National Assembly for Wales

Welcome to this Plenary session. Before we begin, I want to set out a few points. A Plenary meeting held by video-conference, in accordance with the Standing Orders of the Welsh Parliament, constitutes Senedd proceedings for the purposes of the Government of Wales Act 2006. Some of the provisions of Standing Order 34 will apply for today's Plenary meeting, and those are noted on your agenda. I would remind Members of both Parliaments that Standing Orders relating to order in Plenary meetings apply to this meeting.

So, today it is my pleasure to call the joint Senedd to order, for the second time in our history, as both meet together. I would like to extend a particularly warm welcome to the Members of the Youth Parliament joining us today for this very special session to mark the end of the first term of our Youth Parliament. This first two-year term has been innovative as you have gone about discussing and understanding the issues that are close to the hearts of the country's young people. You have represented the voice of your peers passionately, effectively and maturely, particularly during the pandemic that still affects us all.

At the end of your term, you have completed three reports and made a number of recommendations, which have been discussed and presented to the Chairs of our committees in the Senedd and to Welsh Ministers. We very much look forward today to hearing more about your work and your experiences as Members of the inaugural Welsh Youth Parliament. So, without further ado, I call on our first contributor, Sandy Ibrahim, partner elected Member for EYST Cymru, to begin the session. Sandy Ibrahim.

If we can just wait for Sandy Ibrahim's microphone. Yes, there you go—it's all ready for you, Sandy.

There are moments in life that are very emotional and where a few words can hardly describe feelings. After two years of working with the Welsh Youth Parliament it’s time to say goodbye. Myself and all of the Welsh Youth Parliament Members had the privilege to work with every single young person and adult that we’ve met through this unforgettable journey, and thank you very much for that. I personally had the privilege that you introduced me to this country from Cyprus, which is my homeland, to Wales. I had a wonderful time to work, and it was a pleasure to develop my English, my skills and most importantly me as a person, and having all of you by my side.

When I was told about the first ever Welsh Youth Parliament, my first thought was, 'I will never get into it', because I’m still new to this country, I didn't know much language, and didn’t know many people. Therefore, I thought this will not happen. But with my mother’s support and Jenny’s support and push, they’ve supported me to completely change my thought, believe in myself, and lastly, put my name in for election. Back then, this was such a big step for myself, but thankfully I passed it successfully.

Through the period that we had to start finding young people to vote for ourselves so that we could actually get selected, I was really stressed because I didn’t have an idea on how to find these votes. But thankfully, again, I had many people by my side—who are Jenny, Carol, Anna, Shahab and one of my very special teachers, which was Miss Bamsey. They have helped me from all of their hearts to pass this step successfully. I say a very special 'thank you' for all of them, because if they weren’t by my side, I wouldn’t have been here today.

All of the Welsh Youth Parliament Members are feeling really proud that we were part of something monumental and that ensured that young people's voices across Wales have been heard to the highest level. We all have met incredible people and made friends for life. And let’s not forget the Welsh Youth Parliament staff, who were the reason that we all had an amazing experience—thank you for every single minute that you handled us. I wish you all the best for the future and all the best with everyone’s goals and dreams. Hopefully a day will come that we can all meet again. Thank you.

Thank you so much, Sandy. The next speaker will be Jonathon Dawes, Dyffryn Clwyd, Vale of Clwyd. 

Diolch, Llywydd, and thank you for this incredible opportunity to speak in today's debate. Now, today, in preparation for this speech, I spoke to many of my colleagues who, of course, are sat here today, but also young people from right across Wales who have followed my work closely over the last two years, and the message was clear: the Welsh Youth Parliament has re-energised youth engagement in politics right across Wales and has ensured that young people's voices are heard at the highest level in the Senedd, with so many of the Members sat here today. The Welsh Youth Parliament has also shown the power that young people have in driving the policy agenda in Wales—on the Welsh language, mental health, climate change, votes at 16 and, of course, life skills in the curriculum, we have been able to make an impact. 

But out of all the conversations I had, there was one that really stood out for me, and it was with somebody I went to school with, who I fondly remember told me time and time again that she disliked politics. And she said to me, Llywydd, 'Jonathon, your passion and the dedication of the Welsh Youth Parliament as a whole has shown the influence that young people can have in their community, and it's inspired me to make a difference'. But now, more than ever, I think that that quote shows that our work hasn't just re-energised Welsh politics in terms of youth engagement, but it has connected those who previously felt disenfranchised with these vital debates that, ultimately, are going to impact their future. 

Now, while I'm so proud of all the work we have done, in particular my work in representing the Vale of Clwyd and, of course, the young people's voices in education through my work in promoting life-saving skills and, of course, life skills in the curriculum, where I believe as a collective we have shown strength and unity is during the COVID-19 pandemic. From delivering food parcels to founding one of my favourite podcasts, Young, Female & Opinionated—I know the founder is on this call and speaking later—throughout the pandemic, the Welsh Youth Parliament Members have come together and stepped up to serve their community. We've also had the opportunity throughout the pandemic to raise issues that matter to young people, particularly around education, mental health and the green recovery to create the jobs of the future, with many of the Ministers here today, providing young people with a voice, and I really thank the First Minister and other Ministers who have given time to us to raise these issues. 

Now, Llywydd, it has been an incredible honour and privilege for me as an individual to serve the Vale of Clwyd over the last two years, and I want to say a massive 'thank you' and pay tribute to absolutely everybody who has supported my work over the last two years, and particularly you, the incredible unsung heroes that are the Welsh Youth Parliament team, the young people here today and, of course, many of the Members in the Chamber. From organising local litter picks to being a keynote speaker at the Cymru'n Cofio event alongside you, Llywydd, it has been a pleasure. But, of course, I must give a special mention to the votes at 16 panel we both sat on in June, which, I have to say, was a blast from start to finish. 

Now, these are the words I would like to finish with. I think it's fair to say that, as a group of individuals, we all have our political differences, some more than others, but, ultimately, I have never, ever met a more dedicated, passionate and positive group of individuals than my colleagues sat alongside me today. Their commitment not just to representing the young people of Wales, but to representing their constituency is outstanding, and I think it certainly sets a precedent for future Welsh Youth Parliaments for years to come. 

Now, throughout the two years, we put our political differences aside and focused on the issues that unite us and not divide us, and always putting the interests of young people first, and that is the legacy we leave—one of unity and not one of division, and the other that when young people really do use their voices and speak up on the issues that matter to them, they really can inspire change in Welsh politics. Thank you. 

Diolch, Jonathon. Sophie Billinghurst is next, and she is the partner Member of the Senedd Ieuenctid for Talking Hands. Sophie Billinghurst. 

Good afternoon. My name is Sophie Billinghurst and I'm a partner elected Member representing Talking Hands, which is the charity that supports young people with hearing loss and their families in Swansea. Being a Member of the first Welsh Youth Parliament has been an amazing experience. It has had a big impact on my knowledge of politics; before becoming a Member, I had hardly any knowledge on politics, but now I have a lot more. Having Members from different backgrounds and different views meant that a wider variety of people were able to have their voices heard. This worked well because it allowed voices to be heard from communities that may not have been heard before, because of barriers such as communication barriers in the deaf community, but having elected Members such as me meant we could voice their views.

In the last two years, we have heard many powerful speeches and so many powerful stories off other amazing Members. We have all worked together to not only represent different parts of Wales, but to represent different organisations in Wales, to make a difference in three committees. Hopefully, seeing the work that we have done over the last two years will empower young people to carry on and make a difference to younger generations in Wales. Thank you for listening.

Diolch, Sophie. Angel Ezeadum is the next speaker. Angel is the Member for the partner organisation of Race Council Cymru. Angel Ezeadum.

Diolch, Llywydd. First of all, I personally would like to express my gratitude to the Youth Parliament for being so inclusive throughout the duration of our term. As an ethnic minority, the representation we have is low, and from the little representation we do obtain, we are often portrayed negatively in the media and society. However, from the countless opportunities that have been provided for me and other Members elected from partner organisations to represent our marginalised groups, we have been able to make breakthroughs and ensure that the voices of minorities are still heard and valued as much as the majority.

Take the pandemic—BAME people were amongst the most vulnerable to the virus, hence it was ever so important to find solutions and work in cohesion with members of the community to tackle this issue. I had the chance to receive questions from my partner organisation, Race Council Cymru, and specifically the national BAME youth forum, surrounding young people and ethnic minorities' concerns about COVID-19 to ask the First Minister. To be able to have a personal discussion with such an important figure was truly fantastic, and emphasised the importance and necessity for all types of people, regardless of race, religion, gender, age and so on, to be part of influential discussions that affect their lives.

As I mentioned before the importance of positive representation, I aspire, one day, to see a more diverse Welsh Parliament. The amount of people who are discouraged before even starting, as they lack self-belief due to not seeing themselves in a political position, is unbelievable, and that is why the partner organisation initiative is so important. Just as we as Members are diverse, so too are the topics that we have covered. I've been proud to give passionate speeches and cover pieces on subjects such as Black Lives Matter and Black History Month, the environment and knife crime, but none of what I've accomplished could be without the successful running from the staff.

I had two main aims when I applied for the Welsh Youth Parliament: to cater for all and to give the voiceless a voice, and I honestly hope that I have achieved that over my term and that the work that we have done can be continued in years to come to pave the way for a more inclusive and diverse Wales. Diolch.

Diolch, Angel. Ffion Griffith is the next speaker—Ffion Griffith of Islwyn.

Diolch, Llywydd. From the beginning of our time as Welsh Youth Parliament Members, we have seen the importance and the significance of mental health in the lives of young people across Wales, with 36 per cent of the young people that responded to our very first survey naming emotional and mental health support as one of their main priorities. With the support of over two thirds of the Welsh Youth Parliament, we formed our emotional and mental health support committee after our first residential meeting, which includes 26 Members of the Welsh Youth Parliament from across Wales. Since establishing the committee, we as Members have engaged with young people, mental health charities, experts and politicians, with the aim of emphasising the need for better emotional and mental health support for young people in Wales.

Our residential meetings have given us opportunities to have discussions with some of the most influential people with regard to mental health in Wales, and have also allowed us to hear about the important work done by the Children, Young People and Education Committee to support young people's mental health. Additionally, these meetings provided us with space to engage in a question and answer session with young people to highlight the need for conversations surrounding mental health. We were then able to continue this discussion as we held our Let's Talk About Mental Health event during Welsh Youth Parliament Week, giving young people the opportunity to share their views on mental health provision in Wales. This information, alongside the results from our emotional and mental health support surveys, which were completed by over 1,400 young people across Wales, helped guide our regional and committee meetings. Across all four regions, key themes of stigma, training, preventative care and communication were highlighted, demonstrating the need for development and growth with regard to mental health in Wales. These themes then ultimately formed the foundations of our report and recommendations, which were published on 9 October 2020.

Split into two categories, one surrounding information and awareness and the other barriers to support, our committee's 'Let's Talk About Mental Health.' report echoes the opinions and concerns of young people across Wales. From improving the quality of information material to the offering of more and better anonymous support services, our recommendations acknowledge that every young person has a mental health. Whilst we believe that all of our recommendations are equally important with regard to bettering mental and emotional health in Wales for young people, there are some key recommendations that we would like to highlight as a committee.

Our fourth recommendation encapsulates the need for a one-stop shop of information, resources and support surrounding mental health. We as a committee are very pleased to hear of the Welsh Government's effort to develop this over the Hwb platform, as we believe it demonstrates an understanding of the importance of young people's mental health, particularly during this difficult time. Nonetheless, we would like to further emphasise the need for better promotion of this resource, ensuring that each and every child across Wales is not only aware of its existence, but feels comfortable in accessing the information.

We'd also like to highlight our sixth recommendation: the need for mental health to be taught consistently across Wales with greater frequency. The committee welcomes the opportunity for mental health education to come with the development of the new curriculum, however, we are concerned about how consistent the delivery will be. It is essential that young people across Wales have access to the same quality of mental health education, regardless of their location or background, and we must question, therefore, how one can ensure that this is the case under the new curriculum. Consistency must be at the heart of mental health education across Wales.

The final recommendation we would like to highlight is the need for an urgent review of child and adolescent mental health services and other mental health support services. Again, it is great to hear that the Welsh Government has already been working on this issue, giving £8 million extra each year to improve CAMHS services. However, we as a committee are calling for consistent reviews and updates of our mental health services here in Wales. It is essential that we do not become complacent. There is not one solution to bettering mental health services in Wales, and therefore, consistent analysis and reviews are really essential to help better mental health services for young people across Wales.

Every young person has mental health and it is essential that the policies of our future Government and Senedd reflect this. We must continue to pave the way for better emotional and mental health support for young people across Wales, and as a committee, we hope that the work of the next Welsh Youth Parliament, Members of the sixth Senedd and the new Welsh Government will prioritise this issue. Thank you.

Thank you, Ffion. Ffion-Hâf Davies is next. Ffion-Hâf Davies, the Member for Gower.

Thank you, Llywydd. In February 2019, we as a Youth Parliament chose littering and plastic waste as one of our priority issues. As Members, we have been having conversations within our constituents, with our partner organisations, at eisteddfodau and at our residential and regional meetings to try to understand the views of young people on the problem. Unfortunately, COVID pushed everything online, and so we gathered all of our data and drew up our report during the pandemic. In spite of this, we persevered with virtual events such as Youth Parliament Week, and the National Eisteddfod helped us to ensure that the voices of young people were heard.

In November 2020, we published our report as a committee, and it contained 10 recommendations. We called for a greater emphasis on educating young people across Wales and the negative impacts of littering and plastic waste, and how young people could help address these issues. We believe that local authorities should review their procurement processes in order to ensure that the criteria used to choose suppliers reflect environmental and well-being objectives. This includes schools, in order to ensure that educational institutions can support the work of achieving sustainability targets. The ultimate goal is to reduce as much single-use plastic waste as possible. We also call on the Welsh Government to take significant and urgent steps to halt the production of single-use plastics, with some crucial exceptions, and to consider approaches such as banning the production of single-use plastics and a deposit-return scheme.

I would like to thank the Minister for environment for her response to our recommendations. This shows young people across Wales that our voices really are being taken seriously. However, the plastic problem is clearly not solved. Therefore, we need to drive forward the agenda and ensure that it is a major issue for the next Senedd. It would also be great to see a plastic-free Senedd—something that would again emphasise the importance of our work and set an example for other institutions to follow. We are calling for decisive and urgent action within the next six to 12 months.

Finally, we'd also like to call on the next Youth Parliament to continue to call for changes in line with our recommendations. We have only served a two-year term, but in that time, we have ensured that the voices of young people are being heard and that the plastic problem is being taken seriously. Our only hope now is that you will all continue to address this problem and keep our work alive. Thank you.

Diolch, Ffion-Hâf. Harrison Gardner is the next speaker—Harrison Gardner from Clwyd West.

Thank you, Llywydd. As a Member of the Welsh Youth Parliament's life skills in the curriculum committee, we, fortunately, were able to complete the majority of our work before the pandemic struck. We consulted over 2,500 young people, parents and educators in summer shows and Welsh Youth Parliament committee events across Wales, publishing our findings and recommendations in our report, ‘Life Skills, Skills for Life’. With the new Curriculum for Wales on the way, our consultation offered a snapshot of the way that life skills and personal and social education are being taught in schools and colleges across Wales.

Our consultation pointed to several inconsistencies in young people’s experiences of learning about important subjects, such as political education, sex education, financial education and first aid, to name but a few. As the Welsh Government continued to refine the new curriculum, our recommendations included that they should provide a comprehensive list to educators in Wales of the life skills that must be taught within the six areas of learning and experience; ensure that schools in all parts of Wales have the resources to implement the new curriculum to its full potential; and ensure that teachers have the right training to be able to teach a number of new topics that will be new to them as part of the new curriculum.

Since presenting our recommendations to the Minister for Education in the Siambr in October 2019, we have been able to continue our scrutiny work in meetings with Government officials, practitioners who are developing the areas of learning and experience, and officials at Qualifications Wales who are reforming the assessment structure in Wales. We have also helped to develop the votes-at-16 educational resources in advance of this year’s Senedd election.

Whilst we, as a committee, appreciate the Welsh Government’s response to our recommendations and the reasons given for not accepting a few of them, we would like to take this opportunity to emphasise our remaining concerns. We accept the Welsh Government’s argument that it goes against the spirit of the new curriculum to publish a mandatory list of subjects for teachers to teach, and we acknowledge the Welsh Government’s concern that this would be a backwards step towards the old tick-box curriculum that the new curriculum aims to move away from.

However, we remain concerned as a committee that a lack of clear guidance could lead to greater inconsistency, and that the success of the areas of learning and experience as they currently stand is too dependent on how individual schools interpret them. Furthermore, digital poverty in Wales has become a prominent issue due to the pandemic—an issue that will only worsen and lessen the impact of the new curriculum without appropriate interventions. Therefore, we urge the Welsh Government to consider this issue further as it finalises the new curriculum.

We also urge them to commit funding to ensure that pupils in all parts of Wales have the opportunity to experience every element of the curriculum, and to invest in training and centralised resources for teachers. We firmly believe that this would lead to a meaningful learning experience for every pupil. Thank you.

Thank you, Harrison. Our next contributor is Gwion Rhisiart, representing Cardiff Central.

Thank you, Llywydd. It's a privilege to be able to represent the young people of Cardiff Central once again, and it's difficult to believe that it has been two years since our first national meeting, where we selected our three priorities. Since then, we've raised a number of issues that are important to young people in making Wales a better place in which to grow up as a young person. 

However, we wouldn't have been able to do this during the pandemic without the assistance of Members of the Senedd and Welsh Government Ministers. Over the past few months, the First Minister, the Minister for Education, the Minister for health and the Counsel General have all given of their time to meet with us virtually on a number of occasions. The opportunity to meet with Ministers, committee Chairs, the children's commissioner and the future generations commissioner has been invaluable.

The opportunity for us, as Members, to question those who represent us about exams, mental health support and job opportunities during the pandemic means that we can provide answers to young people who are concerned about their future. The Minister for Education has also given so much of her time in discussing the implications of delaying exams, as well as gathering our views on online learning. Again, the opportunity to articulate the views of young people to Members of the Senedd and Ministers has allowed their views to be taken into account when choices are being made. On behalf of all Members of the Welsh Youth Parliament, I thank you sincerely for your time.

We, as Members, have also been very fortunate to appear on various media platforms in Wales. During our time as Members, my colleagues and I have appeared on Radio Cymru to discuss our work, including our recommendations for a new curriculum and mental health support for young people. This has been instrumental in raising awareness among young people of our work, and in discussing issues with pupils, teachers and parents in all parts of Wales. In addition to this, I was very lucky to be able to appear on Wales Live with Hannah Blythyn and Andrew R.T. Davies in order to discuss votes at 16 and the representation of young people in politics. Finally, Betsan Angell and I appeared on Heno when we released our report on life skills in the curriculum. It was a privilege to be able to discuss our recommendations and our hopes for the new curriculum.

Therefore, in conclusion, I'd like to thank all the journalists and Members of the Senedd who have helped to raise awareness of our work. We really appreciate this. Together, we've succeeded in taking action to improve the lives of young people in Wales as we recover from this turbulent period. Thank you very much.

Thank you, Gwion. And our final speaker from the Youth Parliament will be Maisy Evans from Torfaen.

Thank you very much, Llywydd. It's a privilege, once again, to speak to you all.

People often ask me whether, if I could go back in time, I'd change anything. And simply, no. Absolutely not. I'd stand for election, and I'd throw myself at every opportunity time and time again. I really do mean it when I say that the last two years of my life have been the best yet. Amongst ups and a few downs, I've met some incredible people, developed friendships that I'll forever cherish and have had unforgettable experiences.

This year has pushed us all to our limits, personally and professionally alike. COVID-19 has impacted our lives more than anyone could have imagined. And, undoubtedly, it's been tough. But nonetheless, our Welsh Youth Parliament—the very first of its kind—has proven that young people are in fact a force for good in our nation and beyond.

I'd like to take this moment to thank you all, my fellow Welsh Youth Parliament Members, the staff behind our work, the staff behind the technology even—and especially today—and most importantly, each of you, the Members of our Senedd.

On 26 June 2019, we held our very first joint Chamber session, and during that session I was honoured to give the opening remarks, and I read to you a declaration that would shape, and has shaped, our relationship. I'm certain that that day will forever be in my mind, and it's a moment that I take great pride in, and I know that I always will.

Once again, I'd like to draw your attention to some of the points outlined in that declaration. It states the Welsh Parliament and the Welsh Youth Parliament will work together to ensure that our work is an integral part of decision making in Wales, and that the Welsh Parliament will commit to the rights of young people and operate on the principles of openness and transparency.

My greatest thanks of all go to the Members of the Senedd who have committed to engage with us, and to not only hear our voices, but to listen to us. During our term, we've provided you with many realistic recommendations on ensuring young people are equipped for life, on emotional and mental health support, and on protecting our only planet.

It is vital that you, as the Welsh Parliament, continue to work with young people from across the country. With the United Nations Convention on the Rights of the Child enshrined in Welsh law, it is your duty to listen to our views. This Welsh Youth Parliament is evidence of your commitment to article 12, which states that young people have the right to express their views freely, and for their views to be truly considered.

I'm grateful to have had that platform to share my views, and even more grateful for the opportunity to influence real change at the highest levels possible. With the voting age having been lowered to 16, young people in Wales can now do exactly that—influence change. It's very exciting. I urge every young person aged 14 and over to go online and to register to vote—it just takes minutes—because, at long last, you have that opportunity to make your voice heard.

As the inaugural Wales Youth Parliament draws to a close, I hope that you're all ready and willing to meet the next cohort of young leaders. And never forget that we, as young people, are not only leaders of the future, but the leaders of today. Thank you all very much. It's been a privilege on all occasions. Thank you.

Thank you very much, Maisy, and thank you to all our contributors, and to those who have made such a huge contribution during this Youth Parliament term.

I now call on the First Minister to respond. First Minister.

Well, Llywydd, I'd like thank all Members of the Youth Parliament for their contributions this afternoon, but also, as the Llywydd said, for everything that you have done in establishing the Youth Parliament in such a successful manner. I have benefited from meeting with a number of you on a regular basis over this exceptional year. Hearing the pinnacle of your work this afternoon has been our pleasure and an opportunity for us all to learn lessons. Your period in post is now drawing to a close, as is the Senedd itself. I'm sure that every Member of Government would wish to wish you well in the next steps in your lives, and those next steps will be even more successful as a result of the unique experiences that you have had as the founders of the Welsh Youth Parliament.

Llywydd, I'm not going to try to respond to all the different speakers we've heard, but Sandy was right in the very first contribution, that endings are inherently emotional moments, and I'm sure that will be true for all Members of the Youth Parliament. Sandy shared her story with us, and I think we were all glad to hear it. Wales is lucky to have you here, as we have been lucky with all the young people who've played their part in this very first Senedd.

Shall I just focus briefly on three things that I think I drew out of all the contributions we've heard? First, how overlapping the agendas have been between the things that you have been talking about in the Senedd Ieuenctid and the things that we talk about every week on the floor of the Senedd itself: mental health, climate change, education, the new curriculum, how we will forge a future that is better for us all. Secondly, the importance of plurality and diversity: the way in which hearing different experiences and different voices changes the nature of the conversation, enriches it, of course, but also means that we see things in new and different ways. I thought that came through very powerfully in a series of contributions. And finally, that in the work that you do and the work that we do, the work is never over. We never come to the end of the day and can draw a line under what we have been discussing and think, 'Well, that's that done, then.' The work always goes on, there are always challenges that we haven't thought of, there are always new chances to advance the causes that matter to us as individuals and as a nation. And in hearing of the work of the committees, I'm very glad that so much of what you have proposed has been accepted by the Government, and I'm not surprised at all to hear that there are things that you would want to go on advocating, making the case for, looking to secure further changes in the future.

So, thank you very much to each and every one of you for everything that you have done and for the opportunity once again to meet with you and to hear from you all this afternoon.

Diolch. On behalf of the Conservatives, Laura Jones.

Diolch, Llywydd. It is a great honour to say a few words on behalf of the official opposition, the Welsh Conservative group, following such articulate and thoughtful contributions from all of our elected Youth Parliament Members.

I feel a great affinity with our Youth Parliament Members, having been the youngest parliamentarian in the UK when I was elected to the Senedd, the then Welsh Assembly, back in 2003 at 24. For me, the establishment of the Welsh Youth Parliament is the standout achievement of this parliamentary term and will stand as one of the great successes in Wales since 1999.

Over the last two and a bit years, Members of the Youth Parliament have made an outstanding contribution to public life in Wales, but, more tangible than that, they have directly influenced law making in this Parliament. When we debated the new Curriculum for Wales in the Children, Young People and Education Committee, the most powerful contributions were those from young people themselves, from you, from the likes of Jonathon, who I can see on my screen now. Your scrutiny and campaigning on the role of life skills in the curriculum has been particularly compelling, and my group completely agree that key skills, such as first aid and British sign language, should be included in the curriculum.

