National Assembly for Wales

I call Members to order.

Before we move to questions, I call on the First Minister. 

Diolch, Llywydd. Following the exchange in First Minister's questions last week, I want to apologise to the Member for Carmarthen East and Dinefwr for the answer I gave to him. He will know that we have both received apologies too from the health board in relation to the incorrect information on which our exchange was based. I do believe that information was passed to my office in good conscience, and was subsequently passed on to me equally in good faith. I should also make clear that this was not information personally requested by me in any way, shape or form, but it was information that I chose to use, and, on reflection, I don't think that last week was worthy of the exchanges we should promote in this, our Welsh Parliament, and I apologise for my part in that. 

Thank you, First Minister.

 Questions now to the First Minister, and the first question is from Rhun ap Iorwerth. 

We expect citizens who have a clinical need for an emergency ambulance response to receive one as quickly as possible, whenever required. Despite increased demand in recent months, the Welsh ambulance service has continued to meet the target in the Betsi Cadwaladr health board area.

Thank you for that response. Ambulances in the north-west, in Anglesey and across north Wales, I'm sure, have on their sides a large sticker for the FAST campaign, which relates to the Stroke Association campaign encouraging people to phone 999. The slogan is 'when strokes strike, act FAST'. Unfortunately, phoning quickly doesn’t lead to an ambulance arriving quickly. There are two recent examples. The port of Holyhead called for an ambulance for a patient who feared that he’d suffered a stroke and they eventually had to take the patient themselves to Ysbyty Gwynedd and saw eight ambulances parked there. Another recent example is that of an 88-year-old woman—a constituent of mine—who was concerned that she’d had a stroke, waited six hours for an ambulance and then waited another two hours outside the hospital to be transferred to A&E. She passed away some hours later. We know that stroke is now an amber category call. Last week, a senior medical officer in north Wales told me that she was concerned about the categorisation there. Paramedics tell me regularly that they are concerned about categorising stroke calls as amber. So, when will the Government look at this, because lives truly are at stake?

I have to say that the model itself was drawn up by clinical professionals, and therefore it was they who considered the way in which we should do this. It wasn’t something that was done by politicians. It’s true to say that 65 per cent of red calls in Anglesey were responded to within eight minutes, but the Member has raised two issues in this Chamber, which of course are very important, and I would ask him to write to me so that I can consider once again what happened in those cases.

Six years ago, in February 2012, it was reported that a patient had to wait in an ambulance for more than seven hours outside of Ysbyty Gwynedd because of a hospital bed shortage. Last December, Betsi Cadwaladr University Local Health Board released figures showing that 1,010 patients had faced handovers of more than an hour outside their hospitals in October. Last month, with ambulances queuing outside Ysbyty Gwynedd's accident and emergency department, we saw coverage of a pensioner waiting 13 hours for an ambulance after her hip gave way. We know that December figures show that 17,400 patients waited more than the four-hour target time in A&E, with the highest portion—27 per cent—in Betsi Cadwaladr, and 1,460 waiting longer than 12 hours. When will your Government acknowledge that a 30 per cent cut in beds to 10,935 over the last two decades has rendered paramedics unable to offload patients quickly, causing ambulances to be delayed and therefore the next distress calls being unable to be responded to promptly, and will you reverse those bed cuts not only in the district general hospitals, but also in our communities, as called for increasingly by our general practitioners?

What I've said several times in the Chamber is that it's hugely important to ensure that we have a social care system that can get people out of hospital when it is timely for them to do so. And that is, of course, the reason why we have not cut social care spending in the way that England has. Health and social care run together. What I can say in terms of emergency calls, in the Betsi Cadwaladr health board area alone, the ambulance service received 11,232 emergency calls in December 2017, which is an average of 362 calls per day. That's 14 per cent up on the daily average for November 2017, and 9 per cent up on the daily average for December 2016. Despite that rise in demand, the national target for red calls was achieved in all seven health board areas in December. And we of course expect health boards to have plans in place to ensure as smooth a transition, and as swift a transition, as possible between ambulance and hospital.

Yes. The Welsh Government revenue allocation to Betsi Cadwaladr health board is over £1.3 billion in the current financial year.

Well, I thank the First Minister for that succinct reply. The health Secretary said recently, in effect, that things have got worse in 2017-18 for Betsi Cadwaladr, despite special measures. He said in particular it's been disheartening and unacceptable that, during 2017-18, issues have escalated in relation to the financial position and some key areas of performance. Betsi Cadwaladr has now been unable to clear its surgery backlog for at least eight years, and, whilst £13 million extra, as announced recently, is very, very welcome, it's clear that maybe up to £50 million is what's needed to bring waiting lists down to within their 36-week target. There's a highly critical report that has been published by Deloitte, much of which has been suppressed by the health board and not made available for public reading. In this it says that there is limited insight regarding how the health board is ultimately going to recover its financial position. Can the First Minister tell us when we will be able—[Interruption.] Yes, I will ask this. Why is the Welsh Government failing in its duty to the people of north Wales, to provide them with the sort of modern health service that a country like Britain ought to deserve?

Well, I am being lectured by a member of UKIP on proper funding of the health service, when his own party leader at one point said there shouldn't be a publicly funded health service at all. Can I say, in terms of answering his question—[Interruption.]

I'll have my apology next week, shall I, at the start of questions? [Interruption.]

Allow the First Minister to continue in his answer, please.

He has made reference to a £13.1 million allocation to Betsi Cadwaladr and the support for developing sustainable unscheduled care—£1.5 million over two years. What does that mean? Well, our expectations are, by April 2018, that there should be a reduction of referral-to-treatment waiting times by around 50 per cent in the numbers waiting over 36 weeks, and progress to continue into 2018 and 2019, and financial recovery actions to result in the health board meeting the £36 million revised forecast at year end, and improving into 2018 to 2019.

Latest data for Betsi board shows that 9,526 patients requiring treatment have now been waiting over 36 weeks from referral. That figure has more than doubled from when the board was taken into special measures, and 41 per cent of these are orthopaedic and trauma cases. In December, your Cabinet Secretary pledged to halve that number by March this year, and last week, of course, we had the further pledge of immediate action and the allocation of £13.1 million to improve waiting times and £1.5 million for an unscheduled care programme. But he also admitted that mental health care in this board needed urgent attention. As our First Minister, what action will you take to ensure that none of these pledges are broken, and will you also ensure that this latest funding will actually reach the front-line patients and help for positive outcomes within this beleaguered health board?

Well, I think I've given the answer to the previous question, in terms of how the money will be spent.

Additional funding to improve waiting times, of course, is very welcome, but it isn't sustainable, clearly. It doesn't address the underlying capacity issues that we have in the health service in north Wales—not enough doctors, not enough nurses, and your Government clearly not doing enough to get to grips with some of those basic challenges. And what does it say about Labour's running of the national health service that, two years after taking direct control, your Government seemingly now has taken Betsi Cadwaladr from special measures into something that looks a bit like extra-special measures?

No, it's a noticeable way of de-escalating maternity services. It demonstrates what can be achieved with focused action and support. There are still significant challenges that the health board faces and further progress and action are required urgently to transform mental health services. The Cabinet Secretary, along with the director general, are holding monthly accountability meetings with the chair and chief executive of Betsi Cadwaladr UHB. We'll be setting out a revised framework for Betsi Cadwaladr to cover the next 12 to 18 months, with milestones and expectations set out, clearly agreed with Healthcare Inspectorate Wales, the Wales Audit Office and BCU itself. 

