National Assembly for Wales

Croeso, bawb, i'r Cyfarfod Llawn. Cyn i ni ddechrau, dwi angen nodi ychydig o bwyntiau. Cynhelir y cyfarfod hwn ar ffurf hybrid, gyda rhai Aelodau yn Siambr y Senedd ac eraill yn ymuno drwy gyswllt fideo. Bydd yr holl Aelodau sy'n cymryd rhan yn nhrafodion y Senedd, ble bynnag y bônt, yn cael eu trin yn gyfartal. Mae Cyfarfod Llawn a gynhelir drwy gynhadledd fideo, yn unol â Rheolau Sefydlog Senedd Cymru, yn gyfystyr â thrafodion y Senedd at ddibenion Deddf Llywodraeth Cymru 2006. Bydd rhai o ddarpariaethau Rheol Sefydlog 34 yn gymwys ar gyfer y Cyfarfod Llawn heddiw, ac mae'r rheini wedi eu nodi ar eich agenda. 

Mae gen i un cyhoeddiad ac un datganiad i'w gwneud cyn i ni gychwyn ar fusnes y prynhawn yma. Y cyhoeddiad yw'r cyhoeddiad ar Aelodau Senedd Ieuenctid Cymru sydd newydd eu hethol, yn dilyn ymgyrch etholiadol Senedd Ieuenctid Cymru a gynhaliwyd fis Tachwedd. Fy mraint felly yw cyhoeddi'r canlyniadau ar gyfer ein hail Senedd Ieuenctid ni. Dyma benllanw misoedd lawer o waith gan fudiadau, ysgolion a thîm Senedd Ieuenctid ymroddgar y Senedd, ac mae ein dyled yn fawr i bawb a sicrhaodd bod y prosiect arloesol yma'n ffynnu unwaith eto. Roedd yna 272 ymgeisydd ac etholiad ym mhob un sedd etholaeth, ac mae gennym 18 sefydliad partner sy'n sicrhau bod grwpiau amrywiol o bobl ifanc yn cael eu cynrychioli o bob cwr o Gymru.

Bydd ail dymor Senedd Ieuenctid Cymru yn rhedeg am ddwy flynedd a chynhelir y cyfarfod agoriadol ym mis Chwefror 2022. Mi greodd y seneddwyr ifanc cyntaf argraff fawr arnom ni i gyd a dwi'n siŵr bydd yr Aelodau newydd yn ysbrydoli ac yn gweithredu gyda'r un egni ac asbri gan sicrhau bod eu cyfoedion yn gweld perthnasedd y Senedd Ieuenctid gan gyfrannu at waith ein Senedd ni. 

For those young people who stood for election but weren't successful on this occasion, I know you will be disappointed, but thank you for your hard-fought campaigns and for putting your names forward. We hope that you will continue to follow the Welsh Youth Parliament's work and get involved in the coming months and years. The story is not over for you, I'm sure. 

I'm very pleased therefore to announce the successful candidates for the second Welsh Youth Parliament, representing constituencies and partner organisations. Here are the names.

Dyma enwau'r seneddwyr ifanc: Isaac Floyd-Eve, Poppy Jones, Owain Williams, Dylan Chetcuti, Finley Mills, Laura Green, Leaola Roberts-Biggs, Bartosz Firmaty, Rhys Rowlandson, Iago Llŷn Evans, Jake Dillon, Keira Bailey-Hughes, Samantha Ogbeide, Amir Alenezi, Lloyd Warburton, Tilly Jones, Finn Sinclair, Zach Davis, Iestyn Jones, Freddie Webber, Kelsey Hannah Brookes, Tegan Skyrme, Cerys Harts, Ffion Williams, Ruben Kelman, Ellis Peares, Qahira Shah, Andrew Millar, Kasia Tomsa, Tegan Davies, Tobias Baysting, Harriet Wright-Nicholas, Maddie Mai Malpas, Sonia Marwaha, Fatma Nur Aksoy, Ffred Hayes, Milly Floyd Evans, Fiona Garbutt, Hanna Mahamed, Hermione Vaikunthanathan-Jones, Bisan Ibrahim, Ella Kenny, Jake Dorgan, Stella Orrin, Roan Goulden, Ewan Bodilly, Ruby Cradle, Jack Lewis, Ffion Fairclough, Evie Kwan, Seth Burke, Georgia Miggins, Ollie Davies, Elena Ruddy, Shania Adams, Bowen Raymond Cole, Daniel Downton, Sultan Awolumate. 

And that's it—all Members. [Applause.] Two Members, from Llamau and Voices from Care, will be announced shortly in addition, making 60 Members of our new Senedd Ieuenctid, Welsh Youth Parliament. Wishing you all the very best of luck with your work, congratulating you all, and we hope very much that we will be able to welcome you to the Senedd for the inaugural meeting in February.

Felly, llongyfarchiadau i bawb ar y gwaith yna.

Datganiad sydd gyda fi nesaf i chi, ac mae'r datganiad hynny ar y cytundeb cydweithio rhwng Llywodraeth Cymru a Phlaid Cymru. Bydd yr Aelodau yn ymwybodol fy mod i wedi gwneud datganiad ysgrifenedig hefyd ar y ffaith bod y Prif Weinidog ac arweinydd Plaid Cymru wedi llofnodi cytundeb cydweithio heddiw. Mae'r cytundeb yn gwneud trefniadau sy'n rhai newydd ac sy'n codi cwestiynau ynghylch gweithrediad busnes y Senedd. Gan hynny, rwyf wedi cymryd cyngor cyfreithiol ynghylch effaith y cytundeb ar statws Plaid Cymru fel grŵp, ac yn benodol pa un ai yw'n grŵp sydd â rôl weithredol. O dan delerau'r cytundeb, ni fydd gan Blaid Cymru unrhyw rolau gweinidogol, ac felly fy marn ar hyn o bryd yw nad yw'n grŵp sydd â rôl weithredol. Mae diffiniad Deddf Llywodraeth Cymru 2006 o rôl weithredol hefyd yn gymwys i'n Rheolau Sefydlog.

Er y sefyllfa gyfreithiol, mae manylion y cytundeb yn arwain at ystyriaethau o ran gweithredu busnes y Senedd a'n confensiynau presennol. Yn benodol, mae angen ystyried yn ofalus y mater o gyflwyno rôl newydd i Aelodau dynodedig. Byddaf yn awr, felly, yn ymgynghori â'r Pwyllgor Busnes ac yn gwneud datganiad pellach ar sut y mae'r cytundeb yn debygol o effeithio ar weithrediad Cyfarfodydd Llawn y Senedd yma a'n pwyllgorau.

Rydyn ni nawr yn barod i symud ymlaen i gwestiynau i Weinidog yr Economi, ac mae'r cwestiwn cyntaf gan Ken Skates.

Thank you for the question. We're committed to building on Wales’s success in hosting major events. We work proactively with event owners across the whole of Wales, and I was pleased to see events like Focus Wales and the Curtis Cup delivering economic, cultural and social benefits to north Wales this year.

Thank you, Minister. Indeed, the Curtis Cup was a huge success, likewise Focus Wales, and of course we have some wonderful annual events that the Welsh Government supports in north Wales. And indeed, major events such as the Tour de France and the UEFA World Cup have the potential to hugely transform for the better communities in which they are located. Minister, what's your assessment of how a successful City of Culture bid by Wrexham Country Borough Council would help the entire county borough attract more major events and inward investment to the area?

Thank you for the question. And I should say, Wales has a good track record of not just attracting but gaining real benefit from major events, and there is real credit to the Member for his time in Government in helping to move that forward. We see the events that we help to fund having a return on the investment of around about 10:1, so it does provide significant economic benefit, but also, as we said, cultural and social. And I'm enthusiastic about Wrexham's bid for the UK City of Culture; they're the only Welsh entrant still left in the race. And we've seen from other UK cities of culture that it can be a catalyst for more investment and a greater understanding of that city and its near neighbours, and what that can do in terms of attracting more investment from both inward investors in business terms, as well as looking to build on a record of a sustainable visitor economy. So, I think it's a really positive aspect, and my officials will be happy to explore opportunities to collaborate to showcase events for 2025, should Wrexham be successful. And I hope that every Member in the Chamber—north, south, east and west—will wish Wrexham well in their bid to be the UK City of Culture in just a few years' time.

Minister, it goes without saying, really, that the past couple of years have been tough for major events in north Wales, and across Wales as a whole. Events have had to be cancelled at short notice. There is now some reluctance from events organisers to put on events because of the uncertainty over COVID reduction measures. But it hasn't all been that bad, really, because the pandemic meant more people holidaying in north Wales, which is great. We even saw major tv productions like I'm a Celebrity coming to the region—and it was good to see them back on ITV last night after a few days off because of storm Arwen. These events showcase what the region has to offer, and have increased visitors to my constituency. Minister, what assurances can you give to the events organisers in the Vale of Clwyd, and across the north Wales region, that there will be no more lockdowns and they should carry on organising events throughout 2022?

Well, I could agree with much of what the Member said and support it, until the last 'Give me a guarantee on the future.' Look, the reality is that if we see the new omicron variant, and if it is something that spreads much more rapidly than even the Delta variant, and if it has the same level of harm over the population and for each person, then, actually, by the fact that it spreads more rapidly, it is going to be a more dangerous variant. It's why every Government across the UK have implemented a series of new measures. 

I want, though, to be able to support the visitor economy across north Wales, across the south and the middle of Wales, to understand how we generate more activity and have the confidence to build on improving the visitor economy more broadly, because I certainly recognise it's an important economic sector for the future. And I want to build on the fact that more people have come to different parts of Wales over the last two years, and to have a genuinely sustainable visitor economy—one that is year round, and with good jobs within it and not simply seasonal jobs.

So, we will do everything we can to support the visitor economy, and the broader economy, and we will take all reasonable steps we can to avoid further measures that may need to be taken in the course of the pandemic, because we recognise that, if we go backwards, there's real harm to the economy, as well as physical and mental health. So, the Government will continue to be clear, consistent, balanced and open in the choices that we make. 

Our programme for government makes clear our commitments to promote equal access to sport and leisure activities and our aims for a safe and welcoming tourism and leisure sector across Wales. North Wales features prominently in Visit Wales’s promotional activities and in our capital investment programme for tourism.

Diolch, Deputy Minister. I recently visited Plas y Brenin, which is a great facility for adventure sport and training in the heart of Snowdonia, and it's run by a Welsh charity, the Mountain Training Trust. They are looking for funding to bring their building and outdoor facilities up to full disability access to widen inclusiveness and expand the offer. What is Welsh Government doing to support this industry that is so crucial to both the economic and social well-being of north Wales to recover from the pandemic and grow, and would it be possible for you, Deputy Minister, and officials to meet with me to explore what can be done to help this fantastic facility grow and adapt? Thank you. 

Can I thank the Member for that supplementary question? Yes, I did see that you recently visited Plas y Brenin; I do follow you on Twitter. It clearly is an excellent facility, and I'm very pleased that you had a positive experience there. And I do fully recognise, of course, the importance of active recreation across Wales and, in this context, the importance of our programme for government commitment to supporting disabled people and removing the barriers and obstacles that might prevent people from enjoying those kinds of visitor attractions. I certainly hope that I'll get the chance to visit there myself soon, and I would be more than happy to have further conversations with you about that. 

However, Plas y Brenin is owned and run by Sport England. So, I would anticipate that capital funding for the facility would be something that Sport England would need to review as an organisation. But, having said that, across north Wales, Welsh Government is currently supporting nine public amenity projects through the Brilliant Basics scheme to enhance the visitor experience, and several of these will allow better access to our environments, such as the beach access at Dwygyfylchi beach in Conwy. It will see improved conveniences incorporating cycle storage and so on. And, of course, we are committed within the programme for government to a new national park for north Wales, the first in more than half a century, centred on the breathtaking Clwydian range and the Dee valley, which I know is very close to your heart. 

The Welsh Government also continues to consider capital development opportunities that support key visitor and leisure destinations—for example, in Denbighshire, to support the expansion and upgrading of facilities at the coastal Beaches Hotel in Prestatyn, and two phases of an £8 million investment in Adventure Parc, Snowdonia, and another £380,000 going into Plas Weunydd Hotel in Llechwedd to create a hotel that will complement the Zip World development. I could go on, but I think the point that you get here is that the Welsh Government is very serious about supporting the outdoor recreation facilities and centres, and does absolutely recognise the importance of it to the wider economy of north Wales. 

As highlighted, active recreation is, of course, essential to the health and prosperity of many people across north Wales. Not only does active recreation benefit people physically, it also has immense benefits for mental health as well. As, Minister, you will be aware, north Wales is an exceptional area for active recreation, with fantastic nature and scenery for all types of exercise, and, indeed, back in May, I was delighted, as you just mentioned Adventure Park Snowdonia, to actually be at the opening of the Hilton hotel there, a hub of award-winning indoor and outdoor adventures in north Wales, with the world-first inland surfing. So, yes, a great example of a site enabling active recreation—a really important stakeholder in the region. But just going back to the benefits, in terms of both physical and, of course, mental health, I wonder, Deputy Minister, what work you're doing with the health Minister to understand the benefits further, and how the north Wales health board—Betsi Cadwaladr health board—can also ensure that they're supporting the active recreation sector? 

Can I thank the Member for that question? And I think he is absolutely right: this is not something that is the responsibility or within the confines of one single portfolio. I've had conversations with my colleague the Deputy Minister for Mental Health and Well-being and with the Minister for health about how we can work across portfolio to deliver some of those health and well-being objectives, including some budgetary issues. Obviously, within my portfolio, we have lots of areas, whether it's arts, culture or sport, that can help deliver those kinds of activities. We don't necessarily have all the budget that goes with that, if it is specifically around a mental health and well-being objective, but we have a very clear objective within our programme for government about delivering social prescribing, and the areas within my portfolio really are there to enable that support to be given into the health sectors as well. So, it is absolutely something that we're considering on a regular basis.  