On the issue of plastic waste, as outlined by Ffion-Hâf, you have spoken up for so many young people who are crying out for change, and have come up with some excellent suggestions. We've been motivated by distress at what humans are gradually doing to this planet. And Sir David Attenborough only said yesterday that in some ways we are already too late to prevent some of the drastic effects of climate change, so we really do need to act now, and you've made that abundantly clear.

As outlined by Ffion, you've made meaningful interventions and raised important questions on the issue of young people's mental health too, which has been a taboo subject for far too long. This is a massive area of concern for all of us right now, as you'll see from our contributions in the Senedd across the parties, as we worry about the impact that prolonged lockdowns, school closures and just the inability to socialise with friends is having on young people.

Throughout this pandemic, children and young people have sacrificed so much, largely to keep older and more vulnerable people safe. In the coming months and years, as we emerge from this pandemic, we all have a duty to repay that debt and do far more to support young people and better meet their needs. We as MSs have a responsibility to take action on the issues that matter to you, our youngest generation. 

In conclusion, Llywydd, I'd like to wish all 60 Members of the Welsh Young Parliament well in whatever direction their future careers take them, and thank them so much for all that they've done. They are outstanding representatives of their generation. You should all be so proud of your achievements in just two short years. We all as MSs across the board are certainly proud of each and every one of you. You all clearly have bright futures ahead of you, and you've all given us hope, and we look forward to the contributions of future Youth Parliaments. Thank you. Diolch.

Leader of Plaid Cymru next—Adam Price.

'The youth parliament will give Wales' young people a democratic voice at a national level and empower them to bring about change.'

That's how you, Llywydd, described the vision underpinning the Welsh Young Parliament at its launch. And without doubt, the Youth Parliament has delivered on that and much more, and I'm very pleased to provide my party's support to the work that's been done to date, and to provide my full support to the Youth Parliament in its further development in our next Senedd term.

In looking forward to the next Senedd, we will be facing the future. And the debate today on the basis of those topics that you covered invites us to look to the future beyond COVID, and to focus on the major challenges facing our nation and our world and the numerous crisis of our age: the climate and biodiversity crisis, as we've heard; transforming the education system in order to secure social transformation and to deliver the potential of everyone; and changing attitudes towards and strengthening mental health provision. On the basis of your success as young people over the past few years, I am confident that we will all succeed in building a better Wales. It's pressure from you as young people that's made the difference in ensuring that mental health and well-being will be enshrined in law in all aspects of the new curriculum.

Young people have led change across the world, and in the politics of Wales too over the past few years, and the climate crisis and the climate strikes are an example of this. There have been a number of protests and marches across Wales, including one that finished on the steps of the Senedd itself. Change is possible if we insist upon it: that is the hopeful core message of democracy. And it's very often young people who lead that change. You demonstrated that again in August of last year, forcing the Welsh Government to recognise the unprecedented circumstances in terms of the impact of COVID on your education. And in terms of independence, which would be the most radical change, it's the young people of Wales who are in the vanguard on the issue. And I very much hope that many of you one day will represent your generation once again in the independent Senedd of the future—and it will be your future. And given the spirit of unity and creativity and positivity that you've demonstrated, there is room for each and every one of us to believe that that future will be very bright indeed for us all.

It's truly inspiring to welcome representatives of the Youth Parliament for this Plenary session. I'm sure that some of you will aspire to become our future politicians. So, perhaps I can offer a few words of caution if you should do so. First, in whatever endeavours you find yourself involved, try at all times to keep an open mind. Whatever political philosophy you adopt, always be ready to explore other political views and ideas. Above all, I encourage you to do your research. Do not just take the statements of main media or even social media—delve deeper and attempt to approach every idea and proposition as effectively as possible.

I have to congratulate all of you on the work that you've done. You've made a very great difference to the way the Senedd has operated during the two years that you've been in existence, and you've made absolutely sure that we shall never ever be able to ignore the voice of the youth of Wales again. By creating this institution, I believe the Welsh Parliament has opened up an opportunity for the youth of this country to truly participate in matters that affect you, but don't be disappointed if some of your suggestions and ideas are rejected or not implemented. Sometimes, what we want cannot always be delivered. However, I feel you can rest assured the Senedd will respect and take on board all the views and suggestions you've put forward. After all, that is why it initiated the Youth Parliament in the first place. I thank you all for your participation in the Welsh Parliament, and I wish you well in whatever careers you choose to follow. Thank you, Llywydd.

Lynne Neagle, the Chair of the Children, Young People and Education Committee. Lynne Neagle.

Thank you, Llywydd. One of the highlights of my time as Chair of the Senedd's Children, Young People and Education Committee has been the opportunity to watch the Youth Parliament develop. To work with its Members on the scrutiny we undertake as a committee and as a Senedd has been a genuine privilege, and I'm in no doubt that the establishment of the Youth Parliament has enriched the debate on important topics during the fifth Senedd.

Today, we've heard directly from the youth parliamentarians about everything they've achieved since their election. Describing it as impressive is an understatement. As we've heard, the Welsh Youth Parliament has sought to influence key areas of policy, including curriculum reform, emotional and mental health, and littering and plastic waste. These are not small or easy issues. My committee has grappled with two of these topics, so I can certainly say that from experience. We have been enormously grateful for the input and insight shared by the Youth Parliament's inquiries and reports in these areas.

Similarly remarkable, though, has been its ability to provide reactive and timely contributions to developing issues. The Youth Parliament provided important views to our scrutiny of the reasonable punishment Bill, for example, and we know that you've been an important voice in the ongoing discussions about how we manage and recover from the pandemic.

As a committee, we have repeatedly emphasised the importance of hearing directly from children and young people about their experiences. Ensuring that a children's rights approach is adopted for all aspects of policy, legislation and funding has been a key priority for us. As Maisy Evans said, the Welsh Youth Parliament is children's rights in action. The impact of COVID-19 has emphasised more strongly than ever the need to ensure that our children and young people have a voice and that that voice reaches all areas of public life and decision making.

I'd like to draw my remarks to a close with three final points. Firstly, I'd like to take this opportunity to say an enormous thank you to our 60 Welsh youth parliamentarians. You have set an example that will be hard to follow, but one I'm confident will inspire others to engage and participate in future. Secondly, I'd like to encourage any children and young people who are listening to consider putting themselves forward as the next generation of Welsh Youth Parliament Members. As you've heard today, you can really make a difference. Finally, I'd like to place on record my thanks to the team of staff both within the Senedd and within partner organisations who've worked so hard to establish and support the work of these remarkable young people. This last year has tested everyone in all ways, but the resilience shown by our children and young people in Wales, including the Members of our first Welsh Youth Parliament, is a source of inspiration and pride to all of us. Diolch o galon ichi i gyd.

Diolch, Lynne. And just like you, Lynne, the Youth Parliament has been one of my highlights in my term as Llywydd. We spend a lot of time in our Senedd at the moment discussing jabs in arms; the Youth Parliament has been a jab of hope in my arm over the past two years. I've loved the diversity of your backgrounds and the diversity of your political views, but all coming together to try and find common cause for the good of your communities, your peers, and for your nation. I've no doubt that this will not be the last Senedd meeting for some of you—some of you will be back at some point. But, in the meantime,

thanks for all you've contributed.

Thank you for everything you've achieved in these last two years and your legacy will live on into the next Youth Parliament, and beyond.

So, thank you very much.

I bring this part of the meeting to a close, and we'll suspend proceedings for a few minutes, before we recommence formally as just the one Senedd.

Thank you, all.

We now move to questions to the Minister for Health and Social Services. And the first question is from Jayne Bryant.

The Welsh Government has provided a range of initiatives to support paramedics and the ambulance service, including £1.6 million investment to expand the Emergency Medical Retrieval and Transfer Service, and £10.9 million for new operational vehicles, which of course are green and will reduce the carbon footprint of the organisation.

Thank you for that answer, Minister. This last year has been an incredibly hard time for everyone at the Welsh ambulance service, from the paramedics who've been on the front line to the dedicated staff in the control rooms and those staff who support the service. Sadly, we saw earlier this month that the Welsh ambulance service lost a fourth member of staff to coronavirus: Kevin Hughes, aged 41 from Anglesey. Many members of staff are physically and mentally fatigued due to the increased pressure on an already busy service. Support and protection is needed, such as the supply of PPE, investment in vehicles and equipment, as well as investment in the workforce.

Can the Minister outline what more can be done to support our ambulance service workforce, both over the coming months, and as we come out of the pandemic?

Yes, thank you. I've outlined the increased investment in new vehicles in my initial response. We continue to look at the fleet to make sure it's appropriate, both for the emergency side of the service, but also the urgent care and patient transport side of the service as well.

When it comes to well-being, we've worked with social partners, so that's our NHS Wales employers and trade unions, to have a multilayered well-being offer for health and social care workers in Wales, including in particular paramedics as well. So, there's a confidential Samaritans listening support line, funded by the Welsh Government, dedicated for health and care workers in Wales. We have a number of free-to-access health and well-being support apps, like Mind, Sleepio and SilverCloud. We have a range of different resources and, on the Health Education and Improvement Wales website, there's a useful list of what all of those resources are. And it's a matter I regularly discuss with the trade unions in my regular update with them, as well as the partnership arrangements in place.

On PPE, we continue to have a successful delivery of PPE for our front-line workers. The vast majority of PPE issued—there have been over 647 million items issued in the last year to health and social care—the vast majority were directly sourced by the NHS Wales Shared Services Partnership, with all contracts awarded subject to robust governance. That includes protection from fraudulent or substandard PPE. So, in Wales, on PPE procurement, there have been no party favours, no VIP lane, no chumocracy. Everyone in Wales should take real pride, I believe, in the way we have continued to provide high-quality PPE for our front-line health and social care staff. 

I'm sure the Minister will join me in thanking all the ambulance service for all they're doing in such harrowing and difficult circumstances. Minister, last month, it was reported that concerns had been raised that some front-line ambulance staff were refusing to be vaccinated against coronavirus. This obviously poses obvious risks. The director of workforce and organisational development at the Welsh ambulance service confirmed that some staff had refused the vaccine, but that numbers were not being recorded. Can you, Minister, advise why this important information is not available, and can you advise what action is being taken to address the concerns of the ambulance staff who are reluctant to receive the vaccine? Thank you. 

I don't have an individual figure to hand today on the number of front-line staff who have not taken up the offer of the vaccine. We do know we've got incredibly high levels of take-up from our front-line staff, including within the ambulance service. We also know that, unfortunately, there is a sewer of anti-vax information that, in particular, concerns people of working age, with some particularly outrageous claims made about both male and female fertility. So, we do understand there are people with real concerns about that misinformation. 

There will also be a limited group of people who will have medical reasons why the vaccine isn't appropriate for them. That's a very small number of people, but I expect the matter to be not just resolved by the employer and trade unions working together, but by the positive encouragement for people to take up the vaccine. And I should say that I join with not just yourself, but also Jayne Bryant, in her recognition of what paramedics have done and all across the ambulance service. It's a much more wide-ranging organisation than the emergency end of the system, and the way in which they've had support from the military in undertaking their task, in making sure vehicles are ready, it's been a real team Wales effort, and I think everyone, as I say, should take real pride in what they continue to do in these, the most challenging of circumstances. 

Question 2 to be asked by Mike Hedges and to be answered by the Deputy Minister for Health and Social Services. Mike Hedges.

We have taken a number of actions to support people to stay connected with family and friends, including additional funding for the third sector and local government, and for mental health and emotional support services. Our regulations also allow people to form an extended household if they live alone. 

Can I thank the Minister for her response? And I know that she shares my concern regarding loneliness and isolation. No-one should go a day without speaking to someone, but, unfortunately, many do. Does the Minister agree we need to ensure either whole contact or virtual meetings for those living alone, who don't have any family who they can form a bubble with, to ensure that they have priority in being dealt with, especially when they're self-isolating and they have to keep away from people anyway? The COVID crisis will eventually end, but unless action is taken loneliness and isolation will not. Does the Minister agree with me that we need to take action to ensure that people have daily contact with somebody?

Thank you very much, Mike, for that question. And can I thank you for consistently raising in this Chamber issues related to loneliness and also issues related to older people? Because I know you chair the cross-party group on older people, which I attended recently, so thank you very much for that.

Yes, I believe it's absolutely crucial that we do all we possibly can to make contact with people who are lonely. I think that we know that in this pandemic those people who were lonely to begin with are now much more lonely, and particular groups are likely to be lonely, including older people, but, of course, younger people as well, and other groups, such as disabled people suffer from loneliness specifically.

I have responded, in similar questions, to make reference to the Friend in Need initiative, which was organised by Age Cymru, which guarantees a telephone call every week to an older people who is lonely, which I think is the sort of initiative that Mike Hedges would support, because it is giving that contact. So, we actually give £400,000 to Age Cymru to deliver that. And I've actually taken part in one of the sessions, and I can see how much it means to a lonely person to be able to talk over the week to a volunteer, who is often an older person themselves, but who has been trained to specifically take part in this project. So, yes, that reaches a small number of people, but it's initiatives like that, and the other initiatives that I referred to in my first answer, that I think are crucial that we continue to carry out in this pandemic.

Thank you for your answers, Minister. There's very little I can add actually to the excellent points that have just been made by Mike Hedges in his question, other than to reiterate some of those issues. As you said, the health risks of loneliness and isolation were there prior to the pandemic. So, in many ways, those issues have been exacerbated by the pandemic, and it's not just for older people, it seems to be across a wider section of society. So, as we emerge from this difficult time, and we are seeing this reality for people who haven't previously experienced it, what strategy are you developing to help people suffering from mental health issues, which we know are on the increase, and also, specifically, to tackle this loneliness aspect of those issues?

Thank you very much, Nick, for that question. I absolutely agree that it is widespread. I think we tend to think of it as older people who are suffering from loneliness, but it's specifically younger people, and, as I said earlier, disabled people, people from the black and minority and ethnic community and people suffering from mental health problems. This has all been an additional difficult time for them. So, we've certainly recognised this by the funding that we have put in, with additional funding for mental health support—an additional £42 million for mental health in our draft budget to support this—because we certainly see the effects of this pandemic as carrying on beyond the period of the pandemic, and there will be some scars on people that we'll have to continue to work with. So, as I say, we're putting extra money in for the mental health support, and we'll be doing all we can to continue some of this support for people who have experienced loneliness, and some of them in a way that they haven't experienced it before. 

Questions now from the party spokespeople. Plaid Cymru spokesperson, Rhun ap Iorwerth. 

Thank you, Llywydd. Minister, you will be aware that a group of organisations wrote to the UK Prime Minister on measures to protect health and care workers from the virus. They say that steps to reduce airborne transmission have been insufficient and they are calling for an improvement in ventilation and for changes in PPE guidance in order to protect the workforce. Will you work proactively in responding to those demands and recognise that our understanding of airborne transmission has changed considerably over the past 12 months and that public health messaging, as well as that protection guidance, should be amended to reflect that, including putting more emphasis on the importance of fresh air?

I'm happy to say that in regular Welsh Government messaging, we highlight the importance of good ventilation, and that's in not just press conferences and other events that I do, but from others—from the chief medical officer, the deputy chief medical officer and indeed the First Minister, who has highlighted this as well. I know that that's practically been taken on board. For example, we have made sure that my son has an extra layer of clothing because windows in his classroom were open when he returned to school. So, the message is being taken up on ventilation in a much more significant and sustained manner than, to be fair, it would have been at the start of the pandemic.

When it comes to the review of the adequacy of personal protective equipment, that's a matter where we do regularly undertake reviews. The lead for that is the deputy chief medical officer, Professor Chris Jones. He regularly engages with other colleagues across the UK to make sure that our guidance is up to date. I understand the concerns that some people have about whether the current version of the PPE is the right version of PPE, given that we have a more transmissible variant of the virus—the Kent variant—in place as the dominant variant in Wales, but the latest review shows that our current standards are appropriate, and, as ever, they're always under review.

Thank you. I want to turn now to the long-term impact of COVID-19. It's wonderful that the vaccination process is developing well, but many people will wait a long time before getting a vaccination, including young people, and they are also open to acute and serious risk, as we have seen in the most painful manner on Anglesey over the past few days in light of the deaths of two young men, Kevin Hughes and Huw Gethin Jones. I know that I speak on behalf of the whole of the Senedd as we send our condolences to their families today. But for those who will be fortunate enough not to develop serious illness, we are coming to understand more and more of the dangers of long COVID.

I met this week with the organisation Long Covid Wales and discussed the need for far more investment in long COVID care, which is different to post-COVID rehab. We need healthcare for the sufferers of long COVID. I note, today, that an additional £750,000 has been allocated in Scotland for long COVID care. Can we have a commitment of enhanced resources to provide this care and, crucially, to ensure that it's available in all parts of Wales? Because at the moment, you are far more likely to get care if you are living in the south-east of Wales. 

This is a matter that I do take seriously. I'll be writing imminently to the health committee in response to the Chair's letter on behalf of the committee on long COVID with a series of questions within that. We'll set out what we are doing and the work we are undertaking on the long COVID pathway we've agreed as well. I think it's really important to understand that, when we talk about long COVID, we're talking about a variety of impacts, because this is not a commonly experienced condition, in the sense that the symptoms may vary. You may have people who have never been to a hospital, but have never fully recovered and have recurrent symptoms that have an impact on their day-to-day activities. You may also have people suffering from a much more significant impact and there may be people with different organ damage, with longer term consequences as well. We're looking to have an approach that takes account of the different impacts on different people and we recognise that this will require a multidisciplinary approach.

It's part of the reason why we've worked with colleagues in primary care, as well as secondary care, in understanding how to put together a pathway and to make sure that primary care colleagues are equipped to refer people to the appropriate part of that pathway as well. That will be really important for the future, because the honest truth is that today we don't have enough understanding to set up a definitive treatment pathway that will do for everything and anything in the future. We will continue to learn, which is why we continue to invest in research around long COVID. It's why, whatever happens on the first Thursday in May, the next Government will continue to need to reassess the state of our knowledge and our understanding and will, again, need to return to the current pathway we have in place to make sure it's still appropriate and to understand as further advances in care and treatment are provided. So, this is a moving picture but one that we're committed to return to, because I recognise this is going to be one of the longer term impacts of COVID. It's a success story that so many people have recovered, but the nature of that recovery will be varying and there will be recurrent episodes for a number of people. 

There is still a lack of understanding on how hard long COVID can hit people. Even if they don't have to go to hospital, it can take many weeks for some people to recover from COVID and the symptoms of COVID. I've heard of one individual who was threatened with disciplinary action from her employer unless she returned to work within a fortnight. She, as it happens, has recovered now but it took her a month to recover from COVID. Now, most employers are being responsible, but with all sorts of stories to be heard about workers being requested to use annual leave to self-isolate or to ignore a request to self-isolate entirely, will you be entirely firm on this issue and press for prosecution if necessary—which could be as serious as corporate manslaughter in the most serious of cases—if there is clear evidence that employers or others are acting in a way that contributes towards the spread of this virus?

There are two distinct points there. The first is that Ministers don't make prosecution decisions. There's a clear separation of powers. It's probably a good thing for everyone that, as the health Minister, I'm not in a position to direct the criminal justice services to undertake prosecutions or not. However, when it comes to the law and our expectations, we do work alongside the Health and Safety Executive. It's a reserved body, but they're very clear about what requirements of the law are in place here in Wales and what that means in terms of businesses that are not compliant in following those rules, whether it's retail or other activities as well. The guidance we issue has a real bearing on making sure that workplaces are safe workplaces with an infectious condition that is in widespread circulation still around the country. I think that's the point the Member is really driving, about making sure there's a clear message from the Government about expected standards of behaviour from employers and not to hesitate in supporting action that is taken, whether it's by environmental health organisations, trading standards or, indeed, non-devolved areas, to ensure that workers are kept safe. 

We have these conversations on a regular basis, not just in the social partnership but also in the national health and safety forum that's been created as well. We are, I think, being very clear about our expectations for employers about how they need to keep their businesses safe and secure to keep their workers and their customers safe and secure. We'll need to return to this again, as our evidence, knowledge and understanding of COVID changes in the future. I hope that, as we do recover and get out of the pandemic crisis, we'll make sure there isn't a dropping of the guard when it comes to this. Because I also wouldn't want to see employers taking precipitative action against people who, in my former life, I would potentially have been taking discrimination action for if these are people with a material impact on their day-to-day activities with a recurring condition. That seems to me to describe a great deal of what long COVID actually means for people who have the condition and the likelihood of a future occurrence. I hope that all employers are taking a much more considerate approach, because these are matters where our understanding will continue to develop and we want people to return to work and contribute to the future of our economy. 

The Conservative spokesperson, Angela Burns. 

Good afternoon, Minister. When are you hoping to bring forward a national plan for dealing with the waiting list problem that we have here in Wales?

I expect to be in a position to publish an NHS recovery plan before the end of March. I have indicated this previously. We'll need to look at recovery in general terms, so not just planned care and elective services but more broadly as well. We need to describe the approach we're taking and what that will mean to give everyone some context about the scale of the task as it is and then to set out how we're already working to plan and then to be able to deliver it. The challenge will still be that, by the end of March, we're unlikely to have a definitive set of delivery plans because we still don't anticipate reopening all of our services within the national health service by that point, and that will affect the scale of the problem that any future Government will have to confront and resolve. But we do expect to provide a much clearer guide about what recovery will look like. 

You talk about recovery in a general way, and I appreciate that. I understand that you have to look at the NHS as a whole, but I am particularly concerned about the waiting-for-treatment times. We now have over 538,000 people—that's one in five of our population—waiting for some form of treatment. Granted, they're not all humongously urgent—although to the person involved, it may well be—but there are an awful lot of people, ranging from people waiting for diagnostic treatment to women waiting for gynaecological treatment, people needing treatment for their eyes so they don't lose their eyesight; these are all people whose quality of life and whose eventual outcomes could well be severely impacted by waiting for treatment. I understand the position we're in—we've been through hell on earth this last year and a half—but I am desperately seeking from the Welsh Government a real assurance that there's going to be a targeted plan specifically aimed at this.

The reason I ask you, Minister, is because I hear health boards telling me that they are going to take up to a decade to recover and get back to the places they were before the pandemic happened. I am aware that many health boards use other health boards to provide certain services. Unless there's a united national plan in place, it could be very difficult to get all the services to start coming up to the boil at the same time. For example, in Hywel Dda, there is no treatment for keratoconus; you have to go to the Princess of Wales in Bridgend. If that board does not decide to liven up that process in time, then people in Hywel Dda will continue to wait. Can you give us an assurance that you're going to specifically look at this, and can you give us some idea of how you're going to be able to address that problem? As I say, I totally understand it's a significant challenge, but we also need to be aware of funding and resources. Are you able to give us any indication?

When we do publish the NHS recovery plan, we will within it address the fact that there will be a resource requirement for this not just in a year, but over the course of the whole term. I've indicated previously that I think the recovery will take least a full Senedd term. That's the scale of the problem we have. It's probably not much comfort to people here in Wales, but you'll find a huge scale of challenge in every part of UK, because of the last year that we've all lived through. I recognise the point the Member makes about not just the increase in the volume and the backlog that's been built up, but the fact that that may mean that there is harm that is caused that may not be reversible. That is part of the difficulty in having to make choices through this pandemic and about weighing up and balancing the impact on different people.

I should say, though, that it isn't the case that one in five people in Wales are on a waiting list. A number of the people who are waiting will have appointments on different lists, and it's part of the challenge in having an accurate discussion about the scale. The numbers the Member quotes are the numbers of outstanding appointments in a variety of areas, as she's indicated, from out-patients to more urgent activity as well. That reinforces for me the importance of continuing to get on top of coronavirus and not letting the virus get out of control again, because it would just mean a further interruption and even more harm and an even bigger backlog. But yes, you can expect a plan that covers a range of different areas, including a balance between local, regional and national choices. I may not be the Minister who has to make those national choices, but whoever does return as the health Minister after the election in May will need to be prepared to make national choices to build upon the plan that will be published by the end of March, because this, as I say, is going to be a significant undertaking for the whole country.

To go back to those statistics, they did come from Government information, but I am happy to go back and review that, because it was quite clear it was one in five. One of the areas that's leapt astronomically in the last year is the area of gynaecological services. We had less than 1,000 women waiting for over 36 weeks; now we've got over 13,000 women waiting for some kind of treatment. That, of course, spins back to health inequalities, doesn't it? All of the parties will have received a letter in the last week from the Royal College of Physicians on behalf of 30-odd organisations talking about health inequalities. Will the Government be able to make any commitment that in this recovery plan is not just going to be a broad-brush approach, but that you will look at key health inequalities to ensure that groups such as women, who traditionally have suffered unequal health in a wide group of areas, are brought into the mix at the same time? Of course, it's not just women; there are a lot of ethnic minority groups that have particular health inequalities. Will you be listening very closely to the representations being made by the likes of the Royal College of Physicians to try to ensure that we don't allow this pandemic to broaden those health inequalities that we already have here in Wales?