Questions now from the party leaders. The Plaid Cymru leader, Leanne Wood.

Diolch Llywydd. It was right that you today acknowledged the wrongdoing in relation to Adam Price's personal data. We will return to the issue of confidentiality of Members' correspondence at another time, but I'll put that to one side for now. I want to ask you about Brexit. The UK Government reiterated yesterday that they want us out of the customs union. Now, as well as damaging the Welsh economy, this will affect our open border with Ireland through our ports. A hard border is coming. Six months ago, the inquiry into the effects of Brexit on Welsh ports made a recommendation for the Welsh Government to set out, and I quote:

'how it intends to address the lack of physical capacity to accommodate new borders and customs checks at Welsh ports, and develop a highways management contingency plan to manage potential congestion resulting from delays in ports.' 

Six months later, can you tell us what work has been done on that, please?

Well, the issue of physical infrastructure at the ports to deal with issues such as customs are matters for the UK Government, not for us. It's for them to spend the money if that kind of Brexit is what they want. However, it's right to say that nobody argues for there to be a hard border between the UK and the Republic of Ireland, and we expect the UK Government to deliver that. It's not clear how they'll do it, but I expect them to deliver that. 

It is right to say that there are some in the Conservative Party who argue for a hard Brexit. There have been calls to expel them from their own party this morning, in fact. I think that's probably going a little bit too far, even by their Stalinist standards, but the serious point here is this: we have—she and I—never argued for any kind of Brexit that even looks like a hard Brexit. There is no mitigating that. There is no making it better. It can only mean that things get worse, which is why she and I have always, I believe, been in the same position of saying that Brexit has to work for Wales, that we have to make sure that we have full and unfettered access to the single market and that also we should stay in the customs union.

But First Minister, that was a specific recommendation—a call for action on your Government, not the UK Government. 

I move on to the customs union question now. If we pull out of the customs union, the UK will have to negotiate its own free trade agreements. Trade deals outside of the EU and the customs union could have a major impact on our economy. I'm sure you would agree with that. You were asked yesterday whether you believed that Wales should have a veto on such trade deals like the Parliament in Wallonia of Belgium, and in answer to that question you said 'no'—no not only to a veto, but no to finding an agreement with the rest of the UK. You said that we should be consulted. First Minister, it's your duty to protect the Welsh economy from an extreme Tory Brexit. Why are you against giving this Assembly a say on trade deals?

Well, this is a reserved matter for the UK Government, but I do take the view that for any free trade deal to be robust it has to have buy-in from all the different nations of the UK. I expect there to be full consultation in order for people to understand what effect a free trade agreement might have. I have never believed that free trade agreements are some kind of panacea. A free trade agreement can work with an economy that is similar to yours, and Europe is a prime example of that, where a free trade deal, enhanced as it is through the customs union and the single market, works well, but I do not believe it's in the interests of Wales to have a free trade agreement, for example, with New Zealand or Australia that allows the free flow of agricultural produce into Wales; that would destroy Welsh farming. I do not believe that a free trade agreement with any country where steel is produced far more cheaply is in the interests of the Welsh steel industry, and that I can promise I'll fight tooth and nail.

But asking for consultation is weak. Why don't you go for the strongest option of demanding a veto? First Minister, on 17 October last year, I proposed that you should have a plan for all Brexit scenarios, including the prospect of leaving the European Union without a deal. You said then, and I quote—and you've just said it again:

'there is no mitigation for no deal. There is nothing literally we can do in the short term if we find there’s no deal.'

The External Affairs and Additional Legislation Committee has published a report saying that the Welsh Government should be preparing for a 'no deal' scenario. They say that Governments, national and regional, have preparations in place for such an outcome—why not Wales? First Minister, those three words sum it up: why not Wales? There's a strong recommendation for you to start that work and report back in six months' time. Have you reviewed that answer you gave me last October? Are you going to draw up a contingency plan for a 'no deal' scenario, or are you going to leave the fate of Wales in the hands of the hard-right Tories in Westminster?

The UK Government itself has no idea how to deal with this. I don't think the Scottish Government has a plan in place to deal with a hard Brexit, and as far as we are concerned—[Interruption.] Well, I think we've got to be careful here, because I don't want to give the impression, and nor does she, that, somehow, a 'no deal' Brexit is similar to any other kind of Brexit. It isn't; it's far, far worse than that. There is no way of mitigating the effect of the loss of a market to our farmers. There is no way of doing that. There is no market that will replace that. There is no way of mitigating the effect on the aerospace and automotive industries of losing their links with their European operations on the continent. There is no way of doing that.

So, my argument is not: 'Let's see what we can do to mitigate it', but 'Let's fight it.' Let's fight it. Let's fight it, tooth and nail. Let's say to the UK Government that a hard Brexit, building walls around the UK, turning our backs on our biggest market in Europe is not acceptable to the people of Wales and nor, I believe, to her party nor mine.

Have a word with your leader, then.

Leader of the opposition, Andrew R.T. Davies.

Thank you, Presiding Officer. First Minister, last week, I asked you about the Permanent Secretary's inquiry into media speculation around the reshuffle. When I got back to my office last week, I had a written Assembly question come back from you acknowledging that you do, on certain occasions, use a private e-mail address to deal with diary issues and clearing urgent press lines. I'd be appreciative to know if these e-mails were made available to the Permanent Secretary's inquiry, and if this e-mail address was used at all to instruct or to brief staff as to press lines in relation to the reshuffle.

No. And, the answer to the first question is that all relevant evidence was made available to the inquiry.

Well, I'd be grateful if you could be explicit by confirming that your personal e-mail accounts were made available to the Permanent Secretary's inquiry, so that they could've been assessed by the person she appointed who, I believe, was the Welsh Government's head of security, I think, who undertook the inquiry. Can you confirm that access was given to that individual to your personal e-mail addresses that you do use for Government business, which you've acknowledged in your written answer to me?

I can't comment on what the evidence looked like. All I can say is that all relevant evidence was submitted to the inquiry.

I have to say, First Minister, I'm deducing that the person who headed up the inquiry did not have access to your e-mails that you acknowledge that you do use for clearing urgent press lines. Now, people would assume that any activity around a Cabinet reshuffle most probably would be urgent press activity, and it's not unreasonable to assume that, if there's an inquiry into leaks from Government, then all correspondence would've been made available to the person carrying out the inquiry.

Why is it so difficult for you just to say 'yes' or 'no', whether that information was given to the individual undertaking the inquiry? I would be grateful for clarity—crystal clear clarity—as to whether the inspector did have the ability to look into your e-mails. And if he didn't, will you be making those e-mails available so that they can, on merit, decide whether they want to enquire more into these matters?

Firstly, it is a matter for the head of security to decide what he regards as relevant evidence. Secondly, any e-mail that is sent to me to my personal e-mail, which, in any event, is only accessed from a Government machine, is recorded. Any e-mail is recorded in that fashion. So, we know from the Gove judgment that any e-mail that's sent to a Government machine is subject to a freedom of information request anyway. And that is something that I know, but as I say, all relevant information was provided to the inquiry.

So, you haven't made it available.

Leader of the UKIP group, Neil Hamilton.