Cwestiynau nawr gan lefarwyr y pleidiau. Llefarydd y Ceidwadwyr, Paul Davies. 

Diolch, Llywydd. Minister, the new variant of COVID-19 has caused understandable worry, particularly given that we don't know yet how virulent the variant is, and therefore we can't accurately ascertain the threat of the virus to Wales. Nevertheless, the news of a new variant will cause some real worry for Welsh businesses, and so it's crucial that there is an ongoing dialogue with the Welsh Government about the impact of the new variant on how we live and work so that businesses are consulted on any new measures or any changes to existing measures and strategies. Now, I listened very carefully to the answer you gave my colleague the Member for the Vale of Clwyd, but, Minister, at this stage, can you tell us how is the new variant affecting the Welsh Government's economic recovery plans? And can you tell us whether the Welsh Government intends to announce any new measures targeted at businesses in Wales before Christmas? 

Thank you for the question. The difficulty with the omicron variant is that we don't have a fully formed picture of its overall impact. But we are genuinely concerned that it appears to spread even more rapidly than the delta variant. You'll have heard Conservative Ministers in the UK Government talk about that as well, but about the fact that collectively within the UK we don't understand the three main points of difficulty. On the first, we have some impacts, but we don't understand how much more rapidly than delta it appears to spread, but it appears to spread more rapidly; the second is whether it actually causes more harm than the delta variant, and I'll come back to that; and the third is whether it can escape the vaccine.

Now, if you put it this way: we have about 2,000-odd people every day in Wales who test positive for COVID—it's almost all delta—and we know that leads to a certain number of people coming to harm, going to hospital. Unfortunately, we know that a certain number of people won't survive. If omicron has the same impact in those, say, 2,000 people, then you'd say it's about what the scientists call the same sort of pathogenic capability. The problem is, if omicron spreads more rapidly, we'll see more people come in to our health and care system much more quickly, and that does have the real potential to cause a very serious impact, even if it doesn't actually escape the vaccine response. So, we're dealing with a good deal of uncertainty at present.

Our scientists across the UK expect to be able to provide politicians with some more information within the next two to three weeks to have an understanding of those extra factors. So, we're dealing with a point of real uncertainty at what is the most inconvenient time for many businesses, in the last few weeks in the run-up to Christmas. So, we don't plan to introduce more restrictions before Christmas, but, when we get more information on the omicron variant—not just what it entails and what it means, but also how widespread it already is within the UK. And we're not having a fully formed picture; of course, we have confirmed and probable cases, but, because a decision was made to no longer have PCR testing for international entrants about six weeks or so ago, that means we haven't been able to sequence in advance. So, it's likely that there is more omicron in the country and across the UK than we understand at present. Once we get a fuller picture of where it is and its particular impact, then not just this Government for Wales but, actually, across the UK, will need to make choices, and that's why the First Minister wrote jointly with the First Minister of Scotland to the UK Government to be clear that, if measures are needing to be taken, then we want to have the support of the UK Treasury in doing so if that impact is felt first in another part of the union that isn't England. We've seen that in the past, and I believe that a proper and sensible response to that would show the UK acting as it should do and its best to make sure that the risks and opportunities are shared equally with this latest twist in the ongoing tale of this pandemic. 

Well, Minister, the point I'm making is that it's crucial that, as more information comes out about this virus, the Welsh Government communicates clearly with Welsh businesses and sets out its intentions, and therefore I look forward to hearing more from you in the coming few weeks. Now, over the past few weeks, the Welsh Government has published several economic statements and allocated substantial funding, and it's important for us to better understand whether this new variant has any impact on the Welsh Government's plans going forward. For example, last week the Government announced a £45 million package of funding that aims to help small businesses across Wales to grow, and will hopefully support thousands of people across Wales to train to work in key sectors. That funding is vital in addressing skills gaps and upskilling the workforce. Indeed, you yourself told the Economy, Trade, and Rural Affairs Committee that every single sector of business that you talk to—small, medium or large—there's always a key skills challenge. Therefore, can you tell us more about this particular funding stream and how it'll be allocated across local authorities in Wales? And can you tell us how confident you are that this funding will be enough not only to safeguard 4,000 jobs, but also to help create 2,000 new jobs in Wales, as you outlined last week? 

Yes. So, on the additional funding that I was pleased to announce— and I'm particularly pleased to have announced that we'll be delivering that in partnership with local authorities, who will deliver the funding and they'll be able to make choices within the local authority area, so it will cover every single local authority in the country. And the figures that we provided on the number of new jobs we think it will create, as well as those safeguarded, come from our experience of working alongside local authorities and businesses during the pandemic. This, in particular, we think will be of real advantage to small and medium-sized businesses as well.

So, that's the basis on which we have allocated funding and why we have come up with figures about the impact we think it'll have, and I was very pleased to visit a business in the Caerphilly county borough, I believe in the Islwyn constituency, on the launch of the fund, and they've already indicated about the support they've had from previous rounds of support from the Welsh Government, and what that's allowed them to do in diversifying their business and actually managing to grow, and that growth is from local employment—so, decent jobs and the whole thing of, as we say in the Welsh Government, better jobs closer to home. It's a good example of that funding delivering on that. There's been a real appetite from businesses to do that. Part of the challenge has been unlocking business investment themselves. So, the fund allows people to apply for a grant, then to invest some themselves as well. It's a genuine example of 'something for something' that we think has every prospect of being successful. 

On your broader point about business communication regarding the path through the pandemic, I have regular conversations with a variety of different sectors within the economy. I talk with trade unions and I talk with business organisations. I'm having another round of conversations with business groups later this week. So, there is regular communication and business groups themselves say that they've never had a closer or better relationship with the Welsh Government. The necessity of the pandemic has driven some of that, but I actually think there's better understanding and a better sharing of information, trust and confidence.

So, I hope that gives the Member some of the assurance, which I think is reasonable for him to ask for, that there are both regular conversations going on between myself, my officials and business groups, and that those are in a good place to be able to do what we need to do, but I really do hope we don't need to introduce further restrictions. But myself and other Ministers in the Government will make the right choices to keep the people of Wales safe, and to do what we can to save livelihoods at the same time.

Well, I'm very pleased to hear, Minister, that you're having ongoing discussions with the business community, and I hope that will continue over the next few weeks in the run-up to Christmas. Now, in the same ministerial scrutiny session with the Economy, Trade, and Rural Affairs Committee, you also said that the pandemic recovery in business terms has certainly not been complete yet, but it's a matter of discussions between yourself and the finance Minister about the sort of support the Welsh Government will be able to provide businesses in the future.

Now, as you'll be aware, next Saturday is Small Business Saturday, and I hope, Minister, you'll be out sampling and enjoying everything our small businesses have to offer. Wales's small businesses are still in a precarious position, and the new variant could threaten that, as it's winter and we know that COVID-19 thrives in indoor environments. Now, in Scotland, a £25 million fund for ventilation of businesses was established and organisations like the Federation of Small Businesses have called on the Welsh Government to consider doing the same here in Wales. So, Minister, ahead of Small Business Saturday, can you give us an update on the discussions between yourself and the finance Minister in relation to business support, and in particular whether any decisions have been made regarding business rates? Secondly, can you tell us what short-term assistance the Welsh Government is offering to businesses to make their settings as safe as possible during the winter months, including a potential ventilation fund, as has been established in other parts of the United Kingdom?

Yes, I'll happily deal with those points. It will be of no surprise to you that I'm not going to preannounce the budget. The finance Minister and the First Minister would not be wonderfully happy if I attempted to preannounce parts of the budget that will be published at the end of the year, but I have heard, as indeed has the finance Minister, calls from a range of business organisations for further rate relief in the new year. We are, of course, in a place where in Wales we provided a much better rate of rate relief for a range of sectors compared to England, so we're already further ahead than those businesses having to work with the English levels of support, which have been reducing for some time now.

On the Scottish ventilation fund, we were interested in what they were doing, but we weren't convinced the fund as announced in Scotland would work for us here. I don't think that there was clarity in how it would be achieved and what would happen with the supply chain. What we have done now, though, with the £35 million fund that we've announced in tandem with local authorities, is that, actually, ventilation is the one of the purposes for which the fund can be accessed, because some businesses have already taken measures to improve ventilation within their premises, and I'm sure you've had contact from those who have done so. Others who haven't done so and want to further improve ventilation, that's one of the purposes for which they can apply for the fund that I have recently announced, and you've helped me highlight it earlier in questions today.

More broadly on your point on small businesses, I hope that there'll be an outbreak of agreement across the Chamber later this afternoon in the debate on small businesses—the short 30-minute debate that your group has tabled. I certainly do support small businesses within my own constituency and more generally, and I look forward to people right across the different politics of the Chamber doing so and highlighting within their regions and constituencies small businesses that we still want people to support. People did support small businesses at the height of the pandemic, when people had to shop local, and I hope that people will still choose to shop local and support your local high street and support your local small business.

Llefarydd Plaid Cymru, Luke Fletcher.

Diolch, Llywydd. Business Wales currently has skills and training programmes over three areas: recruitment and staffing, workplace skills, and leadership. How does Business Wales choose which courses to offer, and are there any plans to introduce more courses to help boost businesses in Wales?

That would be a matter for discussion with business sectors themselves, about what courses they would offer directly and what our more broad offer is on the skills and training agenda. I'm interested in the future of work and young people coming into the world of work for the first time and are looking to move on. That's why, of course, we've launched the young person's guarantee. The young person's guarantee, of course, straddles apprenticeships, which aren't just for young people. It's also why the recent announcement on personal learning accounts is about investing in the current workforce, and it's why I'm so concerned about the challenges over the reduction in the ability to run a proper and robust skills programme with the changes to the levelling-up fund. It's a real concern for us. But I look forward to further conversations with me and with my officials on the spread of help and support that we should provide and how that meets business need. That will, of course, be driven by lots of work done by our regional skills partnerships, and that really is a key factor in planning how we will support businesses now and in the future.

Diolch am yr ymateb, Weinidog.

And I'm glad he said that that's a question for businesses. As Paul Davies has already highlighted, Small Business Saturday is fast approaching, and, as part of the run-up to Small Business Saturday, many of us in this Chamber have visited our own local businesses. Part of that for me has been visiting businesses in my own region of South Wales West.

One consistent suggestion that has been fed back to me relates to some of the courses provided by Business Wales. For example, one business raised a lack of support relating to SEO training, search engine optimisation, whilst another raised a lack of courses relating to growing their businesses. From my own research, it appears as though Business Wales's main course that focuses on growth is the 2020 leadership programme. However, according to the Business Wales website, that course is only provided in east Wales to businesses that operate there or employees who reside there. Is there any monitoring of how effective the selection of courses provided is, and what is the reasoning as to why there appears to be a significant amount of programmes on the operational and practical side of business, but little on growth and innovation? Would the Minister consider implementing the 2020 Business Wales leadership programme across Wales to provide greater growth and innovation focused courses throughout Wales?

Yes, I am of course interested in the assessment of impact of each of the courses that we run and how they're rolled out in different parts of Wales to meet business need that's assessed there. I think on your broader point around the sorts of courses that are run and the provision to help businesses to grow, actually, this is a point that came up in conversation with the Member for Cynon Valley about the change in not just helping to support businesses to start, but actually what we've been doing in our business support to help businesses to grow. It's been a key factor under the previous leadership of Ken Skates and now it's being continued, and you'll see this in the small business fund that's going out with local authorities. This is about how we help businesses to survive and to grow as well.

So, it's both about funding and it is also about some of the support and skills, but a range of that is also about businesses themselves identifying what they need to do to grow. Not all of those ideas are held centrally within the Government. So, it is about the sort of partnership we have with businesses themselves, with regional skills partnerships who tell us what we need to then provide, and where that's directly provided—there won't always be direct provision from Business Wales. But I'd be more than happy to engage in a more in-depth conversation with the Member about the variety of different courses that we provide directly and how we do so.

I should say, though, that when it comes to small businesses, I regularly go to small businesses within my own constituency. You may notice that I've had a recent haircut, that was a small business in my constituency; I go to a local butcher, the local fruit shop, I could mention more and more and more, but I'm sure that we'll hear lots of that praise of people's local businesses later on this afternoon as well, by name.

Of course, I will also be highlighting a lot of the businesses that I've been frequenting locally in the debate later on, and of course I'll be sharing my secret on where I get my hair cut as well. [Laughter.] And of course I'm very glad that the Minister says that he's engaging with businesses. More often than not, a lot of the ideas that solve a lot of the issues these businesses have come up on the coalface, so I'm glad that conversation is happening.

If I could turn to trade and the Northern Ireland protocol, threats from the UK Government to trigger article 16 are not only concerning with respect to stability, peace and trade in Northern Ireland, but the triggering of article 16 would negatively impact Welsh trading relations with the EU. While Wales is trying to recover from the effects of years of austerity, Brexit and COVID-19, and of course we've already seen disruptions to trade at Holyhead, we cannot risk causing further disruption to the Welsh economy. Has the Minister had any clarification as to how the UK Government would plan to implement article 16, if they do so, and what the role of the devolved Governments would be in that process? Will we, for example, be able to raise concerns about the impact on Welsh trade and the Welsh economy, and what preparations, if any, have the Welsh Government made to cushion the blow to the Welsh economy in case article 16 is triggered?

Toward the start of November, in the Economy, Trade, and Rural Affairs Committee, I asked the Minister about the timeline for an assessment of the cumulative impacts of the market-access provisions for agriculture in the New Zealand and Australia free trade agreements, and was told that it depends on the information provided and whether the agreements in principle become finalised. Has the Minister had any more details from the UK Government and is he able to share those details with me today?