If I deal with the point about the figures first, and then deal with your point about health inequalities, on the figures, the figures are accurate in terms of the number of appointments that are outstanding, but there isn't one fifth of people who have an outstanding appointment because some of those will be individuals on more than one list, and that's the point that I'm making. In terms of the number of people that are really waiting, it isn't actually one in five of the population. The figure you quote is an accurate figure for the number of individual appointments. I myself know that I could potentially be on two waiting lists, for the sake of argument, if I were a new patient with the two individual issues where the NHS regularly cares for me. So, that's the point that I'm making in having an accurate conversation about the scale of the challenge we face.

On your point about healthcare inequalities, we recognise the pandemic has exacerbated healthcare inequalities and made them even more stark than they were before. The level of harm, the different harm that has been meted out by coronavirus—. It is not a great leveller. It is the reality that harm is done in those communities, those families, those individuals who started this pandemic with the greatest number of health inequalities at the outset.

We have to make sure that the recovery does properly take account of that in how we prioritise people in the greatest clinical need, how we get to those people first, and how we make sure that our recovery doesn't exacerbate, yet again, the healthcare inequalities that there are. That means that it can't be about the sharpest elbows finding their way through a system. It's actually about how we deliberately design a recovery that does take account of all of those healthcare inequalities, and that will be difficult because of the scale of the challenge that we have. But I actually think that our prudent healthcare and value-based healthcare approach will help us to do that, to drive that into our system. This is all entirely consistent with the 'A Healthier Wales' approach that we have, where, of course, you'll recall from the outset of this term, from the parliamentary review to having 'A Healthier Wales', healthcare inequalities were very much at the heart of that plan, and they'll need to be at the heart of our recovery approach, too.

Yes. The Welsh Government continues to work alongside Betsi Cadwaladr University Health Board to develop their orthopaedic plans and to support them to adapt their delivery to meet the changing needs brought about by COVID-19, including the significant increase in waits for orthopaedic treatment.

Thank you. This follows on, really, from my colleague Angela Burns and the concerns around what's happening with regard to treatment. So, I've been liaising with the chief executive of Betsi Cadwaladr University Health Board. Earlier this month, she sent me a letter that stated, and I quote,

'with the small volume of elective surgery that we've been able to perform over the past 12 months, waiting times have increased considerably'.

I was writing to her about a constituent who'd been waiting a long time in immense pain. She said one consultant, Mr Ganapathi, now has more than 450 patients waiting for treatment, and, according to the chief exec, over 350 of these have waited longer than my constituent who—just listen to this—was referred for double knee replacement in November 2017, long before our pandemic, Minister. So, whilst acknowledging the pressure caused by COVID-19 and welcoming the news that a new post-anaesthesia care unit has opened at Ysbyty Gwynedd, the evidence is clear that orthopaedic treatment is in crisis here in north Wales. So, please advise what steps you are taking to help facilitate more day-case and in-patient surgery, and whether consideration can be given to increasing the health board's partnership with English trusts, and coming to an arrangement with more than just two, for patients to be offered their surgery outside of this health board. Thank you.

I think there are several things there. The first is to acknowledge that there was already a challenge with orthopaedic delivery in north Wales before the pandemic. We were seeing an increase in activity in north Wales, but it wasn't keeping pace with demand coming in, so lists were broadly getting longer on orthopaedic treatment. That is undeniable.

The second point is that, during the pandemic, though, that has been exacerbated even further. As Members will be aware, there's been significant interruption of normal care and treatment, so the orthopaedic waiting list has grown even further over the course of the pandemic, not just in north Wales, but across the whole country. Our challenge is how we get to a sustainable system and how we deal with the big backlog that has built up as well. With respect, I don't think that partnerships with NHS trusts in England are likely to address the backlog or a sustainable service. The reason for that is that, actually, the system within England needs to get to a point where it is more in balance as well. We won't be able to buy our way through this by undertaking more activity in the private sector alone. We are going to need to have a proper approach that I think is consistent with NHS values here in Wales.

It's worth reflecting that England also have a significant increase in their orthopaedic waiting lists; there isn't going to be capacity in the NHS in England for us to make use of for some time to come. So, that means we need to find an approach here in Wales that understands the nature of our challenge, how we get to a sustainable part of our system and, at the same time, how, as to staff who are going to be exhausted when the pandemic crisis finally ends, we actually generate even more activity to deal with the backlog. This is not a straightforward challenge to address, and we'll need to move beyond a simplistic 'just work harder' or 'spend more money'. We're going to need to have some innovation in the way that our NHS continues to run a public service that delivers against the enormous challenges that confront it.  

As said by the previous two speakers, Minister, waiting lists are at levels that we haven't seen for years. Many on those waiting lists before too long will end up being emergency admissions after their quality of life has been obliterated by pain and disability. Constituents report a very patchy and hit-and-miss non-COVID health service across the region, which suggests that we are facing a very different sort of crisis for the NHS, but a crisis nonetheless. You've said there's a plan, that you have a plan. When will we see this plan to scrutinise it, and when will it possibly start to be implemented? Thank you. 

As I said, we're expecting to publish an NHS recovery plan before the end of March. I'd want Members to be able to see that plan before we move into the election period. I think that's the right thing to do. But more than that, in terms of then seeing that activity recovering, that really depends on the course of the pandemic. When we've still got critical care units that are at 115 per cent of their capacity, when we still have significant numbers of COVID patients in our hospitals, it isn't reasonable to expect the NHS to regenerate the same level of normal elective activity that we were used to more than a year ago.

We also, of course, have the additional PPE requirements that Jayne Bryant was referring to—PPE delivery—in her first question. That means that we can't undertake as much activity in the same day. So, we have a number of real handicaps for the NHS about keeping our staff and people safe whilst undertaking activity. So, this will be difficult. The plan, as I say—the recovery plan—you can expect it to be published before the end of March. Of course, the pandemic will help to determine when we can start to deliver some of this, as well as the work that our NHS organisations are already undertaking for planning and delivering that further activity. 

Thank you. We met our first milestone to offer vaccination to those in JCVI priority groups 1 to 4 by mid February. We are in the fortunate position of being the first UK country to do so. We are making good progress towards the next milestone, which is, subject to supply, to offer vaccination to groups 5 to 9 by the middle of April. Within Alyn and Deeside, I'm pleased to say that all GP practices are helping to deliver our successful vaccination programme.

Thank you for that answer, Minister, and the important information within it. I'm sure you'll agree with me that Members of the Senedd have a responsibility to act as leaders in their community, and since the start of the vaccination programme I have sought, through my 'let's vaccinate Flintshire' campaign, to work with the health board and to work with the Welsh Government to assist and support the roll-out where I can. Now, other Members of this Chamber had a lot to say in the first few days, almost demanding to know why the population hadn't been vaccinated immediately. Now, for some time, under the brilliant leadership of our First Minister, Mark Drakeford, Wales has led the way in the United Kingdom and across Europe, and these critics in the early days have gone silent. Minister, do you agree with me that we all have a role to play in publicly congratulating and encouraging everyone involved in the vaccination programme?

Yes, I do. I think it's really important that everyone, regardless of their politics, recognises the fantastic success that Wales's vaccination programme represents. The hard work, the dedication, the skill and the expertise of our staff, partners in the military, local government and the voluntary sector have demonstrated that the first few weeks, when we did have a slower rate of delivery than other UK nations, were well used to plan for our ability to go at a much quicker rate. That's why we are at the top of the four-nations table at this point in time for the overall percentage of the population who have had their vaccine and for the numbers of adults who have had their vaccine as well, and I look forward to a further successful roll-out in groups 5 to 9, and then for the rest of the adult population. I hope that those people who were critical will now give their full support and recognise the credit for this Government and our fantastic national health service for the amazing success that the vaccination programme represents for Wales.

The national vaccination strategy to 14 February included care home staff, but Care Forum Wales stated last week that the decision by Flintshire County Council to base care home fees on paying half the staff the minimum wage is an affront to care workers who put their own lives on the line and have heroically done their utmost to protect their residents from the deadly coronavirus pandemic. Responding, Flintshire council told me, 'This is not a local issue and we work to regional funding formulas in the allocation of funding, and we mutually agreed the annual uplifts with commissioning providers.' Responding to this, however, Care Forum Wales told me, 'I don't believe you'll find a single independent care home provider who would agree that Flintshire's 2021-22 fees uplift has been mutually agreed with providers.' How do you therefore respond to their question why, when every shred of evidence shows that the dependency of residents in care homes during the last 20 years, and particularly the last year, has increased significantly, north Wales fees have gone from the top of the league and now occupy the relegation zone?

Well, I'm robustly confident that follow-up question has nothing to do with the success of the vaccination programme in Alyn and Deeside, but, as you'll know, this Government is committed to a longer term future to revise not just the way the social care sector is organised but how we fund it, how we reward our staff. I look forward to all parties putting forward their alternative ways to properly fund social care in the future within the next manifestos we will all put before the people of Wales. I look forward to returning to this Chamber before the end of the term to give an update on the work of the inter-ministerial group on paying for care, and I look forward to Conservative Members finding new ways to put extra resources into our social care system as opposed to demanding extra resource without ever identifying where that money should come from.

Yes. The Welsh Government provided guidance on the delivery of the Healthy Child Wales programme by health visitors during the pandemic, to ensure that children are safe and seen and that families are supported as far as possible. We are aware that health visitors may have redeployed to other acute areas, if workforce numbers allowed, at the height of the pandemic. My understanding is that this is not currently the case.

Thank you for that response. I have raised this question on a few occasions because I conducted a survey of new mothers during the pandemic, where they raised numerous concerns about their access to health visitors during this important time. But I understand, yesterday, after having met with the Minister for mental health—and thank you again for that meeting—as you said, Minister, that some actually were deployed during the first stages of the pandemic but now have returned to their role. We were also told, though, that due to some of the profiles of those members of staff, many have been shielding or many have been off on sick leave. So, I am curious to understand how you are going to protect the service for the future and give them the relevant level of support that this vital service needs. It's a lifeline to many new parents—mothers who are seeking that initial advice and that support at the beginning of a baby's life.

I think there are several points to make there. The first is that, in terms of the longer term future, that is partly about our investment in the future of the workforce, and the Member will know that we have sought to significantly increase the number of health visitors in training and then to maintain them in the service as well. This will be a challenge for the whole service, looking forward, because we do anticipate that some members of staff may want to change NHS careers. We'll need to keep people in the service. That's why, again, Jayne Bryant's first questions about well-being and support services for paramedics are just as relevant for health visitors and everyone else right across health and social care.

The second point that I think is important to make is that it's not just from a Government policy point of view about recognising the importance of health visitors—so, our investment in the future Flying Start relies on having high-quality health visitors in good numbers, who are motivated and I've been very proud of the work they're doing—but also from a personal point of view. I remember very well the impact that the health visitor had when we had our child as well; it does make a real difference. So, having those people redeployed back to their roles all across the country is hugely important, and then to think again about how we take care of our current workforce, because the future of the NHS is already here in large number—the workers in 10 years are almost all already with us in terms of overall numbers—but also making sure that we continue to train and have a new generation of health visitors coming in in the right numbers, and in a way where their roles will change in the support they are well placed to provide because of the trusted relationship that most health visitors build up with the women and the families that they work with. So, there are challenges ahead, but I think that not just this Government but any future Government will remain committed to the future of our health visiting service in the right numbers, with the right skills.

Thank you. In our revised testing strategy, we have set out our plans to support asymptomatic testing in workplaces in order to safeguard the vulnerable, and to maintain key services. I have confirmed today the wider roll-out of asymptomatic workplace testing for employers of more than 50 people. 

Thank you, Minister. The aerospace sector is worth more than £1.4 billion in Wales and employs over 11,000 workers, including many people from Torfaen. However, it has also been very badly hit by the COVID pandemic, and those workplaces may well not have either the resources or the ability to undertake their own workplace testing. What assurances can you give that the new strategy you published today will prioritise workplaces like this that we really need to retain for high-quality, highly skilled jobs in Wales?

I think the fourth element of the testing strategy, testing to maintain, will be relevant here. And we recognise that, not just those larger employers with 50 or more employees, but in particular, those employees who can't work from home who may still need to work in closer proximity with others are ones we want to prioritise. I think that, actually, not just your own employer that you're referencing, but more broadly in the sector, this should help those businesses. And we're looking to have an approach with the guidance that we've published not just to make that testing more widely available, but to have an approach that brings both the employer and workplace trade unions together to have a shared understanding of how that testing will be used, how it will be administered and how it will protect the business and the jobs and, of course, the health of the whole workforce, with the early warning that it will give with lateral flow devices with a rapid test result and then the ability to have the expectation of a confirmatory PCR test result if someone does test positive. I think this is good news, and I hope that the business in your constituency takes up the offer and talks to their local team about how to access these tests and how to do so in a way that has the support of the workforce as well.

Minister, I just wonder if you could give us some indication of what's been learnt from trying to carry out tests in schools. Because, as I've mentioned before, in my region, certainly, there was at one point a definite disconnect between school staff and NHS leads about who should take responsibility for the administration of lateral flow tests. So, I'm wondering, can you give us an indication now about who should take a lead in the workplace—and that's whichever sector we're talking about? And how will workers who cannot or will not take a test be deployed?

Well, your second question is really a matter for employers, that's why it's important that they work that through with their workplace representatives, including, crucially, trade unions. Because the tests are there as a tool to help protect the workforce, to help us to have early warning of those people who don't have symptoms. And as we understand it, about a third of people don't display classic symptoms, but nevertheless do have coronavirus. We also know that lateral flow tests have quick results, but also, they're not as accurate as a PCR test—that's why anyone who tests positive should then get themselves tested with a PCR test as well, but they need to go home and isolate from the point they test positive with a lateral flow test. As we're seeing a reduction in transmission and prevalence of the virus, the accuracy of the lateral flow tests—I think that second test with PCR is even more important then as well.

Then, when it comes to how to administer the tests, part of the offer for businesses is about the training on the undertaking of those tests as well. We're not going to be in a position to have healthcare workers going in and administering the level of tests we're providing. The current tests we've made available to early years and education and health and care will amount to about a quarter of a million tests being delivered each week. We don't now have healthcare staff to deliver all of these tests. We've had to have approval from the regulator, the Medicines and Healthcare products Regulatory Agency, on how tests can be undertaken by individuals, but the training to undertake those, to make sure they're taken appropriately, is really important.

We accept that in providing it this way it's the same challenge that every other UK country faces too, but even if we accept that not every test will be taken in the optimum manner, we will identify a range of people who are asymptomatic whom we would not otherwise have identified. It will help to take positive cases that would not otherwise be identified out of workplaces and out of circulation. The self-isolation will help to reduce the transmission of the virus.

So, there is no pretence that this is a perfect, error-free approach, either in Wales or any other part of the UK, but it is part of reducing the prevalence of the virus and getting more people to self-isolate appropriately to reduce the harm, economically and in healthcare terms, that coronavirus has caused. 

We continue to implement a safe, phased re‑establishment of NHS dental services. Dental practices are now providing a full range of treatments for patients. As COVID-19 is still in circulation, public health measures remain necessary to ensure a safe environment. This will mean that fewer patients are treated in each clinical session.

Minister, as I know you're aware, I've been contacted by local dentists in my constituency who are frustrated at the lack of support that they've received during the pandemic, as they've incurred substantial costs in order to treat local patients and help offset a potential crisis in oral health by providing vital care to local people.

I know that we've corresponded on this matter a few times over the last few months, and I appreciate from your latest letter that health boards have the flexibility to pay NHS contractors 80 per cent to 100 per cent of their annual dental contract value. But, clearly, from the discussions I'm having with dentists, that doesn't seem to be the case.

Given that it's important to ensure that dentists can survive during this pandemic, and if health boards have the flexibility to support dentists as just mentioned, what discussions has the Welsh Government had with Hywel Dda University Health Board about this issue in order to ensure that there is consistency across the whole of Wales? Can you also tell us what the Welsh Government is doing to protect the sustainability of the sector for the future, so that people who need treatment are able to access it in their local communities?

I think there are several different things there. The first is that there's a distinction between NHS dental services and those that are wholly private-run practices as well. There's a point about business support for private practices, but operating within a process and procedure that take account of the health and safety of both the patient as well as staff members. That goes back into earlier questions about employers doing the right thing as well.

When it comes to NHS practices, it would probably be better if I can write to you about the approach that Hywel Dda are taking, their conversations with the chief dental officer's office and how the flexibility to provide support for NHS dental services is being delivered, because I do know you've got concerns that have come to you from people delivering dental services within the area.FootnoteLink

On the further support we've provided, we have, of course, provided ventilation funding support to help make sure that improved ventilation has allowed a further range of activity to be undertaken. On the longer term future, we are looking to continue with our contract reform programme. So, we know that the significant changes in contracts have been broadly welcomed by the dental service, with about 40 per cent of all practices being part of the reform programme before it was suspended prior to the pandemic.

So, we do have a significant contract reform programme to return to once the pandemic is over, and that should mean we have a longer term and more sustainable way of delivering the service, in terms of the financial envelope we have to do so, but also in terms of the value that dental services will provide to the patient in the new way of working that, as I say, has the broad support of dental practitioners.

And finally, question 8, Hefin David.

Having met our target to offer vaccination to JCVI priority groups 1 to 4 by mid February, we are making good progress in delivering vaccines to groups 5-9. Not only are we making good progress already, but today you'll be aware that the JCVI issued some updated advice in respect of group 6 for people with a learning disability. I expect to publish guidance later today, for both people with learning disabilities and indeed for unpaid carers, to clarify how they will be invited and how they will receive their vaccines within priority group 6.  

As a parent of a child with a learning disability, I declare an interest and welcome that decision. You've said the guidance, you're going to publish today, but the key issue that unpaid carers are asking me is: how will they be called? And I understand, if you could clarify, that will be in the guidance. Can you give us, here in this Senedd, the chance to explain—? Can I give you the chance to explain how those unpaid carers will be called for vaccination?

So, we've worked with national carers organisations to try to set out and explain how we go beyond the very narrow initial view that the JCVI provided about people in receipt of carers benefits. I think the JCVI guidance looked at a system in England primarily about the identification of carers on GP lists. We've had a different approach here in Wales, you'll be aware, with our carers legislation. So, if people have undertaken carers assessments, the local authorities will have an idea who those people are. We'll also have people who won't have undertaken a formal carers assessment who won't be on a list anywhere, but are undertaking unpaid carer duties. So, we're looking to have an understanding of how we understand who those people are and how we gather that information for the Welsh immunisation system to send out their appointments. We haven't followed the approach that England are taking by having people contact their GPs to go on a register. I think that would have the real risk of overwhelming hard-pressed general practice if unpaid carers were told to contact their GP. So, we've worked with national carers organisations to try to identify who those carers are, and to make sure that that information can then be provided to the Welsh immunisation system. I think the guidance will set out more clearly what that's going to look like to provide the clarity for people who I know have wanted to know how they will access the vaccination that is important for them and, crucially, for the person that they're caring for, and the potential risk of COVID getting to that carer, and what that means for the vulnerable person that they look after. So, later today I need to sign that off once I've finished questions, and that should then be able to go out later this afternoon.

You can go and sign it off now, Minister. That's the end of your questions for this afternoon.

So, the next questions are questions to the Minister for Mental Health, Well-being and Welsh Language, and the first question is from Jack Sargeant.

Diolch. Our immediate priority is to work with partners to respond to changing mental health needs due to the pandemic. Our revised 'Together for Mental Health' delivery plan 2019-22 sets out a range of specific actions, supported by the additional £42 million for mental health in our draft budget to support this.

Thank you for that answer, Minister. Now, we know that serious traumatic incidents can have a serious impact on long-term mental health, and I have raised with you before my concerns that we are not reaching people who perhaps do not seek help through the normal prescribed routes, and I should say that is through no fault of their own. So, with that in mind, how do we proactively support people in my own constituency who have suffered the recent trauma of flooding, and may not even recognise or spot the signs that they are in need of support?

Thanks very much for, Jack, and just to make it clear that I'm very aware that actually those kinds of traumas that impact people's lives is something that has come across to me very clearly during my time in this post. And it is something that won't come and go; it's something that can last for a long time. So, a trauma-informed approach to mental health is absolutely central to what we need to be doing. I know when it came to the flooding in the Pontypridd area that Mick Antoniw wrote a report, and I was very pleased to be able to get in touch on that issue with the health authority to make sure that they were providing some support there. I did the same thing for Dai Rees when there was a flooding incident in his area. And, of course, I'd be very happy to do the same for you.

But I think it's probably worth pointing out that, in relation to Natural Resources Wales, they have sent out to all communities a newsletter, and they have put in that newsletter a call centre number—our call helpline—and a number for them to contact Mind, in addition to of course those people who are younger perhaps, that they should be contacting Meic, which is our support centre for younger people. So we have encouraged health boards also to make sure that they work with local agencies to ensure that there is access to these services. But if there are any specific issues you want me to take up, I'd be more than happy to do that, Jack, as I've done for others.

Afternoon, Minister. Minister, do you think it's possible for us to do more—for Welsh Government to do more—to reach out to people suffering, or potentially suffering, from mental health issues in rural areas? As I sit here now, by the wonder of Zoom, I can see through the window passers-by walking by in my village. But I spoke to a constituent earlier who lives in one of the more deeper rural areas of my constituency, and she hasn't seen a passer-by for months, due to pandemic restrictions. So, it just seems to me that there are people out there who perhaps aren't being reached out to as much as they could be. I know that your strategy on mental health has been looking at ways that we can reach out to these people, so could you give a particular emphasis on mental health in rural areas?

Thanks very much, Nick. And I'll be doing a speech on this very issue in the St David's festival that'll be taking place in the next couple of weeks. So, I'm very happy to be giving this issue some attention, because I do think that there are slightly different issues when it comes to mental health in rural areas, in particular for middle-aged men. So, very often, what we find is that they don't particularly want to go to GPs, for example, because everybody knows each other in these areas. So, whilst in cities the issue very often is the lack of connection, there is, very often, a connection in rural areas where everybody knows each other's business and sometimes they don't want people to know that business.

The other thing I've been doing is liaising very extensively with a lot of the farming communities. I'm very aware that there is a particular issue in the farming community, where of course a lot of people are used to working alone—and of course we're all going through a lot of the experiences that farmers have had to put up with for years and years and years. But there is a particular issue there that I think we need to focus on as well. But I absolutely agree that we need to make sure that those measures are in place. Of course, they're able to access the services that everybody else can access, in terms of call centres, online support, but I am very aware that there is an older community that may want that face-to-face support. And of course, we'll be looking to make sure that, when we come out of this very strict lockdown period, there will be opportunities through our increase in funding to the third sector, that there will be facilities for them to access there.

Question 2, to be answered by the Deputy Minister for Culture, Sport and Tourism, and to be asked by Huw Irranca-Davies.

Thank you very much for such a timely question, Huw. We continually engage with the sector—all tourism sectors, in fact—through the tourism taskforce, which meets on a weekly basis, and the next meeting is to be held this coming Friday. And we also of course have the four regional forums in place. And the tourism barometer will be published early next month, and I do want to ensure that the necessary information about the demand for camping and domestic caravans is recognised as something that is crucially important at this point.

Diolch yn fawr iawn, Gweinidog. Thank you so much for that answer. I think you will recognise that many people from working families in our communities will not be rushing off for extravagant holidays overseas this year—they will be looking for cheap and cheerful but good open-air opportunities in domestic tourism. And it's an opportunity, in fact, to make sure that our tourism providers in all parts of Wales, who have struggled over the last year, get a welcome shot in the arm—not the vaccination, but a shot in the arm economically—but also so that some of those families can get to these sites.

Now, in those discussions, Minister, I wonder if you could raise the question with some of the smaller operators, particularly, of camping and caravanning sites, of whether they have sufficient COVID-safe facilities, because I know from experience last year that some of the smaller sites were unable to open because they didn't have simple things such as the ability to provide showers for people to stay overnight and do it COVID-safely and so on. Very simple. So, it might be that there's some scope there maybe even for some grant in aid or soft loans to enable some of the smaller sites as well in parts of Wales to open up. 

Diolch, Huw. I'm very much taken by that suggestion, and, indeed, Visit Wales is already working on the lessons learned from last year's reopening with the local authorities to see what we can do. There are interesting and difficult planning issues, of course. The 28-day rule already allows landowners to use land for tented camping only without formal planning permission, but I'm very keen that we should look again—this is a matter obviously to be discussed with my colleague, the planning Minister—at the way we can make our planning system both environmentally sound, but also open to the demand that will arise for the use of the open air and the countryside.