Diolch yn fawr, Llywydd. I'd like to follow up the last question that was asked by the leader of Plaid Cymru a moment ago. She referred to this excellent report from the external affairs committee on how the Welsh Government is preparing for Brexit. In the Chairman's introduction to the report, as she said, there is a need for the Welsh Government to be doing more in terms of scenario planning, including a 'no deal' to prepare for Wales. Governments, national and regional and elsewhere in the EU, and the European Commission itself, have preparations in place for such an outcome. Why not Wales? If they can do it, why can't the Welsh Government?

I have to say the leader of UKIP comes from a position of saying, 'It doesn't matter if there's a hard Brexit. These things are not important. Tariffs, non-tariff barriers are not important.' He suffers from the same misguided view as the leader of the Welsh Conservatives, namely that these things are not important. Well, they are important for Welsh farmers, because the Welsh Conservatives have never said how they will protect Welsh farmers if there are tariffs placed on their produce sent to the European Union. They have never said how the markets of the food and drink industry—90 per cent of which are exported to the European single market—will be protected. Our position is based on evidence, evidence that has been produced, for example, by Cardiff Business School and others, and not on wishful thinking.

But the First Minister is still fighting the referendum campaign. My question was a practical one—that other Governments and regional Assemblies are doing something to prepare for the possibility of a 'no deal' Brexit. That will not come about, if it comes about at all, because of what the UK Government wants; it will come about because the EU will irrationally decide to cut off its nose to spite its face. But, the question I asked was a simple one. If there's a 'no deal' Brexit, obviously, there will be certain consequences that would differ from doing a deal of some kind, depending on the nature of that deal. There will always be problems of transition on leaving the EU, just as there were problems of transition, as I remember very well, when we joined the EU. So, it's not that it doesn't matter at all, it's just that, in the long term, economies adjust. I revert to my question, though: if other Assemblies of this kind and Governments throughout the rest of the European Union—[Interruption.] If his Members will stop chuntering, and the chunterer-in-chief in particular over there, then perhaps I can get to my question. I'm sorry to be doing your job, Llywydd; I didn't mean to.

No, you carry on with your job, which is asking the question.

Thank you. Exactly. Why is the Welsh Government not doing anything at all, so far as I can tell, to prepare for the possibility of a 'no deal' Brexit, to help Welsh businesses to cope with the transition period that is inevitable, whatever the outcome?

There it is: the word 'cope' is used. 'Cope'—that's the whole point. A hard Brexit is a disaster. Sixty per cent of our exports go to that single market, 90 per cent of our food and drink exports go to the single market. The parties of the right try to ignore that: 'It doesn't matter'—wishful thinking—'we'll find other markets.' There is no evidence of that. Why on earth should businesses have to pay a price for what he said and his party said to the electorate? Why should they have to 'cope'? Why can't they prosper? Businesses will prosper if we remain inside the single market and the customs union.

But the First Minister talks as though there is a world of certainty that we're in at the minute and we're about to go into a world of uncertainty. Anybody who's ever run a business, and I know the First Minister hasn't, knows that you have to cope with changed circumstances. 

Indeed I have.

Sir James Dyson, who runs one of our biggest companies, has said that uncertainty is an opportunity. [Interruption.] The opportunity, actually, is the rest of the world—

I do—

—which is growing at a far greater rate than Europe. So, the opportunity is to export to the rest of the world and to capitalise upon that. What is the Welsh Government doing to prepare for the possibility of opening up other markets around the world, where the European Commission itself says that 90 per cent of growth in demand is going to come in future years?

Do you still want to be part of a common front with him and his party? I mean, that's one of the questions that, perhaps, people will want to ask. Of course not, given what he has just said.

Can I invite him to do something? He is a leader of a political party in Wales. Come to a hill farm anywhere in Wales, a sheep farm—the leader of the Welsh Conservatives can join him, actually, and get away from the Vale and his acres in the Vale—and go and talk to the farmers there, the sheep farmers, and say to them, 'Uncertainty is an opportunity'. Say that to them. I offer him the invitation, he can be joined by his political bedfellow over there. Go and talk to them and tell them they're worrying about nothing, moaning about nothing, and that, in fact, the reduction in their subsidies and the loss of their market is actually an opportunity.

Yes. Since 2009, we have invested nearly £175 million in a wide range of projects across Wales, including over £12 million in the South Wales West region. 

First Minister, while there have been good examples of the scheme being used to improve the lives of constituents in my region, such as funding for additional foster carers in Neath Port Talbot or a support worker for looked-after children in Swansea, the biggest investment of nearly £1.5 million was used to improve the offices of Bridgend council. Surely the scheme should prioritise areas that are suffering as a result of council cutbacks. Swansea council has a £56 million backlog of road repairs. It is believed that insurance payouts and compensation claims will skyrocket as a result of the repair backlog. Therefore, investing in repairs now will save more money in the longer term. First Minister, what consideration have you given to allowing the scheme to be used to make vital repairs that truly benefit the public, rather than those that benefit elected councillors?

Well, let's have a look at some of the investments made that benefit elected councillors: £2.2 million recently awarded to Abertawe Bro Morgannwg University Local Health Board, which includes £769,000 for modernising the patient records system so that records can be located and are available, £400,000 for reducing sickness levels in the board and £441,000 for a primary care out-of-hours service—now, that doesn't seem to me like helping councillors; £500,000 to the mental health charity Hafal, and that's supported the development of a specialist mental health rehab facility, the first of its kind in the UK, that benefits the public; £3 million to the South Wales Fire and Rescue Service; and £108,000 to Swansea council social services to work with young people to break the cycle of ex-looked-after children entering care themselves. This is a way in which public money makes a difference, and I'm surprised that UKIP can't bring themselves to praise that.

First Minister, as you've already pointed out, the invest-to-save in my area, South Wales West, has actually been focused on the health service. ABMU has received money for the new record system, also money for the academy, for the out-of-hours service, to improve that, and also for re-looking at the governance of medicines and the management of medicines. It's that type of investment that is improving efficiency, and therefore delivering better services for my constituents. Do you agree with me that we need to do more of this to ensure that patients can get better services out of ABMU, because they will be improving productivity and efficiency?

Well, this is why, of course, the money was made available to ABMU: in order to make sure that those obstacles that might exist within the system are removed, making it better for the people who work there and, of course, particularly for the patients.

Well, lessons from the Waterhouse inquiry have been taken forward with Welsh public bodies. Safeguarding arrangements have been strengthened through legislation, including a new duty to report, and the National Independent Safeguarding Board, and a multi-agency Welsh reference group has been established in partnership with the independent inquiry into child sexual abuse.

Thank you, First Minister. I do appreciate the devolved limitations surrounding this question, but in my role as an Assembly constituency Member, I am currently dealing with a number of cases of historical sex abuse, and I am having to talk to, on a regular basis, some very, very hurt and traumatised people.

On a number of occasions, there appears to be an absolute marked reluctance by the Crown Prosecution Service to take a prosecution forward, despite good and corroborated evidence, either because of changes in the law within the intervening years—if you're talking about something, say, 30 years ago, the age of being able to be tried, for example, for a crime has obviously changed, I think in 1985 or 1987—or because, in their view, it's not in the public interest. But, of course, it is in the interests of those who've been affected. I have one case where the claimants, in the end, took their case themselves to the High Court and won, and had an improvement in the prosecution or in the judgment. Is there anything the Welsh Government can do to act as a check and balance on the decisions of the CPS, and of the police, in order to ensure that we are doing justice as well as talking about justice and trying to be seen to be having justice?