I'll deal with your second point first, and that is with regard to the free trade agreements around Australia and New Zealand. We do think that the agreements in principle may change when it comes to final text. You will have seen there has been lots of speculation in public about that as well. I can't provide you with an updated statement at this point in time because they're not concluded. Once they are concluded, I've already committed that the Welsh Government will share an assessment with Members and the wider public of our assessment of the direct impacts. Some of that, of course, is forecasting, because, for example, the significant increase in the quotas for agricultural produce that can be imported is a concern about what happens now but also in the future, over time, as there's a significant increase in the tariff-rate quotas—the quotas that are agreed—with those two countries, and the bar that that sets the negotiations with other countries and other trading partnerships.

On article 16, we are genuinely concerned about what may happen if article 16 is triggered, but equally, we're concerned about the current period of time and the uncertainty that the diplomacy through headlines and speeches is causing in the current trading relationships. Whilst we were still within the European Union, I think there were a dozen direct ferry crossings from the island of Ireland to continental Europe, and that's now increased to over 40, so there's already been a significant increase in trade that is avoiding Welsh ports and going directly to mainland Europe. That affects trade and it affects jobs and we've seen a significant reduction in trade through our ports already. If article 16 is triggered, then it is almost certain that there will be retaliatory measures. We can't tell you what the impact of those will be, because we don't know what those measures would be. We've already raised our concerns about what it would do to Welsh jobs and businesses if article 16 were triggered, but we're not in a position where the UK Government are engaging us directly in those conversations. I've made clear that I think the Welsh Government should be part of those conversations because of the direct impact on arrangements with the whole island of Ireland—the Republic and Northern Ireland—and what it does to trade within Wales. The UK Government have not engaged us in that.

I'm hopeful that, given what appears to be a constructive offer from the European Union to change a range of requirements on goods checking, there can be a constructive and agreed way forward that does not cause the significant disruption and undoubted economic harm that would be caused if article 16 were triggered. But I'm not in a position to give the Member any kind of guarantees about that; as the Member knows, I'm not in control of those negotiations. But whatever does happen, the Welsh Government will continue to stay engaged and make clear the case for Welsh jobs and businesses and, of course, I'll continue to report back to the Senedd and the relevant subject committees.

The Counsel General and I have had a relatively recent discussion on the importance of the legal sector’s contribution to the economy. In terms of GVA, using a wider definition to include some accountancy services, the legal sector contributed £926 million to the Welsh economy in 2019. It is also, of course, of major social importance. And I should note that I'm a lawyer in recovery and I do happen to be married to a real lawyer with an actual practising certificate, so I have some personal interest in this too.

I should also declare an interest in this as a member of the Wales and Chester Circuit, being a barrister. Now, you're quite right about the contribution of the legal sector to the Welsh economy; it's a similar proportion to the agriculture sector's contribution to the Welsh economy. I'm sure, Minister, you'll agree with me that a full range of legal apprenticeships up to level 7 would boost the significant contribution of the legal sector to the Welsh economy. It would also help with sustainability with regard to rural and post-industrial areas; it would help with diversity and help encourage people who can't afford to go to university to join the profession. So, what work is the Welsh Government doing alongside the profession to use the full range of legal apprenticeships that are available to increase the already significant contribution that the legal sector is making to the Welsh economy? Diolch yn fawr.

Thank you. Actually, part of the conversation that I did have with the Counsel General was exactly on this basis: the potential to develop apprenticeships and for paralegal occupations as well. Some of the work for those paralegals is on track to be introduced in January. The qualification route for qualified lawyers is something that we're still examining. I understand—and I think this is reasonable—that law firms that were caught up in the apprenticeship levy do not feel that they've got value for money; there's been a tax with no return in apprenticeships and I understand that concern. It's a similar concern for a range of other businesses too. What's different, of course, about the legal profession is that we don't have an undersupply of lawyers; the challenge is who accesses the legal profession and what can be done about those people from relatively under-represented parts of our society within the profession.

The alternative challenge for us, in the Welsh Government, is a sense of priority. If we put funding into degree apprenticeships for lawyers when, for example, I self-funded—I took out a loan to undertake my own course—. I had the benefit and the comfort of a training contract, but I then repaid that during my working life—the loan that I had taken out. It's about whether or not we do need to have alternative routes to qualification; it's one of the recommendations of the Thomas commission. So, we're scoping that work out within the Government and we're looking to talk to the profession about it.

But, of course, the arrangements for law firms to support people into study, they're in a different place to other parts of life, where degree apprenticeships may make a larger difference. Degree apprenticeships themselves have a good track record of getting people into higher value, higher skilled jobs. We, of course, have a significant budgetary challenge to manage, given the smash and grab on our budgets with the way that the levelling-up funds have been allocated in future. So, there are very real practical questions about what we can do, not so much about what we want to do, but the Counsel General and I remain engaged in really constructive discussions to try and find a way forward.

Yes, our tourism recovery plan, published in March 2021, aims to bridge us back from the pandemic to the overarching tourism strategy, 'Welcome to Wales: Priorities for the visitor economy 2020-2025'. That aims to grow tourism and deliver benefits across the whole of Wales, with environmental sustainability and social and cultural well-being at its heart.

Thank you, Minister, for that answer. You'll know that tourism is a major employer in my region of South Wales West. It creates thousands of much-needed jobs and accounts for around 9.5 per cent of employment across Wales. However, after reading the coalition document agreed between Plaid Cymru and the Labour Party, which was signed today, I see a tourism tax that threatens to punish these businesses is very much still on the cards.

We know this tax would damage local economies and cost livelihoods, hitting taxpayers in the wallet in a time of economic uncertainty. With the industry already facing several issues, from COVID restrictions to the highest business rates in Great Britain, many will find Plaid Cymru and Labour even considering this tax completely unacceptable. The chief executive officer of North Wales Tourism, Jim Jones, described it as not listening to the people whom it will affect the most. He said,

'Back when it was proposed in 2017 it was unpopular. That’s why it was dropped. Nothing has changed.'

Now I read from your coalition agreement that this tourism tax will be rolled up into the local government finance reform legislation, potentially tying it up with local council tax reform and other ways that councils raise revenue. Therefore, can I ask, Minister, what economic impact assessment have you made of a tourism tax on our tourism economy and small businesses? In the light of that coalition agreement signed today, what discussions have you had with the Minister for Finance and Local Government to ensure that those councils that decide not to adopt a tourism tax are not punished financially by other means?

Well, I think there's an inaccuracy—I'll put it that politely—in the way the Member has presented this. The proposals to consult on a tourism levy are part of the manifesto that saw 30 Welsh Labour Members elected by the people of Wales to the Senedd. They already form part of the programme for government, and it's no surprise that they're there within the co-operation agreement that has been signed today.

We've been really clear on several occasions in the past, when the Member and others have asked about this, that we're looking to consult on this during the next year or so. That will be led by the finance Minister, as a potential new addition to taxation policy, and it would be on a permissive basis to give local authorities the ability to use the powers that we're looking to give them.

Now, some local authorities may decide not to proceed with that, and that would be a matter for them. It's a permissive power that we're looking to consult on, rather than requiring people to have a tourism levy. I do think that it's worth considering how people in the sector may see that as being positive, but also how it supports sustainable tourism, with the additional pressure that tourism causes to some communities around Wales and the services that exist for local people who live there year round as well as visitors. We want to have a proper balance in the way that the visitor economy functions, with good jobs year round, improving seasonality and making sure that local facilities and services aren't compromised.

It's worth, of course, noting that every time a Conservative stands up and says that a tourism levy would destroy jobs and be dreadful, actually, tourism levies are entirely normal in many parts of the world, including our near neighbours. Anyone who's holidayed in Spain has almost certainly paid a tourism levy; lots of people who go to France have almost certainly paid a tourism levy at some point. This is really quite mainstream in permitting local authorities to determine if they want to use it and, if so, at what level and for what purpose. It certainly hasn’t deterred Brits from going and travelling to different parts of world to contribute to the visitor economy in other parts of the world. I think this is a very sensible contribution, and it’s one we committed to consult on in our manifesto. It should be no surprise that it appears in the a co-operation agreement signed today.

Thank you. As the Member will know, on 18 October, I held an economic summit to discuss with stakeholders how we can work together to pursue a progressive economic policy that focuses on better jobs, narrowing the skills divide and tackling poverty. A prime example is the Swansea bay city deal, which aims to create over 9,000 skilled jobs and increase gross value added by £1.8 million.

Can I thank the Minister for that response? Anyone listening to discussion in the Senedd would think that the two key economic sectors were agriculture and tourism and, therefore, our ambition was to emulate the economic success of Greece. I would like to see more done to support three of the high-paid sectors, namely ICT, life science and highly skilled professional services. What is the Welsh Government doing to work with the Welsh universities to develop these economic sectors?

Thank you for the supplementary. I don’t think I’d share the Member’s characterisation of debates within the Senedd and the priorities of the Government. Today, we have, of course, heard about tourism from a number of questions, but it’s a significant part of our economy. We think it can grow sustainably in the future, year round. But, also, we've talked about other sectors too. We’ve heard a question about legal professional services today, and I myself have recently had a follow-up meeting in my role as the lead Minister for science in the Government with the life sciences hub around the corner from the Senedd. So, I am certainly interested in how we deliver high skills and good wages here within Wales. It’s been a key part of what I’ve discussed and, indeed, my predecessor has made clear during his time as the economy Minister as well.

I am optimistic about our ability to generate greater growth within these areas. We know digital innovation is key for small, medium and large businesses in the future. We know that, in life sciences, we already punch above our weight. The way that the health service is organised within Wales is a real benefit for generating more investment in that sector, as well as the excellence in research terms within the university sector. The Member will, of course, be aware that his local university, Swansea, have Pfizer, for example, where they chose to come to Swansea because of the excellence in the university and because of what the healthcare system offers in terms of having a whole-system analysis on improvement.

So, yes, we are already working with universities. They’re concerned about the loss of some of the research funding that European funds used to give them, but I am confident that we will continue to see greater return from what universities do in research, development and innovation to improve our economy, not just in the three areas the Member outlines, but in other areas too, and I look forward to working with the Member to do just that.

Minister, the question about more people in higher paid sectors is vital. There are some parts of Wales where people have not had the opportunity to be employed in those higher paid sectors because we have not seen the required growth. What is your ambition, and what proportion of jobs in Wales will be higher paid by the end of the parliamentary term? Thank you.

We don’t have a definition of what you mean by higher paid. We certainly think that our tax base in Wales is in the wrong shape. We need more people who are higher rate taxpayers. That’s both by growing the economy here in Wales, investing in skills and people, as well as understanding what we can do in some of those sectors where we have particular expertise in different regions within Wales. It’s why we've invested so much time and effort as a Government in having a proper framework for regional investment, because we think that will make a real difference. It’s why we’ve been proper and constructive partners in city and regional growth deals. There’s been a real response from businesses, local authorities and, indeed, trade unions on the mission that we have within the Government.

It’s why I’m interested in what we do to make sure that young people don’t need to leave the country—'You don’t need to get out to get on' has to be a reality, not just a slogan—and also why we’re interested in seeing if we can persuade more people to actually found themselves and their businesses here in Wales. There are real opportunities to do so. I’m not going to have a hostage to fortune in having a particular percentage indicator on growth. It’s about how successful we can be in doing what the mission of the Government sets out—to have a fairer, more prosperous and more sustainable Wales. I’m confident that, by the end of this term, we will have done just that.  

Minister, the aerospace industry is a source of well-paid employment in my constituency, in particular Airbus and its surrounding supply chain, but the benefits do go a lot further than just Alyn and Deeside—they stretch across every part of Wales. These skill sets based within this industry will stand us in good stead for the future, and I think we saw the very best of that skill set last year when we saw the workers turn their hands to ventilator production at a time of desperate need. It is my view that it's important now that we do send a clear signal that we support the aerospace sector and that there is political will to do so. Minister, do you agree with me about the importance of this clear message, and will you meet with me to discuss this topic further?

I've been really consistent since I've taken on this post, but even beforehand. My interest in the economy as health Minister was the reality that people who are in better-paid work are much more likely to have better health outcomes. It's not just about the taxes they pay to fund public services, but they are less likely to need healthcare as well. I had a number of conversations with Ken Skates in that former role about our joint interest in life sciences, our joint interest in helping employers to become better employers. Because the improvement of well-being in the workplace is a really important factor for the health service as well. When it comes to well-paid jobs in advanced manufacturing, aerospace is a good example, and I'm really keen that we don't see jobs leave Wales; I want to see this sector continue to have a good future and, indeed, a growing future in Wales. Part of that is the work that those companies are already engaged in, in looking at how they decarbonise the industry, how they take advantage of new methods of construction that can improve the products they provide, and, crucially, I think, the transition to new fuel technologies as well. Net-zero flight is likely to be a generation away, but between that time, there is a real imperative to reduce the carbon not just in the production process but in the way that aerospace operates, and we have a range of those examples within Wales. So, I'd be happy to meet with the Member to discuss that in more detail, because I am confident and positive about the future of the aerospace industry here in Wales.

Thank you. Employers can fill their skills gaps through the young person's guarantee by offering an apprenticeship place, recruiting and training via our employability programmes, or by advertising their jobs through the Working Wales jobs bulletin. Employers can discuss their needs by contacting the Business Wales skills gateway.