Minister, I listened very carefully to your answer to Huw Irranca-Davies there. As you will know, in Conwy and Denbighshire here, we rely heavily on tourism as an industry, and we have amongst the very best holiday caravan sites and campsites in the whole of the United Kingdom. They tell me that it's very important that they have a clear understanding of when they will be able to reopen again, and, clearly, if there is going to be a phased reopening, it does need to be cognisant of the fact that many people are owners of the caravans on those individual sites and will want to avail themselves of the facilities that they are paying for. So, can you tell us today what your estimation is of the dates on which these holiday caravan parks in particular will be able to reopen their businesses, to give some security to those caravan owners, and the site owners, about the ability to enjoy their holidays once again here in Wales?

Well, I think you will know from other occasions when I've spoken about this that I am the last person to ask about dates where public health issues are involved, because, clearly, as a Government, we've taken a very firm line that everything we do has to be within the context of public health. I'm aware that our neighbouring Government in England has decided to announce dates. Welsh Government will not be announcing dates, and I certainly don't intend to announce this afternoon any dates. But I will certainly take on board your point that we should make sure that all our businesses who provide such a valuable way of enjoying the Welsh countryside, as is provided by the caravan and camping sites—that all these businesses are informed in good time when opening will happen. 

Minister, the 'Visit Wales. Later' slogan was used to great effect last year. Those using caravans in Wales are often people, as Darren said, who own their own, and coming to Wales feels, for them, like coming home. I'm deeply concerned though about the anti-English, anti-incomer rhetoric used in Wales, and also in Scotland. It has been noticed by a lot of caravan owners, and they're saying that they really don't feel that they're welcome and they're thinking of leaving lock, stock and barrel. Will you condemn such rhetoric, and give an assurance that, once it is safe to do so, visitors will receive the warm welcome that they have come to expect over the years? Thank you. 

That's an absolute and strong yes. 

Questions now by the party spokespeople. The Conservative spokesperson, David Melding. 

Diolch yn fawr, Cadeirydd. Minister, you'd have heard in our joint session with the Youth Parliament the emphasis they place on well-being and good mental health. Many of them will soon be entering the workforce, so I'd like to ask what plans are in place, as we move towards the end of the lockdown, to support workplaces that promote well-being and good mental health.

Thank you very much, David. I can assure you that we've put a lot of work into—. In particular, when we come to the workforce who are on the front line, we've made sure that we've put a lot of protection in place for them, but we've gone much further than that when it comes to Working Wales. So, we have a programme, Working Wales. I think about 35 per cent of businesses and public sector areas, they have signed up to this, and they have made a commitment to really stand by their workforce to make sure they get rid of the stigma relating to mental health, and they are adapting what is happening in that space in relation to COVID. So, I'm very pleased to see that that's happening. 

And, of course, the other thing we've done is we've continued to fund Time to Change, which is very different from what's been done in England, unfortunately. I think it was a huge mistake on the part of the Conservative Government to cut the funding for Time to Change just in the middle of a pandemic. It was a real shame, because, actually, the one thing that we've done in this pandemic is we've talked about mental health in a way that has now become absolutely accepted. Everybody understands that it is a societal issue that we all have to take seriously, and I'm very pleased to see that happening, and that support in the workplace is absolutely really being driven alongside that project that we have in the Welsh Government. 

Well, Minister, I commend the change in attitude that's taken. I speak as someone who has for many years—in fact, throughout my service here—worked with a mental health condition. And would you commend, as I do, charities like Mind, and in particular Mind's workplace well-being index? That's a key tool, it seems to me, for healthy workplaces. 

I do want to shift focus now. As many people have been dislocated from their jobs—they've been on furlough for long periods of time, and alas some have now lost their jobs and they suffer the stress triggered by isolation. As unemployment rates are predicted to climb, though I know we did see a recent fall—and let's hope that continues, but the prediction is that unemployment will increase in the next year or so—what measures will be in place to promote mental health and well-being resilience in training and back-to-work programmes?  

Thanks very much, David. I think, just to pay tribute to the incredible work that Mind has been doing over the years, and we're very pleased to be funding Mind to really run lots of the projects that we're involved with in Wales—. And I pay tribute in particular to Sara Moseley, who will be leaving the organisation in the next few weeks, for all the work she's done with us in recent years.

Of course, mental health and well-being in the workplace is something that we all have to take very seriously. I do think that dislocation that you talk about is something that we have to take seriously. I'm very interested at the moment—. I'm reading a book about Johann Hari about lost connections, and I do think that that's something that we need to understand. It's the connectivity that is so important when it comes to mental health. 

The one thing that I can assure you, David, is that we, as a Government, are very aware that this is not just a health issue, that actually the relationship between mental health and socioeconomic issues is absolutely one and the same. And we are really fearful of a possible downturn when it comes to the economy and the potential increase that that may cause in terms of mental health issues. And that's why we're working very closely with organisations across Wales who give support in that space to make sure that, when we're giving advice when it comes to employment, we're also making sure that we are giving advice and pointing out where people can go to for advice when it comes to mental health services. So, I'm very pleased to see that, and I would encourage people to make sure they call our call helpline or access our online facility, SilverCloud. 

Well, thank you for that answer, Minister. I do think there will be a lot of work to do in various training and back-to-work programmes in the future, because many people have suffered real trauma in the way they have been forced to leave the workplace or their traditional work has been taken away from them. 

My final question, however, is that COVID has changed also the patterns of work, sometimes permanently, it seems to me, and we've seen this in much of the public sector. And I just wonder how the Welsh Government will ensure that, as the civil service and public agencies shift to greater home working, for instance, this does not reduce the level of support and constructive supervision needed to maintain good mental health and well-being in the workplace. We've seen a societal shift in this area, it seems to me, but it is one that needs careful management if we are to have maximum well-being.

Thanks very much, David. Absolutely, that pattern of working has, I think, changed forever; I don't think we'll be going back to the patterns that we had before and certainly, as a Welsh Government, we've got a commitment now to work towards that 30 per cent of the workforce working from home. So, that's a significant shift. And you're absolutely right: just because people are working from home, it doesn't mean that they don't need support. In fact, they may need more support because they are less connected. So, we are making sure, certainly from a Welsh Government point of view, that we're offering that support. What's really heartened me, though, is that the private sector have really started to understand this now. They've understood that, actually, when it comes to their workforce, their productivity is going to decrease if people have mental health issues and that's why they are putting support in place as well. 

I was very pleased to meet up recently with a group of employers from the private sector, who are really focusing on this issue, making sure that the kind of support that they're putting in place for their workers is really listening to the requirements that people are asking for. So, I do think that we also have to be sensitive to the fact that, actually, there may be people who find it very uncomfortable to work from home. You think about some people, in particular, maybe in domestic abuse settings, it may be very, very difficult for them. So, we need to make sure that we keep these lines of communication open for people and provide that option to get back to an office, if that is the way that they want to go in future.

Plaid Cymru spokesperson, Rhun ap Iorwerth.

Thank you, Llywydd. Will the Minister outline what steps the Welsh Government has taken to secure access to mental health services during the pandemic?

Well, we have ensured that that access is available and that it's still seen as something that is an essential service within the NHS. Of course, demand for services has increased during that period and that's why we have provided far more funding into this particular area. We've provided an additional £1.5 million to target that help at help in our communities, through the third sector. And I think, for me, that's a new emphasis that we must provide in order to take the pressure off the NHS, wherever possible, and to provide that care where it will be more sustainable in the longer term, within the community. 

I'm of course pleased to hear the Minister say that services and access to services are crucial. We're all agreed on that, but it's true that many people are having difficulty accessing the support that they need. If you look at Stats Wales data, we see that the numbers referred to mental health services at a local level reduced by over a quarter in the nine months to December, as compared to the previous year. The number of assessments fell by around a quarter too and the number of therapeutic interventions fell by 10 per cent in the same period. So, although we are hearing that these are crucial services, there are too many people who can't access them. So, what additional steps can the Welsh Government take in order to ensure that people who need that support can access it?

Thank you. The data published today does demonstrate that we have only just missed our target of 80 per cent of assessments being carried out—I think it was 78 per cent that we reached. So, I do think that it's positive that we were able to reach that level although there had been a huge increase in demand. One thing that concerns me is that the data refers to those under the age of 18 and that's below target and that's something that's concerning, but of course we've put a number of measures in place to provide far more support within our schools. And, of course, in the summer, we will be rolling out a new system where there will be early intervention in order to support young people. So, I do very much hope that we will be focusing on those, particularly young people, as 80 per cent of mental health problems, as we know, start among the under-18s.

Well, I'm pleased that you referred to young people, because, as you said, the stats demonstrate that young people do suffer more. And we know that the pandemic has had a very grave impact on the mental health of people and that young people have suffered more than anyone. Early access to care for young people is particularly important in trying to prevent problems from becoming more acute in the longer term, and that's why we in Plaid Cymru are talking about having this network of well-being centres for young people, where they can access mental health support immediately.

Now, you've referred to the data, but will you commit to looking in detail as to how we can make sure that that data is changed the next time it's published, and put a very clear plan in place that will note what support should be available and how that could be accessed, and also ensure, in addition to the additional funding allocated over the past 12 months, that mental health services, in primary care specifically, are given the resources necessary in order to cope with the demand now and in the future?

Thank you, Rhun. Well, of course, the figures that came from that survey conducted by the children's commissioner raised major concerns for us, the fact that 67 per cent of children between 12 and 18 had said that they felt sad some of the time or all of the time, and of course that is a cause of great concern to us. That is why we have targeted much of our work over the past few months in this area, and I want to pay tribute to the children and young people's committee that has done so much work in this area and have assisted us in terms of our direction of travel.

I do think that the additional support and the additional funding that will be provided to assist in schools—and I do hope that that will help—but we must ensure that that does link up with the early help and enhanced support. So, a new framework will be put in place in the summer in order to ensure that we do co-ordinate the offer available in school and the offer available within our communities, not necessarily through the NHS, because I'm very keen to ensure that we do use the third sector to assist us in this area too.

Well, I'd like to pay tribute for the real interest that Jayne Bryant has shown in this issue. I know she's just just asked the question to the health Minister on a similar subject, and I think it's absolutely right to focus on this. The Welsh Government fully recognises the incredible physical and emotional demands faced by our NHS and social care workforce, and we're really closely monitoring the impact and working with partners, to provide immediate additional support to respond to people’s changing mental health needs.

Thank you very much for that answer, Minister. Last month, I was able to hold a short debate to highlight the pressure on our front-line NHS and social care staff and what they've experienced over the last year. I was privileged to read out some powerful and emotive statements from nurses, theatre assistants, paramedics and practitioners about the realities of facing the virus. Staff are exhausted, both mentally and physically, and many have feelings of grief and guilt. It's clear that the consequences of COVID will be felt by those on the front line for many years to come. It's likely to have a legacy of mental health issues and people questioning whether they still want to, or are able to, stay in the job because of burnout. What steps can the Welsh Government take to target support on our NHS and social care workforce so that we do all we can to look after those who care for us?

Thanks very much, Jayne. I must say that I'm very pleased that we've been able to give an extra £1 million to enhance the support of the programme that we have, Health for Health Professionals Wales, and that psychological support, which includes a helpline. The Samaritans are there specifically to help people; there is a doctor who will be able to ring back within 24 hours. And what's really great is that we know that there's been a really good response to this provision.

Since that debate, I've been fortunate enough to meet the Royal College of Nursing and they were very clearly trying to outline to me the kind of trauma that people on the front line have been undergoing, and they know that's not trauma you can tuck away, that is something—. They haven't had a chance to process what they've gone through on the front line, and they're very aware that when it comes to this programme of intensity that they're going through at the moment, when they have time to process that, that's when the impact may hit them. And so they were very keen to emphasise that whatever we're putting in place now will not be able to be taken away, because that longer term trauma that we really have to consider, we will have to make sure that we are giving that support for the longer term, so I'm very pleased to see that. I'm very pleased to see also that the Royal College of General Practitioners have responded very positively also to the support we give to Health for Health Professionals Wales.

Minister, Jayne Bryant and I only heard this morning in health committee about the mental health impact on nursing staff, and the absolute need for them to have a chance to rest and recuperate. And so many are putting in long hours way above and beyond what they should be doing as they feel the responsibility to do so, but they need respite and looking after themselves. But, as well as this, and as part of NHS England's response, they've created hubs. These hubs are free of charge and offer confidential advice and support to NHS staff who, over the last year, have cared for millions of people with coronavirus, whilst keeping vital services like maternity, mental health and cancer care going. Minister, will you commit to studying these measures to see whether similar action could benefit NHS staff here in Wales? Thank you.

Thanks very much, Laura. Well, we don't set up these programmes without consulting with people to ask them what it is that they want, what it is that is meaningful and useful to them. One of the groups that I've been speaking to—. One of the issues, of course, is we've put a lot of support in place, but I was hearing that some people simply don't have time to access that support. So, if they come in in the morning, they feel like they've got to hold it together to do their work during the day, and by the end of their shift they just want to collapse. So, when is it that they can have that support that we're offering them? So, you're absolutely right: we need to make sure that there is some space to allow people to access that support when it's right for them. Of course, we do have alternatives; we've got online support that they can access as well. But I think we're going to have to think very carefully, when we see a reduction in the numbers in relation to the virus, despite the pressures that we've heard of from Angela earlier today—how many people are waiting—we really have to think about looking after those front-line staff and making sure that they do get some kind of break. I think we're going to have to ask the Welsh public to be a little bit patient, just to give these people time to breathe so that they can really get on with their work, because the last thing we want is to see these people leave the NHS.

Thank you very much, Vikki. Since launching 'Cymraeg 2050', the narrative around the language has changed considerably. We must build on this new momentum in order to ensure more access to Welsh-medium education, and we need to open more early years settings in addition to the 40 planned for opening. We also need to continue to provide exciting opportunities for people to hear and to use the language.

Diolch, Minister. Recent figures have shown that Rhondda Cynon Taf has the most pupils being taught through the medium of Welsh of all council areas in the Central South Consortium area, with just under 19 per cent of learners. Huge strides are being been made to improve the Welsh-medium offer in Cynon Valley still further through the Welsh Government's twenty-first century schools programme, with Ysgol Gyfun Rhydywaun being awarded £12.1 million for an expansion, which will allow it to accommodate an additional 187 pupils, and Ysgol Gynradd Gymraeg Aberdar being the recipient of £4.5 million, which will enable it to offer an additional 48 places. Minister, how are you working with colleagues in the Welsh Government and our partners in local government to improve the provision and the take-up of Welsh-medium education?

Thank you very much, Vikki. First of all, I want to pay tribute to the excellent work that they do in the council in Rhondda. It's incredible, the way that people have taken the opportunity to learn the language, and it's good to see that 19 per cent are already receiving their education through the medium of Welsh. But, of course, over the next few years, we need to see an increase in those numbers too, and that is why we as a Government have provided enhanced capital funding to ensure that the schools are available to assist with those projects. There will be an expectation that RCT, over the next 10 years, will increase those numbers to around 27 per cent of the population. Of course, in order to do that, we must ensure that there is a pipeline of those younger children coming through, and that's why we're always focused initially on increasing the numbers attending nursery provision, so that then they follow that route to Welsh-medium education. I very much hope that we will see that increase. It is incredible to see that difference, and I'm very pleased that we as a Welsh Government have been able to provide that additional funding, and also increase capacity at Dolau school. There are some ideas too in terms of changing the category of Penderyn school so it becomes a Welsh-medium school too. So, I hope that this will all lead to a huge celebration in this area when the Eisteddfod comes in 2024.

I'm sure the former head of Penderyn school will be very pleased to hear that news. Minister, what consideration have you given to establishing a digital fund for the Welsh language to support more use of everyday Welsh in the digital sphere? As you know, I'm eager to see everyday Welsh being normalised in day-to-day communication. It's a language for everyone, not just for some communities or some roles within the public sector, and, of course, the digital world is an increasingly important part of our daily lives. The Welsh Conservatives will include something of this kind in our manifesto to encourage, support and facilitate the use of Welsh online, and I hope you would agree with that idea.

We not only agree, Suzy, but we have a programme for Welsh and technology that is already in place. I provided an update on this just before Christmas to show just how far we've gone with that technology plan. It's become quite clear during the pandemic that we need to understand that our society has moved to a great extent online, and we must acknowledge that we need to consider the Welsh language in those discussions as to how we communicate online. That's why we've been pushing Microsoft, for example, to see if they can do more to ensure that we can use the Welsh language on Teams. They have now said that they are eager to see those developments, and we hope that will be delivered in the autumn. They've taken a while, but we do hope that we will now see a difference in that area.

During the pandemic, we've worked very closely with area planning boards and other partners. Thanks to the excellent efforts of our substance misuse services on the front line, as well as other services, we have provided additional guidance and support, including new treatment options and funding to meet the complex needs of this group.  

Organisations like Kaleidoscope, working as part of the Gwent drug and alcohol project, are concerned at the difficulties in ensuring good vaccination take-up amongst service users. Their front-line workers have very strong relationships of trust with those service users. They're in regular contact with them and understand the difficulties of chaotic lifestyles. Minister, would you agree that those front-line workers are well placed to actually deliver the vaccinations, given their own training and backgrounds and willingness to undergo any additional training that may be necessary? Allowing them to do that would be one way of ensuring good take-up of vaccine amongst this very vulnerable group. 

Thanks for your support and your interest in this very sensitive area. I was really pleased to meet with the Developing a Caring Wales group, and, of course, Kaleidoscope was there as a part of that representation of people looking after people in these very difficult situations. I heard in that meeting of their offer that they would like to make in terms of offering to vaccinate some of the most fragile people within our communities, with whom, as you say, there is a degree of trust that's been built up. I'm pleased to say that I did pass that information on to our vaccination team. Also, just in terms of the other priority groups, you will see today that we are going to issue new guidance—it has just been published, at 3 o'clock—in terms of people with serious mental health conditions. I think there will be people within the scope of the people who work with Kaleidoscope who maybe will come into that category. We've asked the health boards to make sure that they work with the third sector, with organisations like Kaleidoscope, to make sure that we can reach out to these more vulnerable groups who perhaps are not the kind of people who would go into a normal system. 

We've ensured that mental health services are essential services during the pandemic and have invested in a range of approaches to improve support. Preventing suicide is a complex issue and requires a multi-agency approach. We have strengthened arrangements, therefore, to improve the co-ordination of actions with partners including police, local authorities and the third sector.

I thank the Minister for that response. 

This is an extremely difficult and sensitive subject, as anyone who has lost a loved one to suicide will know, but I feel it is important that we talk about it so that we can be sure that everything can be done to prevent deaths. The issue came home to me last week after watching an ITV news report that included an interview with the leader of RCT council. He said that the suicide rate had doubled in the area during the pandemic, and I've heard concerning stories across Wales. The situation was already concerning before COVID, with Office for National Statistics data showing that suicides were at their highest for 20 years in the latest year for which data are available, which is 2019. The Welsh Government does have a suicide and self-harm prevention strategy, which is very welcome of course, but could you give me some more detail, Minister, about how the effects of the pandemic have been taken into account in delivering this service, and will you please set out the support that is currently available for people who are suffering from depression during the lockdown so that people can know where to turn to for help?

We have been able, with some additional funding, to appoint a national suicide prevention co-ordinator, and we've now got three regional co-ordinators to make sure we strengthen that partnership working. It's a very odd situation, because one of the things that we've tried to do is to make sure that we follow real-time information. Suicide is a really difficult area, because actually you have to wait until there's an inquest to get a formal understanding of what exactly has happened. That provides us with a problem, but rather than waiting for that to happen, we've got now these organisations, including the police, making sure they've fed into this task and finish group with us and the police to make sure we understand what's going on on the ground. 

I guess one of the heartening things is that The BMJ recently published a report to say there wasn't any evidence of a consistent increase in suicide rates during the early stages of the pandemic. So, that's the picture that they've seen, and of course, we'll just keep an eye on what's happening within this space, because of course, this is the most tragic situation and we have to do everything we can to make sure that we're assessing that. Health boards are required to report unexpected deaths of patients within 24 hours, and there's an expectation that there's going to be an investigation within 60 days, so that real-time issue is something that we're keeping an eye on.

We take the health and well-being of our workforce extremely seriously and encourage employers to provide a range of extra support during the pandemic. We are monitoring the impact closely and working with partners to provide immediate additional help to respond to people's changing mental health needs. 

I've listened with interest to your comments to I think it was Jayne Bryant and to David Melding. It's all about mental health and how we can keep our eyes open for people who are suffering. You will know as well as I do that organisations such as Mind have done endless surveys that show that public sector workers suffer disproportionately, take more time off work, and have greater mental health issues across the whole of Wales. I've had a number of e-mails from public sector workers in Carmarthen West and South Pembrokeshire just saying how hard they're finding it to manage lockdown, to cope with it, like so many of us. I just wondered are there any programmes that we can put in place or are there any ways of Welsh Government being able to encourage public sector organisations to be able to really try to reach out to those who are working on their own, isolated at home or perhaps in a very busy home where they're finding it very difficult to do their jobs because of all the noise around them. They may have young children at home who aren't at school and the whole situation is getting to them. Because if you have a person in front of you or in the office just next door, you can have a much better feel for how they might be. It's very difficult to tell when you're on a Zoom call to somebody once a week. Is there anything the Welsh Government can proactively do to help public sector employers really look after those employees?

Absolutely. I won't dwell on help for health professionals, because that's a specific programme we've got in place, but we do have Healthy Working Wales, of course, which is a programme that lots of public sector organisations have already signed up to. I know all seven of the health boards and the Welsh Government have signed up to this, and many local authorities, including Dyfed-Powys Police. So, there are lots of organisations that have already signed up to that. What's happened is that there's been strengthened advice within that programme in order to understand the new context of the pandemic. What is important also is that there are a number of programmes and organisations in the Hywel Dda area that are able to help in this space. We've got lots of different programmes, including the healthy and active fund. If we can get people to understand the link between mental health and physical activity, I think that is really important that we encourage people to do that, and I know that there are projects across west Wales that are helpful in that sense. So, there are plenty of places people can go for advice. The first thing to do, I think, is to go to the websites of the health boards. We've asked them now to update their advice on those to make those much more accessible, much easier to read, and every one of the health boards has now done that. That should be easier for people to access now and they should get that local advice that may be suitable for their area.

And finally, question 8, Rhun ap Iorwerth, to be answered by the Deputy Minister. 

I am fully aware of the pressure on the industry in Anglesey and I very much appreciate the relationship between ourselves as a Government and the local authority in Ynys Môn, under a strong leadership there. I'm pleased to say that we are continuing to seek ways of collaborating and also of securing adequate funding from the UK Government.

Thank you. The sector certainly needs further support. There are still businesses who are only receiving a little support, or virtually none—those who are self-employed, those who don't pay their staff through PAYE, businesses that opened too close to the original lockdown, those that are receiving the self-employment income support grants, but therefore haven't been eligible for the grants from the specific fund for the sector. There is one fund looking at commercial profits, looking at the threshold and another on turnover. I've received correspondence from a company running a number of restaurants—the staff are on furlough, but the owners can't pay themselves because there is no profit in the business.

These are very common stories. I want this sector to be fit and ready to reopen, so can I ask you what you are doing now to try and close these gaps? With the new normal being very different to how things were, when things do reopen—fewer customers in restaurants, for example, a bus company not being able to work, possibly—how do you hope to assist businesses in reopening on a phased basis? When will we have the kind of recovery plan that will engender confidence in the sector for the future?

Everything that we do as a Welsh Government is aimed at the recovery of the tourism sector, and other sectors. We have secured almost £3 million for almost 200 tourism businesses on Anglesey, and that is in addition to the grants that have been allocated very effectively by the local authority. That will continue.

I continue to meet regularly with tourism Ministers across the UK and I have to say that strong pressure is being placed on the UK Government by my fellow Minister in England, because he represents a rural area that relies on tourism, similar to what we have in Wales. That's how we're seeking to work.

I would like to have any information on anyone who is having such difficulties as you mentioned. Where they fall between the gaps between the Welsh Government and UK Government support programmes, we will look into that.

Thank you to the Deputy Minister and the Minister.

We now move to a topical question, which will be answered by the Minister for Environment, Energy and Rural Affairs. The question is to be asked by Adam Price.

Diolch. On 27 January, Welsh Government announced a further £6.5 million funding to support local authorities to respond to severe weather events. This includes support for households who suffered flooding in their homes or were evacuated, with payments of up to £1,000 administered by local authorities.

I'm grateful for that response. Can the Minister also tell us whether businesses affected by the most recent floods will be able to access the flood support grant fund that was announced earlier this year, specifically targeted at businesses? In looking at those communities that have been affected recently by floods, in my constituency and in nearby constituencies, will they now be given further investment from NRW in order to build flood defences and flood prevention programmes?

