagues, Jason Thomas and Steffan Roberts to comment on this as well. But what we do is we try to review the impact of the pandemic on sport in detail, as I have discussed, via discussions with Sport Wales. But whether we get additional funding to be made available to them depends on the discussions that we have within Government on additional funding, and that, as you will well know, also depends not just on the Barnett consequentials, as they're called, that come from spending on areas which are devolved in Wales, in England, or by the UK Government. We also have to ensure that in the assessments that we make that we are able to secure our proportion within the budget of Welsh Government generally, and so, I can't give you, in all honesty, a figure that would quantify the funding requirements, a figure that I would able to stick to. Obviously, I'll ask my colleagues if they feel able to provide more detail; I'm very happy for them to do that. 

Diolch, Gadeirydd. Diolch, Weinidog. 

Just to support the Deputy Minister's comments there. It is too early to say, because in quantifying the level of support that may be needed for sport, you would need to understand where we will be in terms of the pandemic response and what would be the impact on sport at that time in the next financial year, and we simply do not know that at the moment. So, what we will be doing is continuing to work extremely closely with Sport Wales, extremely closely with the various governing bodies, which is what we've done throughout the crisis. And as the situation changes, we will continue to react to that as we need to, and if we move into the next financial year, and the situation remains incredibly challenging, we will do everything that we can to provide the support that's needed. But, again, Steffan may be able to add more to that as well, Chair. Thank you. 

Okay, Steffan. 

Bore da, thank you, Chair. Just a couple of comments just to add to what's been said. Yes, there's extremely positive engagement with the sector, and we'll continue to listen to the needs of the sector as they evolve. Just to point to the committee a couple of other sources at play in this context as well. Obviously, the UK Government's job retention scheme has been a significant source of support during this process, and we know Ministers have been calling on the UK Government to look at that into next year as well, along with the local government hardship fund, which has also been a vital source of support for local authority facilities, and for leisure trusts as well. So, we'll continue to work within that context. And also just to respond to the Member's comment there about football in particular, we're still looking at the funding support that continues to be needed this financial year as well, so work is progressing on that front as well. Diolch, Gadeirydd. 

Thank you for that. My thinking is also—it's just my consideration—that we are probably in a situation where we can estimate the amount allocated or needed for various funds, which you've already mentioned, not just the direct funding, of those sporting organisations to date, and therefore, I'll assume, for some of them, for example, there'll be some sporting organisations, some sporting activities whose sporting season will identify a loss of income probably until a certain point, even if vaccinations take place, there's still going to be a loss of income and therefore there's a possibility of a problem. So, are you in the process of identifying from the last twelve months, perhaps, an area for the next twelve months where organisations and sporting activities or sporting bodies will actually require that funding in the early stages, or maybe in the later stages, depending on what we know? If the vaccinations take place and everyone gets vaccinated by the summer, some sports can start in September, but they've already lost income from April to September. So, are you in the process of identifying where the sporting bodies that will require that additional support are going to be?

What I can tell you is what the principle is. The principle is to maintain the level of activity to the extent that we are able to do that under the existing allocation of funds that we have within the overall budget of Welsh Government, and that's absolutely clear to our partners—that that is our intention.

Steffan.

Diolch, Gadeirydd. Just to add to that comment, there's a lot of reflection and learning we can do from this year, and we've worked very closely with Sport Wales and the governing bodies to understand the impact this pandemic has had on those sports. So, we know what the numbers look like, we know what the impact looks like, and reflecting on what's happened this year, we have significant intelligence feeding into the support packages that will be needed next year as well.

The £14 million—the Deputy Minister has just highlighted that £1.5 million was allocated to culture aspects. There's £2.8 million allocated to the local culture and sport part of your budget. How much of that will be focused upon sport? Because, obviously, culture tends to—. We're not responsible for the culture side of things, but how much, actually, will be focused on the sporting agenda? Is it going to be more focused because of COVID? Do you have your agenda? I'm worried, in a sense, that we may still be dependent upon the COVID fund to help businesses and organisations out in the first six months in particular.

Since we take advice, as I've indicated, on a very regular basis, from Sport Wales, on the performance of sporting bodies, then we will react in a way that seeks to maintain, as I've already told you, the viability of those bodies. And therefore, for the rest of the period where I have responsibility, I will respond to applications that come through the process from the organisations—whether they're from the national governing bodies, or whether they are from Sport Wales—in terms of its strategic activity on our behalf. I will respond to that, and that is the way that we operate our planning within the department.

Okay. I may want to come back to that at a later time. Just a final point from me this morning at the moment is your capital expenditure has basically doubled, from £3.2 million, basically, to £6.4 million. So, how do you intend to focus the strategic position of allocating the capital funding?