There's a danger in that that we're simply putting out more journalists, for example, or hairdressers. Others have talked about the aerospace industry; I want to focus on the construction industry. We heard from the construction cross-party group earlier this week that there are 3,000 unfilled vacancies in the traditional construction skills, so there are clearly opportunities there. But also, the future generations commissioner has highlighted the thousands of jobs and skills that are needed, both to build the zero-carbon social housing that we have, as well as retrofitting all our existing homes, and that includes the need for nearly 3,000 retrofit engineer assessors. I'd like to understand what the Government's strategy is for ensuring that this fantastic young person's guarantee is leading into the specialist retrofit and construction work that is so urgently needed to ensure we deliver on the zero-carbon strategy that we've set ourselves.

I think it's both the work we do with the guarantee, as well as what we're doing on, more broadly, looking to generate better value from local supply chains. When we talked about the foundation economy and getting better jobs closer to home, actually, this is part of it, to make sure that we're investing in local businesses. The business that I visited to launch the £35 million fund is a good example in exactly this area. They provide energy-efficiency services, they retrofit houses, including solid-stone properties, to improve not just the bills for that person but, actually, what it means to have a genuinely decent and warm home. They're a good example of where they're already investing in their current workforce and their future workforce to provide exactly the skills that you refer to.

I mentioned earlier in answers today regional skills partnerships. They're really important to make sure we don't do what you suggested might be possible in simply generating a range of people for jobs that don't exist. It's really important to match up the skills that businesses are telling us they will need for the future, the skills we recognise we need for the future, and to make sure that the way that the courses are provided from providers actually match the skills that are needed. It is about a proper partnership—skills partnerships, local authorities, businesses, trade unions and the Government—and it all fits in with our approach on regional investment and support for our economy. I'm confident and optimistic that the young person's guarantee will fit in with that. The way that we're structuring the new Jobs Growth Wales+ programme, and, indeed, the announcement I'll make in the new year on ReAct plus, I think, will give the Member the sort of comfort that she is looking for that we are genuinely looking at skills for the future. 

Thank you. Our export action plan sets out the measures we are taking to promote the benefits of international trade. This includes delivering a comprehensive range of export programmes to support businesses on their export journey. We want to build export capacity and inspire other businesses to export, to find overseas customers and to access overseas markets. We'll continue to do that work in tandem with my officials, and, indeed, business organisations themselves.

Thank you, Minister, for that response. As we know, the pandemic has had a substantial impact on the export market across the world. In Wales, for example, the value of goods exports has reduced by £2 billion in the year ending June 2021 compared to the previous year. I recognise the work that your Government is doing to support the export market, such as through the export action plan, as you've just mentioned. Whilst the plan states that the Government is focusing its support on priority sectors, it also notes that the existing strategy's focus on so-called enabling sectors, such as tourism and education, is being revised in light of the impact of the pandemic. Could you, Minister, provide an update on the implementation of the action plan, and the impact that current uncertainties, such as the omicron variant, may have on Welsh exports? Also, how is the Government supporting the development of enabling sectors to help promote them in the wider world? Thank you.

On the omicron variant, I think it's fair to say that we're living through a period of uncertainty, so it's hard to have a specific programme when we're not certain what the end outcome is going to be. I think that would be the same response for any Minister in any of the four administrations across the UK. I think it's really important that I don't try to set out an artificial level of certainty that will prove to be incorrect and may lead to people making choices that they then regret on the basis of what I've said. I'm sure the Member understands that.

On your point about enabling sectors, we already have support for tourism within the UK as a visitor economy, but also, going back, if you like, to one of Jack Sargeant's points about a sustainable future for aerospace, we still expect that there will be travel between different countries for leisure and for businesses, and how Wales is seen in the rest of the world is important for that. So, we are looking at international visitors in terms of what does that mean for a sustainable model of an international visitor economy, what does it mean for Wales's image around the world, not just in things like our sporting and cultural traditions, which are an important part of the offer. I think people sometimes underestimate the cultural offer that Wales has in itself. But, actually, in the last two years, I think Wales as a country has had a significant interest in other parts of the world more generally. I have done more international media in the last year and a half than I have done in the previous six or seven years as a Minister within the Government, and I think it's also true that the First Minister has done much more international media than his predecessor.

So, actually, the profile of Wales is on a different level now, and that's a good thing, because it's been broadly seen as being a positive as well. We're looking to then work alongside businesses to understand what their aspirations are, how we present Wales in some of the developing international fora—the world expo, for example, being a good example—but also working alongside businesses and organisations like the CBI. My recent speech to the CBI was exactly in this space about what we can do for British businesses, including Welsh businesses, to be much better at gaining new markets internationally. So, I don't think, on those points, the Member will find there's disagreement between us.

Ac yn olaf, cwestiwn 8, Joyce Watson.

Thank you. The foundational economy is central to our economic resilience and reconstruction mission. We are supporting partners to deliver projects that nurture the foundational economy, and, of course, the backing local firms fund, which I announced earlier this month. We believe these will help businesses to overcome barriers to engaging in procurement, and deliver more jobs and better jobs closer to home.

Thank you for that answer. Of course, the foundational economy challenge fund has helped numerous businesses in my region of Mid and West Wales since its launch. One of the areas it has helped is Cyfle, who provide excellent apprenticeships and opportunities in the construction industry, and Jenny Rathbone has already mentioned this morning that that industry is in need of shoring up in terms of those apprenticeship opportunities. You've pre-empted the fact that I was going to go on to your announcement on the £1 million for the backing local firms fund that you've announced earlier. What I would like to know, Minister, is when you will be able to give any details on businesses in my region that will benefit from that new and very welcome fund.

Yes, I'd be happy to work with the Member as we go through, not just the announcement of the backing local firms fund, but then when we get to identifying those firms that have been successful, because we don't just want to see where they are, but then the impact of the money and how we will want to help them to engage within their local economy. So, I'd be more than happy to take up an opportunity to take the Member through that once we've had some of the outcomes. And who knows, we may be able to visit one of those firms within her region in the future.

Diolch i'r Gweinidog.

A dyma ni felly yn symud ymlaen at eitem 2, sef y cwestiynau i'r Gweinidog Iechyd a Gwasanaethau Cymdeithasol, ac mae'r cwestiwn cyntaf gan Rhys ab Owen.

Diolch yn fawr. Mae pob practis meddygon teulu ar draws Cymru yn gweithio'n galed i ymateb i'r pwysau a'r galw cynyddol gan gleifion. Rwy'n cynnal cyfarfodydd rheolaidd gyda chadeiryddion y byrddau iechyd i drafod sut y caiff gwasanaethau eu cynllunio a'u darparu.

Diolch yn fawr, Weinidog. Yn chwarter cyntaf 2022, bydd canolfan feddygol Saltmead yn Grangetown a meddygfa Albert Road ym Mhenarth yn cau eu drysau i filoedd o gleifion am y tro olaf. Yn ogystal, os bydd Bwrdd Iechyd Prifysgol Caerdydd a'r Fro yn cael ei ffordd a bwrw ymlaen gyda chynigion, bydd yr un peth yn digwydd ym Mhentyrch. Hyn, er gwaetha'r ffaith bod yna gannoedd o dai wedi cael eu hadeiladu yn yr ardal yn ddiweddar.

Fe wnes i ysgrifennu atoch chi yn ôl ym mis Hydref, yn codi pryderon ynglŷn â chau'r feddygfa yna, ac er gwaethaf argymhellion y cyngor iechyd cymunedol, dyw'r bwrdd iechyd heb ymgynghori â'r gymuned leol ynglŷn â'r cau. Mae yna gyfarfod cyhoeddus ym Mhentyrch ar nos Lun, 13 Rhagfyr. A wnewch chi annog cynrychiolwyr o'r bwrdd iechyd i fynychu'r cyfarfod hynny, neu os dyw hynny ddim yn bosib, sicrhau bod yna ymgynghoriad llawn yn digwydd gyda'r trigolion lleol fel bod modd iddyn nhw godi eu pryderon a'u bod nhw ddim yn teimlo fel eu bod nhw'n cael eu hanwybyddu? Diolch yn fawr.

Diolch yn fawr. Dwi'n ymwybodol bod y sefyllfa yn peri pryder i bobl sy'n byw yn ardal Albert Road, Pentyrch ac yn Saltmead, a dyna pam mae'r bwrdd iechyd yn edrych i mewn i'r sefyllfa yma. Wrth gwrs, o ran Albert Road, bydd y bobl sydd yn mynd i'r feddygfa yna yn gallu parhau i fynd yna tan 18 Mawrth, ac wedyn byddan nhw'n cael mynediad i bractis arall yn yr ardal leol. 

Fel rŷch chi'n ei ddweud, o ran Pentyrch, dwi'n gwybod eu bod nhw wedi bod yn gweithio gyda thrydydd parti i weld ble maen nhw'n gallu codi lle newydd, ac wrth gwrs, dwi'n meddwl ei fod yn bwysig fod pobl yn cymryd rhan yn yr ymgynghoriad yna a'u bod nhw yn cael eu llais nhw wedi ei glywed. A hefyd o ran Saltmead Medical Centre, mi fydd y gwasanaeth yn fanna yn cau, fel rŷch chi'n ei ddweud, ar 25 Chwefror blwyddyn nesaf. Beth sy'n digwydd yw bod y timau lleol a'r bwrdd iechyd lleol wrth gwrs yn ymwybodol iawn o'r sefyllfa ac maen nhw'n rhoi pethau mewn lle i sicrhau fod pobl yn cael y ddarpariaeth sydd ei angen arnyn nhw.

A recent British Medical Association tracker survey has revealed that over half of the doctors surveyed in Wales have worked extra hours during the pandemic with a quarter of them reporting that these hours were unpaid. Over a third of the doctors who responded to the BMA's survey felt pressurised by their employer to work extra hours and over a third had also either skipped taking their allotted break time or had only taken it on rare occasions. This has unfortunately left many exhausted, with over half of the surveyed doctors reporting a higher than normal level of fatigue or exhaustion, and, worryingly, 76.6 per cent revealing that their stress levels had worsened since the start of the COVID-19 pandemic. Another survey commissioned by the BMA in April this year revealed that 51 per cent of members are currently suffering from depression, anxiety, stress, burnout, emotional distress, or another mental health condition, 16 per cent plan to leave the NHS altogether, and 47 per cent plan to work fewer hours after the pandemic. I'm sure that these percentages are reflected throughout the United Kingdom, and further afield, but they do indicate that the medical profession is under enormous strain, and this can only be made worse by the continuation of the pandemic and the new omicron strain. With this in mind, Minister, what measures are the Welsh Government taking to help support the health and well-being of GPs, as we begin another winter with COVID? Thank you.

Thanks very much for that question. I'm more than aware of the pressure that GPs have been under for an extended amount of time now. I know that many of them are absolutely exhausted, that they've seen far more patients than they've ever seen before, that the way they've had to change the way they facilitate access for patients very quickly has been difficult for many, and I'm aware that the sickness levels are at around 11 per cent, which is significantly higher than many other people working in the NHS. So, we're very aware of that, and my colleague who is responsible for mental health will be aware and is making sure that the help for health professionals is available for them. We've put £1 million into that over the course of the pandemic. And of course, we're trying to recognise with the announcement today that there will be a 3 per cent increase in terms of what we are giving in support to doctors, to recognise the work that they have been doing over this extremely difficult time.

It is going to be difficult. We've changed the way we work, and some of that has worked really well for patients, but GPs have had to adapt as well. And I think we do have to all make sure that we understand the pressure they've been under, which is why I would urge the people of Wales to consider if there are other mechanisms for them to get the support they need. And that could be through phoning 111; it could be through asking their pharmacy for support. So, just making sure people are aware of those alternatives.

Mae mynediad at wasanaethau gofal sylfaenol wedi newid yn ddramatig ar draws Cymru dros y ddwy flynedd ddiwethaf. Mae gwasanaethau wedi gorfod addasu fel y gall cleifion gael mynediad at ofal sylfaenol mewn ffordd ddiogel ac effeithiol. Mae llawer yn defnyddio technoleg ddigidol i helpu i ddarparu'r gwelliannau hyn.

Diolch yn fawr, Weinidog. A number of constituents regularly complain to me that they find it very difficult to obtain an appointment to see their GP. Typically, they ring up at 8 a.m. as required to, but are unable to get through for quite some time, they're constantly telephoning, and then, when they eventually get through to the practice, they're told that all the appointments for that day have been allocated and that they should ring back at 8 a.m. the next morning, when they may well have the same experience all over again. So, in light of those problems, Minister, I very much welcome the announcement you've made today of changes to the GP contract, so that new funding and new systems will be put in place for these telephone services, to enable better access, and we're no longer in this 8 a.m. situation, as it were. But I wonder if you could tell me when these new systems are likely to be in place, and also whether you will work with the health boards to ensure that those practices with the greatest problems are the first to receive this very necessary support?

Diolch yn fawr iawn, John. I'm pleased that we were able to make that announcement today. This has been several months of very sensitive negotiations with those people who have been on the front line for all that time. So, we had to get the balance right here, because, obviously, we have a responsibility to support the GPs, who are in a very difficult situation, but also to make sure that there is a decent provision and service for the people of Wales. And that's why we've really focused that GMS contract on the access issues that, as you have pointed out, so many of your constituents, and others, encounter, with that 8 a.m. bottleneck in particular a problem for so many, people trying time and time again to get through to their surgeries. 

So, we've announced today a £12 million contribution. Some of that will obviously go towards the 3 per cent pay rise, but also, we are ensuring that there will be additional support to invest in systems that will improve the way that people get through, but also, to get better planning in place in those surgeries so that they don't have that charge at a particular time of day. 

So, this is going to happen from April next year, but, obviously, we need to make sure that everything is in place and ready to go from April, which is why we made that announcement today. 

Minister, since primary care practitioners often care for people over extended periods of time, sometimes many years, the relationship between patient and doctor is particularly important. Now, when it comes to mental health issues, trusting relationships have been found wanting, because, simply, they can't get through to their GP. And in my own local health board, I'm seeing now many patients passed between department, between pillar and post, due to such a high turnover of staff in mental health services. 