Specifically, in terms of prioritising those communities, I understand that there is a threshold, Minister, in terms of what's called section 19 reports where there have been floods. I think that threshold is around 20 buildings having been affected. Now, in a number of rural communities, it's a small number of properties that are affected, but they are regularly affected by flooding. I'm aware in my constituency, in Pontargothi, there are eight buildings that have been flooded three times in three months. So, would it be possible to look at the cumulative impact of flooding in rural communities, where there are fewer buildings, but of course you can just imagine how the residents in those buildings feel, having faced that kind of damage a number of times in a brief period. 

Diolch, Adam Price, and if we can just focus on Pontargothi, first of all, as you know, we met with a range of partners in relation to the flooding that happened, unfortunately, in your constituency. And I should just say there's no threshold set in statute when it comes to a section 19 report. We expect if 20 houses have been flooded that that local authority, or that flood risk management authority, would then bring forward a section 19 report, but they could choose to have a lower threshold and assess that in relation to each event. So, I would certainly discuss that with the local authority in relation to your own constituency. 

We have seen some unprecedented flooding over the past year, as you're aware, and I've made it very clear not just to NRW but to all risk management authorities that funding is available, and they should come forward with schemes that we can then consider. The Welsh Government has and continues to proactively manage and respond to flood risk across Wales. By the end of this term of Government, which obviously is only a few weeks away now, we have invested £390 million in our flood defences. So, the funding is available—there's still funding available—and whenever there is an event, that needs to be looked at by, as I say, either the local authority or NRW, and the funding is available from Welsh Government. 

Thank you, Minister, for that answer regarding flood defences. As I think all Members are aware, the flooding has posed major challenges in rural communities, including those in my constituency, and I'd like to pay tribute to those in the communities who've come together and supported those that have been worst affected by the floods. Can I ask you, in villages in Monmouthshire, the flooding has exacerbated already underlying capacity issues in the drainage and sewage network, and I've been in contact with Welsh Water Dŵr Cymru over a number of constituency cases? They've been very helpful. Are you as a Government liaising with local authorities and also Welsh Water to make sure that the network is being monitored properly, and is upgraded as and when necessary so that it is fit for purpose, so that when future flooding comes along, perhaps the problems aren't quite so bad? 

Absolutely. Welsh Water Dŵr Cymru are a valued partner in relation to this work, and whenever we have a—. You will have heard me just say in my answer to Adam Price that I met with him and a range of partners, and Welsh Water were part of that. But it is really important after any flooding event, we know how heartbreaking—. If your home is flooded, it's very, very stressful and very traumatic. So, whenever there's any flooding, it's really important that we find out the cause of that flooding, and sometimes it can be something that can be obviously rectified straight away, sometimes it needs a longer solution, and it's really important that our partners work with us, with local authorities, all partners together to look at those potential solutions. And a solution could be much longer term, and could be a new flood defence, so somewhere between something simple and, as I say, a new construction. So, it's just really important that everybody works together, and I know that has happened in Monmouth. 

Thank you, Minister.

The next item on the agenda is the 90-second statements. First up this week is Dawn Bowden. 

Diolch, Llywydd. On 21 February, we marked one of the many significant days in the remarkable history of Merthyr Tydfil and Rhymney. It was on this date in 1804 that the Trevithick steam engine made its first ever rail journey, nine miles from Penydarren to the Merthyr-Cardiff canal. This journey made Richard Trevithick and not George Stephenson the real father of the railways. And such was the scepticism on the part of the Cyfarthfa ironmaster, Richard Crawshay, that he placed a 500 guineas bet with Samuel Homfray from the Penydarren works on whether the train would actually be able to haul 10 tonnes of iron to Abercynon. He lost his bet.

Today, it's through our heritage that we remember this event through the Trevithick trial and, of course—and I remind the Deputy Minister for culture of this—the replica of the Trevithick engine is in Swansea, not in Merthyr Tydfil. There are now significant plans to develop the Cyfarthfa experience under the brand of the Crucible Project. In my view, Richard Trevithick and what he did in Merthyr Tydfil on 21 February 1804 should form an important part of that story. As National Museum Wales states:

'We cannot underestimate the importance of Trevithick's locomotive. In 1800, the fastest a man could travel over land was at a gallop on horseback; a century later, much of the world had an extensive railway system on which trains regularly travelled at speeds of up to sixty miles per hour.'

This

'remarkable transformation, a momentous occasion in world history'

was initiated in my constituency in February 1804. Diolch.

Monday 22 February marked the start of Fairtrade Fortnight, an important movement within the country, given that Wales became the first Fairtrade Nation on 6 June 2008. At the heart of fair trade is localism, and I'm proud to be a member of the Abergavenny Fairtrade Forum, which is a vibrant and enthusiastic team. The forum was founded in 2007 and has been very active since then. Over the past few years, I've been honoured to be invited to open various events in Abergavenny, such as the Fairtrade Fortnight finale, organised by local couple, David and Martha Holman, from the charity Love Zimbabwe. However, due to the current restrictions, all public events, such as the fair-trade breakfast and the pancake morning, have had to be cancelled. The forum has several online events, which can be accessed on the group's Facebook page. Fair Trade Wales also has numerous other online activities, which are featured on their website. This year's theme, as established by the Fairtrade Foundation is 'climate resilience' and the challenges posed by climate change to farmers and their workers across the world—something that I know is of great concern to Members here, and of which you'll be fully supportive. I'm pleased that the Senedd has committed to using fair-trade tea, coffee, sugar and biscuits on the Senedd estate, and whilst we're not able to be there at the moment, I do hope that you'll all join me in celebrating this fortnight with a cup of fair-trade tea or coffee at home.

Dr Julian Tudor Hart was one of the most influential and inspirational doctors of the twentieth century. He was a general practitioner who began his career shortly after the birth of the national health service, and most of his working life was spent as a GP serving the deprived mining community at Glyncorrwg, in my constituency of Aberavon. Here, he was able to further his research, combining his training in public health with the everyday care of his patients. He was able to study the effects of planned, anticipatory care over several decades, and thus was a strong advocate for preventative actions to avoid the need for treatment. He understood that effective primary care depends on a solid foundation of trust and continuity amongst all parties. This research led to the production of his paper on the inverse care law, which was published in The Lancet for the first time on 27 February 1971, thus celebrating its fiftieth anniversary this weekend. Dr Tudor Hart's work concluded that people in living in more deprived areas had higher death rates due to people's predisposition towards sickness as a result of circumstances or lack of a correct treatment. It was visionary, and became recognised throughout the world as a major piece of work on health inequalities, stating that the availability of good medical care tended to vary inversely with the needs of the population served. The paper considered the market distribution of medical care to be 'primitive and historically outdated'.

Market forces should not dictate the healthcare of communities. That should be based upon need and not status. I have strong socialist views and believe in this concept, that the need to address health inequalities cannot be owned by any one political party but should be owned by everyone. We frequently praise our fantastic NHS staff as they care for people across Wales, but if we wish to ensure that many people do not need to seek care in the first place, then we must continue to address the challenges that were identified by Dr Tudor Hart in his paper 50 years ago. It is concerning that the inverse care law remains as relevant today as it did 50 years ago. We must all commit to ensuring that it does not remain important over the next 50 years.

Good health is something we all wish for, and often take for granted. When our child is born, we hope for a healthy baby with the requisite number of fingers and toes. As we get older, we expect that medical advances will keep pace with our needs, and, if the worst was to befall, our healthcare system, with its plethora of research, medical interventions, drugs, and, above all, options, will soften the blow. But for those diagnosed with a rare disease, that is not always the case. Research into orphan conditions is often poorly funded, options are limited, and treatments usually incredibly expensive, and, on the grounds of costs and minimum need, often rejected by regulators and Governments. With that in mind, imagine being a SWAN: someone whose condition is so rare that all the science in the world can't pinpoint it—a syndrome without a name.

But there is hope. Today, all four home nations came together, in the week that we mark Rare Disease Day, to discuss the progress made by individual nations on implementing the UK rare diseases framework. In Wales, there have been some extraordinary improvements, but, nonetheless, access to treatments and support for the rare disease community is basically left to a handful of passionate and dedicated clinicians and the tireless efforts of campaigners and organisations such as Genetic Alliance UK, Rare Disease UK and SWAN UK. But we do have the opportunity, and the groundwork is in place. So, I ask that the next Welsh Government take up this baton and make it happen. Whoever you are, you have the ability to ease if not transform lives—please, take the challenge.

Thank you.

Item 6 on our agenda is a debate on a Member's legislative proposal for a British Sign Language, BSL, Bill. And I'm pleased to say that this debate will be interpreted live into BSL for those watching on Senedd.tv today. And I call on Mark Isherwood to move the motion. Mark.

Diolch. Based on official statistics, the British Deaf Association believe that 7,200 people in Wales use BSL, of whom 4,000 are Deaf. In October 2018, calls were made at the North Wales 'Lend me your ears' 2018 conference for British Sign Language legislation in Wales, looking at the 2015 British Sign Language (Scotland) Act, and their national BSL plan, published in October 2017, establishing a national advisory group including up to 10 deaf people who use BSL as their preferred or first language. Although the Wales Act 2017 reserves equal opportunities to the UK Government, Senedd lawyers have confirmed that a BSL (Wales) Bill would be compliant if it related to the exceptions listed in it.

The BSL (Scotland) Act was passed on 17 December 2015, marking a new era in the deaf community's campaign for the legal recognition of BSL across the UK. The Northern Ireland Assembly has also recently recommenced preliminary legislative work on both British and Irish sign languages. My proposed BSL Bill for Wales seeks to ensure that the deaf community and people with hearing loss have a voice in the design and delivery of services to ensure they meet the needs of service users, with actions including the establishment of a BSL national advisory group in Wales.

The British Deaf Association have told me that my proposed Bill is very important for their deaf members and supporters in Wales, who've been campaigning for a BSL Act in Wales for several years. Although they've been commissioned by the Welsh Government to develop a new BSL charter for Wales, they tell me that my, quote, 'planned BSL Bill is an enormous step forward, and if it's anything like the BSL Bill in Scotland, will receive unanimous and total support of all the parties.' 'It's a win-win', they said. They added their hope that this motion will be warmly received by the Senedd and convince the Welsh Government to establish a cross-party working group, where this coming together and working together was a critical factor in the success of the BSL Bill in Scotland.

My proposed Bill would make provision to encourage the use of BSL in Wales and improve access to education and services in BSL. In 2019, Deffo!, Wales's deaf youth forum, submitted a petition to the Senedd to improve access to education and services in BSL. They state their disappointment that nothing has happened since then and that one of the most important things is that BSL starts in early years and is continued through the whole of educational development. On National Deaf Children's Society—or NDCS—Cymru's advice, the Welsh Government established an advisory group on access to the new curriculum for BSL users and to develop guidance, which is currently out for consultation. However, an independent review of opportunities for families of young deaf children to learn sign language, published by the Welsh Government, confirmed NDCS's view that opportunities are far too limited, and that many families of deaf children want to learn to sign to aid communication with their deaf child, but feel unable to do so. The Royal National Institute for Deaf People state that weaknesses in the 2011 census resulted in many people who use BSL not being captured. They say that experience from Scotland has shown that their national advisory group have struggled to get local authorities to engage with and develop their BSL plans, suggesting that any future BSL legislation in Wales must place duties on local authorities and be sufficiently enforced. As they state, a BSL Bill would not be a means to an end in itself, but act as a platform to ensure improved services for the deaf community and people with hearing loss, and improve the support currently offered, so people can fully engage in things like employment and education. As they also state, the Bill should be seen as a piece of enabling legislation, to help focus efforts to improve BSL skills within public services and address communication support, so costs are not borne by the people who need additional help to tackle the barriers faced by D/deaf people and those with hearing loss, when the cost of BSL classes is so high. 

RNID staff want to see improved access to education and lifelong learning, employment, volunteering, media and news and arts, culture and leisure. It is the view of Senedd legal services that a Bill about British Sign Language similar to Scotland's British Sign Language (Scotland) Act 2015 would be within the Senedd's legislative competence, and the wording of my legislative proposal has been drafted with them to achieve this. The only potential issue will be whether this Bill would fall under the equal opportunities reservation under paragraph 187, Schedule 7A of the Government of Wales Act 2006. In January 2004, the Welsh Government recognised BSL as a language in its own right. The exclusion of language in the definition of equal opportunities reserved to the UK Government in the 2006 Government of Wales Act suggests that the equal opportunities reservation would not apply. Scotland is also subject to the equal opportunities reservation, and the Scottish BSL Act provides a good precedent for Wales, where Senedd legal services are not aware of any legal challenge to the Act by the courts. As a D/deaf constituent told me, 'This BSL Bill is important. BSL is a language in its own right, with its own grammar and vocabulary, which enables many of our deaf, deafblind, and hard-of-hearing citizens to learn, work, be creative, live life to the full and make their contribution to our culture and our economy.'

I hope Members will support my proposal accordingly. Thank you. 

First of all, can I put on the record that my sister is profoundly deaf and uses sign language? I will be supporting the Member's legislative proposal today, but we're so close to dissolution it is very unlikely to succeed in becoming law before we dissolve. But that's no reason not to support it. In 2018, the Petitions Committee produced four recommendations, all which I agreed with. If you want to know what it's like being deaf, put the television on, watch a drama and turn the sound off, because that's the life they live. That is what watching television is like for people who are deaf. 

The Welsh Government should support British Sign Language as a minority language, and encourage local authorities to recognise it as the first language of very many deaf people. Because you've got to remember that we have three first languages in Wales, and British Sign Language is one of them. And before somebody says, 'What about Welsh sign language?', because of the way sign language exists, it's much more akin to Japanese and Chinese and other languages that are based on pictures and signs, as opposed to vocabulary. 

The Welsh Government should give consideration to the development of a national charter for the delivery of services and resources, including the education of deaf children and young people. We need deaf people to be educated through sign language, because that's what they understand. We believe—and this what the Petitions Committee said—that a charter underpinned by the Equality Act 2010 would enable local authorities to plan and resource support, with a nationally recognised framework to ensure consistent arrangements throughout Wales—we haven't got consistency of provision; some areas are better than others—and the importance of sign language to actually get information across. The Petitions Committee also welcomed that the Welsh Government has indicated British Sign Language is actually being considered in the new curriculum. It needs to be part of the curriculum, not only for deaf children, but for children who aren't deaf, so that they can speak and correspond with children who are deaf.

A lot of basic sign language can be learnt relatively quickly, like a lot of most languages can be learnt very quickly. It gets much more difficult with time, but there are probably over 50 or 60 signs that would get you around quite well. So, it's really important. And, saying that, we should have a GCSE in sign language. We've got nowhere with that—'It's because there are not many applicants or potential applicants.' I've looked through some subjects the WJEC supports. A number of them have under 100 people entering them each year. So, that is no excuse. This just demands, and I really am pushing for this, somebody to take this on and show some leadership and aim of doing something on behalf of the deaf community in Wales. 

We need as a minimum to introduce a minimum standard of BSL qualification for learning assistants supporting deaf children and young people. There isn't any. I could work as a learning assistant in a school with deaf children because I know a small amount of sign language. I don't think I'd be suitable. I'm sure you don't think I'd be suitable either. 

Finally, we've had petitions, we've had debates, before, but I have come, unfortunately, around to the conclusion that the only way we're going to get action is by legislation. So, I will be supporting this legislative proposal, even though I'm doubtful that we will get it done before we break in March.  

I'm very pleased to support Mark Isherwood's motion, which asks us to note a proposal for a Bill that would make provision to encourage people to use British Sign Language in Wales and to increase access to education and services through the medium of BSL.

Now, over the years, as a GP, and, in more recent years, as chair of the cross-party group on deaf issues, I have become very much aware of the whole host of challenges facing the deaf community, including the range of solutions to those challenges, and Mike Hedges has spoken very well about those. BSL is one of those solutions. 

Now, in an ideal world, the majority of our population would, naturally, respect the rights of any minority, looking at everyone as being equal. But, as we know, that isn't always the case, with the expectation that the minority will comply with the priorities of the majority for all sorts of different reasons. So, we must safeguard the rights of the minority through law. We cannot rely on the goodwill of the majority. It is law that allows a change of attitudes, as Mike has just outlined. We have seen this in a number of areas already. And, in the linguistic context, we have seen legislation in the area of the Welsh language in order to secure rights and services through the medium of that language in Wales. Well, I would argue that the need is exactly the same with BSL. We need legislation. Mark Isherwood has already outlined the case in favour. There is a need, as many of my constituents have told me over these past few days, once they discovered that this debate was taking place today.

A Bill or a piece of legislation isn't going to transform the situation overnight, clearly, but it is a way of showing respect and giving credibility to valid beliefs on the dire need to develop further training, more job opportunities, better communication and, in general terms, to enhance the lives of deaf individuals within our nation. Although BSL is the only language of many of the deaf community in Wales, it does not have legal status. So, support this motion today in order to change that. Thank you.  

Firstly, I would like to thank Mark Isherwood for bringing forward a legislative proposal that would help us to create a better Wales. It is a sad fact, however, that the BSL community continues to face such challenges, even after the petition submitted by Deffo!, which then called on the Welsh Government to improve access to education and services in BSL to improve the quality of life for D/deaf people of all ages. Our nation has simply not delivered and I wholeheartedly agree with introducing the requirement that public bodies co-produce and publish their own BSL plan to develop awareness, training and improved access to front-line services.

As Members of the Senedd, we truly represent residents who use BSL, so I thought it essential that my own office team and I strove to learn. This should be the case across front-line, public-facing bodies in Wales, so that services are at least trying to be accessible to the around 7,500 people who not only use BSL, but rely on it in Wales. We need to empower this community. Now that requires us to have a Welsh Government that acts on the Children's Commissioner for Wales's findings that there is a blatant lack of support available to ensure that family members can use BSL. With a lack of communication skills, this, therefore, places an unnecessary and unfair barrier between BSL users and their families.

Now, a Government that addresses the terrible fact that only half of all adult BSL courses were fully funded by the Welsh Government, that has to change; a commitment to tackling the finding by the National Deaf Children's Society that not all online learning resources are accessible, despite schools being required to make provisions available under the Equality Act 2010; and legislation that helps to address the unacceptable fact that levels of support provided by local authorities vary, I can see no better way of achieving this than through this proposed Bill and the establishment of a BSL national advisory group. In fact, we could go so far as backing Professor Graham Turner's suggestion of a signing Parliament, to boost engagement in securing positive changes across Wales. We need to see progress, so I do hope that the Bill would also explicitly require the publication of BSL performance reviews.

I endorse all the comments made by the speakers previous to me today. I am pleased to be voting in favour of progress and this particular proposal, and I would ask all my Senedd colleagues to do the same. Thank you. Diolch. 

As the British Deaf Association has told us in their lobbying letter, Labour, Plaid and the Lib Dems have all committed to supporting a British Sign Language Act in their general election manifestos, so I hope that these proposals will get full support today. Like Janet, I learnt some basic British Sign Language when I first became an Assembly Member. I'm very sorry, I've already forgotten so much, but watching the signing at the Welsh Government's COVID press conferences makes me realise how important it is and it also makes me notice its absence at the UK briefings and I think that's worth me, as a Conservative, calling that out.

As I suggested in my short debate on modern foreign languages a couple of weeks ago, using another person's preferred or necessary language goes far further than a simple exchange of information; it makes you ask questions about others and questions about yourself. As Mike says, that's no different for British Sign Language either. And it's something that the new curriculum embraces, and I hope it's something that teachers will find exciting enough to want to teach, because it's something much bigger than perhaps we all expect. As the BDA says, BSL is not just a language, it's a gateway to learning, a path towards a sense of deaf identity and the means whereby deaf people survive and flourish in a hearing world, and that should surely interest us all. If twenty-first century schools are really about the twenty-first century, then deaf awareness should absolutely be built into every new design.

If the Welsh Government's been keen enough to look at Scotland for inspiration for minimum alcohol pricing and the new curriculum, I hope it'll do the same here. The Act that Mark has already mentioned has led to some positive improvements in service provision for BSL users in Scotland, with the Act upgrading BSL, as we heard, from a minority language to a language in its own right. But I think the key thing is that public services have started to pay attention. Glasgow City Council is creating a secondment opportunity for a deaf BSL user from another organisation to assist with their BSL work. Dundee City Council has a deaf person as an apprentice—the beginning of something really quite exciting. The Scottish Government and Scottish Parliament have created roles specifically tailored for deaf people. And 20 colleges and universities have already progressed well in terms of accessibility to their websites, application processes and student activities, as well as providing BSL training for staff and students, and there have been improvements in the other universities and colleges for interpreting provision as well. NHS Scotland, the health boards of Scotland, have done a lot of work to help implement the Act, although they still complain of a lack of deaf BSL representation and they're trying to deal with that.

So, it's quite right that there continue to be some challenges; a piece of legislation doesn't solve everything. The rural councils in Scotland are finding it difficult to access BSL interpreters, for example. But that need for BSL awareness and empowerment training, as well as collaboration across the public sector, is something that a piece of legislation can fix, and that then leads more widely, as a magnet, if you like, to more being done to empower deaf people through employment. So, it's not perfect, but at least they've started in Scotland, so we need to do that as well. Thank you.

Thank you. Can I now call the Deputy Minister and Chief Whip, Jane Hutt?

Thank you very much, Deputy Presiding Officer. Can I thank Mark Isherwood for bringing forward this important Member's legislative proposal and for the stimulating and important debate contributions from Members across the Chamber this afternoon? Also, I'll just say how important all of the purposes are of such a Bill that you put forward today in your proposal, Mark Isherwood, and I want to respond to all of those, as well as obviously noting your proposal.

I am very pleased to say that I was the Minister back in 2004, believe it or not, the health and social services Minister who enabled and supported the Welsh Government's stance that we would formally recognise British Sign Language as a language in its own right. That was back in 2004 and there are some Members here who'll recall that, who were there at the time. Actually, I do want to pay tribute to yourself, Ann Jones MS, as you were, with a former colleague, Karen Sinclair, very, very engaged at that time in making sure that the Welsh Government did respond. That was 2004—a long time ago—and at that time we were breaking new ground, and I always remember Karen Sinclair, as you reminded me this morning, Ann, speaking, as we did at the lectern, having a signer there on that occasion in 2004. So, just one of your legacies, Ann Jones, from your time here in this Senedd.

But it was important to make that statement back then in 2004, and since then we've supported training to increase the number of qualified interpreters in Wales, and ensured that all legislation, policies and programmes across Wales recognise the importance of accessible communications. I very much welcome the fact that we have a signer here today. Also, thank you, Suzy Davies, for acknowledging that, actually, awareness is raised by having a BSL interpreter at the Welsh Government COVID-19 press conferences. In fact, we were the first Government in the UK to do this, and it does make a clear statement, but it ensures that the language is accessible.

Of course, we know that more needs to be done. We have been exploring options to develop a national BSL charter for the delivery of services and to provide resources to deaf children, young people and their families, and that's come over very strongly in the debate and in Mark Isherwood's proposal. I recently agreed funding for the British Deaf Association to undertake an audit of our BSL policies and provision in the Welsh Government. The audit is crucial to show where we're going, what the gaps are and what we need to do. That work has just commenced. It will conclude in July of this year; it will result in a report; it will assess the Welsh Government's policies and services, and recommendations will come from that to inform an action plan and proposals for ongoing engagement with the deaf community. Whilst the proposal for the BSL Bill, as I said, is duly noted and recognised, we do need to review this at that stage, once the British Deaf Association's audit and recommendations on Welsh Government services and policies is complete.

In the Welsh Government, we have put in place a very good mechanism in which the views of our stakeholders are heard. Our disability equality forum, which I chair, covers membership from a wide range of stakeholders, including the Wales Council for Deaf People and the Royal National Institute for Deaf People. The forum provides an opportunity for all partners to advise and influence the Welsh Government on the key issues that affect disabled people in Wales, increasingly important during COVID-19, when the forum has met frequently, ensuring the voices of disabled people are heard.

We did set up, last June, the accessible communications group to overcome barriers and improve access to information during the COVID-19 pandemic. The outcome of the group's work is currently being finalised. A commitment is forthcoming from the Welsh Government to provide more information in a number of communication formats, including BSL.

As part of the BSL audit process, the British Deaf Association is arranging a number of events with the deaf community in Wales to ensure that deaf people have an opportunity to express their views and share their experiences of accessing services provided by the Welsh Government. We will ensure the involvement of as many deaf people as possible in the planning and action stages as part of our co-production values, which I know Mark Isherwood would welcome.

The Welsh Government is currently consulting on the Curriculum for Wales's BSL non-statutory guidance. As with other aspects of the Curriculum for Wales, this draft guidance has been developed through a process of co-construction. The guidance will be refined to reflect feedback from the consultation; it'll be published in autumn 2021 as part of the languages, literacy and communication area of learning and experience. The Curriculum for Wales will be rolled out, of course, as we know, from 2022.