Directly, of course, these bodies are not devolved. Our view is that they should be, but they're not, and that's for a different time. But she's absolutely correct to ask what, then, we have done as a Government in terms of echoing her concerns. Well, obviously, we have expressed our abhorrence that the survivors in this case didn't receive the response that was owed to them. We have introduced a duty to report children at risk, and a duty to report adults at risk, to ensure that concerns about the abuse of people are reported and can be properly investigated. I know that the Minister for Children and Social Care has contacted the mid and west Wales regional safeguarding children board to request an update on actions being taken to address concerns that have been raised about the current safeguarding arrangements. Dyfed-Powys Police and Pembrokeshire, I understand, have met with representatives of Caldey island because there is a need to strengthen their arrangements—

It's not just Caldey island.

I hear what the Member says and, of course, I don't dispute that.

The Minister for Children and Social Care also wrote to the Catholic Safeguarding Advisory Service to seek assurances they're taking action in relation to current concerns. It's not isolated. I understand that. Caldey island, of course, has been the incidence that has been most in the news, but I hope I've given her some comfort there about what we have done as a Government, given our devolved responsibilities, to ensure that this situation does not happen again.

Well, historical sexual abuse doesn't become historical if we deal with it in the here and now. We know that there is an investigation by Healthcare Inspectorate Wales as a result of the Kris Wade allegations, but it had to take significant public and political pressure for the Cabinet Secretary for health to initiate that particular Healthcare Inspectorate Wales report. I was shocked that it didn't come from Healthcare Inspectorate Wales themselves—that they would take a more proactive role in seeing where there are allegations of abuse, and for them therefore to carry forth those particular reports. What are you doing as a Government to ensure that there are uniform complaints procedures, that people feel confident that they can come forward with these allegations, so that we don't have these problems in the future, where people are having to go back in time, as Angela Burns said, talking about public interest, talking about what's relevant in the here and now, when, to those people who have been abused, it is very important for them to get answers to those questions?

The Member raises a very distressing case, which I'm also familiar with. If I could write to her, giving her more detail in terms of the answer that she seeks—because it is important, of course, that the complaints system is as streamlined as possible and that nothing falls through the gaps, but I will write to her with an answer, a detailed answer, to her question.

Cervical screening can save lives and we want to maximise uptake. Seventy-seven per cent of eligible women in Wales regularly attend for cervical screening. From October 2018, we will be introducing a more sensitive primary test, allowing us to more effectively identify women requiring treatment, reducing the need for repeat smears.

Thank you, First Minister. Despite letters sent to all eligible women in Wales for cervical screening, recent figures suggest that there has been a decrease in participation. Jo's Cervical Cancer Trust found that the numbers of women attending screening in Wales is at a 10-year low. In particular, the charity highlighted concerns about the number of women aged between 25 and 29 participating in screening. With cervical screening found to prevent 70 per cent of cervical cancers from developing, what more can the Welsh Government do to promote and encourage women to have a potentially life-saving test?

Well, from October of last—of this year, I beg your pardon—Cervical Screening Wales will be introducing human papilloma virus testing, and that represents a completely new approach to cervical screening. It is a more sensitive test, which will allow us to more effectively identify those women requiring treatment, as I said. We know that coverage, in general, is falling across the UK nations, and there is work to be done in order to maintain and improve participation rates in Wales. Public Health Wales's Screening for Life campaign runs each July to raise awareness of access to cervical screening in community groups that have an inherently low take-up, and it encourages eligible individuals to attend for screening when invited. Through these things, we want to make sure that the trend where we see fewer people having the test is reversed in the near future.

First Minister, research has shown that women from black, Asian and ethnic minority backgrounds are less likely to attend cervical screening than white women. A survey found that only 28 per cent of women from ethnic minority communities would be comfortable talking to a male GP about cervical screening, compared to 45 per cent of white women. Twice as many BAME women as white women said that better knowledge about the test and its importance would encourage them to attend. First Minister, what is the Welsh Government doing to increase awareness of cervical screening among women from our ethnic minority communities in Wales, please?

Well, I'd refer the Member to the answer I just gave in terms of the Screening for Life campaign, which is aimed at ensuring that community groups that have inherently low take-up of screening—to ensure that that take-up improves in the future. 

We do recognise the important contribution that pubs make to communities. We are working with community groups and other representatives, including the Campaign for Real Ale—I declare an interest as a member—on how best to protect premises and facilities and help bring people together. I've always said that a community without a pub is a collection of houses. Quite often, I've seen this happen in my part of the world. We will be consulting on a review of the Town and Country Planning (Use Classes) Order in May, with a view to looking at how we can better protect our pubs. 

Thanks for that response. Yes, you mentioned on a previous occasion that you were a member of CAMRA, and it's good that you are involved in the real ale sphere. We are trying to—. We've got a cross-party group now. Nick is involved in it as well. Simon Thomas is running it. We're going to, hopefully, help you to push this forward, because we have been waiting rather a long time for a statement on this. I don't want to anticipate what your review is going to come up with, but we do have the—well, they do have the—Localism Act 2011 in England now, so that does give some protection to pubs as assets of community value. Might that be the direction that you could be thinking about going down in Wales?  

Well, we have been working with CAMRA, and that work has been helpful to explore the implications of splitting the A3 food and drink use class, and we will look at how that might work. We're also considering the recommendations made by the University of the West of England in terms of the operation of the use classes Order, and I mentioned how the consultation will proceed in that regard. It is true to say that, for some pubs, the business is no longer viable, but there are many pubs that I know of where it was a perfectly viable business but there was more money to be made by turning those pubs into flats. That is what we have to guard against in the future, because pubs are hugely important assets to our towns and villages and communities across Wales, and we want to make sure that we can do all that we can to protect those that are viable and provide such a service to locals.

I've also been involved in the CAMRA sphere over the years, First Minister, so we have something in common that we can talk about over a pint sometime. I agree with the sentiments that Gareth Bennett mentioned. There was a CAMRA event held at the Assembly last week, and I'm pleased to see the cross-party group on beer and the pub being re-established. There are many issues facing pubs across Wales. You were right to say in your answer, First Minister, that pubs aren't just pubs. They are, for many of our rural communities particularly, the heart of our communities, and, when you lose the pub, you lose the hub of the local community. At the CAMRA event we heard that many pubs in Wales are closing a week, and, across the border in England, planning law's been changed to make change of use more difficult. Are you looking to follow through with similar changes here? I hear what you're saying about bringing an Order forward later in the year. Will you be looking at restricting planning law so that it's much more difficult to change a pub, particularly in a rural area, into another use?   

All options are open, in terms of how that's done. We want to find the most effective way of doing it in order to make sure that our pubs are protected.  

Yes. I welcome the Auditor General for Wales's most recent assessment that progress has been made in improving financial performance, but that town and community councils still need to do more to ensure they have robust accountability arrangements in place. 