Now, by having dedicated mental health support workers within their surgeries, or mental health nurses, GPs have found previously these have been really, really useful, and have actually been able to provide support there and then. Local GPs have asked me to raise this again as to when introductions of these nurses could be put back into GP surgeries. Will you confirm what steps you have taken to evaluate the training and recruitment costs required to place a mental health professional in every GP surgery across our constituencies, and will you listen to our GPs on the front line, who are simply asking for this? Diolch. 

Thanks very much. Well, obviously, mental health is an issue that my colleague, Lynne Neagle, leads on, and I know that you'll be aware of her incredible commitment to this cause over many, many years. It's absolutely clear that the number of people who are contacting their GPs for mental health support has increased significantly, and there are lots of ways for us to deal with this. I think one of the key things, though, is that we need to not overmedicalise mental health issues if they are not medical. So, social prescribing is something that we're very keen to encourage, but the early help in our community, I know, is exactly the kind of route that Lynne Neagle is very keen for us to focus on. 

When it comes to specific cases, nurses in our communities, I think what's more likely to happen is that we'll start that on a kind of cluster basis, and I think that's probably the route, so that we know that, at least in a particular area, there will be access. But, as I say, I think we absolutely need to get to the point where we understand that mental health issues are not all medical. Sometimes they're about social issues, they're about relationship issues; they are not medical issues. And we need to make sure that we don't overmedicalise mental health issues if it's unnecessary to do so. 

Good afternoon, Minister. I'm appreciative of all of the work that you've done; you have an incredibly busy job. But I just want to talk about teeth and dentists, specifically the teeth of people in mid and west Wales, and specifically the teeth of the people in the town of Llandrindod Wells. As you know, I've written to you on a number of occasions, but there are massive concerns around the lack of dentists, both across the region, and specifically, in Llandrindod Wells, which has been the case for a number of years, pre COVID. We know that there are significant challenges in COVID with treating people in dentists, but there is a massive difference here. If you go to a private dentist, you can be seen almost straight away. If you go to an NHS dentist, you can't. And that doesn't matter if we're in COVID times or not.

So, I just really want to ask you specifically: could you tell us what your plans are for dentists, both in mid and west Wales, and in Llandrindod Wells, and across the whole of Wales as well? Thank you very much. Diolch yn fawr iawn.  

Thanks very much, and thank you for your perseverance on this issue. And I know it's an issue that matters a huge amount to you in particular; I know that there is a particular problem in the Llandrindod area, and that's why we have been trying to focus our attention on that.

It's not an easy issue to resolve, but one of the things we have done is to make sure that we've injected an extra £2 million this year to try and encourage dentists to take up more opportunities to see those NHS patients that we're so anxious for them to extend their abilities to at the moment. So, that money has been put on the table. Part of the problem we have, frankly, is that lots of dentists won't come in and pick the money up. So, that is part of our problem, and so I think there is a longer term issue that we need to address here.

We need to have a situation, and I've asked my officials to start to develop a 10-year plan, to understand where are we heading with this, because it's absolutely clear to me that more people in Wales want access to NHS dentists than the places available, and, at the moment, the model is not providing for that to happen. So, we need to think fundamentally about how we change the model and what's possible here. So, it's not going to be a quick fix, I'm afraid, and it's not easy to do this whilst dentist services, of course, are still in amber. So, you're aware that, at this time, when COVID is still an issue, and that it is a case where we see the change and things being carried through aerosols, it is really problematic. And the cleaning in between, all of that does not help to speed the situation up. 

We've also got to make use of all of the dental technicians and people who have real skills, and I know a huge amount of good work's been done in Bangor University to demonstrate that actually we could be using those skills to a much broader extent than we are at the moment. But I'm meeting on a monthly basis now—. I've only picked on about five different things to just keep on coming back to to make sure we don't lose focus on this, and I can assure you that dentistry is something that I'm having monthly meetings on so that I keep that focus very clearly on what needs to happen.

Cwestiynau nawr gan lefarwyr y pleidiau. Llefarydd y Ceidwadwyr, Russell George. 

Diolch, Llywydd. Minister, are you confident that everything is being done, in your power, to ensure the speedy roll-out of the booster vaccination in Wales?    

Well, thanks very much, Russell. I am confident that all the stops are being pulled out, as we speak; that the NHS health boards are developing, and, today, are supposed to come back to us with what their proposals are to massively increase the booster roll-out in Wales. We're not just asking that of health boards; we know that we're getting offers of support from local government, from the fire brigade, and we may be looking to the army for more support as well. So, all of those things are being put in place. We know that there's no problem with supply, but we will be calling for a volunteer army as well, in particular those people who stepped up the first time and who won't need to be retrained. It is a short period of time that we're asking people to step up here. If we can get this done very quickly, before any possible omicron wave hits us, that would be very helpful. 

Thank you for your answer, Minister, and it's a positive reply, I think. I think that it's correct to use every tool in the toolbox and to call upon the army and the volunteer army that you talked about as well. I think it's welcome, and, of course, it's good news that we've got that supply as well.

But there's one area I would like to pick up, and this is, again, about walk-in centres for booster vaccinations. I raised this with you yesterday, and you cited the JCVI advice that each and every age group should be worked through in order, and you again claimed that it would be a free-for-all. Now, I think perhaps there's been a misunderstanding about what a walk-in centre is and how it operates. NHS England's advice is that letters, text messages and e-mails are automatically sent to those who need a booster, which can then be taken to the walk-in centre. And if you don't get one, then you can ask your GP. So, no letter, no jab. So, this is in order of the correct approach and taken in terms of need, but it also means those who are to receive the booster being able to do so as quickly as possible and as easy as possible for them. 

We're now at the point where the new variant has been, of course, identified in the UK, and I would say we must boost the booster programme. And the BMA this morning said that, 'If they want us to be involved'—talking about you—'If they want us to be involved in the COVID booster campaign, then, of course, something has to give.' So, to ensure that we have significant uptake of the booster, it's clear that we need to use every tool at our disposal. So, with GPs overstretched beyond their limits, can I ask you now to reconsider your rejection of walk-in centres as a means to support the booster jab roll-out?

I'm sorry if there's been some misunderstanding in terms of the situation with the BMA. My understanding is that, of course, they are aware that their members are under huge pressure already, but I don't think they were closing the door on the option of GPs being able to help out if they were called on to do so. What they were saying is, if we do that, then, obviously, something else will have to give. Now, there is an understanding of that. We believe that this is a priority now in order to make sure that we're not overwhelmed at a later date, and I know that there will be GP practices all over Wales that would be more than willing to step into this position.

When it comes to walk-in centres, well, maybe we're just getting terminology mixed up here. We obviously have mass vaccination centres, where people come in with their appointments. So, that sounds quite like a walk-in centre to me, if that's what you're talking about, and we do have those, of course, all over Wales. Obviously, we're looking at how we can increase massively the number of people who are admitted to those centres. 

Thank you, Minister. I appreciate, if this is a misunderstanding, that's positive—perhaps a step forward in terms of making sure that we do have those booster walk-in vaccination centres across Wales, because some health boards are already operating those. So, I think perhaps it would be helpful to provide health boards with clarification in terms of your views in regard to booster walk-in centres.

You and I both know, Minister, that we're facing, of course, an unprecedented level of demand on the NHS. We've got the worst accident and emergency waiting times, sadly, on record, alongside the slowest ambulance response times on record. On top of that, one in five of the Welsh population are stuck on a waiting list. Specifically, it's deeply concerning that 59 per cent of cancer patients were treated within 62 days of being suspected of having cancer. We also know from your own figures that 20,000 fewer people were urgently referred for a cancer diagnosis between March and November of last year, compared to the previous year, before the pandemic, and 1,700 fewer people began treatment in the first few years of the pandemic. So, the cancer workforce is also overstretched beyond capacity. Now, your predecessor published the quality statement for cancer in March, but this has been severely criticised by the Cancer Alliance for lacking detail and accountability, meaning we're soon going to be the only UK nation without a cancer strategy. So, I'm sure you'll be responding in more detail to the Member debate this afternoon. But, can I ask you how far you are with your plans to roll out rapid diagnosis centres across each health board, what progress you are making on regional surgical hubs, and when will you be publishing the cancer workforce strategy?

Thanks very much. Well, there's no question about it, our NHS services are under pressure like they've never seen before. We've seen a huge increase in terms of demand, but I can assure you that when it comes to cancer, this has always been an essential service; it has never been something we've switched off. We have invested significantly in new equipment, and I'll have a lot more to say about that in the debate later. The cancer pathway is a unique approach in the United Kingdom, making sure that we count people right from the beginning of the suspicion of cancer. It's a very different method, and that perhaps goes some way to explaining why we see significantly more on the waiting lists in Wales, because, actually, the way we count patients in Wales is very different. They're counted very differently, particularly in relation to cancer, in England. So, rapid diagnosis is, of course, really important, and developing an adequate workforce is key, as well, which is why we're investing in those as well.

Llefarydd Plaid Cymru, Rhun ap Iorwerth.

Diolch yn fawr iawn, Llywydd. Mae'r Gweinidog wedi disgrifio yn reit frwdfrydig sut mae am greu byddin frechu ar gyfer cyflymu cynlluniau i roi'r booster. Does yna ddim llawer o fanylion eto; mae'n eithaf cynnar. Dwi'n edrych ymlaen at weld rhagor o'r manylion. Ond, er fy mod i'n ymwybodol o'r datganiad gafodd ei gyhoeddi heddiw am ddiwygio contractau ar gyfer gwasanaethau meddygol cyffredinol, rydyn ni wedi clywed pryderon gan y BMA heddiw fod yna broblem ddifrifol o gapasiti gan feddygon teulu i gyfrannu at wneud y gwaith. Felly, sut mae'r Gweinidog yn bwriadu gweithredu'r cynlluniau brechu yma, yn cynnwys gofal sylfaenol, ac ar yr un pryd drio sicrhau bod gofal sylfaenol yn gynaliadwy?

Diolch yn fawr. Wrth gwrs, bydd yna broblem capasiti os ydyn ni'n mynd i daflu popeth at hwn yn ystod yr wythnosau nesaf. Yn amlwg, fe fydd yn rhaid i bethau eraill gymryd sedd sydd ychydig tu ôl i hynny. O ran gofal sylfaenol, rŷn ni'n ymwybodol iawn fod pwysau aruthrol arnyn nhw, ond mae'n ddiddorol i weld bod rhai meddygon teulu wedi bod yn barod i ddod i'r adwy, i gymryd yr awenau yn fan hyn. Fel rydych chi wedi gweld yn ardal Pen Llŷn, er enghraifft, maen nhw eisoes wedi bod yn helpu gyda'r boosters. Dwi'n meddwl eu bod nhw'n deall y sefyllfa. Dwi'n obeithiol iawn y bydd meddygon teulu yn camu i'r adwy, ynghyd â phobl ar draws Cymru, y rheini sy'n wirfoddolwyr ac, wrth gwrs, bobl o lywodraeth leol ac ati hefyd. 

Diolch am yr ateb yna. Pan fydd y Gweinidog yn sôn am rai pethau'n gorfod cael eu rhoi yn y sedd gefn, dyna dwi'n poeni amdano fo, ac mae yna, wrth gwrs, oblygiadau difrifol iawn—y mwyaf difrifol—pan fydd rhai pethau'n cael eu rhoi yn y sedd gefn, a dwi'n meddwl am ganser a'r angen am ddiagnosis canser, er enghraifft. Mae yna lawer o bobl sydd yn dal, o bosib, yn cadw draw o ofal sylfaenol, â pheswch, a dylen nhw fod yn cael triniaeth oherwydd efallai mai canser yr ysgyfaint ydy o, ond yn dewis am ba bynnag rheswm i gadw draw. Mi ges i gyfarfod â Tenovus ddoe, oedd yn disgrifio beth roedden nhw'n ei weld fel nifer devastating, i'w dyfynnu nhw, o bobl rŵan oedd ddim yn canfod canser yr ysgyfaint, er enghraifft, tan gyfnod 4. Mi fyddai strategaeth i sicrhau bod canser yn cael ei ganfod yn gynnar, wrth gwrs, yn rhan allweddol o'r cynllun canser newydd i Gymru rydyn ni'n wirioneddol angen ei weld. Ond, beth mae'r Gweinidog am ei wneud rŵan i sicrhau (1) fod pobl yn teimlo eto'n ddiogel i fynd at y meddyg teulu, (2) eu bod nhw yn gallu gweld meddygon teulu, a (3) pan fydd hi'n dod at ganser, fod y referral yn dal yn gallu digwydd rŵan, hyd yn oed pan fyddwn ni'n wynebu'r amrywiolyn newydd yma sy'n achosi cymaint o bryder?

Wel, diolch yn fawr. Mae'n rili bwysig i danlinellu'r ffaith bod canser bob amser wedi cael blaenoriaeth a'i fod wastad wedi bod yn wasanaeth hanfodol, hyd yn oed ar ddechrau'r pandemig. Felly, dydyn ni byth wedi cymryd y ffaith fod hwnna'n flaenoriaeth i ni i ffwrdd o'r cynllun. Bydd hi'n bwysig i ni gael cyngor clinigol ynglŷn â beth fydd yn rhaid inni ei roi yn y sedd gefn wrth inni ddatblygu'r system frechu yma dros yr wythnosau nesaf. Bydd yn rhaid i hwnna fod yn benderfyniad clinigol, a byddaf yn edrych ymlaen at dderbyn cyngor ar hynny. 