Also, officials recently commissioned the Learning and Work Institute to undertake a round-table event in March 2021 to engage with the deaf community and wider stakeholders on the recommendations from the independent review of BSL provision for adults in Wales, and that independence is crucial so that we get this right. We'll focus on the demand for BSL, consideration of how provision is currently delivered, what improvements could be made, and where there are gaps in provision and access. That will, of course, inform further policy considerations for BSL provision for adults in Wales.

Finally, Deputy Presiding Officer, we've got the BSL audit and BSL consultation engagement event, a strong basis to consider our BSL support services in Wales, how they might be improved and how skills may be enhanced right across Wales. Once the audit process is complete, we anticipate signing up to the British Deaf Association's BSL charter. As an organisation, this will allow us to lead by example and promote good practice, and, indeed, consider those opportunities that we have, as you've brought forward today, Mark Isherwood.

Could I just finally say that next week, of course, as we celebrate St David's Day, there will be a BSL choir showcasing Wales to the world? I hope you will take note of that as we celebrate St David's Day. Diolch yn fawr. 

Thank you. No Member has indicated that they wish to make an intervention, therefore, I'll ask Mark Isherwood to briefly reply to the debate. Mark.

Thank you. Well, I thank Mike Hedges for his comments: 'The proximity of the election is no reason not to support this proposal; we need leadership to do something on behalf of the deaf community in Wales.' Dai Lloyd: 'There is a need for this legislation; we must safeguard the rights of a minority through the law.' Janet Finch-Saunders says, 'This legislation will help us create a better Wales, making services more accessible to people who rely on BSL in Wales.' Suzy Davies says that BSL is not just a language, but a sense of identity, and deaf awareness should be provided in every school. The Deputy Minister, Jane Hutt, as I've said in my speech, reminded us that in 2004 the Welsh Government recognised BSL as a language in its own right, but as D/deaf people across Wales have told me, although this was necessary, it is not sufficient.

Deafness is not an intellectual impairment, yet D/deaf learners generally have a lower educational attainment than hearing children. That's a disgrace. The Children's Commissioner for Wales has previously identified a lack of support available to ensure that family members can use BSL—a disgrace. As the British Deaf Association state,

'BSL is not just a language; it is also a gateway to learning, a path towards a sense of Deaf identity, and the means whereby Deaf people survive and flourish in a hearing world.'

Giving BSL full legal status in Wales would ensure that it has the same protection as the Welsh language. Existing legislation does not meet the needs of BSL users or the wider D/deaf community. As BDA Scotland said, in evidence received by the Scottish Parliament's Education and Culture Committee on the British Sign Language (Scotland) Act 2015, the UK Equality Act 2010

'accords rights to individuals to protect them from discrimination but it does not protect or promote BSL as a language.'

The same applies to existing Welsh legislation. I urge all Members to support this motion accordingly.

The proposal is to note the proposal. Does any Member object? [Objection.] I see objections, therefore we'll vote at voting time.

Item 7 on our agenda is the Welsh Conservatives debate on the Wales-wide nitrate vulnerable zone and I call on Janet Finch-Saunders to move the motion.

Minister, it is a sad reality that your draconian NVZ measures that you're introducing are now bringing your own Welsh Government's honesty and integrity into question. Indeed, at least eight times you have promised not to do anything whilst we are in the middle of this COVID pandemic. Responding to me in Plenary on 3 February, you claimed that the voluntary scheme you had worked with NFU Cymru to deliver had failed. That simply isn't true. In fact, the blue flag farming approach was not backed by Welsh Government when farmers actually applied for funding through the RDP sustainable management scheme.

Shockingly, it is my understanding that despite project results and water standards being shared in letters to you and the First Minister in March 2020, including recommendations for next steps and a response being issued by officials stating that detailed consideration will be given to the water standard, NFU Cymru have yet to receive a further reply. Despite industry organisations committing to the Wales land management forum sub-group on agricultural pollution and the group submitting a progress report to you with 45 recommendations in April 2018, as of earlier this month you had not responded or even met the expert group. Clearly, you have written off the voluntary approach far before giving it a proper chance.

Earlier this month, the First Minister claimed that we've seen no diminution in the rate of agricultural pollution. That again is not correct. You yourself have acknowledged that there has been progress over the last four years. NRW's executive director for evidence, policy and permitting had spoken of a steady decline in pollution incidents in the last two years, and a clear downward trend of 28 per cent has been observed over the last three years. In trying to justify these regulations, you have referred me to NRW's dairy project. You informed this Parliament that 50 per cent of the dairy farms visited are not compliant. I tabled a written question asking you to clarify what steps officials took to examine reasons for non-compliance. You responded on Monday stating that you will thoroughly analyse the results once the project is complete. I think you know where I'm going with this. You may recall also in committee this month that you told me that, and I quote,

'In relation to the costs around the agricultural pollution, as I said, there is a higher cost if we don't do anything.'

Again, you're wrong. Your own regulatory impact assessment estimates that the upfront capital costs of the NVZ could run to £360 million. That's £347 million more than the assistance you are actually offering, £99 million more than the latest total income from farming in Wales. In fact, according to the RIA, over 20 years, the total cost is over £1 billion to our agricultural sector. Why are you making farmers spend these ridiculous sums of money that they don't have, between now and 2040, for benefits worth £153 million? The costs are £950 million more than the actual value of the benefits. In fact, Griffiths's great big gap between cost and benefit could be even larger, as the explanatory memorandum states, and I quote:

'Due to the large range of potential environment costs associated with these pollutants and the variability of farm types and practices, there can be no certainty of the cost benefit ratio.'

Why do you claim that these regulations are proportionate? Why increase the number of holdings affected by NVZs to over 24,000, when huge swathes of Wales have seen zero incidents during the last decade? Why make a mockery of Brexit and devolution by choosing a European option when we should be looking to work with farmers to develop a voluntary Welsh solution? Why pursue an NVZ when a study by your beloved European Commission found that about half of European monitoring stations on nitrates showed no significant change, and a further 26.6 per cent presented increasing trends of nitrates? Why push Wales into an all-territory NVZ when Denmark and Ireland have applied for derogation?

For the sake of Welsh farming and, indeed, for our farmers and custodians of our countryside, we need to halt the progress of this. Minister, I do hold you in high regard, and I realise it is a large portfolio that has some difficulties. One incident of pollution is one too many. But I will say to you, in all honesty, and in all earnest: it is not above somebody to be able to say, 'I am listening to my farmers, I am listening to the people of Wales, I am listening to my elected Senedd colleagues.' Change your mind on this decision, Minister, and let's change that lack of trust now into respect. Thank you. Diolch.

I have selected the amendment to the motion and I ask the Minister for Environment, Energy and Rural Affairs to formally move the amendment tabled in the name of Rebecca Evans.

Formally.

Members will be aware that I tabled a motion to annul these regulations that will be debated and voted on next week, but it's good to have an opportunity to air some of the arguments as we prepare for that important vote. Of course, we will be supporting this motion today.

I oppose these regulations not because there is no water quality problem in some parts of Wales; I oppose these regulations because these regulations are not the right solution to tackle this problem. The regulations are disproportionate, they will have unintended consequences for the environment and, of course, they will undermine the viability of many Welsh farms. Why are they disproportionate? Well, Natural Resources Wales has recommended that 8 per cent of Wales should be placed within NVZs, targeting those areas of Wales where there are problems. But, of course, the Welsh Government has ignored that and has gone for a 100 per cent approach, even those areas that haven't seen any cases of agricultural pollution over the past decade. We know that the trend across Wales has fallen. When you look at the cases year on year over the past three years, they're down 28 per cent in that period. So, yes, target where targeting is needed, make regulations where you need to regulate, but don't place this unreasonable burden on every farm in Wales and every acre of Welsh land, even where it is not an issue that causes concern. This Government needs to be far more sophisticated and more appropriate in this place. Follow the data and follow the science—that's the Government's mantra when it comes to COVID. Well, do the same in this context.

There will be unintended consequences for our environment. Using the calendar to spread slurry is absurd, and the Minister herself acknowledged that she found it difficult to accept that that is the best approach in this area. Weeks before the time where this can't be done, and weeks after it has come to an end, there will be huge spikes in the nitrate levels in land and water as every farm in Wales clears their stores simultaneously. That will create pollution problems in areas where there are no pollution problems currently. The only option for many farms, particularly in those less-favoured areas, which, perhaps, keep 20 or 30 cattle, will be to get out of keeping cattle because of the cost, and that will mean that we will miss out on the environmental contribution made by grazing those cattle in terms of biodiversity and habitats, particularly in our upland areas. In losing those cattle, what you will see is farmers being forced to introduce more sheep on those lands, which will graze harder and damage those habitats. If you do keep 20 cattle, then the cost of paying for this infrastructure to store worth three of four months of slurry is going to be beyond those people's reach. The Government will say, 'Well, we're providing some £11 million to support', but that's laughable. That's less than £1,000 for every agricultural holding in Wales. I know about one farm that's been quoted £300,000 to put in place appropriate agriculture on the farm to meet the needs of these regulations. There's no way that farm could afford that investment, even if the Government were to contribute half the cost.

I will conclude with this—

Can I ask the Member to wind up, please?

Okay. They are impractical regulations, they are regulations that can't be delivered without creating economic and environmental disruption to farms across Wales, and they will come into force a week before the original day that this Senedd is to come to an end. There's an election in a matter of weeks; don't rush these regulations through. Take a step back and reconsider.

Can I remind all Members that it's a 30-minute debate, and it's a three-minute contribution? Actually we've oversubscribed on the number of speakers, so some of you will be disappointed. Jenny Rathbone.

I think this is an important debate to ensure that people realise in the farming community that we are listening to them, but I think there has been some exaggeration of what the problem is as far as what we're asking of farmers. We're asking farmers not to pollute the land and not to pollute the rivers, and that is a perfectly rational and civilised ask. We can't go on having nearly 3,000 substantiated agriculture-related pollution incidents over the last 20 years. We've had more than three each week in the last three years. There's been loads of discussion going on between the Minister and representatives of farmers over the last five years, and the farming community has simply not come up with the solution that we need to see. We can't have zones where we have regulation and zones where there is no regulation. You wouldn't expect to see that when it came to a butcher's shop or a hospital—'We'll have a bit of regulation here but not there.' It seems to me that of course we need to listen to our farmers, but I just think that they have been made overanxious, and doing nothing is simply not an option.

Lord Deben, who chairs the Climate Change Committee, is coming to talk to the climate change committee here tomorrow, and he would be pretty shocked if we weren't doing all we needed to do to reduce our emissions. This is one of the ways in which we can do it. Money is available to help small farmers put in suitable places for storing the muck that they need to store. There's always been this phrase that there's money in muck, and I do not understand why it is not possible to make it into a marketable commodity in order to enrich the land and make it easier and better to grow crops on. This seems to me a really significant issue, and I think that the overspecialisation of farming with these mega dairy farms is really going to be a major source of the problem here. We need to ensure that the circular economy applies to farming, just as much as to plastic bottles.

So, I really do hope that we can find some resolution of the fine detail of this problem, but probably not in a 30-minute debate. We need to be looking at this in the climate change committee to see if there's anything here we can do to ensure that small farmers are not going to be put out of business by being compliant with the existing regulations, never mind anything that the Minister thinks we need to do to improve on them. We have to remember that this is all being done in the context of being warned that one third of all the fish and freshwater invertebrates in our fresh waters are due to be exterminated in the not-too-distant future, and, therefore, we have to act now to protect our environment, protect nature and ensure that we have sustainable farming that does not undermine other aspects of our economy.

Minister, I do want to be clear on this matter, I think it is vital the Welsh Government bring forward proposals to tackle pollution in Wales, but I do not believe this is it. Recognising the need to protect our environment, at the very beginning of all of this, I supported the calls for there to be a mixed suite of methods for farmers to be able to use to reduce nitrate levels on farms. I recognised that a one-size-for-all solution would not be the most environmentally effective or financially stable way forward, and I find it extraordinary that you've taken the decision to introduce a Wales-wide nitrate vulnerable zone, despite the compelling evidence that came before you. I'd like to point out to the previous speaker we already have nitrate vulnerable zones in certain areas of Wales, my patch of Carmarthen West and South Pembrokeshire being just such a one, you don't need to have it over the whole country.

Responses from farmers and land managers highlighted they'd be unable to afford the proposed all-Wales NVZ, and the vast majority of farmers actually use very little nitrate fertilisers. Seventy-three per cent of farms that produce slurry not have sufficient storage on their farms capable of meeting the proposed requirements of two and a half months' storage. Not only will the cost of this requirement put some farms out of business, even those who will decide they can achieve it will face issues with funding, with planning—try getting planning—and physically doing it in the short transition period. And remember, Minister, this places more pressure on already hard-pressed farmers who are dealing with a loss of cash due to COVID-19 and uncertainty over the post-Brexit plans.

Then there are the closed periods for spreading. As any farmer will tell you, you cannot farm by the calendar, you farm by the conditions. So, for example, here we are in late February and farmers could in theory be spreading slurry in very wet conditions, but could not have taken advantage of all the dry spells between 15 October and 15 January. The end result of this requirement will be very high risks of pollution before and after the closed period, something that's very common in Ireland.

I think the other major area I just want to briefly mention is the issue of no derogations for a limit of N produced on-farm. Farmers tell me this is the biggest issue with the regulations. The regulation stipulates that a farm cannot exceed 170 kg N N/h. In all the other home nations, a derogation lifting this figure to 250 kg is offered to farms of 80 per cent of the farm down to grass. It was in the draft regulations, but it's gone missing.

I could talk about the fact that I think that this is a quota on production per hectare and that it will have consequences on the price of land and consequences on the downstream business that comes out of farms. I'd like us to talk about the mental health issues, I'd like to talk about the difficulties of record keeping, but I think I just want to end with my utter frustration, because I've lobbied you and previous Ministers on actually tackling the sinners. You could have used a slingshot and got the guys who laugh, go to the bank, laugh at NRW, ignore NRW, pay their fines, trash their local communities and carry on regardless. Instead, you've used a sledgehammer to crack a nut. I do not believe this is the way forward, Minister, and I think you should reverse your decision. 

I and my group shall be supporting the Conservative motion. The regulations implementing a blanket set of slurry regulations for the whole of the Welsh farming industry are totally disproportionate, both in cost and implementation. It appears yet again that the many are being punished for the actions of the few. It may also be the case that, even with the few, the majority of pollution accidents were unavoidable or simply, as in life in general, a matter of simple mistakes. Even these, as has been said before, have fallen by over 24 per cent over the last three years. The Welsh Government say they have set aside £22 million to help farmers to implement the changes needed, but even a cursory glance at the cost of the infrastructure needed shows the sum to be totally inadequate. It is estimated that the average cost of the construction of slurry storage facilities is around £80,000. Given there are 24,000 farms in Wales that might be affected by these regulations, we get a flavour of how inadequate the figure set aside is. 

It is obvious that the farmers themselves will bear the brunt of the cost of implementation. The £80,000 figure only represents the initial cost for the necessary infrastructure. The Welsh Government's own cost analysis puts a figure for upfront capital costs of £360 million and ongoing annual costs in the region of £22 million, and this does not include the estimated one-off payment of £7.5 million planning consent fees. Given the farming industry is in the middle of a huge upheaval with regard to Brexit, not to mention the disruption caused by COVID, how does the Government expect farmers to cope with this huge extra expense? It is said that the banks are unwilling to make loans for the cost because they do not positively affect farm income.

We then have to ask ourselves: what are the benefits achieved over the next 20 years? Well, Welsh Government's own figures put this at around £300 million, set against a cost of over £800 million for implementation. Again, out of the 953 water catchment areas identified across Wales, just 113, 12 per cent, were failing through farming practices. Surely a far more proportionate and cost-effective way of managing the pollution problems would be to target these failing areas.

Should these draconian measures go forward, I believe we shall see many of our already impoverished farmers fail. One farmer has told me that his dairy herd will have to be halved if these measures go forward. The Minister says that there has been extensive consultation with the farming industry, but the farming industry tells us that almost all of their suggestions and input have been ignored. Given that British farmers are some of the most hardworking, innovative farmers in Europe and whose husbandry standards are among the highest in the world, we should be doing everything to help the industry, not creating obstacles to their survival. It appears the farmers are being made scapegoats on the Welsh Government's altar of environmental goals. Thank you, Dirprwy Lywydd.

The Welsh Government's decision to bring forward regulations that will see the whole of Wales designated as a nitrate vulnerable zone from 1 April has certainly caused an immense amount of frustration and anxiety for farmers in my constituency. The volume of e-mails I've received on this issue demonstrates just that. As someone from a farming family myself and as someone who has married into a dairy farming family, I'd like to think I'm acutely aware of the impact that these proposals will have not just on the financial viability of many farms but also on the mental health of farmers, who face these regulations during a global pandemic. Indeed, the very fact that the Welsh Government has had this issue hanging over the farming sector for several years now has caused a lot of anxiety, uncertainty and, indeed, frustration, and it's deeply disappointing that the Welsh Government now intend to introduce these regulations, especially when they promised not to do so during a pandemic. The excessive burden that these regulations will put on farmers will do nothing to attract people to farming, and therefore I believe that it will seriously damage the industry in the long term. Indeed, the many e-mails I've received tell me that, sadly, many farmers will be forced out of business because of these regulations.

Now, the Welsh Government tell us that the regulations are necessary to tackle water pollution, but the portal run by the Welsh Government and Natural Resources Wales, which was sent to me by the Members' Research Service, shows that, in the last year or so, only up to 15 per cent of pollution occurrences were caused by agricultural incidents. As Angela Burns said, these regulations are a sledgehammer to crack a nut. Now, the Welsh Government's approach also fails to take into account some of the good work already being done by farmers across Wales. For example, in my own constituency, the Wales catchment sensitive farming demonstration project is an example of a very successful voluntary scheme that was well received by farmers. There was also an offset scheme operated successfully by a group of First Milk farmers in the Cleddau catchment, led by local farmers Will Pritchard and Mike Smith, which also delivered a workable alternative delivering measurable reductions in nitrates. Therefore, it was deeply disappointing that the Welsh Government has not sought to build on this activity and develop a solution that works with our farming sector and not against it.

Now, as you would expect, local farmers in Pembrokeshire have raised several issues with the regulations, for example, the closed periods, as we've already heard, for spreading do not take into account the weather conditions that farmers have to work with, and the prolonged wet weather has an impact on the ability to undertake slurry spreading and storage. As has already been said, there are also concerns over the regulation that stipulates that farms in Wales can't exceed a certain amount of nitrogen per hectare, while in other parts of the UK, the limits are much more flexible. To put this into context, one business has made it clear that they will either have to find another 125 acres of land to support their current stock numbers or reduce their stock levels, which will have a significant impact on their output and therefore their business. This shows the very real impact that these regulations will have on farmers, and how some of them will now be forced to make huge decisions that will impact their livelihoods.

And the Welsh Government has committed to providing some financial assistance to farmers in order to help them comply with the regulations, but the £13 million offered by the Welsh Government does not sufficiently support the farming sector, and there's no mention in the Welsh Government's statements about the support that the Welsh Government should be making available to businesses that have had to reduce their stock levels because of these regulations. So, therefore, perhaps the Minister will take the opportunity today to spell out exactly what support will be offered to farmers who have had to reduce stock or accrue additional land to comply with these regulations.

And finally, Deputy Presiding Officer, I believe these regulations will harm the future of the sector in the long run, and they will do little to attract the younger generations into farming, and so the Welsh Government must consider all of these wider consequences and find an approach to tackling water pollution that is not only evidence based and proportionate but that ultimately works with the industry and does not destabilise its future. I therefore urge Members to support the Welsh Conservatives' motion.

Can I now call the Minister for Environment, Energy and Rural Affairs, Lesley Griffiths?

Thank you very much, Deputy Presiding Officer. As a Government, we support the ambition of Welsh farmers to be the most climate and nature friendly in the world, building on a reputation for high animal welfare standards, high environmental standards and the high quality of the food they produce. This ambition is under threat because of the ecological and reputational damage caused by widespread pollution from poor agricultural practice.

A prosperous future for Welsh farming will involve capturing more domestic and international demand for truly sustainable produce. I believe our farmers have the expertise and determination to achieve this, and I believe the public want the very significant support we give to the farming sector on their behalf to be focused on achieving that sustainability for the rural economy and for Wales' natural heritage. I'm aware there's been a great deal of misinformation surrounding the Government's intentions in dealing with agricultural pollution, and that some have seen it as their role to create anxiety and uncertainty in farming communities, rather than to carefully scrutinise, to put forward constructive ideas, and to responsibly inform the public about the issues at hand. Jenny Rathbone referred to the exaggeration about asking farmers not to pollute. Shall we just remember, it is their statutory duty not to pollute? In that context, I welcome the opportunity for this Senedd debate so that we can seek to reach a consensus on the need for change and around the need to support the sector to implement existing good practice measures as a first step towards making both our farming sector and our natural environment more resilient.

Earlier this month, I made regulations before the Senedd to set in law a net-zero emissions target for Wales. I hope this ambition for an urgent and accelerating response to the climate emergency is shared by everyone in this Senedd. I do know that the ambition is strongly supported by Wales' farming unions, who have themselves set a net-zero goal for the sector. The scientific evidence is clear: the scale of the net-zero challenge means we cannot afford to put off until tomorrow the emissions reductions we can achieve today. It is not credible for opposition parties to say they support the net-zero goal if they are not willing to follow the scientific advice on the measures we need to take to meet it and the timescales to which we have to work, where there is no room for delays or reversals. All I've heard from Members of opposition parties this afternoon is a call for inaction; this Government is about action.

Implementing good practice in nutrient management means planning where, when and how to spread slurry in a way that minimises the losses to the environment that are otherwise driving our emissions up to unsustainable levels. The farming sector has a very broad contribution to make to providing the solutions we need to the climate and biodiversity emergencies. Raising the standards of nutrient management such that the good standard already met by many becomes the minimum standard is one of the most important and immediate actions they can take, and I hope the whole Senedd can agree these steps are now needed. 

Sadly, it remains the case that, because of shortcomings in nutrient management in some parts of the farming sector, we still see far too many preventable agricultural pollution incidents. Even on the eve of this debate, I was alerted last night to a substantial slurry incident on a river and estuary in Pembrokeshire. The incident has not been self-reported and therefore investigations by NRW are under way. Janet Finch-Saunders said one incident is too many; well, let me tell you, over 100 every year for over 20 years is far too many. These incidents kill wildlife, they poison our air, our soil and our water. They increase greenhouse gas emissions, and they damage the good reputation of Welsh farming. I hope, therefore, all Members of the Senedd can agree with me and those in our farming communities and the wider public who say we have had enough of these incidents; we will no longer accept the poor practice that causes them. And I repeat what Janet Finch-Saunders said—one such incident is one too many.

Thank you. I will now call Members who've indicated they wish to make an intervention of up to one minute. Llyr Gruffydd. 

Thank you, Dirprwy Lywydd. I just wanted to pick up on the assertion that the Welsh Government is actually providing sufficient funds for farmers to respond to these new requirements. I make it around £11.5 million that's being provided. According to the Government's own estimates, that would just about cover the needs of Anglesey alone, let alone the rest of Wales. The low-cost-scenario estimates from the Welsh Government make it £109 million required, the high cost is £360 million, and you're providing £11.5 million, I think. So, let's not believe what we heard from some Members in this debate—that the Government is providing the support required. 

Thank you. Can I now call on Russell George to reply to the debate?

Thank you, Deputy Presiding Officer. The Minister talks about action; well, the farming community, Minister, want action from you. Now, the only area that I can agree that you spoke to this afternoon, Minister—and Jenny Rathbone—was that we all have a role in improving water quality. That's correct—all of us do, businesses and farmers included, and farmers accept that role. But any regulations have to be evidence based, proportionate and targeted, and the regulations that you have proposed and will be bringing forward next week are none of those things. Minister, it seems that you will bring forward these regulations next week to introduce a Wales-wide NVZ, and, in doing so, you have broken your commitment to Welsh farmers and this Senedd that you would not bring forward these regulations during the course of that pandemic, and I'm sure the First Minister and the health Minister will confirm to you that we are still in the middle of this pandemic.

Now, I heard the contributions from Jenny Rathbone. I'm astonished. She talks about exaggeration. She talks about not being able to introduce zones. That's why they're called NVZs. This is done all over Europe. I can't believe that contribution from Jenny Rathbone. 