Thank you, First Minister. I'm glad that you've read the report. But, as you rightly pointed out, the auditor general has raised several concerns. One thing, in particular, though: local council reserves currently stand at £41.5 million. This is money that taxpayers have paid through a council precept to provide services for them. He also noted that community councils in Wales are receiving avoidable qualified audit opinions—over 170—and 81 councils failed to comply with the statutory timetable for publishing their accounts, and 174 submitted incomplete returns. Now, I know there's an ongoing community council review, cross-party, and I was working with the previous Cabinet Secretary on that. The consultation process, though, is extremely vague, and it doesn't seek to address the fundamental issues of financial probity and auditable accountability, which the auditor general feels the need to raise year on year. Will you work with your Cabinet Secretary in order to address the failings of this particular level of democratic governance?

I think we should be careful not to attribute failings to every town and community council. We know that there are some that have struggled, we know that there are some that are very small—very, very small—and, sometimes, it’s difficult to see how they manage from time to time, but they seem to.

In terms of the review panel, well, just to be clear, the remit of that panel is to explore the potential role of local government below local authority councils, drawing on best practice to define the most appropriate models or structures to deliver this role, and to consider how those models and structures should be applied across Wales. Now, as part of that, of course, financial sustainability is an important factor. The panel is currently gathering evidence and seeking views from community councils, yes, but also the communities that they serve and the people that they work with. And, indeed, the panel have already taken evidence from the Wales Audit Office.

First Minister, we often hear the word 'austerity' used in this Chamber. So, given the limited size of many of our local authorities, how can the money spent on community councils be justified, in that it requires the expense of a chief executive, several staff, and a number of office buildings to facilitate their operations? In other words, First Minister, what do community councils offer that the local government couldn't implement themselves?

I’m not aware of any town or community councils that have a chief executive, I must say. I’m aware of those that have clerks, and some are full-time and some are part-time. I think that town and community councils are an extremely valuable level of government. If the Member is suggesting we should abolish, for example, Bridgend Town Council or Porthcawl Town Council, then he is welcome to explain that to any—[Interruption.]—apart from the Rhondda, of course, where there are no community councils—he is welcome to come and explain that to them. What is important is not that we abolish an entire level of local government, but look to find ways to strengthen that level in the future.

Our tourism strategy sets out our priorities to support the tourism industry right across Wales. That includes marketing campaigns in the UK and overseas, capital development funding for new and existing tourism businesses, along with revenue funding for regional products.

I thank you very much for your answer, First Minister, but Wales is home to some incredible wildlife, like the iconic bottlenose dolphin in Cardigan bay, red kites in Powys and other areas, and ospreys in Montgomeryshire. And we are lucky enough to have some fantastic nature reserves, like the Llanelli fowl and wetlands centre, Skomer island, and the Dyfi osprey centre, and many more beside. 

I think that when wildlife centres and wildlife tourism are put together and run very well they offer a real opportunity to the visitor to enhance that local community and to spend their money very, very locally, without harming or doing any harm whatsoever to the environment that they are enjoying. So, I ask you, First Minister: what steps is the Welsh Government taking to promote sustainable wildlife tourism in Wales?

In 2013-14, funding was awarded to Wildlife Trusts Wales for an interactive wildlife brochure, and £15,000 was awarded to the wildlife trusts of south and west Wales for Wild Wales Adventure in 2015. In 2016-17, £30,000 was awarded to the wildlife trusts of south and west Wales for Wild  Wales Adventures and Legends, and £100,000 has been awarded for 2017, also to the wildlife trusts of south and west Wales, for See Wild Wales Lonely Planet projects. There are four examples there of the support that Government has given in order to promote our wonderful natural heritage.

Yes. Our recently published update of the national transport finance plan sets out the delivery of an ambitious programme of road, rail, bus and active travel improvements for the next three years, and that will help to ensure that South Wales West is connected via an accessible, affordable, reliable, and fully integrated public transport system.

Thank you very much for that answer. You may know that additional events in Swansea and Carmarthen have just been added to the consultation programme for the GW franchise, the Great Western franchise, and I hope that constituents in South Wales West will take this opportunity to press the case for a Swansea parkway station to the north-west of the city. Given the cross-party interest in a Swansea-west metro, if I can call it that, and of course your Government's commitment to the concept of that, can you tell me what money the Welsh Government has already committed or spent on further feasibility and scoping, perhaps, beyond the original ideas of Professor Barry? Thank you.

We have funded the initial concept development work for the Swansea bay metro from the local transport fund. That phase of development work will be completed by the end of next month. We have allocated £4,378,940 from the local transport fund in 2017-18 for the Swansea bay city region. In addition to the metro concept work, we know that there are schemes in Swansea, such as the Baldwin's bridge interchange and the Kingsbridge active travel plan, that are examples of where transport improvements are being made.

A Swansea parkway station would sit on the Swansea district line, which I suspect would need some upgrading. It carries occasional passenger services at the moment. It's mainly a freight line, but nevertheless would serve a substantial area of the northern part of Swansea and the lower part of the Swansea valley, in the same way that Bristol Parkway serves a particular end of Bristol compared to Bristol Temple Meads.

Social care is an area of national importance. Welsh Government has prioritised funding for elderly people, fully recognising locally provided social care services are a lifeline in supporting older people in Wales.

Thank you very much for that response, First Minister. Perhaps you will be aware of a proposal by Swansea council to charge £40 a day for elderly people who attend day centres that are supported by the council. This is a service that’s available free of charge at the moment. These day centres offer considerable support to the users and are of great help in tackling loneliness and isolation in the city. Therefore, do you share my concerns that introducing a daily charge of £40 risks causing more loneliness, and does your Government agree that there’s a need to review day centre fees to ensure that these centres are accessible and tackle loneliness amongst our elderly people?

Well, this consultation is something for Swansea council and for them to proceed with and to come to a decision on. However it’s crucially important that we ensure that nobody loses out because of any changes, ultimately, if that is the decision taken.

And finally, question 11, Hefin David.

The pharmaceutical industry depends on integrated international supply chains and pan-European regulation through the European Medicines Agency. There is a risk of serious damage to the UK industry if the UK Government maintains its red lines in terms of leaving the single market, the customs union and the EU regulatory systems.

Would he therefore agree that the pharmaceutical industry in particular needs a special trade deal, as it's an industry with fast-decaying supply chains and short product-to-market turnaround times, and that the consequences of not recognising that will be dire for skills, jobs and pharmaceutical research in Wales?

Yes it would; in common with many other sectors, that would be true. Rather than have a trade deal for one sector, I'd like to see a comprehensive arrangement whereby we remain within the single market, negating the need for a trade deal with our European partners, and also of course within the customs union. All the evidence that has been published so far, even by the UK Government, suggests that that is actually the most sensible outcome. Those who do not agree with empirical research are trying to suggest that that research is wrong.

Thank you, First Minister.

The next item, therefore, is the business statement and announcement, and I call on the leader of the house, Julie James.

Diolch, Llywydd. There are two changes to this week's business. The First Minister will make a statement on 'Trade Policy: the issues for Wales' shortly, and later this afternoon I will be making a statement on the centenary of women's suffrage. Business for the next three weeks is shown on the business statement and announcement found amongst the meeting papers that are available to Members electronically.