O ran gweld meddyg teulu, rydych chi wedi gweld heddiw ein bod ni wedi gwneud cyhoeddiad. Bydd mwy o arian yn mynd i mewn i sicrhau bod pobl yn gallu cael gwell access i weld meddygon teulu. Mae £12 miliwn wedi mynd tuag at hynny, yn cynnwys systemau newydd ac yn cynnwys y ffaith efallai y gallen nhw recriwtio mwy o bobl er mwyn gwneud y penderfyniadau yna, a bod pobl yn cael eu harwain at y gwasanaeth cywir a'r person cywir. Nid y GP yw'r person cywir ar bob achlysur. Felly, mae hwnna'n rhywbeth rydyn ni'n awyddus iawn i'w weld, ac rydyn ni'n falch dros ben ein bod ni wedi cael cytundeb oddi wrth y GMC. 

Dwi am newid trywydd ar gyfer fy nhrydydd cwestiwn, os caf i. Roedd yna groeso cyffredinol yn ddiweddar pan wnaeth Llywodraeth y Deyrnas Unedig gyhoeddi y byddai tasglu menopos yn cael ei greu fel rhan o'r strategaeth iechyd menywod. Dydy hi ddim yn hollol glir, o bosib, lle mae'r ffiniau o ran datganoli yn hyn o beth, ond yn sicr mae yna fwy o ddisgwyliadau gan ferched yng Nghymru rŵan, a da o beth ydy hynny, yn sgil y cyhoeddiad yna yn San Steffan.

Mewn cyfarfod o'r grŵp trawsbleidiol ar iechyd menywod ym mis Hydref, mi ddaeth hi'n reit amlwg fod yna dipyn o loteri cod post mewn difrif pan fydd hi'n dod at wasanaethau sy'n cael eu cynnig i ferched sy'n mynd drwy'r menopos yma yng Nghymru. Felly, all y Gweinidog ddweud wrthym ni pa gamau y mae hi am eu gweld yn cael eu cymryd i wella gofal menopos yng Nghymru? Pa bryd welwn ni effaith y camau hynny yn cael eu cymryd? A sut allwn ni fod yn hyderus y bydd yr adnoddau ar gael i roi'r gofal y mae menywod ei angen wrth fynd drwy'r menopos?

Wel, diolch yn fawr, a diolch am y cwestiwn. Fel menyw sydd o'r oedran yna ble mae'n rhaid inni ofidio am y pethau yma, dwi'n falch o weld bod Llywodraeth y Deyrnas Unedig wedi dilyn beth rŷn ni'n ei wneud yma yng Nghymru. Rŷn ni wedi bod yn cynnig HRT am ddim ers blynyddoedd lawer, felly mae'r chwyldro sy'n digwydd yn Lloegr wedi bod mewn lle ers blynyddoedd lawer yma yng Nghymru. Rŷch chi'n eithaf reit o ran y loteri cod post, ac un o'r pethau sydd angen i ni ei wneud yw sicrhau dyw menywod ddim yn gorfod aros cweit mor hir cyn bod pobl yn deall mai dyna yw'r rheswm pam, efallai, maen nhw'n teimlo'r ffordd y maen nhw. Dyna pam dwi wedi gofyn i'r women's implementation group, sy'n gyfrifol am edrych ar iechyd—. Ar hyn o bryd, maen nhw'n edrych ar ychydig iawn o bethau mewn ffordd eithaf cul, o ran mesh ac ati. Dwi wedi gofyn iddyn nhw feddwl am sut gallan nhw ehangu ar hynny. Un peth dwi'n benderfynol o'i wneud yw edrych ar raglen iechyd i fenywod, a byddwch chi'n clywed mwy am hynny yn ystod yr wythnosau nesaf.

Thank you very much. Health boards are responsible for planning to meet the needs of their residents. There has been concerted work throughout the pandemic to forecast demand and develop surge capacity to meet anticipated peaks. Ensuring sufficient capacity for winter is a key priority and it's discussed regularly with health boards and included within winter plans.

Thank you, Minister. New data published in 2021 by the Welsh Government show that, within Welsh hospitals, there is an average of 10,340 beds available, a drop of over 200 beds recorded from the previous 12 months. Minister, when was it decided that slashing beds was the right course of action, especially during the pandemic? In 1999, when the Senedd was first established, there were 14,723.4 average daily beds available in Wales. That's a nearly 30 per cent decrease in hospital beds since Labour have had control in Wales. My region of South Wales East continues to be the worst affected area for COVID infections, with further concerns of flu levels obviously coming over the winter, and we see beds now still at levels lower than in 2009-10, by nearly 50 beds in my region. Can the Minister assure me that she will not make any further cuts to bed numbers and work with health boards to bring bed capacity up in South Wales East and the rest of Wales?

Well, I think it's really important for us to understand that actually we've got a programme, and the programme, 'A Healthier Wales', is trying to make sure that people get support as close to home as possible, and ideally that would be in the home. So, that's where we need to be heading. I think we've also got to understand that, actually, the way we do health is changing all of the time. So, a few years ago, if you had a problem with your eyesight, for example, you'd have to go into hospital, have an operation, and you'd be there for days. Well, today, you can go in and leave on the same day. So, obviously, there is no need for beds for that kind of operation in future. So, technology has helped us to move things on.

I think it's really important also for us to understand that, actually, if we can, we want to get people out of hospital as quickly as possible. The next question you're going to ask me is why we've got so many infections in hospitals. I don't want people in hospital. I'd like to get them home as soon as we can. So, that is the answer—we absolutely need to provide the care we can as much as we can at home.

Now, at the moment, we obviously are in a situation where we're stretched. The fact is that about 9 per cent of the hospital beds in Wales at the moment are taken up with COVID patients, many of whom have not had the vaccine. And I do think it's really important that the people of Wales are listening to this, particularly the people who haven't taken up that opportunity. You are taking up a bed that could have been avoided. There are people waiting in pain that could have had that bed, and it's really important that people understand their responsibility to the wider community to take up the opportunity to have the vaccination. 

Minister, I've heard various reports about the new Grange hospital in Cwmbran, and I would stress that this is in no way a criticism of heroic front-line staff. The Royal College of Physicians' recent report calls for an urgent review of the provision of care for the elderly; they raise concerns about chronic workloads and staffing problems and they spoke about parents—patients, forgive me—being moved between the Grange and three other hospitals in the area that don't have A&E departments, with elderly patients with dementia being moved eight times between different hospitals and wards. A senior doctor has recently warned that the hospital is struggling to get patients through the system safely and that the hospital is struggling to cope with emergency arrivals, with ambulances having to wait outside. I note, Minister, that you'd said in a recent written answer to Peter Fox that there have been nearly 8,500 ambulance patient handover delays since the hospital opened. Now, I know that we're going into a really difficult winter period, Minister, and this is concerning. I'd be grateful if you could set out what support the Government is able to offer the health board to improve patient safety as we enter these crucial winter months to root out these systemic issues and reassure staff that their concerns are being listened to.

Diolch yn fawr. I think it's—. I'm very aware of the Royal College of Physicians inquiry into the Grange hospital. I know that the health board has responded and are taking that very, very seriously, but I'm also aware that the community health council have written a report as well. They also highlight some of the challenges at the Grange, but they also have emphasised some examples of good patient care, and positive patient and staff experiences, so I think it's really important that we don't talk down the Grange hospital. This is an incredible facility; it's really important that people understand that, actually, it's a facility that is right at the heart of a huge area, it was very carefully thought through, but, obviously, what we're facing here is a huge amount of pressure, the likes of which we've never seen before, particularly when it comes to ambulance services. That's why we have made £25 million additional support funding to go to the transformation of urgent and emergency care services to make sure we deliver the right care in the right place at the right time. I know this is being used in the Grange hospital to see if we can do more work in cohorting multiple patients who've come in in ambulances—so, a lot of creative ideas coming through there.

So, I do hope that things, of course, will improve in the Grange. They are making sure, I think, that there's an electronic waiting-time board, so that people have more visibility on how long they've got to wait, but also there's a work stream on admission avoidance, and that's what we've got to see, to make sure that people are going to the right hospital at the right time. I know they've sent a leaflet to every household in the area, but it's important that people perhaps take the opportunity before they set out to make sure that they are going to the right hospital for their care.

We continue to prioritise support for eating disorder services in Wales and we've been increasing our investment each year since 2017. This funding aims to support the transformation of services towards early intervention, in line with the recommendations in the 2018 independent review.

Thank you, Deputy Minister. As you rightly point out, you did set out an ambitious vision for a world-class service in every part of Wales in the 2018 review and strategy. This called for a shift towards prevention and assertive early intervention and for access to evidence-based treatment and support being available equitably. Staff in eating disorder services are now under even greater pressure than before, due to the level of demand for treatment. Will the Welsh Government publish a new service model or framework, including timescales, to guide health boards in their response to the eating disorder service review? And will it ensure that there is an appropriate central resource in place to support this work?

Can I thank Heledd Fychan for that question? As I believe she's aware, health boards now receive, since 2017, an extra £3.8 million to support improvements in ED services and waiting times, and since 2019 funding has been provided to health boards specifically to reconfigure services towards early intervention to work towards achieving the National Institute for Health and Care Excellence standards on eating disorders within two years, and to develop plans to achieve a four-week waiting time across adult and children's services, as recommended in the review. We've also provided an additional £100,000 to the eating disorder charity Beat as a direct result of the pressures seen during the pandemic, which she has highlighted herself in her supplementary question.

Aside from the funding that we provided specifically for ED services, we're also improving primary care understanding through the dissemination of clinical resources for GPs, improving awareness within the paediatric community of the need for their skills and experience within eating disorder services, improving specialist knowledge on eating disorders amongst non-clinical staff, and including body image and relationship with food and body issues in the new well-being curriculum and the whole-school approach. We'll continue to use our whole-system approach across Government to build in early intervention support for young people, including at their schools and colleges.

Evidence shows that the impact of COVID on those living with eating disorders was very significant, and throughout the pandemic Welsh Government has released funding with flexibility to manage the increased demand within the eating disorder service. We know, of course, there will be more work to do, and she will be aware that there is an implementation lead in place who has been driving that change across Wales. 

Deputy Minister, social media's impacting young people massively, and apps such as Instagram are affecting the way that people view their bodies. For some young people they take inspiration from what they see online, but for many others the reality is that, due to a huge number of factors, including genetics, work-life balance and affordability, they will just not look like people do on social media and the way society expects them to. Subsequently, we've seen a rise in the number of people treated for anorexia and bulimia, and it's almost doubled in the last five years. Here in Wales, we don't have waiting time targets for those suffering with eating disorders or specialist centres to help people, and that cannot continue. So, what is the Welsh Government doing to ensure that young people are educated about the effects of social media? And what plans does the Government have to improve access for people suffering with eating disorders?

Thank you for that question, James. I think I've already set out the very significant investment we are putting into eating disorder services to transform those across Wales, with a very strong focus on early intervention. We are investing £3.8 million extra every year, and that has continued since 2017. It has been a really challenging time, because we did see during the pandemic an increase not just in the numbers of people suffering from eating disorders, but also an increase in the acuity of people at the time that they presented for support. That has been really challenging, and that's why our focus is on ensuring that, across the board, we've got that range of services from primary care up, including the eating disorder service provided by the charity Beat, which offers a range of really excellent online and telephone support for people with eating disorders and their families to try and make sure that there is support there across the board.

The issue that you've raised in relation to social media is really challenging, and I think one that we all recognise. I think it's vital, really, that through our whole-school approach we work with young people to make sure that they do understand that what they see on social media is not necessarily something that is going to be achievable for most of us. It's also really important that we, through the work in schools and the other work we're doing through the Nest framework, make sure that there is early help, and also encourage people to seek help. But the challenges with social media are real, they're large and, of course, they go well beyond Wales and include—. You know, I hope that you'll make some of those arguments to the UK Government on the work that they are doing to try and tackle some of the harms because of social media.

People on social media do not look like the people on social media in terms of their photograph. Many have been Photoshopped and many have used filters to make themselves look an awful lot better. Can I just say that eating disorders, like all other mental health services, are under increasing pressures? It has been reported that eating disorder services across Wales are experiencing unprecedented demand in referrals. So, the question that I've got is: when will we see the full implementation of the Welsh eating disorder service review recommendations, including the allocation of sufficient staff training and an implementation plan?

Thank you for that supplementary, Mike. We were clear when the Tan review was published that the changes wouldn't happen overnight, given the range and the breadth of the recommendations, and that's why we've continued to invest such a significant amount of funding in implementing the Tan recommendations year on year. As you've highlighted, the pressure that eating disorder services have seen as a result of the pandemic has created challenges with implementation. I'm very pleased that the increased demand in the latter part of 2020 now appears to have stabilised. However, we are continuing to monitor the situation closely, undertaking census days to quantify the volume and complexity of patients occupying a bed with eating disorders. 

In terms of the workforce issues that you've highlighted, recruiting to posts in eating disorder services is, unfortunately, a challenge felt across the UK. The eating disorder implementation lead confirms that all posts from 2020-21 funding were filled by the end of the financial year, but they were often slow to recruit to. As implementation lead, Dr Menna Jones has championed more creative solutions e.g. upskilling current staff to move the vacancy; lowering the structure, which may be easier to fill by less-skilled staff; and recruiting on a regional basis to ensure that an individual has a full-time contract, but across areas. This is, of course, not an issue that is confined to Wales; there are challenges recruiting for mental health across the UK, including in eating disorders. But, I'd just like to reassure the Member that the implementation of the Tan review remains a priority for me as Deputy Minister.

[Inaudible.]—funding a national advertising and social media campaign. We are supporting a range of targeted initiatives to encourage the take-up of employment in social care. We fund regional staff to support campaigns led by local authorities and by health boards.

Thank you, Minister, that's excellent to hear, and I'm sure you'd agree that throughout the pandemic, care homes in my constituency of Clwyd South have dealt incredibly well with the huge challenges that coronavirus has brought, often to the detriment of both the physical and the mental health of staff. On behalf of those care settings in my constituency, can I ask how the £42 million of extra funding announced by the Welsh Government will help them?