In regard to other Members, Janet Finch-Saunders and Llyr and others pointed out the devastating impact on farmers and the many businesses that will rely upon those farming businesses, the complex record keeping of regulations that will be subject to cross-compliance, inspection and the penalty, leaving little option but to resort to costly consultations that farming businesses simply cannot afford. As Janet Finch-Saunders and others pointed out, your own impact assessments talk about the upfront costs of £360 million to the industry, and then there's the evidence that shows that many catchments across Wales have incurred zero incidents of agricultural pollution over the last 10 years, and Llyr, of course, points correctly as well to the NRW evidence, which backs that up.

Over the past 48 hours, I've had hundreds of e-mails from farmers across my own constituency in Montgomeryshire, urging me to vote against the regulations next week. Minister, you've heard from opposition parties, you've heard from the farming unions, you've heard from the farming community, and your response is, 'I'm going to ignore and carry on', which is so disappointing. I met with—

Can the Member come to a conclusion, please? 

Thank you, Presiding Officer. I met with Montgomery Young Farmers last night, making many of the points, I think, that Paul Davies and Angela did—Angela Burns made—in terms of the health and safety implications of rushing in terms of managing that slurry and the timetable involved.

In coming to a conclusion, Deputy Presiding Officer, I urge you, Minister, to rethink about this. I'd urge Labour backbenchers to examine the evidence, examine how proportionate this is, examine whether the targeted approach is correct or not. And I would urge Dafydd Elis-Thomas as an independent Member of the Government to think very independently when he comes to vote next week, and I'd urge Kirsty Williams to listen—

Yes. The Minister—

—and support our motion—

The Member does need to close. Thank you. The proposal is to agree the motion without amendment. Does any Member object? [Objection.] I see objections, therefore we will vote under the item in voting time. 

We'll now move on to item 8, which is the Plaid Cymru debate on free school meals eligibility. And I call on Siân Gwenllian to move the motion. Siân. 

Thank you, Deputy Presiding Officer. As a matter of principle, every child should receive free school meals. To get to that point, we need planning and to do so in a phased way. The first step is to start to include the 70,000 children living below the poverty line in Wales, and that is what our motion puts forward today. They are missing out at the moment, mainly because their parents are in low-paid employment. In supporting our motion, you would also be supporting the 6,000 children in Wales who don’t qualify for free school meals because their families have no recourse to public funds.

Today, therefore, we are calling on the Welsh Government to ensure that some of the fiscal resources that are as yet unallocated in the draft budget for 2021-22 are used in the final budget for 2021-22 in order to expand the free school meals eligibility criteria to include all children in families in receipt of universal credit or equivalent benefits or any child in a family with no recourse to public funds.

According to surveys by the Welsh Government itself, the cost of doing what we are calling for, the cost of expanding school meals to all children in families in receipt of universal credit, would be between £33 million and £101 million—the lowest figure if only one child in every family were to take advantage, and the highest if three were to do so. Now, it's clear that Wales will receive more funding from Westminster. Last week, there was an announcement on further Barnett consequentials of £650 million, which could be carried over into next year. This is in addition to the £350 million that the Government can also carry over into next year from this year. So, there is no excuse now for not expanding eligibility. The funding is available to be allocated for the purpose that we set out in our motion today.

In terms of the budgetary process, then today is the last chance for the Senedd to have a meaningful vote on the issue of extending free school meals. The final budget is expected next week; it’ll be published on 2 March, and discussed on 9 March. So, it is crucial that all Senedd Members make their views clear to Government by supporting our motion today so that the appropriate fiscal adaptations can be made.

It is truly disappointing to see that the Government has tabled a delete-all amendment to our motion, and rather notes that it is unacceptable in a modern society that children still go hungry. Well, I would agree. But an amendment simply noting that but refusing to do anything to resolve the issue is good for nothing for the poorest children who are missing out on free school meals. In addition to that, it's very disappointing to see the Government ignoring its own child poverty review. This report noted that expanding free school meals to a broader range of children and young people is the one step that would help most in tackling child poverty—the one thing—and yet again the Government continues to reject that, although the funds are available. It is disappointing and entirely unbelievable, if truth be told.

The reality is that Wales provides fewer cooked free school meals to its children at the moment than any other nation within the UK. In Scotland and England, every child of school age, in the first three years of their education, is in receipt of free school meals, whatever the family income. In Northern Ireland, the earnings threshold for those in receipt of universal credit is set far higher, helping to support more working families. Providing a balanced, nutritious meal, locally sourced, would improve child health and educational attainment. A sufficient free school meal will enhance concentration throughout the day and will give children an opportunity to taste new foods. Expanding eligibility, and, in future, moving forward to introducing a universal approach, would reduce inequality related to education, health and other areas. It would be a means of supporting the foundational or circular economy that this Government is so determined to promote. It would create jobs locally, support farmers to take foods from farm to fork, supporting local businesses, creating local food chains, and contributing to reducing emissions. We would be doing all of this and providing nutritious food for Welsh children. I urge you to support our motion today.

I have selected the amendment to the motion, and I call on the Minister for Education to move that amendment formally.

Formally moved.

I think I must begin by asking why this is the third time we're debating Plaid's position on free school meals in as many months. This motion replicates an amendment to the budget debate on 9 February, just two weeks ago. Back in December, we agreed that if you had no recourse to public funds then you shouldn't also have to worry about relying on someone's discretion in order for your child to be able to eat, and we recognised also that some families who might not have struggled in normal circumstances to pay for their children's food have found it more difficult during the pandemic, and that we supported Welsh Government's extension of free school lunch provision during the holiday period while we were in the throes of all this. But I also said that we shouldn't slip quietly into perpetuity with what was on offer here, and that we did not agree with proposals on universal provision of free school meals, and, in all fairness, Helen Mary was gracious enough to recognise that this was down to different philosophies about how best to tackle child poverty, rather than an unwillingness to face and take action on the challenge. 

Universal free school meals includes breakfasts, which we reject for the reasons I set out in December, which means we cannot support the Welsh Government amendment, but, having said that, we do agree with paragraph 1 of that amendment, and acknowledge again the Government's COVID response on free school meals, as well as wishing it well with its review. But we will be supporting the motion unamended. Earlier this month, we agreed that any underspent budget this year should be targeted in a temporary way to help families in receipt of universal credit. There are families in receipt of universal credit for the first time because COVID has robbed them of their jobs, and who will remain on universal credit for the foreseeable part of the coming year because they cannot find work or better paid work. But I have to say, Plaid, it was touch and go that we are agreeing to this motion as it is, again, because Welsh Government has kindly drawn our attention to the Education Policy Institute report in its own amendment, and what it says about the four nations' spending decisions on education during the pandemic. One hundred and seventy four pounds being spent on education recovery for every pupil in England, but just £88 per pupil in Wales, despite Wales receiving the £5.2 billion extra from the UK Government that we've heard of. We've had the lowest number of home learning hours here too, especially in more disadvantaged families, although, of course, those families have suffered the most across the UK. And Welsh Government has also been less generous up until now with its support for childcare funding and additional learning needs per pupil. And that should worry all of us who believe that education is an essential part of the route out of poverty, seeing this huge discrepancy in catch-up investment, meaning that too many of tomorrow's parents will still be relying on free school meals however much Welsh Government fiddles about with the criteria. Thank you.

The Welsh Government have not covered themselves in glory on the issue of free school meals in the past year, and provision has been ad hoc, without a clear enough path of leadership. Since the start of the pandemic, my team have campaigned to ensure that children in South Wales West are given parity of access to the free school meal allowance, and all but three local authorities across Wales have opted to provide cash or vouchers to the value of £19.50 to cover five breakfasts and lunches. This is the right approach.

In Wales, a very small number of authorities have continued to stick with a parcel delivery service, such as Bridgend, justifying this in a number of ways that have not been supported by other authorities here in Wales. In England, as we all know, there was, rightly, an outcry about the variance of quality and value for money of food parcels, which led to a Government response to ensure access to cash or vouchers. In Wales, this was not the case. 

Over the past year, we have shared images of food parcel deliveries and the varying levels of quality. There's been particular criticism of the parcels being delivered to families in Bridgend from the Bristol-based supplier, The Real Wrap Company. Money is being profited on the back of poverty and hunger, as these parcels, on average, amount to £10 or £11 when compared to a supermarket purchase price. In response to my letter outlining my concerns, the Minister for Education referenced images of food being delivered to families in Caerphilly and compared those to those being delivered in England. Well, here is an image of a food parcel that has been sent out to those in Bridgend. An image not included in the correspondence from the education Minister. I wonder why that is. It doesn't suit their spin, because it simply isn't good enough. Surely, parents are better placed to shop for their families and meet their child's nutritional needs within the budget of cash or vouchers.

These packages don't either reflect the diversity of food that families may choose to cook with, or reflect varying dietary requirements. Or how about at least giving people the option available to them? The fact is, Welsh Government should have mandated cash or vouchers being an option for all in Wales from the very beginning. Welsh Government advise local authorities to use a number of systems in parallel, however, the Labour-led council in Bridgend have committed to food parcels as their only option. In the meantime, I have seen many Labour councillors, MSs and MPs berating the UK Government on social media for the way they are treating children in poverty in England, when Bridgend are offering the same thing. Families have told us that they are being treated like children, handed individual portions of jam to feed their children, and, on occasion, even out-of-date fruit and vegetables, as you can see from this picture here: out-of-date oranges.

Responses from the local authority have impacted the mental health of constituents. The stereotyping of families in poverty as neglectful must stop. One councillor even suggested to me that they didn't want to introduce vouchers or money in case the parents didn't actually spend the money on food. Are they that disrespectful of the intentions of parents that they wouldn't spend the money or vouchers on food for their own children?

Almost a quarter of Wales is living in poverty, and research from the Child Poverty Action Group has shown that, of the four nations in the UK, Wales has the least generous provision of free school meals. This debate is no political stunt. What we have is a first-world country where children are going hungry, and a Government that have the power to make sure all children are fed, but are not using that power. We need to ensure that this issue is dealt with for the future benefit of all our children. Diolch yn fawr iawn.

[Inaudible.]—because during this COVID pandemic, what we have seen exposed are the searing inequalities that still exist in our society and the impact that they've had on the quality of life, the health and education of some of the poorest in our society.

Can I start by commending those in our communities who've done so much during the pandemic to ensure that, in addition to the financial support made available from the Welsh Government to families entitled to free school meals, they nevertheless raised funds to provide and deliver food boxes to those families to make sure the children did not go hungry? In Tonyrefail, Leanne Parsons and her team of volunteers from Tonyrefail Community School prepared and delivered hundreds of boxes every day all the way through the summer; Councillors Maureen Webber and Carl Thomas, local community activists in Rhydyfelin and Hawthorn, and all of the local food banks that have become so vital in recent years.

School meals are iconic. Under the previous income support regime, entitlement to free school meals was clear, but since the introduction of universal credit, there's been a replacement financial qualifying criterion of £7,400 net of tax and excluding any benefits received, and we do now need to review that. In Wales, we've ensured that almost 86,000 pupils receive free school meals or an equivalent of £19.50 per week. As more pupils return to school and as more families become dependent on universal credit, we must guarantee a principle that I believe we can all agree with in this Senedd: that no child in Wales should go hungry.

Now, I do want to commend the action taken by the Welsh Government, which has led the way in the UK by providing £50 million of funding to ensure free school meals during holidays and the further £23 million that has been put in place to extend this provision.

The motion tabled is very timely, albeit, in my view, too unspecific, because it does not give the clear assurances that we want to see and aspire to, and which can be delivered. The amendment establishes the principle that it is unacceptable for any child to go hungry. The final section of the amendment is the most important, because it is the clearest commitment to action. It commits the Senedd and the Welsh Government to reviewing all of the sources and policy options, including the income threshold, which is vital to fulfilling this principle.

We all know the cost could be around £100 million per year, so in that review it is vital that we focus on all the causes of poverty in our communities and ensure that any redirection of funding does not impact on other vital projects, such as the Welsh Government's free school breakfasts programme, which is just as important in ensuring that our children are not hungry when they come to school and whilst in school.

Llywydd, I'm sure we all aspire to the principle that one day school meals will become a universal benefit for all as part of the education system. Until then, despite the Tory financial austerity we are again likely to face, we must do everything we possibly can to maximise entitlement around this principle that no child should go hungry. This is a matter of absolute importance to all of us on the Labour side of the Senedd and in all other parties, I'm sure. I'm sure that it is something that we can all equally aspire to and unite around, so I welcome this clear commitment from the Welsh Government to enable us to achieve this. Diolch, Llywydd.

While we agree with the sentiment behind Plaid's motion, we cannot support it. We do need to end child hunger, however, we will not do that by extending free school meals to all children, which is the logical conclusion of the motion before us. We have limited resources and they have to be targeted at those most in need. We will, therefore, be supporting the Welsh Government's amendment.

I'm sure that every single one of us wishes to do all that we can to end the scourge of child hunger. The UK is home to 54 billionaires, a nation where the ultra rich make more in a minute or an hour than most people earn in a year, yet one third of children live in poverty. Far too many children go to bed hungry and free school meals are often their only reliable source of nutrition. I welcome the Welsh Government's additional investment in free school meals, and for being the first UK home nation to extend free meal entitlement during the holidays. And I also welcome their commitment to a review of the income threshold for receiving free school meals. We must not allow a single child in Wales to go hungry.

However, we must also address the elephant in the room: the rise of childhood obesity and the lack of nutrition. According to the Food Foundation, a staggering 94 per cent of children consume less than three to five portions of veg a day, and Wales is one of the worst UK nations for fruit and veg consumption. It's hardly surprising when we consider that healthy foods are three times more expensive than less-healthy foods for the equivalent number of calories. The poorest fifth of UK households would need to spend around 40 per cent of their disposable income on food to meet Eatwell guidance. We must, therefore, ensure that school meals meet and exceed Eatwell guidance. I also urge Governments across the UK to work together to make healthy food cheaper. Diolch yn fawr.

The Minister for Education, Kirsty Williams.

Thank you very much, Presiding Officer, and I thank colleagues for their contributions to the debate this afternoon. Can I say that I am very proud of how the Welsh Government and local authorities have reacted to the unprecedented challenges of the COVID-19 pandemic, ensuring that those who rely on free school meals have not had to go without whilst they are not in school?

We have now made available up to £60.5 million in additional funding this financial year for free school meals, and building on this we will provide and additional £23.3 million to extend free school meals in school holidays for the entirety of 2021-22. Free school meal provision remains a key priority, and our aim is to make sure that this support continues to be made available to families who need it the most.

In 2019 we estimated that if no earning threshold was put in place by the time that universal credit was fully rolled out, around half of Wales's pupils would be eligible for free school meals in Wales, compared to 16 per cent in 2017. With no additional funding made available to Welsh Government, this would have necessitated some very difficult funding choices elsewhere within the education portfolio and the wider Government, and we are yet to hear what people think should be cut to afford such a change.

During the pandemic, there has been a significant increase in families taking up free school meal entitlement because of the economic crisis that COVID has also brought, and the number of pupils who are now in receipt of provision has increased in just a matter of months from around 91,000 to now over 105,000. Members will recall that, in December, we calculated that to provide free school meals to every child whose parents receive universal credit would cost an additional £67 million a year. Further work has been done to update these figures, with the latest calculations now indicating that the additional cost would be between £85 million and £100 million, even before taking account of the impact of the pandemic.

But I think it's also important for colleagues in the Chamber not to forget that increasing the eligibility of free school meals also has a knock-on to other policy areas. For example, a rough estimate of extending free school meals to all pupils in families claiming universal credit would result in an additional pupil development grant cost of between £220 million and £250 million. Of course, it may be the intention of Plaid Cymru to do away with the PDG or to cut the worth for each individual pupil of PDG, but the fact remains that a rough estimate is that this policy could cost an additional £350 million a year.

In a similar debate in December, Plaid said that this would just be the first step towards their policy of offering universal school meals, and my question today is the question it was then: where do you expect this money to be found? Because I have to say, it simply doesn't wash that this money is found from the additional funding this year's budget contains. What about future years? The money that was referred to is one-off funding. We would still need to find hundreds of millions of pounds for future years. To be clear, that means cuts in other areas. I of course recognise the importance of free school meals in supporting children and families. If I didn't, we wouldn't have taken the steps that the Welsh Government already has. The changes needed when we introduced the threshold were incredibly complex, but we are absolutely committed to undertake a rapid review of the threshold when new data becomes available.

With regard to other parts of today's motion, calling for the criteria to include families with no recourse to public funds, I agree that this is really very important. Whilst recognising that not all people with no recourse to public funds are on low incomes, I do recognise that, for many, many of those families with no recourse, without a doubt, they are in need of support. I can therefore confirm that we will consider making formal amendments to this complex piece of legislation once the impact of COVID-19 has eased. In the meantime, we continue to strongly encourage all local authorities to exercise their discretion to allow the children of these families to benefit from free-school-meal provision. I appreciate that local authorities are always worried about their own individual budgets, but let me be absolutely clear to all local authorities this afternoon: they are able to claim from the Welsh Government in respect of additional costs if they take this step forward to support these families.

Llywydd, to finish, this is about choices, and where we should target our resources is always a question that we as a Government are constantly challenging and asking ourselves. Only today I am pleased to announce additional funding to extend our PDG access scheme to be now worth over £10 million. This is funding that will support our most disadvantaged learners and help more families meet the costs of school uniform, school equipment and now electronic devices. I can assure Members that, within the limited budget provided to us by the UK Government, we here in this Government will continue to ensure that resources are spent in the best possible and the most targeted way. Thank you.

Helen Mary Jones to reply to the debate.

I'm grateful to everybody who has taken part in this important debate. Time does not allow me to respond to all of every Member's contributions, but there are some points that I feel that I do need to make, particularly in response to Mick Antoniw and to the Minister.

Of course, we'd all commend the voluntary work that Mick Antoniw describes, but does he really think these families and their children should be depending on charity? I hardly think that that's consistent with a person's socialist principles. He says that we all agree to the principle that no child in Wales should be going hungry. Well, I have to say that the Child Poverty Action Group, supported by the Bevan Foundation and that hotbed of nationalist politics the National Education Union, estimate that 70,000 children are going hungry today. So, it's no good us talking about the principle. I can't imagine that anybody in this room or practically anybody in Wales thinks that, in principle, children shouldn't be fed, but those children are not being fed today. I'll repeat what other Members have already said: research from the Child Poverty Action Group shows that in terms of access to free school meals, the Welsh Government has a tighter means test and less generous universal infant provision than other UK nations. That's not us saying that; that is the most respected research and influencing bodies in this field.

I was very pleased, I must say, to hear what the Minister has said about those with no recourse to public funds, and I think it's very helpful that she has reiterated that local authorities who make those discretionary decisions will be reimbursed. That was clear before; it's nice to hear it reiterated. But other than that, I have to say to her that this debate is not about what the Government has done, it is about what the Government has not done. It's interesting every time we have this debate—and I do take Suzy Davies's point, we've talked about this many times, but we will keep talking about it until something gets done. If you look at the tone of the Government's amendment this time, it's softened from the Government's amendment last time. So, I make no apology for banging on about wanting hungry children to be fed; I've been doing it for 40 years and will propose to continue doing so until we can.

The Government moves the financial goalposts about what we're including every time we discuss this, and about the risks, and that's a legitimate way for them to respond to the debate. Of course, Kirsty Williams's position is honourable and consistent; Kirsty doesn't present herself as a socialist. But I have to say to the Labour Members in this Chamber and those Labour MPs who've been making statements about this today that you can't look both ways on this. The people of Wales will not be fooled. They will not believe you when you say, 'We want to extend the criteria, but we can't', because now we know that the money is there. You can't keep looking both ways on this matter and expect to get away with it. And while you are looking both ways on this matter, 70,000—well, 76,000 if we include those will no access to public resources—are not being funded. 

I'll reiterate, Llywydd: the tightest means test and the least generous infant provision of any UK nation. Is this something that any of us in this Chamber can be proud of, and is this something that Labour Members are prepared to tolerate? Of course, politics is about priorities, and I can assure this Chamber today that feeding those hungry children—children that the Tory UK Government has acknowledged are poor and in need of support because their families are receiving universal credit—will be a priority for a Plaid Cymru Government. And if you won't feed them, it's time to get out of the way and make room for a Government that will.

The proposal is to agree the motion without amendment. Does any Member object? [Objection.] Yes, there is an objection, and therefore I will defer voting under this item until voting time.

That brings us to voting time, but we will take a short break to ensure that the technology is working properly. So, we'll take a break.

That brings us to voting time. The first vote this evening is on the debate on a Member's legislative proposal, a British Sign Language Bill. I call for a vote on the motion tabled in the name of Mark Isherwood. Open the vote. Close the vote. In favour 37, 15 abstentions and none against. Therefore, the motion is agreed.

The next vote is on the Welsh Conservatives debate on the Wales-wide nitrate vulnerable zone. I call for a vote on the motion tabled in the name of Mark Isherwood. Open the vote. Close the vote. In favour 24, two abstentions and 27 against. Therefore, the motion is not agreed.

The next vote is therefore on amendment 1, tabled in the name of Rebecca Evans. Open the vote. Close the vote. In favour 28, four abstentions and 21 against. Therefore, amendment 1 is agreed.

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

Open the vote. Close the vote. In favour 28, 12 abstentions and 13 against. The motion as amended is therefore agreed.

The next vote is on the Plaid Cymru debate on free school meals eligibility. I call for a vote on the motion tabled in the name of Siân Gwenllian. Open the vote. Close the vote. In favour 20, two abstentions and 31 against. Therefore, the motion is not agreed.

Our next vote is on amendment 1, tabled in the name of Rebecca Evans. Open the vote. Close the vote. In favour 31, three abstentions, 19 against. Therefore, amendment 1 is agreed. 

A vote, therefore, on the motion as amended. 

Open the vote. Close the vote. In favour 31, three abstentions, 19 against. Therefore, the motion as amended is agreed.

That concludes voting for today. But it doesn't conclude our business for the day, and we will move to the short debate. 

We have two short debates this afternoon, and the first is to be introduced by David Melding. 

Thank you very much, Presiding Officer. I have agreed to give some of my time to Hefin David and to Angela Burns.

The subject of my short debate is the Cumberlege review—lessons for informed consent in the NHS. I want to start by commending the authority and insight of the review undertaken by Baroness Cumberlege, aptly entitled 'First Do No Harm'. That is the oldest principle of ethical medicine, and I think it's appropriate that we bear that in mind when we consider the issues before us in this debate. Although commissioned by the Secretary of State for Health in the UK Government and focused predominantly on the NHS in England, evidence was taken in Wales and Scotland, and, indeed, many of us have probably had some casework from witnesses who did give evidence in Wales; I certainly have. 

The review investigated what had happened in respect of two medications and one medical device, namely hormone pregnancy tests, which were withdrawn from the market in the late 1970s and which are thought to be associated with birth defects and miscarriages; sodium valproate, an effective antiepileptic drug, which causes physical malformations, autism and developmental delay in many children when it is taken by their mothers during pregnancy; and pelvic mesh implants, used in the surgical repair of pelvic organ prolapse and to manage stress urinary incontinence, the use of which has been linked to crippling, life-changing complications. However, it has been widely acknowledged that the review has general relevance and application to the safety of medicines and medical devices. 

One of the things the review was asked to consider was how to strengthen the patient's voice, which simply wasn't being heard and was leading to poor choices and outcomes. A central recommendation of the report is the establishment of a patient safety commissioner. As the report states, and I quote,

'The patients’ stories were harrowing.... They told their stories with dignity and eloquence, but also with sadness and anger, to highlight common and compelling themes'.

And the theme—arguably the strongest theme—that I want to examine today is the lack of information to make informed choices and therefore give informed consent. 

Innovation in medical care has brought great relief to millions and saved many lives, however without, as the report states, comprehensive pre-market testing and post-marketing surveillance and long-term monitoring of outcomes, innovation can be dangerous. The lack of basic information is astonishing. The NHS does not know how many women have undergone mesh procedures, it does not know how many pregnant women took the antiepileptic drug sodium valproate. As the report concludes, 

'In the absence of such information, it is impossible to know how many women would have chosen a different form of treatment...if only they had been given the information they needed to make a fully-informed choice'.

And I do think that is a damning conclusion. 

Indeed, the health system cannot be relied upon to identify promptly adverse outcomes arising from a particular medication or device. The yellow card scheme in which doctors can report adverse reactions to treatments is not fit for purpose. As Cumberlege notes, there is gross underreporting and our complaint systems are both too complex and too diffuse to allow early signal detection, and I do think that is very, very worrying. And it led to recommendation 7, which calls for databases on all devices, allowing for patient identification and audit of outcomes. Lack of information and databases makes the system opaque.

A further flaw is the opportunity for conflicts of interest to arise in the medical profession. This is particularly so, the report notes,

'where doctors have financial and other links with the pharmaceutical and medical device companies. Currently there is no central register of clinicians’ financial and non-financial interests.'