Could I have a statement or clarification on two issues, please, leader of the house? The first is in relation to termination of pregnancy provision for women from Northern Ireland and the consultation that has been brought forward by the Government. I make no observations about the substance of the consultation, but I have had heavy representations over the weekend about the length of the consultation that the Government has allowed for this important piece of work. Apparently, the length of the consultation, it has been put to me, is only a four-week consultation. It was launched on 12 January and will close on 9 February. And I was wondering, in light of the public interest in this matter, is the Secretary prepared to extend the length of consultation? It has been brought to my attention that other consultations that were launched similarly on a similar date do have far longer consultation periods. The one, for example, that's been brought to my attention started the same day and has 65 days to go, and is closing on 3 April, and the next consultation, which was launched on the same day, on the defence of reasonable punishment, has another 64 days to go, and was launched on 9 January and closes on 2 April. As I say, I make no observations about the substance of the consultation, but I do think that representations around the length of the consultation merit an explanation as to why this particular consultation that the Government have brought forward only has a four-week period of consultation, rather than a longer period, which is the traditional norm that Welsh Government attaches to such pieces of work.

And secondly, could we have a statement from the Cabinet Secretary for local government? I understand that in a recent meeting of the partnership council for Wales, he indicated that it was very much back on the Government's agenda—local government reorganisation—and that this was as a direct result of no mandatory collaboration being undertaken. This obviously contradicts the previous Cabinet Secretary for local government's assertion that there would be a 10-year window of stability for local government. Now, if he has been misrepresented, then it would be very beneficial to have a statement to clarify his remarks in that partnership meeting, because, obviously, I am led to believe that he did give an assurance that reorganisation was back on the agenda, which does contradict the assurances of the previous Cabinet Secretary. 

On the first very important matter, the Cabinet Secretary certainly heard your representations, and if you have specific instances that are leading you to the conclusion that that consultation is too short, then I suggest you write to the Cabinet Secretary and set those out. He's indicating his willingness to consider them. 

And on the second, I think you can hear the Cabinet Secretary vehemently denying that he said any such thing. So, I don't think there's any need for a statement to follow. 

Very strangely, I have the same two topics to raise with the leader of the house, but in a completely different way. So, first of all, can we have a debate, indeed, on local government freedom from central Government control? Because I note that Alun Davies, who is the Welsh local government Minister, attends the national executive of the Labour Party, which last week decided to interfere directly in the workings of Haringey local authority. Now, Alun Davies has told me in this Chamber that he believes that local authorities such as Pembrokeshire should be free to make their own decisions, and be answerable only to their electorates for their decisions in the ballot box. But as a Member attending Labour's national executive, he's been part of telling Haringey council how to behave and, indeed, getting rid of the local council leader. Now, I'm not going to take sides in Haringey— 

No, but you do need to come to the point as to why Haringey council deserves discussion here. 

Because of this, surely. It's highly irregular—highly irregular—for a Minister for local government in one devolved nation to be telling a local authority in another devolved nation how they should be behaving, and I think if it had been an English Minister in another party—say, the Conservative Party—telling a Welsh local authority what to do, there would be enough said in this Chamber. So, let's have a debate, Presiding Officer, to tease out these issues. Who is really in control of local government—is it the local elected councillors or the Minister opposite me here? 

Secondly, can I call for a debate on the other issue that I said was common to myself and the leader of the Conservatives, but again, in a very different way—a debate on, indeed, the provision of abortion services for women and girls from Northern Ireland in Wales? The First Minister gave an undertaking, actually, in July to this Chamber that the provision would be made. So, actually, I'm a little uncertain as to why we're having a consultation. [Interruption.] I take a very different view. Why is there a consultation? Why has the announcement of the First Minister that this would be done in July not been actioned already? But nevertheless, let's take the opportunity that this consultation has given us, and the fact that it is 100 years since women first had a vote and a say to have their own political rights over their own bodies and reproduction, to hold a debate on abortion rights so that we can move towards a truly medical-based approach in this country. I believe that this Parliament would resolve overwhelmingly to extend to our sisters in Northern Ireland the same medical support that is extended to other citizens in the UK and indeed throughout the EU.

Finally, can we have a debate on a real crisis in rural banking in Cymru at the moment? In the next few weeks, Fishguard will lose its last bank. If you look at a map of west Wales, there will be very little banking between a part-time bank in St David's and a bank in Cardigan. We can see, from ONS data, that west Wales has suffered most from the loss of banking over the last five years compared to other parts of the UK. I and Adam Price have laid a statement of opinion here referring to the Public Policy Institute for Wales report, 'Time for a Full Public Bank in Wales?' This would be an excellent subject for debate, I think. It would allow all Members to reflect on the issues of public banking in their own communities and also enable us to express a real positive alternative, including a Welsh people's bank on the model of local savings banks.

Thank you for those three topics. On the first one, I can't help but feel that the internal workings of the Labour Party are not a matter for the Senedd, although if the Member is that interested I can supply him with an application form, if he wants to join the party and take a further interest. 

On the second point, the Cabinet Secretary was here to listen to the important points that you raised, and I'm sure that he will be writing to you in due course to explain what the consultation is about. Indeed, he is indicating to me that he is happy to do so.

In terms of the rural crisis in banks, actually it's a crisis across the piece. I have a similar crisis in my own very central and urban constituency. It is an important point, and I will certainly be discussing, as the equalities Minister, with a number of Cabinet Secretaries, the best way to discuss that and the solutions here on the floor of the Senedd.

On this one hundredth anniversary of women getting a limited vote—of course, this was at a time when men also had a limited vote; it wasn't all men who had the vote either—we need to make sure that women's votes count and that women's representation in our political institutions counts as well.

I wanted to raise, leader of the house, the issue of period poverty, because it is shocking to learn that one in 10 women cannot afford sanitary products when they get their monthly period and even more shocking, I think, to learn that 12 per cent of girls are using other materials to deal with their period because they simply can't afford these materials, and obviously that has a huge impact on their ability to engage in their studies and all other aspects of engagement in civil society. So, I wonder whether it is possible to have a statement from the Government on how we deal with this very complex and intimate subject so we can have a debate on how we are collectively going to resolve it.

The Member raises an extremely important point. As part of the Welsh Government's wider work to reduce inequality and mitigate the impact of poverty, we are exploring a number of ways of having a scheme to supply feminine hygiene products free of charge to, say, food bank users and in schools and so on. The work's in its early stages. We are monitoring a lot of the work that's being done by colleagues in Scotland and elsewhere, and we will be bringing forward a range of measures once we've completed the work of monitoring the exact impact of the various possibilities of the schemes that could go forward, and it may well be that we introduce a range of different measures in appropriate circumstances. But I assure the Member that we take this very seriously indeed and we will be looking very seriously at these schemes in the future.

Leader of the house, may I ask for a statement from the Cabinet Secretary for health on waiting times for bowel cancer tests in Wales? A report published by Bowel Cancer UK has revealed that patients at five out of seven health boards in Wales are waiting longer for the test to diagnose bowel cancer. Worryingly, they also found that fewer than half of the people eligible for bowel cancer screening tests in Wales took part. This is actually a worrying state. Wales is ranked—out of 29 countries in Europe, we stand at twenty-fifth for bowel cancer survival after five years, which is virtually the second-largest killer in Wales and the fifth, virtually, in the whole of the United Kingdom. Also, there is increasing demand for endoscopies in hospitals and a lack of capacity also in our hospitals and long waiting times in our hospitals for bowel cancer screening, which is totally unacceptable these days. In view of the fact that bowel cancer is the fourth—not the fifth, sorry—most common cancer in Wales, could we have a statement from the Cabinet Secretary on what action he will take to address the serious findings in this report as soon as possible? Thank you.