I thank Ken Skates for that question, and also thank him for his recognition of the tremendous work that has been done in the care sector during the pandemic. We were very pleased to allocate the additional £42 million allocation, and that was announced through the health and social care winter plan. And the winter plan sets out how this investment will provide community-based integrated responses, and additional support for carers and for families. I know that the recovery plan responses we have received from local authorities show that Clwyd South will benefit from targeted financial support for providers of social care, increasing the current number of volunteers and the recruitment of additional workforce for specific service areas, such as complex disability services, domiciliary care, children's services and supported living. Where providers have not been able to resume the provision of day-care services, for example, there will be financial support and also investment to support additional technology within residential facilities and more activities for residents.

[Anghlywadwy.]—ambiwlans Cymru yn gweithio gyda Bwrdd Iechyd Prifysgol Aneurin Bevan i roi ystod o gamau gweithredu ar waith i reoli’r galw am wasanaeth 999 ym Mlaenau Gwent. Bydd hyn yn arwain at fwy o gapasiti, gwell ymateb i bobl sydd â chwynion lle mae amser yn dyngedfennol, a'r gallu i drosglwyddo cleifion ambiwlans yn gyflymach.

Can I say I welcome that from the Minister? The Minister will have seen the same reports as I've seen and listened to the same experiences of constituents that I represent and she represents, in different parts of the country. We know that there's a real crisis in the interface between the national health service and the people it serves at the moment, and we know that at the heart of that is the ambulance service. We know that people are working harder than perhaps they've ever worked before and that resources are under more pressure than perhaps they've ever been before. So, will the Welsh Government look specifically at how we do manage the ambulance service? Will the Welsh Government look specifically at the resources available to the ambulance service? And will the Welsh Government look at how emergency structures and processes can be put in place today and over the coming weeks and months to ensure that the ambulance service continues to deliver the service that people need, require and have a right to expect, wherever they happen to be?

Thanks very much, Alun, and there's no question that the ambulance service has been under huge pressure, and of course none of these things live in isolation from each other. I think it probably is worth emphasising that, actually, in terms of 999 calls, for example, this October has seen a 24 per cent increase compared to last October. So, it's not just about them not performing well; they're trying to deal with a massive increase in demand, and so I do think we have to understand what is happening here. What we're trying to do is to make sure that the Welsh ambulance service are getting much better at forecasting, that they implement the requirements of the independent demand and capacity review, which looked at the way things were managed, and that we're directing people to clinically safe alternatives to try and dissipate some of that 24 per cent. But you'll be aware that we've already injected £25 million of additional funding into trying to sort out this problem over the winter months; that, since October, 100 military colleagues have been providing support for the Welsh ambulance service; and the trust is committed to recruiting a further 127 staff this year. So, all of these things, I'm hoping, will start to make a difference soon. Obviously, it needs to be sooner rather than later, because we're just about to enter the even more pressurised winter months. So, we're more than aware of the need to fix this problem sooner rather than later.

Diolch yn fawr. Mae Llywodraeth Cymru yn gweithio gyda gwasanaeth iechyd Cymru i gynyddu'r gweithlu yn Hywel Dda, ac mewn mannau eraill o Gymru. Mae hwn yn cynnwys mesurau i gynyddu recriwtio a chadw pobl i weithio yn yr NHS, a hefyd annog pobl broffesiynol i ailgydio yn eu gyrfa a dychwelyd i ymarfer.

Diolch, Weinidog. You'll be aware that Wales's second largest GP surgery is Argyle Medical Group, which is located in Pembroke Dock within my constituency of Carmarthen West and South Pembrokeshire. According to the latest data, over 22,000 patients fall under Argyle's care, making it one of five practices in Wales with over 20,000 registered patients; yet, the group has only nine registered GPs working from the centre. This is compared to 17 GPs at the Sketty and Killay Medical Centres in Swansea, which have a similar patient count. This means that the patient to GP ratio at the Argyle Street practice is a dangerous 2,506 patients per GP. Let's be clear, the Argyle Medical Group staff are working hard to deliver the best quality service they can. However, and as the stats show, their hands are tied by increasing recruitment pressures. Given this situation, can the Minister outline what steps she is taking to support Argyle Medical Group in the recruitment of further staff, including GPs, nurse practitioners, pharmacists and physiotherapists, to ensure that all staff members are supported in delivering the best care for their patients? Diolch.

Thanks very much, Sam. It's important to recognise that there have always been difficulties to recruit to some of our more remote areas. That's why we've had a very significant campaign, the 'Train. Work. Live.' campaign, which has been significant and we've managed to recruit significant numbers to west Wales because of that campaign—30 in 2020 and 26 in 2021. So, we also have Health Education and Improvement Wales, which have published their 10-year workforce strategy, but I think it's important that all GP practices look not just at the recruitment of GPs, but also other models of practice. There are different practices that are calling on other professionals who are able to provide some very, very high-level and quality clinical support not necessarily from GPs. But we are aware that there is always a need to increase the number of GPs in Wales. You'll be aware that, over the next five years, we have committed to training 12,000 additional doctors, nurses and health professionals in Wales.

Ac yn olaf, cwestiwn 8, Adam Price.

Mae byrddau iechyd yn gyfrifol am gomisiynu gwasanaethau i ddiwallu anghenion eu poblogaeth leol. Mae cynllun cymeradwyo ymlaen llaw Cymru gyfan yn sicrhau bod cleifion yn cael eu trin mor agos â phosibl i’w cartrefi o fewn ardal eu bwrdd iechyd lleol eu hunain.

Dwi'n ddiolchgar i'r Gweinidog. Mae'r polisi cenedlaethol yn nodi ni ddylai cleifion ganfod triniaeth feddygol mewn bwrdd iechyd arall heblaw i bob opsiwn lleol methu â darparu'r driniaeth honno. Mae e'n effeithio'n drwm iawn ar gymunedau sydd ar y ffiniau. Dwi'n meddwl am Frynaman Uchaf, er enghraifft, yn fy etholaeth i, lle mae pentref wedi'i rhannu'n ddwy—Brynaman Isaf ym mwrdd iechyd rhanbarth Abertawe a Brynaman Uchaf wedyn ym mwrdd iechyd Hywel Dda—sy'n golygu, wrth gwrs, fod yr amser i gyrraedd ysbyty Glangwili o Frynaman Uchaf dair gwaith yr amser y byddai'n cymryd i gyrraedd yr ysbyty agosaf yn Abertawe. Ers cyflwyno'r polisi cenedlaethol yma yn 2018, mae'r trigolion lleol yn teimlo bod yna waethygu wedi bod yn eu triniaeth glinigol. Felly, onid dyma'r amser, Weinidog, i adolygu'r polisi er mwyn sicrhau bod yna ddatrysiad sydd yn deg i'r cymunedau hynny sy'n digwydd bod ar gyrion ein rhanbarthau iechyd?

Diolch yn fawr. Mae byrddau iechyd yn gorfod datblygu gwasanaethau ar sail beth yw'r boblogaeth leol, ac os ydy cleifion wedyn yn gofyn i fynd i rywle arall, mae hwnna yn gallu cael effaith ar ansefydlogi’r gwasanaethau yn y ddau fwrdd iechyd. Felly, os ydyn nhw wedi cynllunio ar gyfer un peth ac mae rhywbeth arall yn digwydd, yn amlwg mae hwnna'n mynd i greu problem. Dwi'n meddwl ei bod yn bwysig i gydnabod pe bai, er enghraifft, rhywun eisiau mynd o fwrdd Hywel Dda i Abertawe, beth fyddai hynny mewn gwirionedd yn golygu yn y tymor hir i'r ysbyty yng Nghaerfyrddin. So, mae'n rhaid meddwl drwy beth yw'r goblygiadau. Felly, beth rŷn ni'n trio'i wneud yw cael byrddau iechyd i weithio mwy ar raddfa ranbarthol, ond dwi yn meddwl ei bod yn bwysig bod pobl yn deall ein bod ni'n gwneud y pethau yma nid achos ein bod ni'n ceisio gwneud bywyd yn anodd i bobl, ond er mwyn sicrhau ein bod ni'n gallu rhoi gwasanaeth i bob un a sicrhau ein bod ni'n gallu cynllunio gwasanaeth ar gyfer pob un.

Diolch i'r Gweinidog.

Yr eitem nesaf yw'r cwestiwn amserol. Mae un cwestiwn i'w ofyn heddiw a hwnnw gan Paul Davies.

The First Minister and the leader of Plaid Cymru this morning signed the co-operation agreement. The agreement, the detailed policy programme and the mechanisms document that sets out how the agreement between the Welsh Government and Plaid Cymru will work have also been published.

Minister, the mechanisms of the co-operation agreement that have been published this morning make for some very interesting reading. And given the huge impact that this coalition will have on the people of Wales, it's very disappointing that the Welsh Government has chosen not to come forward with an oral statement to this Chamber outlining these mechanisms, so that Members can have the opportunity to scrutinise and ask questions. It's even more disappointing that the First Minister is not here to respond to this very important question. So, Trefnydd, can you explain to us why the Welsh Government has chosen not to make a statement on this agreement in this Chamber, and is instead being forced to respond to an opposition topical question? Because I'm sure even Labour backbenchers would welcome the opportunity to scrutinise this particular deal.

Turning to the details of the mechanisms, the document confirms that

'the Welsh Government agrees to take decisions jointly with Plaid Cymru across the agreed range of co-operation'

on 46 policy areas. However, the Welsh Government has given itself the flexibility to widen the scope of this agreement, as the document says that

'Any decision to widen the scope of co-operation in this agreement in the interim and any other amendment to it may be made by the joint agreement of the First Minister and the Leader of Plaid Cymru.'

And widening the scope of this agreement is even more explicit, as Plaid Cymru has agreed to facilitate the passing of annual and supplementary budgets in exchange for influence on other budgetary matters. Therefore, does the Welsh Government accept that this agreement covers more than just the 46 areas of policy that it initially set out to the people of Wales this morning?

Of course, the agreement will have an impact on Senedd business, and I note that both parties claim to respect the independence of the Senedd committee system and the distinctive roles and functions of the respective parties within the Senedd. So, Trefnydd, can you confirm what discussions have been had with the Presiding Officer regarding the impact of this agreement on Senedd business?

The document also makes it clear that the co-operation agreement will be supported by a civil service unit, known as the co-operation agreement unit. So, Trefnydd, can you tell us exactly how much taxpayers' money has been earmarked for this new unit, and indeed any other aspects of machinery that will be put in place to support this specific agreement?

The document also says that Plaid Cymru designated Members will have the same responsibilities as Welsh Government Ministers to respect the political impartiality of the civil service, and will be bound by aspects of the ministerial code. Can you tell us why that is the case, given the document makes it explicitly clear that they will not be represented by ministerial or deputy ministerial appointments in the Welsh Government? Trefnydd, did the leader of Plaid Cymru just forget to ask for Plaid ministerial appointments?

And finally, Trefnydd, this agreement says that the involvement of Plaid Cymru is recognised as part of normal Government communications, and, as such, this is a coalition in everything but name. So why won't the Welsh Government just come clean with the people of Wales and call it what it is—a coalition?

The First Minister is unable to be with us this afternoon, but I'm here, obviously, to answer on behalf of the Welsh Government, and I'm very pleased to answer your questions. That often happens with topical questions. You asked some very specific questions, which you're absolutely right to do, but I should point out that a lot of the arrangements in relation to the co-operation agreement are the functions of the Government, which clearly is not the responsibility of the Senedd—it is a matter for the Welsh Government to work through.

You ask about Plaid Cymru in relation to Senedd business. Well, that is absolutely a matter for the Llywydd, for the remuneration board, and for the Senedd Commission. You ask what discussions have taken place. You may be aware that the Llywydd has been in correspondence with the First Minister, and they continue to be in correspondence. And I know, prior to the announcement of the co-operation agreement, discussions were certainly undertaken at an official level.

This is not a coalition, it is a co-operation agreement. And if you look back at the last 22 years of the Senedd, and, prior to that, the Assembly, every Assembly since we've had devolution 22 years ago has involved a partnership arrangement of some sort. We haven't had a co-operation agreement before, but we do see many different arrangements, right across the world. This is not novel; it's different to what we've had before, but it's certainly not novel. And we absolutely have a history of working collaboratively, for the benefit of the people of Wales. We're very happy if the Tory party want to enter into informal arrangements with us. You know the First Minister wrote to the leader of the opposition around a clean air Bill, for instance. The trouble is, the Tories aren't interested in working collaboratively, and I think that says more about your party than it does about my party. 

You asked around funding for the co-operation agreement unit. Well, as you may have heard the First Minister say, money has been set aside, and that will be part of our draft budget, which we'll be publishing later this month, and, of course, you will be able to scrutinise that. 

In relation to your question around the code of conduct for Plaid Cymru designated Members, as you will have seen, that's been put into annex A, which was published as part of the mechanism document of the agreement this morning. But I do reiterate that this is not a coalition; it's an agreement to deliver a shared programme of work through the co-operation agreement for a three-year period.

It might not be a coalition, but it looks like one. I welcome the agreement. I welcome the publication of the documents today that underpin the agreement; I think that's important in terms of transparency. I welcome the politics of the agreement; I think it's a good thing to do. And I welcome the statement from the Presiding Officer this morning on the advice that she has taken. 

But this does raise questions for us as a Parliament, and I don't believe the Government can wipe that under any carpet and pretend it doesn't exist. The Government is already too powerful in this Chamber. It is powerful, and it does not receive the same scrutiny as other Governments receive, either in Westminster or Holyrood, or even in Stormont. So, there are questions here, because Plaid Cymru will have a role that goes beyond that of simply a budget agreement that we have experienced before. The fact that there is a finance committee within Government overseeing public expenditure I think is right, and I think is proper, and I welcome it, but it is different and it does put Plaid Cymru in a different situation. 