What we have done here is to consolidate, in the draft budget, the support for local culture and sport in the figure of £2.8 million, and this budget is available for initiatives across the portfolio. The old support for the sport revenue budget is consolidated at £157,000. It's consolidated in the local culture and sport budget line, and that is how we have operated. The planning assumptions include an allocation of between £30,000 and £40,000 to maintain our existing funding commitment, for example, to armed forces free swimming schemes.

And that's revenue and not capital, I would have thought.

I'm sorry. Capital funding for Sport Wales has increased by £3.2 million in the draft budget—that's £2 million being added to the strategic sport facilities fund, and the priorities will be to ensure that the £5 million investment in the draft budget ensures that the activities that we have supported in the past within the national governing bodies, through the national governing bodies and Sport Wales, will continue.

The question is: is it strategic thinking? Where's the strategy for that capital spending? You've increased it to £6 million—where's the strategy for it?

The strategy for it is the strategy agreed between ourselves, Sport Wales and the national governing bodies.

Okay. All right, Chair.

Jason Thomas, you indicated earlier.

Thanks, Chair. If I could make a brief comment on the previous question, and then I'll respond to this one as well. So, just in terms of the just over £2 million funding that's there on revenue, so the question was largely about what priority will sport be given in that. I just wanted to make the point that, across the whole portfolio that the Deputy Minister is responsible for, the pressures are significant everywhere. The entire portfolio has been impacted by COVID, so every single bit of the portfolio is asking the same question, basically, which is, 'Can we be prioritised?' So, we just have a difficult task to ensure that the money goes as far as it can across the portfolio.

And just in terms of the question on capital funding, this is a new scheme that's been put in place during this Government term. We've created a capital programme, in partnership with Sport Wales, and what we do is that we work really closely with them. They work with their governing bodies to identify what the need is in terms of capital investment in sporting infrastructure across Wales. They present us with opportunities to fund those projects, and then we look at what money we can make available to invest in capital infrastructure in Wales. And we're really pleased to have increased the allocation this year, and it's a signal of the way that this new fund is working well.

Thank you for that. We've got to move on now. So, Jayne Bryant's got a couple of questions. Jayne Bryant.

Thank you, Chair. Good morning, Minister. We've just touched on Sport Wales this morning, but what has been the impact of the pandemic on commercial income for Sport Wales, and how do you see that the draft budget has responded to that challenge?

Well, it's been an impossible situation, really, in terms of commercial income, because, clearly, many of the major facilities are closed, and therefore the closure of the national centres has, inevitably, impacted on the commercial income levels. Funding from the UK Government, through the job retention scheme, has supported Sport Wales during this period, and there is obviously a shortfall of income above furlough in this financial year of—I think we have noted a figure of £750,000, which was allocated to Sport Wales from central reserves. That is an indication of our commitment to Sport Wales to address these difficulties.

Commercial revenue and income for national sports centres, both north and south—and, obviously, I have a keen interest in Plas Menai, where we have sought to invest, but, of course, that facility also has been paused and unable to raise commercial income. So, further financial decisions will be assessed as we see what the impact of the winter months and spread of the disease has been, and that includes our internal discussions within Government about the priorities. And, of course, we wait to see, with some anxiety, what the UK Government, in its budget, will be announcing in March.

Thank you, Minister. You've highlighted this morning the pressures, financial pressures, that are impacting your portfolio in relation to this. How will the draft budget help to move the sport sector forward post pandemic and post Brexit as well?

Well, in a sense, I think the activity relating to Brexit has been overshadowed by the activity involving the public health crisis, and I have emphasised that the important thing that we need to do is to concentrate on that—this applies, of course, across Government—concentrate on understanding and seeking to respond to the public health crisis as our priority. And I think it's very difficult for us to start a process of assessing recovery when it is not clear yet where our public health situation will be in the spring, whenever the spring will come, as it were. So, it's not that I'm not prepared to express my views and my own responsibility as a Deputy Minister; it's just that I don't want to give you figures that will not prove possible for us to live up to.

Thank you, Minister.

Morning, Minister. Can I ask you how you feel the draft budget demonstrates the Welsh Government's commitment to increasing physical activity levels and the importance of preventing ill health more generally?

Well, I am very concerned that, really, I have not really been able to carry out the responsibility that I have across Government for promoting physical activity. Our main concern has been trying to ensure that, through our discussions—. And part of the issue, of course, is when and if and where schools will be able to reopen, because, clearly, there's been, I suspect, and the surveys seem to show that, the recent studies—there was one that was published in May—seem to indicate that the level of physical activity by young citizens was, in fact, reduced substantially as a result of the public health crisis, and this is a matter of concern for us. But there is no simplistic way of tackling this; it's just continuing to encourage people to take advantage of the opportunities, mainly to exercise in the outdoors in a situation where, obviously, gyms and sport centres are not available for use, and unlikely to be for some time.