Well, we publish all of the information that the Member is using there very regularly. The Cabinet Secretary was here to hear your concerns, and you raised a number of important points there that are a matter for some discussion between myself and him on the equalities issue, for example, and the take-up in different communities and so on. We've certainly heard that and I'd be very happy to speak to the Member about how we can best ensure that all communities in Wales are served. 

Leader of the house, you may be aware that this morning there's been yet another accident on the M4 at the Ynysforgan roundabout just outside Swansea, which, as you will know, is a common occurrence in the area. And as well as being a clear safety issue, it can bring about traffic chaos on this stretch of motorway and surrounding roads. Now, back in October 2016, the Cabinet Secretary for transport issued a written statement where he stated that he had asked his officials to engage with the Swansea bay city region in a wider study of the M4 corridor around Swansea. So, recognising the importance of this issue, will the Cabinet Secretary now agree to bring forward a debate on the options for improvement on this stretch of the M4 around Swansea? Thank you. 

The Member raises an extremely important point. The M4 around Swansea has experienced a number of difficulties recently on an ongoing basis, which I'm sure we all know, especially those of us from that area. I know the Cabinet Secretary is looking at a range of measures on that and he will be updating the Senedd when that piece of work is done. 

As previous speakers have said, today is a historic day, celebrating 100 years of some women getting the vote for the first time. So, what can the Government do to try to make it easier for women to vote? I wondered if the Government could give consideration, in the course of its business, to see what they could do, particularly for women whose first language is not English, and whether there are any specific schemes that could be developed. 

And, secondly, if there was any possibility of extending the anonymity that victims of domestic abuse receive—. That only lasts for a year, which means that every year they have to reapply and go through all the proof to show what they have been suffering. I don't know whether the Welsh Government has any powers in this area, but is this something that the Government could look at?

Yes, indeed. The Member raises a number of very important points there. Electoral powers will be devolved to the Assembly in the Wales Act, and they're not yet enforced, as I'm sure Members are aware. We have been working very hard with the Cabinet Office in looking at the law of electoral registration, to make it easier for women to register anonymously in circumstances of domestic violence and other circumstances. And the UK Government has just confirmed in September that they will press ahead with plans to make it much easier for domestic abuse survivors to register anonymously, and we're fully co-operating with that in advance of having the powers ourselves.

We're also introducing a range of measures. The Cabinet Secretary for public services has been looking at a range of issues around electoral reform, many of which will be around making it easier to vote in a number of circumstances, and they will include for people where English isn't a first language, and for people with mobility and other equality issues, and I'm in a series of discussions with him about that consultation and its results, which we will be taking forward. 

I only wish to raise a single item and call on the Welsh Government to have a Government debate on prevention and early intervention services, which its legislation and its statements continuously and rightly support, but in practice its actions are stripping out these services at huge additional cost to our health services and social services, which are at crisis level. Last week, we heard disappointment from both the First Minister and the education Secretary about the closure of Afasic Cymru, despite the decision to close Afasic Cymru being forced on its trustees by the Welsh Government's decision to end the children and families delivery grant and switch the funding elsewhere. Afasic Cymru is the only charity representing families of children with speech, language and communication needs in Wales, and in north Wales alone it has supported hundreds of families over the last year, taking pressure off statutory services, improving lives.

Welsh Women's Aid has expressed concern that the direct funding it receives from the Welsh Government has fallen from £355,000 for specialist violence against women, domestic abuse and sexual violence services, to just £34,000 in the current financial year, and although the funding is passed to regional health boards, this, they say, hasn't happened. Last Friday, I attended the Save the Welsh Independent Living Grant exhibition at Theatr Clwyd, to show my support for the campaign, led by Nathan Lee Davies in Wrexham, because they recognise that Welsh Government plans to remove ring fencing will mean that independent living for disabled people with high care and support needs will be at risk, as the funding instead goes without ring fencing to local authorities. Similar concerns have been raised loudly and consistently with you by the housing-related support community about Supporting People, after you wrote to local authorities saying that you're removing the ring fence for Supporting People, and giving them spending flexibility that currently goes to prevention and early intervention services.

And finally I'll mention one more example. Last year, you scrapped or removed £5.5 million from the Family Fund for vulnerable families with disabled children, meaning that the number of families supported this year has fallen from 5,429 to just 875, and the majority not getting the support said that there was no other support available for them. This false economy is adding tens, if not hundreds, of millions of pounds and pressures onto our health and social services. It goes completely against the spirit of your legislation and actions in respect of prevention and early intervention, and I urge you to have a debate so that we can air this fully, and hopefully agree a way to start restoring the support to the projects making such a big difference in the communities and families across Wales.

Thank you for raising those important points. And I don't doubt the Member's sincerity in wanting to support the organisations that he set out, but there are a number of underlying causes, not least the continuing austerity programme of the UK Government in cutting the budgets to this place, quite severely, for ideological reasons. It's very difficult to separate the two things out in the way that the Member seeks to do, because these are direct results of austerity policies. On top of that, we are responding to local government's request, which I fully support, and so does the Government, to trust them, and the local democratic mandate that they have, in distributing money equitably locally. And so we are taking ring-fenced and hypothecated restraints away from them, to give them maximum flexibility, in the face of the continuing austerity agenda. So, I don't think there's any need for a debate on that. The ideological lines are very firmly drawn, and I'm afraid we are very much on the side of both trusting local government and ensuring that we do our very best to offset the austerity agenda that his Government continues to pursue.

I wondered whether we could have a debate or a statement giving us an update on the Valleys taskforce and its discussions. I'm aware that they had engagement with Neath Port Talbot County Borough Council last week, and it would be useful for us as AMs to understand what those deliberations were. I say it in the context of having been at a public meeting last night, where there are proposals to close Cymer Afan school in the Afan valley. We appreciate that the taskforce isn't just to do with education, but if you do close the school, it will take away the heart of the community, and therefore may lead to the taskforce being not as relevant as the Welsh Government would like it to be. So, I wondered whether we could have an update on those discussions, because we want the community to engage in that taskforce. But if they're going to be confused by the agenda of the Welsh Government as to the local council, then we need to have clarification over that.

Yes, the Minister for public services, who chairs the Valleys taskforce, will be giving an update to the Senedd after this current round of meetings, and there's another one on Monday, for example. A number of us are members of the Valleys taskforce, and it is absolutely the intention of the Valleys taskforce to report back regularly to the Senedd, giving the update, as the Member sets out.

I was actually going to ask the same question Bethan Jenkins just asked. We both attended a very emotional, very well-attended meeting last night of communities who are passionate about their community, who have seen services gone in their community, and as far as the Valleys taskforce is concerned—not one of the hubs, but on the periphery of two hubs, and it doesn't understand whether they could actually benefit from either of those two hubs. But what's important is to understand what the resilience means in those resilient communities. Because if resilient means including education provision delivered within the community, to actually ensure that community is able to build within itself, then it's important. Now, I understand that Cabinet Secretaries can't comment upon individual school closure proposals, but the role of Welsh Government policy in this proposal is going to be important. And therefore a statement on exactly what they mean by resilient communities, and how education plays a part in that definition, is important.