I welcome the fact that there are designated Members. I welcome Siân Gwenllian's appointment, which I saw on Twitter earlier this afternoon. I think it will empower the Welsh Government, and I think it will strengthen the Welsh Government, but again, it asks questions about scrutiny. I welcome the fact that there are agreements in place between the two parties to manage business in this Chamber. Again, that asks questions. It is not credible to argue that the agreement between the Welsh Government and Plaid Cymru means that Plaid Cymru does not have an executive role. That is simply not a credible argument to make. 

I do believe that we need to consider this matter. I'm not sure that the format of a topical question this afternoon is the best way of resolving these matters, but I do believe that the Presiding Office, and the Government, and all of us as Members, need to take the same approach to the scrutiny of Government as Plaid Cymru and the Welsh Government have taken to the delivery of Government. Good government is improved by better scrutiny. We need to ensure that the structures are in place within this Parliament to ensure that this Parliament is not made redundant and a bystander over the next three years.

I think we've been very open and transparent. We've published all the documentation this morning, which absolutely sets out how it will work. I don't think we could have been any more open and transparent, and, certainly, we have nothing to hide. I don't think anybody's arguing about the role of Plaid Cymru. The status of Plaid Cymru as a party in this Chamber, as I said in my answer to Paul Davies, is a matter for the Llywydd, for the Senedd Commission, and for the remuneration board. The working of Government is a matter for the Welsh Government—the internal workings—which, I have to say, are very dry; everybody suddenly seems very interested in them. The Member will know very much that this is not a coalition. He understands full well what a coalition is. 

Dyna ni. Diolch i'r Trefnydd am ddod i ateb y cwestiwn.

Eitem 4 sydd nesaf, y datganiadau 90 eiliaid, ac mae'r datganiad cyntaf gan Adam Price. 

Diolch yn fawr, Llywydd. I wish to make a quick statement today on SUDEP, which is sudden unexpected death in epilepsy. In Wales, there are an estimated 32,000 people living with epilepsy. Twenty-one people a week or three people every day in the United Kingdom die from SUDEP, with a large percentage of them being young men between the age of 20 and 40. As a group, people living with epilepsy are at a one in 1,000 risk of SUDEP. However, this can change drastically for some people depending on their individual circumstances. For some of my constituents, this is a very real issue that they live with every day, and some of the experiences they have shared with me over the past few weeks have been truly inspiring.

I would particularly like to reference Hayden Brown, a young man from Ammanford who lost his life to SUDEP just over two years ago now. His mother, Helen, is working with Hywel Dda to produce a resource that can be given to people at the point of diagnosis to increase people's awareness and inform them on how they can minimise risks. She also gives out an award in his name every year at his old junior school, Ysgol Bro Banw.

SUDEP Action are an excellent charity, who are doing their utmost to raise awareness of SUDEP specifically, and I would encourage anyone who has had family or loved ones affected by the condition to visit their website. Also, Epilepsy Action Cymru do a fantastic job of raising awareness and increasing understanding of the condition here in Wales. I would like to thank these organisations for their excellent work on this issue. 

On Monday, a memorial service was held for the late Dame Cheryl Gillan at Westminster. For those of you who may not be aware, Cheryl was born in Llandaff, Cardiff, and raised in south Wales. Indeed, her family still runs a farm in Usk. She was educated at Elm Tree House, a former alma mater of mine, and Norfolk House primary school in Cardiff, before attending Cheltenham Ladies' College and the College of Law. In 1992, she was elected to Parliament as Member of Parliament for Chesham and Amersham, a seat she held until her sad and sudden passing in April this year. Cheryl was appointed Secretary of State for Wales, the first woman to hold this role, after the general election in 2010, a post that she held with sheer distinction and pride. I knew her for many years, and her passion and kindness always shone through. She was widely respected amongst the political spectrum, and admired for her dedication to Wales. Cheryl is greatly missed by all of her friends in Wales, who will always remember her good humour and kindness. Public life is certainly poorer without her. Thank you. 

Diolch yn fawr am hynny. Egwyl fer nesaf nawr er mwyn gwneud ambell i newid i'r Siambr, ac fe fyddwn ni'n dychwelyd ar gyfer eitem 5. 

Eitem 5 yw'r nesaf, dadl Aelodau o dan Reol Sefydlog 11.21(iv): diagnosis a thriniaeth canser. Galwaf ar Mabon ap Gwynfor i wneud y cynnig.

Diolch yn fawr iawn, Dirprwy Lywydd, a diolch am y cyfle i gyflwyno’r cynnig yma heddiw ger eich bron, a diolch i’r holl Aelodau eraill sydd wedi ei gefnogi o. Mae’r nifer sydd wedi cefnogi'r cynnig yn dyst i bwysigrwydd y testun.

Mae canser, wrth gwrs, yn rhywbeth sydd yn agos iawn at bob un ohonom ni—yn llawer rhy agos mewn gwirionedd. Mae fy nhad yn glaf canser, ac wedi bod ers diwedd 2019. Yn ôl yn yr haf, cafodd fy nhad y newyddion da fod y canser wedi diflannu, a'i fod mewn remission. Roedd yn achos dathlu, wrth reswm. Yna, ar ddechrau’r hydref, wrth fynd am ei brofion, gwelwyd fod y tyfiant wedi dod yn ôl.

Dwi’n dyst, felly, i’r ffaith fod y broses ddiagnosis, aros am ganlyniadau, aros am driniaeth, aros am atebion pan fo rhywbeth annisgwyl yn codi—hyn oll yn boen meddwl creulon, a gallaf ddim dychmygu'r gwewyr mae fy nhad a mam yn gorfod mynd drwyddo heb wybod os ydy’r erchyll beth yma yn tyfu ynghynt y tu mewn iddo, neu wedi ymledu.

Ond dydw i ddim ar fy mhen fy hun yn byw'r profiadau yma. Mae yna filoedd o gleifion a theuluoedd yng Nghymru yn byw'r profiad yma yn ddyddiol ac, wrth gwrs, mae eraill yn y Siambr yma heddiw wedi ei brofi o, dwi’n siŵr.

Rydyn ni oll, wrth gwrs, heddiw, yn cofio am yr annwyl a'r diweddar Steffan Lewis, a gyfrannodd gymaint mewn amser llawer yn rhy fyr, ac fe'i gollwyd o i ganser.

Wrth gyflwyno’r cynnig yma heddiw, dwi am ganolbwyntio ar effaith COVID ar wasanaethau canser, y gweithlu, amseroedd aros a diagnosis.

Wel, mae ychydig o dan 20,000 o bobl yn derbyn diagnosis canser yng Nghymru bob blwyddyn, ac mae'n wybyddus i bawb erbyn hyn fod canser yn lladd mwy o bobl yng Nghymru nag unrhyw glefyd arall. Y newyddion da ydy fod y nifer sy'n goroesi'r clefyd yma yn cynyddu, gyda 60 y cant o’r cleifion a dderbyniodd ddiagnosis rhwng 2014 a 2018 yn goroesi eu canser am bum mlynedd neu fwy, sydd yn dangos bod triniaethau yn gwella.

Ond er y camau ymlaen, mae effaith COVID-19 a'r diffyg staff yn y gwasanaeth iechyd yn debyg o arwain atom ni'n gweld y niferoedd sydd yn goroesi yn lleihau am y tro cyntaf. Mae'r heriau sy'n wynebu gwasanaethau canser yng Nghymru wedi'u dwysáu oherwydd COVID, fel ym mhob sector o fewn y gwasanaeth iechyd. Mae ffigurau'r Llywodraeth yn dangos bod 20,000 yn llai o bobl wedi cael eu cyfeirio ar frys am ddiagnosis canser rhwng mis Mawrth a mis Tachwedd 2020 o'i gymharu â chyn y pandemig. Gwyddom bellach fod 1,700 yn llai o bobl wedi dechrau triniaeth canser yng Nghymru yn y flwyddyn rhwng Ebrill 2020 a Mawrth 2021. Arweiniodd y COVID yma at y gwasanaethau canser yn cael eu tarfu'n sylweddol gan beryglu diagnosis a’i wneud yn anoddach i’w drin, a oedd wedyn yn arwain at ddirywiad yn eu cyfleoedd i oroesi.

Gwyddom hefyd fod staff y gwasanaeth iechyd wedi blino'n lan ar ôl ymateb i'r pandemig, yn ogystal â cheisio cynnal y gwasanaethau canser, tra hefyd yn ceisio cynnal mwy o fesurau rheoli heintiau. Ond, er bod llawer o wasanaethau canser bellach wedi dychwelyd, i raddau helaeth, i'r lefelau lle yr oedden nhw cyn COVID, y gwir ydy nad oedd canlyniadau canser yng Nghymru yn ddigon da cyn y pandemig. Fedrwn ni felly ddim mynd yn ôl i fel oedd pethau. Erys yr angen i drawsnewid gwasanaethau ar frys er mwyn gwella canlyniadau canser yn y tymor hir.

Sydd yn dod â mi at y gweithlu. Dwi eisiau gosod ar record yma heddiw ein diolch i’r gweithlu sydd wedi mynd yr ail filltir drosodd a thro yn ystod y cyfnod anodd diweddar. Fel mab i glaf canser, dwi’n diolch yn bersonol iddyn nhw, a dwi’n sicr fod y diolch hwnnw yn cael ei ategu gan bawb yma heddiw. Ond, y gwir anghyfleus ydy fod y gwasanaeth iechyd wedi dibynnu ar ewyllys da'r gweithlu er mwyn cynnal y gwasanaeth, gyda rhagor nag un o bob pedwar meddyg yn gweithio dros oriau yn ddi-dâl. Hyd yn oed cyn y pandemig, roedd Cymru'n profi bylchau sylweddol yn y gweithlu diagnostig a chanser, megis delweddu, endosgopi, patholeg ac oncoleg nad yw'n lawfeddygol, neu non-surgical oncology.

Mae’r bylchau yma wedi effeithio yn sylweddol ar ein gallu i adnabod canser yn gynnar; darparu'r math mwyaf effeithiol o driniaeth; a gwella cyfleoedd goroesi. Er enghraifft, tra bod yna gynnydd wedi bod yng ngweithlu ymgynghorwyr oncoleg glinigol trwy’r Deyrnas Gyfunol a thrwy Ewrop, does yna ddim cynnydd wedi bod yn y bum mlynedd ddiwethaf yn ardal Betsi Cadwaladr. Yn 2020, dim ond 7.8 radiolegydd am bob 100,000 o’r boblogaeth oedd yng Nghymru, tra bod y cyfartaledd Ewropeaidd yn 12.8. Yn wir, mae gan Gymru hanner nifer y radiolegwyr i bob pen o’r boblogaeth ag sydd gan Ffrainc a Sbaen. Ac mae gan ogledd a gorllewin Cymru'r nifer lleiaf o radiolegwyr clinigol y pen o’i gymharu â gweddill y Deyrnas Gyfunol.

Mae yna gamau y gellir eu cymryd yn y tymor byr i ddiwallu’r sefyllfa, megis cymysgu sgiliau. Gall arloesi efo technolegau newydd helpu i wneud y mwyaf o allu'r gweithlu canser hefyd. Ac, wrth gwrs, mae’n rhaid edrych ar gefnogi lles y gweithlu er mwyn eu cadw. Ond, tra gall y camau yma helpu, dim ond trwy fynd i’r afael â’r argyfwng yn y gweithlu go iawn y cawn ni ddatrysiad i’r cwestiwn ehangach o staffio. Rhaid felly gweld y Llywodraeth yn ehangu'r nifer o staff mewn proffesiynau canser allweddol drwy fuddsoddi mewn hyfforddiant a chyflogi mwy o staff canser i lenwi'r swyddi gwag cyfredol a sicrhau bod gan y gweithlu'r gallu i ateb y galw cynyddol, yn ogystal ag amser i arloesi a thrawsnewid gwasanaethau.

Daw hyn â fi at y pwynt nesaf, sef amseroedd aros. Mae’n deg dweud, fel rydym ni wedi sôn, fod COVID wedi cael effaith andwyol ar y gwasanaethau canser. Dengys data mis Medi 2021 fod 59 y cant o gleifion wedi derbyn triniaeth cyntaf o fewn 62 niwrnod i’r amheuaeth fod ganddyn nhw ganser. Mae hyn ymhell o dan y targed o 75 y cant. Mae’r ystadegyn pryderus yma yn dweud wrthym ni fod llawer gormod o gleifion yn aros llawer rhy hir cyn cael diagnosis neu driniaeth. Ond fedrwn ni ddim gwella’r canlyniadau heblaw ein bod ni’n gweld cynnydd yn y gweithlu a’r offer angenrheidiol er mwyn ei ddal yn ddigon cynnar.

Rŵan, mae’r llwybr amheuaeth o ganser, a gafodd ei gyhoeddi nôl yn y gwanwyn, i'w groesawu. Ond mae angen gwneud mwy i leihau yr amseroedd aros a rhoi’r cyfle gorau posib i gleifion gael diagnosis cynnar, i gael triniaeth buan ac i oroesi.

Dwi hefyd yn croesawu’r datganiad ansawdd ar gyfer canser a gyhoeddwyd eleni. Ond mae’n ddatganiad sydd yn annigonol. Nid strategaeth canser mohoni, ac mae’r strategaeth canser flaenorol bellach yn dirwyn i ben. Cymru, felly, fydd yr unig genedl yn y Deyrnas Gyfunol heb strategaeth canser, rhywbeth y mae Sefydliad Iechyd y Byd yn dweud y dylai pob Llywo