This led to recommendation 8, which calls for the register of the General Medical Council to include a list of financial and non-pecuniary interests. And I'm pleased the GMC has noted that the current arrangements to record and manage interests falls short of delivering adequate transparency and assurance for patients. Indeed, I should note that the GMC has taken an interest in this short debate and I believe they've made a very helpful briefing note available to Members and I do welcome that.

Let us return to the voice of patients. Here are a few patient voices quoted in the report:

'I have had a constant battle to get the help and treatment I needed with my mesh complications. "Gaslighting" and a "fobbing off" culture appears to be rife'.

And I would remember that this is probably from an older patient, but the term 'gaslighting' is used for when someone in a position of power implies the person is losing their mind. What an experience that patient must have gone through. Another patient:

'the person I once was, she has gone and no-one seems able to help me. No-one is listening.'

Another patient:

'They would tell you there is nothing wrong with you and that you are just a hysterical woman'.

What a thing to have implied to a patient who is suffering complications from a particular procedure. And finally:

'Had I realised the full implications of this medication, I would never have taken it.'

In the UK Supreme Court's landmark case Montgomery v Lanarkshire Health Board, it was held that obtaining consent needs to be framed by the information an individual patient requires. It is the patient's right to be told whatever information they need to know and in a manner that they can understand so they can make decisions on whether or not to proceed with a particular procedure or medication. In other words, there needs to be a true equality, a true partnership in the decision-making process between patients and their treating physicians. But this requires not a plethora of information by a confetti of patient information leaflets that lead to confusion and give little support in their interpretation, but rather effective patient decision aids. Patient decision aids encourage active participation by patients and healthcare professionals to make decisions. They make it easier for patients and those professions to discuss treatment options, and this is done through information and clinical evidence, the discussion of benefits, risks and uncertainties, the acknowledgement of patient preferences, which can be quite profound in many areas of medical practice, support for patients, so that they are taken through the decision-making process and given a chance to fully understand it, and recording and implementing these joint decision-making decisions. And it is not to be a one-off consultation but a process that allows patients time for reflection and understanding, hence the need for recording, and that done by various technologies now—audio and video.

I now want to conclude by asking the Minister if, in his response, he could cover the following: whether the patient safety commissioner that has now been established by the UK Government for England will have a role in Wales, and possibly be an England-and-Wales appointment, or will a similar office be established for Wales, and if not, why not, and how will the Cumberlege review in this respect be carried forward in Wales; if he would review the provision of informed consent in the Welsh NHS, and in particular the use of patient decision aids, their improvement and their application across the board as a matter of common practice; and finally, whether databases are going to be held on devices, so that we can have proper audit and evaluation of outcomes.

I finish by once again commending the work of Baroness Cumberlege and also paying tribute to the many witnesses from Wales who gave evidence. It's time for us to act on this excellent review. It has many, many lessons for us to learn in Wales. Thank you very much, Deputy Presiding Officer.

Thank you to David Melding. One of the reasons that I asked to contribute today was to pay tribute to the work of my constituent Jo Cozens, who is chair of the Organisation for Anti-Convulsant Syndrome charity, or OACS. For several years, Jo has campaigned tirelessly on behalf of families across the UK touched by foetal anti-convulsant syndromes. Jo does this out of first-hand experience, having been given sodium valproate to treat epilepsy, with which she was diagnosed as a  teenager. Later on, on the advice of a doctor at the time, she continued to take this medication while pregnant with her son Tomas. Tomas is now a teenager and he's faced multiple health challenges all his life, having been diagnosed with foetal valproate neurodevelopmental effects, and it's through her work with OACS that Jo's discovered that many other families have been affected like her, due to mothers taking sodium valproate when pregnant.

Jo's made it her mission to ensure that Governments across the UK legislate so that experiences like hers, and of other families affected, never happen again, and that's why she wants to see the implementation of the Cumberlege review's recommendations. I would be grateful to the Minister if he, as David Melding said, could provide us with an update today as to where we are with this in Wales. He will be aware that I've written to him about this, and that Jo has met with his officials, although not since last September. We're really keen to see progress on this, for the benefit of Jo, Tomas and all those who have been affected like them.

I'd like to thank David Melding for bringing this forward, because the Cumberlege report is such a crucial piece of evidence in trying to move medicine for women forward. I have two points I really want to make. One of the things that Cumberlege said very clearly was that the system, the big system, is not good at spotting trends in practice and outcome that give rise to safety concerns. We can look at this, we can look at maternity services at Cwm Taf—it doesn't matter, whatever it is. Now, if you had an aeroplane that fell out of the sky, they're not going to send the next plane up until they absolutely not only know what went wrong, but can ensure that it never happens again—safety record is par excellence in something like the aircraft industry. But we don't apply the same kind of principles to what we do here on the ground in the NHS, whether it's in Wales or the UK. It's that sort of drive that we must have to ensure that we follow innovation, that we give it good pre-market testing, that we follow the outcomes and we ensure it does no harm.

The first thing I'd like to ask, Minister, is: can we start looking at really developing a robust system to ensure that we learn from our mistakes? We're always going to make mistakes—it happens—but we must learn from each and every one. And my last comment is—and I have to say it again: gender bias. There is such strong gender bias in the development of medicines, the trialling of medicines. You've only got to look at all the reports that are written about it, and how gender bias is shown in cardiovascular and the management of irritable bowel syndrome, even just risk bias for saying, 'We'll let this device go forward'. And we need to look at how we alter that paradigm within research. I think it's probably a question for all Governments—I'm not aiming this at the Welsh Government—but there is gender bias in the delivery and research of medicine, and we need to work our way slowly towards balancing that out. Women and children tend not to have quite the same attention to some of the details. I'm not saying it; report after report that I've read say that, and I think we need to consider that. 

Thank you. Can I now call the Minister for Health and Social Services to reply to this debate, Vaughan Gething? 

Thank you, Deputy Presiding Officer, and I'd like to thank David Melding, Angela Burns and Hefin David for their contributions today, for the thoughtful nature of those contributions, and the manner in which they were put on a subject matter that is difficult, upsetting and life-changing. And I recognise what Angela Burns has said about the bias and the challenges over women's health, and I've said this before on other subjects. I do think that we have a particular challenge with the history of our NHS that is still with us; that was part of the reason why I set up the women's health group, with a particular focus on taking forward issues where there is a need to deliver improvement.

And the independent medicines and medical devices safety review, commonly known now as the Cumberlege report, that was, as David Melding said, published in July last year, 'First Do No Harm', was commissioned by the previous Secretary of State for Health in the UK Government, but that review did take evidence from across the UK, and much of what it has to say is relevant here in Wales. 

In terms of the three issues, the pregnancy tests such as Primodos, the impact of sodium valproate especially, as has been said, on an unborn child during pregnancy, and medical devices were the particular issues that led to the report, but there is much broader learning here, and I think it's entirely appropriate that David Melding has focused on informed consent.

The review's focus did look more generally at patient safety in order to build a system that listens, hears and acts with speed, compassion and proportionality. That is much of what we say about our NHS at its finest—the speed with which new treatments are brought on board, the compassion of our staff and the challenge of a risk-based approach to delivering care and treatment, much of which we are living through now. But we also know that when you get that wrong, the impact can be significant for the person receiving treatment. 

The report identified consent as an overarching theme, and it identified the missed opportunities where avoidable harm could have been prevented, and which should be addressed. And it specifies that patients should receive information they require in a form that they can understand to make decisions, including on procedures, treatments, the options available, including no treatment, the risks both long and short term of adverse outcomes, and the alternative available remedial treatments. It recognises, as David Melding highlighted, the need for clear, consistent and meaningful information leaflets to avoid confusion, and the need for a single patient decision aid for each surgical procedure or medical intervention. It also advocated more use of non-paper information sources.

The requirement, though, for clinicians to seek, at pace, to give informed or meaningful consent does not come from the Cumberlege report. It has a longstanding history in our NHS, including here in Wales. The previous Welsh Government incarnation issued guidance to clinicians in 2008 on this subject. The chief medical officer wrote to clinicians again on the subject in 2014, when the first signs of complications experienced by those who had received mesh implants became evident.

Welsh Government guidance was reinforced to reflect the ruling of the Montgomery v Lanarkshire case in 2015 that David Melding referenced, and that again shifted the focus of consent towards the specific need of the patient. Now, that went through the points about examination and treatment becoming shared between clinicians and patients, and embraced the principle of patient-centred care and co-production—exactly the sorts of things we find in our prudent healthcare approach and in the centre of our plan, 'A Healthier Wales'. We've had a model of informed consent policy since 2017, backed by a Welsh health circular, and guidance, which incorporated the Montgomery ruling and was supported by clinicians from all of our health boards.

The NHS Wales shared services risk pool co-ordinates an all-Wales consent group to support the development of a unified approach across all health boards on consent matters. That group has produced refreshed training and education packages for clinicians across Wales, including an e-learning system, a series of webinars, and presentations. These are all designed to ensure that clinicians receive up-to-date training on legal matters and good consent practice. The Cumberlege review called the wide range and number of patient information leaflets 'bewildering' and a 'major source of confusion'. Again, David Melding highlighted this in his contribution. To avoid this, the Welsh risk pool has adopted a more standardised approach and commissioned an all-Wales basis, professionally authorised, clinically reviewed, plain English campaign that should support patient information leaflets, and the Welsh risk pool has recently commissioned a pilot programme of digital consent platforms within a number of NHS Wales organisations. If successful, and I expect it will be, this will result in an all-Wales procurement exercise to be rolled out to all of Wales's health boards, and that will not be a matter of choice. There will be a decision, and that will be a national platform that everyone must use.

The new platform should provide patients who experience different comorbidities with access to information to cover their individual treatment requirements, to move away from those generic information sources that the Cumberlege report identified and criticised. The new platform should support a move from an informed consent to a shared decision-making approach, where patients are active participants and not simply recipients: active participants with clinicians in determining their future treatment, based on access to relevant advice and information, and possibly contact with those who have experienced similar clinical procedures. And this is what Cumberlege calls that true equality of partnership. Finally, the risk pool intends to undertake a national review of the arrangements for informed consent, to establish their effectiveness, identify areas for development, and determine future direction. The review has been delayed by the pandemic, but it will commence in April this year and is expected to report to the new Government.

I want to finish by dealing with some of the questions and points that were raised, and on improving patient safety and improving patient outcomes, on devices, as Members will know, we've given consent for a UK-wide system to introduce a device register. That should allow tracking back to understand more clearly the safety of devices, and I think will be a significant step forward for patient safety, and understanding patient outcomes for different devices. There is, of course, more to do, and you can expect a fuller response within this term before the Senedd ends, to take forward how equivalent improvement is made here in Wales as envisaged by the recommended patient safety commissioner in England. Our system is set up in a different way, and so our answer will be slightly different but the aim is the same: how do we practically improve patient safety and have a more visible way for that safety being assured?

My final comment is to reflect the sadness and the anger for people who have been let down: those people who were not listened to, those people who were harmed, and the length of time it has taken to respond. That response is not complete yet, but I confirm we'll do more within this term, and whoever is in the next Government will still have more to do with the changes that we intend to make to make sure they deliver the improvement in not just consent but in patient outcomes and patient safety.

Thank you very much.

We'll now move to item 11, which is the second short debate this afternoon, and I call on Llyr Gruffydd to speak on the topic he has chosen. Llyr.

Thank you very much, and thank you for the opportunity to bring forward this short debate on the future of sea fishing in Wales, and I have agreed to give a minute of my time to Janet Finch-Saunders, who will contribute to this debate too.

Before we begin this debate on the future of the fishing industry in Wales, I would like to take a moment just to remember the three fishermen from north Wales who are still missing today, and to send our best wishes to the family. Allan Minard, Ross Ballantine and Carl McGrath, as well as their boat, Nicola Faith, disappeared in January off the north Wales coast, and I would like to extend my sincerest sympathies, as well as this Senedd's sympathies, to their family, and to note that we are thinking about them as they grieve. 

Wales, of course, has a long and proud history of sea fishing. The tradition goes back a number of millennia, with seafood having been a central part of the diet of people in this part of the world across those many centuries. Archaeological work shows piles of shellfish going back to the Mesolithic age in Prestatyn, and we know about the fish traps across the Welsh coasts, which can also be seen along the Menai Straits. So, fishing and seafood has played an important role in the development of Wales, and the sector continues to make an important contribution economically, environmentally, socially and culturally too. There are hundreds of small vessels under 10 metres fishing from Welsh ports, and making a living directly for thousands of people and families, and indirectly to thousands more. And these people working in the industry do see themselves as the stewards of our seas, and the wealth of food that our seas provide in Wales. Like farmers on land, these fishers recognise the sea beds, and how the seasons impact on those different areas. 

So, what's the future for this historic and important sector? Well, like all sectors, of course, they are facing numerous challenges, but there are three main challenges facing sea fishers in Wales, and these three challenges are facing broader society too. Namely, in the first instance, climate change. Brexit, of course, has brought challenges, as well as COVID-19. Climate change has meant that the seas have become far more stormy during the winter months. We are seeing far fiercer storms, and many more storms than we have perhaps been experiencing in the past, and this is a very real threat, particularly bearing in mind that the Welsh fleet relies on small vessels. 

Brexit means that one of our main markets that the sector's relied on over the past 40 years has changed overnight, as some species of fish which were exported daily, such as mussels, are prevented, as this state is no longer within the borders of the European Union. COVID-19 has brought the hospitality sector to a close, a sector which the industry is reliant on in selling its produce here at home, in the domestic market. So, those are some of the challenges facing the sector. 

The COVID threat is the most apparent in the short term. We often hear spokespeople on behalf of the Government declaring how the Welsh Government has provided more generous support to businesses here in Wales than any other Government in the UK, but that's not the view of the fishers that I've spoken to, those who feel that they have almost been ignored during this crisis. Now, there is one grant payment of up to £10,000 per vessel, which has been offered, based on the average fixed costs, and that's to be welcomed, of course it is, but that's all that's been available in a 12-month period. And it's true to say that the UK Government has contributed some millions of pounds recently to seafood exporters, but that shouldn't mean that the Welsh Government doesn't have its own responsibility to listen to the sector and to respond to what they hear from the sector in order to make sure that it doesn't contract as a result of the current crisis. 

The Scottish, Northern Irish and the Isle of Man Governments have provided additional support to the sector, but that's not the case here in Wales. So, I want to make one call in this afternoon's debate to ask the Welsh Government to provide additional support to this sector, particularly, of course, given the current circumstances, and I very much hope that the Minister can respond positively to that in her reply to this debate. 

And then, of course, there's the impact of Brexit. Historically, only two EU vessels would fish Welsh seas, although up to 10 had a right to do so. But under the single designation, or the single issuing authority of the UK rather, the suggestion is that up to 76 vessels will now have permission to fish in Welsh waters. Of course, this raises major questions on the sustainability of our sea fisheries on the one hand, never mind the possibility that the indigenous industry in Wales will be squeezed out of our seas even further. Is this really in keeping with the aims of the Well-being of Future Generations (Wales) Act 2015? Is it in keeping with the Environment (Wales) Act 2016? So, I want to hear this afternoon what steps the Welsh Government has taken to ensure that this doesn't happen. What discussions has the Government had with the Westminster Government to ensure that the voice of the industry in Wales is heard in the corridors of the UK Government?

We are all now aware of the mess that the UK Government has made in dealing with the shellfish industry. We don't need to rehearse that sad history, but it is having a detrimental impact on the viability of the sector here in Wales. Prior to Brexit, shellfish producers could export their produce to the Netherlands so that it could be prepared there for the main market, namely the nations of the European Union. Under the new regime, of course, that's not possible. As a result, one of the main markets of the sector has shrunk almost entirely, and that's happened overnight. We must, therefore, develop a new market for this produce, which contributes tens of millions of pounds to the Welsh economy every year and maintains thousands of jobs and the families of those working in the sector too. We must look to promote the produce in the domestic UK market, but to date there's no sign that the Government is taking the proactive additional steps necessary in order to deliver against that.

As part of that, we, of course, need to increase the ability to process. We must get more produce into pre-prepared foods and onto shelves on our doorstep here in Wales and in the wider UK. There is huge potential to develop this sector. Yes, the sector at the moment is relatively small, but, despite its scale, or perhaps because of that, Wales can lead the way and become an example of how sustainable fisheries can work in a way that works for the environment, but also works for the fishing industry. Because sustainable fisheries are crucial to the fishing industry and the sustainability of that industry. A report by the Wales Centre for Public Policy provides some ideas and provides us with a blueprint of how we can develop work and policy of Government in this area. But what work has been done by the Government itself to consider some of these proposals with the sector? And the report itself makes it clear that we must have collaboration with the sector if any plans are to succeed.

If I can conclude with one frightening statistic shared with me by the Welsh Fishermen's Association, the Welsh balance sheet would show that this sector is worth around £250 million to the economy, and the cultural and social value is far greater, of course, but it's difficult to reflect that on a balance sheet in a way that actually does justice to that contribution. But we should look beyond that stark figure, because it is estimated that some 83,000 tonnes of produce is landed from Welsh seas every year, but only 10 per cent of that—between 5,000 and 10,000 tonnes a year—are landed by Welsh fishers. Now, of course, I mentioned in another contribution yesterday in the Senedd how half of Welsh milk goes over the border to be processed, and how losing abattoirs has led, over the years, to more and more meat being processed outside of Wales. Well, our food economy is an extractive economy.

We can add seafood to that list now, of course. The Welsh economy is missing out on 90 per cent of the produce coming from Welsh seas. This highlights the huge potential that exists, of course, off our coastline to create a viable industry in Wales and to develop the contribution of that sector hugely. If the pledges made during the Brexit debate had been delivered and we had more control of our seas—and 'take back control' was the mantra, of course—then we could build a very different future. But that was a pipe dream, of course, and Boris Johnson's disastrous agreement made the situation much worse.

Rather than the pledge of reducing the number of fish taken by foreign vessels, while also ensuring that the indigenous sector had greater control of the seas—something that would have been better for our marine environment and for the Welsh economy—what we have, of course, is a situation that will lead to damaging the marine ecology of Wales and undermine our economy, and I don't feel that the Welsh Government has responded sufficiently to that situation, or has shown enough desire or ambition to do anything constructive about that, and that is why I have brought this short debate before the Senedd this afternoon. It's an opportunity for the Minister and the Government to show the ambition that the sector is so keen to hear, and, of course, that ambition that is so necessary to ensure that the sector does actually survive. We need to invest in the sector, to create infrastructure for processing and to build a new domestic market, as well as resolving the problems that will ensure that there is access to foreign markets in the future. Even without the climate crisis and without Brexit or COVID-19, there would be a strong case for this Government to turn over every stone possible to create a more sustainable future for our sea fishing sector here in Wales. So, rather than being willing to see that wealth flow out of Wales, we need to ensure that the tide has turned and that wealth flows back into our communities. Thank you.

Thank you to Llyr for bringing this short debate forward on such an important issue. And I would like to echo his very kind sentiments and condolences to Carl, Alan and Ross, their families, in terms of the very sad and tragic circumstances. And in close working with the family now, we need to find out exactly what happened on that dreadful day that they went missing.

Now, Minister, you may be aware that, under the proposed bylaws put out for consultation by Britain's Marine Management Organisation, bottom trawling, which involves weighted nets being dragged over the seabed, would be prohibited in four English marine protected areas. It is considered that such action sets a precedent now for the devolved administrations. So, what discussions have you had around limiting or banning bottom trawling off Wales?

And turning to shellfish, whilst I'm sure you will all join with me in welcoming the news that the UK Government has expanded the eligibility criteria for the £23 million fund to target catching and shellfish aquaculture businesses, within the industry, they do feel there are steps the Welsh Government can take to tackle the crux of the dilemma. Will you explore whether a review of water classifications can be undertaken so as to establish if areas can be classified as 'A'? Because it's regrettable that, in the Menai strait, those waters were 'A' and now they're 'B', and so they need purification. What plans have you got for developing purification capability here in Wales? I'll speak to you again outside this debate, but there are some proposals coming forward from a company that wants to go forward, working with you, about having a purification unit. I'd like to think that the Welsh Government could work with the UK Government on the latter point as well, especially as the UK fishing and seafood sector is also set to benefit from significant Government investment, with a £100 million fund to help, for example, with modernising the fish processing industry.

As a keen Brexit supporter, I believe that we are well placed now to actually take the benefits of Brexit and move forward collectively with the Welsh Government and the UK Government. Thank you and thank you, Llyr.

Thank you. I call on the Minister for the Environment, Energy and Rural Affairs, Lesley Griffiths.

Thank you, Deputy Presiding Officer, and thank you, Llyr, for bringing this topic for short debate today. And I too, again, would like to send my thoughts to the families of the crew of the Nicola Faith at this very difficult time.

In talking about the future of the sea fishing industry, it is impossible to ignore the current issues facing the sector. Our seafood industry has been severely hit on a number of levels as a consequence of us leaving the European Union. Impacts are being felt across the whole supply chain in Wales, and I am pleased the UK Government has now finally listened to my repeated demands to ensure the whole of the sector receives financial support. It is regretful it's taken six weeks since I first wrote and met with the Secretary of State for Environment, Food and Rural Affairs for him to take action. My hope is this support gets through to businesses in need before it's too late.

It is also a matter of regret the UK Government shows no respect for the devolution settlement in choosing to directly administer the scheme rather than funding in the usual way, with relevant consequentials for devolved administrations. As demonstrated by our Welsh fisheries grant, we know we are able to administer funds to fishers quickly, efficiently and effectively. The UK Government must now do the same or Welsh fishers could face further hardships, driven by delay and ineptitude.

I reiterated on Monday evening, in a meeting with George Eustice, that he appears to now be determined to erode years of good collaborative ways of working between all fisheries administrations in the way it's reacted to the fallout of the trade and co-operation agreement since the beginning of this year. The Welsh Government is supporting the industry and working with the other administrations to find solutions, where possible, to the current issues. However, the TCA falls far short of what the UK Government promised, but we are seeking to make the best of it and maximise opportunities for our fishers. I've been very clear with the Secretary of State that it's essential Welsh fishers receive their fair share of the modest additional quota delivered by the TCA. 

We continue to respond to the immediate needs of the industry, and whilst it is clear the UK Government has failed on every level to deliver on its many promises to our fishers of a sea of opportunities for the industry, we can in Wales develop a bright future for the industry—one that is ecosystems based, has sustainability at its core, and is based on an adaptive management approach, co-designed with the industry.

We are committed to delivering a post-EU fisheries policy for Wales, designed with stakeholders to reflect the needs of the modern Welsh fisheries sector, and to manage the impact on the environment. At the centre of this will be a fisheries policy recognising the need to extract more benefit for our coastal communities, whilst ensuring our stocks can continue to provide benefits for future generations, building resilience now and for the future. We must look to the future, not only to maximise opportunities and manage our stocks sustainably, but also to build strength and resilience in our industry and the markets available to them. This is more important as ever, as we help the industry to recover from the impacts of the COVID-19 pandemic, as well as exiting the EU. 

I issued a written statement in September last year, and the outcomes and views raised from the 'Brexit and our Seas' consultation still remain as valid and important as ever. These include managing our fisheries in a sustainable way, providing for a thriving fishing industry, as well as maintaining the biodiversity of our seas and taking into account the impacts of climate change. Also clear is the need to make decisions based on sound evidence. In addition to well-managed fisheries, we also need to look at what infrastructure is needed to support our industry and help improve access to markets for our wonderful Welsh seafood, both here in the UK and internationally. Given the issues the industry's experiencing right now, this is more important than ever to protect and build resilience for our industry in the long term.

As we move forward with the next steps of our future fisheries policy, as I've already said, co-production with stakeholders will be a core principle. I am keen we ensure all interested parties have the opportunity to help shape the future we want for our Welsh fishing industry and, importantly, how we achieve it. At the UK level, a joint fisheries statement will set out policies for achieving or contributing to the achievement of the fisheries objectives as outlined in the Fisheries Act 2020. We are committed to delivering the objectives—they are cornerstones of modern fisheries management. They place sustainability front and centre, and, coupled with our Well-being of Future Generations (Wales) Act 2015, give us a clear direction of travel for the sustainable management of our fisheries. The JFS will also set out our intended use of fisheries management plans, an important tool in delivering the objectives. It is by balancing all objectives that we will achieve long-term sustainability. Reflecting our commitment to work closely with stakeholders on the JFS, a UK-wide community of interest has been established, and I welcome the positive take-up of Welsh stakeholders to date to help inform the development of the statement. 

We've taken the first steps towards a future fisheries policy for Wales, but I want to be clear: this is not a quick fix; it is not a policy that can be developed overnight. It will take time and effort to get to where we want our sector to become, and we need to be clear that our focus now has to be now on the twin crisis of COVID-19 and EU exit. But the future, obviously, of fishing in Wales is positive, and we have the opportunity to develop our sector into one that is thriving, sustainable and supports our costal communities. Diolch.

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