Thank you.

Steffan.

Just to comment on the back of the Deputy Minister's answer there, and just to highlight one particular example, if I may, Chair, we know—. You know, part of the approach to the draft budget—maintaining the revenue funding and investing in the capital side is a key part of the way forward. And maintaining the revenue allows Sport Wales in particular to invest in key programmes and partnerships, and one in particular is the healthy and active fund, and this is part of supporting sport and exercise as part of the recovery as well. That fund had been hampered last year as part of the pandemic, but, hopefully, we can continue and rebuild the momentum on that next year in particular.

Diolch. Jason Thomas, before we move on to Rhun. Jason.

Diolch, Chair. I just want to return briefly to the capital fund that Steffan mentioned there, and Place for Sport as well. Obviously, many people on this call will have grown up playing sport and been active in sport, myself included, and one of the things that certainly holds people back, and particularly holds young people back, from accessing sport is infrastructure and the availability of facilities. I well remember 20-odd years of playing Sunday league football and the amount of times that you couldn't play on a Sunday because the pitch wasn't good enough. What we've got through our capital funds now is an annual programme that allows Sport Wales to invest in that infrastructure. So, over the years to come, the sporting infrastructure across Wales is going to improve, and that is definitely going to lead to increased access to facilities. 

Lynne. Back again, then.

Yes. Can I just ask on that: how are you ensuring that you monitor how that money is spent to ensure that it's targeted to the areas that most need it, which is usually our most deprived communities?

By working closely with Sport Wales. They've got a really detailed evaluation system to look at the bids that come into them. We ask them to prioritise certain things within that, and maybe we could provide you a note on that, but we ask them to look to see where there can be multi-use of facilities. So, not just investing in a football pitch or a particular sports pitch—can you do something that will allow other sports to use that facility so there can be this much greater use of the whole infrastructure that's there? But, broadly, it's through working with Sport Wales, and they've got a very—. They've been doing this for around two years now, so their ability to run an effective grant scheme is increasing year on year.

Sorry, can I just add one thing? When I mentioned Plas Menai, I didn't give you the figure. It's a £1.6 million investment in maintenance, because of the current state of the building, especially the heating system. We're working with the Carbon Trust, and this is a significant investment, for longer term efficiency for Plas Menai. And £5 million of it is being invested in community and national facilities to provide more accessible facilities and to ensure that those facilities are as sustainable as possible. So, those are our priorities, and Plas Menai investment is a very good example of that.

Thank you. I just want to press this free swimming agenda a little bit further, because I understand your point, Minister, that we're in a situation where COVID is still unknown and we don't know what the long-term impacts are yet. But, when the decision of the Welsh Government to reduce the free swimming for certain groups was taken, there was uproar amongst many people across Wales, including in my constituency. And, considering now that we are seeing COVID attacking older people, older people are the ones who are being protected and it's important therefore that they are able to maintain their health and well-being, are you going to reconsider the situation with free swimming to ensure it goes back to where it was—in other words, all over-60s are able to get it—so that they're able to benefit and make sure they can keep themselves fit and healthy following the COVID issue to ensure that they're protected?

I don't want to reopen this discussion, because really I was very disappointed at the take-up of the free swimming scheme for the targeted age groups, both young people and the over-60s. And I think we have a serious issue here. The funding that was made available for that scheme was not taken up sufficiently, in our view, and that's why the scheme was changed. And I think when we have targets and initiatives in the area of public health, we have to make sure that they are effective.

Okay. We're out of time, really, so the final question, Andrew R.T. Davies, to round things off. 

Thank you, Minister, and officials for your evidence so far. Just very briefly, if I may, at the heart of what all politicians try to do is to strive to create equality. Regrettably, in the uptake of sport very often there is great inequality, and the pandemic has exacerbated that in many parts of Wales. How do you believe this particular budget will shrink that gap and, hopefully over time, eradicate it, because we know full well the positive impact that sport has in not just driving the public health agenda, but increasingly the mental health agenda as well?  

I've already been as straightforward as I can in saying that I don't think I have really been able to undertake my responsibility effectively for the promoting of physical activity, which is part of my remit as a Minister. Part of the issue there, I think, is that we still don't understand what motivates people to undertake participation. One of the areas that we were hoping to take action on was to increase the participation of people as spectators, which would lead to more active participation in physical activity, but of course that also has not been possible because of the pandemic. So, that is not an answer that will satisfy you, because it's not an answer that satisfies me. 

Thank you for your honesty, Minister. Thank you, Chair.