The Member makes a very good point. Obviously, we can't comment on individual school closure programmes by individual local authorities—it's a matter for them. The Valleys taskforce isn't a thing in itself—it is the way to co-ordinate Government action across the Valleys areas. So, the Member's quite right to highlight that we need to be able to set out what we're doing across each of those areas, not just in the hubs, and I know that the Cabinet Secretary for public services will be taking that into account when he does his update.

I want to call very briefly for two statements. The first is from the Cabinet Secretary for Economy and Transport on emergency vehicle access to Shell Island campsite via Llanbedr airfield. Emergency vehicles have had high-tide access through the Government-owned airfield for more than 50 years, but the tenant, Snowdonia Aerospace LLP, has not guaranteed long-term continued access, putting the future of that business in jeopardy. So, I just feel that where we own land and where we sublet it, we are actually mindful that the two businesses, in this case, operating either side of that are able to communicate and carry on to the benefit of those communities.

And the other statement that I'd like to see is from the transport Minister over the collapse of the Express Motors bus company. I understand that Gwynedd Council has found other operators to deliver subsidised bus services, but the bulk of the former Express Motors services that were commercial have not been replaced. For example, as far as I'm aware, the hourly Barmouth to Porthmadog service has already disappeared. And this is the third commercial operator to go out of business in this area in the last five years. Every single time that happens, people's jobs and the services locally are badly affected, leaving people stranded and without work. And I think this actually raises a need for a much longer term vision on how we deliver bus services and whether we need to look at regulation if we're going to get those powers back here to stop this stop-start bus service that people are completely dependent on in those areas.

The Member raises two very important issues there. On the first, we are aware of the emergency services access issues in relation to Shell Island during periods of high tides especially. It is a matter for the directors of Shell Island to pursue discussions with Snowdonia Aerospace directly to reach amicable arrangements, and we are encouraging both parties to explore all the options available to seek solutions that work for everyone concerned. I'm sure the Member has made her concerns very clear as well.

In terms of the serious bus issues that the Member raises, I know the Cabinet Secretary is looking, as we speak, into the regulation of bus services and the pros and cons of that, and what we can bring forward when the powers arrive here in Wales. I know that he is planning to update the Senedd at an early stage as to some of the plans that we are able to bring forward in terms of the regulation of bus services and to ensure the joined-up travel system that I know that she would like to see for Mid and West Wales.

,Leader of the Chamber, I recently raised the plight of the Kurds in Afrin, Syria, who are being attacked by an aggressive Turkish state. I asked you if you would write to the UK Government to urge them to use their diplomatic channels to stop what Turkey is doing. There are Kurds outside our Parliament right now who are from Afrin and they're incredibly worried about their families and cannot believe this Government's complete reluctance to do anything. They tell me that most AMs have not gone to speak to them—and that's not right; their loved ones are dying and they deserve a hearing. You've said nothing about Yemen either where part of my family originated from. I gave an example, a precedence, last time, where the First Minister spoke giving his sympathies to Belgium after an attack there. So, why does Labour have such selective sympathy for victims of violence? Are only whiter, European countries worthy of sympathy? [Interruption.] With respect to everybody here, this Government has made a statement about Belgium, and you are refusing to say anything about the Kurds and Yemen. Will you make a statement?

The Member is—. I can't comment on the language he uses. It's clearly not an acceptable thing to say and it's not true either. We expressed a statement of sympathy for a fellow European country after a terrorist attack. The countries you're talking about are unfortunately embroiled in war situations.

It's state terrorism. Civilians are being bombed. [Inaudible.]

Neil McEvoy, shouting does not make your political point for you, neither does trying to discriminate in attacking a particular ethnic group help you in making your point. So, I'm asking you to make the political point you want to make, but make it in language that is appropriate to this Chamber. Shouting is certainly not appropriate.

Thank you, Llywydd. I was simply saying everybody in this Chamber expresses their sympathies to all communities caught up in war—of course they do. That's quite different from expressing specific sympathies in specific instances of terrorist attack that we would do to any country in any part of the world subject to such attacks.

Thank you, Minister.

We'll now move on to the statement by the First Minister on trade policy for Wales. I call on the First Minister, Carwyn Jones.

Thank you, Llywydd. We have published a new document in our series of Brexit policy position papers entitled 'Trade Policy: the issues for Wales'. This is the fifth in our series of papers, which sets out how we believe we in Wales, and the UK as a whole, should respond to the very significant challenges posed by the UK's decision to leave the European Union. The paper sets out our trade policy ambitions and reflects the analytical and practical work we are doing in preparation for our exit from the European Union.

Llywydd, this paper illustrates the importance of trade to Wales. Wales is an outward-facing, globally trading nation, and we are committed to internationalism. However, we can't lose sight of the fact that a clear majority—61 per cent—of Welsh goods exports goes straight to the European Union and that our strong record of attracting inward investment reflects our historic position offering a business-friendly environment within the European single market.

The work we have undertaken over the last 12 months, including the research commissioned from the Cardiff Business School—also published last week—has only strengthened our conviction that the position we set out in last year's White Paper 'Securing Wales' Future', authored jointly with Plaid Cymru, is the right one. Continued full and unfettered access to the single market is vital to Wales's forward economic interests, as is continued participation in a customs union with the EU. We have seen no sound economic arguments to the contrary, and the recent leaks of the UK Government's analysis of our economic future outside the EU suggest that this is because there are none.

Can I just emphasise here the strong commitment of the Welsh Government to evidence-based policy? Of course, we have limited resources and, of course, we can't predict the future with any precision. But we can, and have, gathered evidence about what practical issues our larger businesses are facing as a result of the vote to leave the EU, and we will continue with further research focused on smaller businesses. We can and do listen intently to the evidence from stakeholders in Wales and beyond about the implications of different scenarios for their capacity to operate effectively in future.

It is on the basis, Llywydd, of listening to the evidence, not some ideological zealotry, that we have arrived at our position supporting the closest possible relationship with the single market and the customs union, one which is completely compatible with fulfilling the mandate from the referendum of ceasing to be a member state of the EU—a position that is also broadly in line with that of all the main business organisations as well as the TUC.

What a contrast, then, to UK Government Ministers, seemingly attacking their own civil servants for failing to come up with the right answers and simply holding their hands over their ears to blot out the rising clamour for a sensible Brexit; a Brexit that puts the interests of our economy first, not one dictated by the arbitrary red lines set out by the Prime Minister in her Lancaster House speech.  

Of course, we fully accept that there are also significant trading opportunities outside of Europe, but we don't believe that the UK Government should pursue free trade agreements at the expense of our trading relationship with our closest and most economically integrated neighbours. Building new trading relationships with other countries around the world should be seen as a complement to the relationship with the EU and not as a substitute.

Brexit poses huge challenges to our economy, but, as we set out in our paper 'Brexit and Devolution', it also raises questions about the way in which we manage inter-governmental relationships within the UK. Over the last 45 years, the European Union has had exclusive competence to manage customs and the common commercial policy—the negotiation and agreement of international trade agreements—on behalf of the UK. Once we leave the EU, although international trade will remain a reserved matter in terms of our devolution settlement, we will need deeper and more sustained co-operation between devolved administrations and the UK Government over these issues. Because trade policy will have a significant intersection with devolved powers, such as environmental standards, economic development, agriculture and fisheries, and skills and qualifications. The UK Government can't develop a trade policy fit for purpose for the whole of the UK in isolation—something that the UK Government itself recognises.

I'm not used to finding myself in agreement with Dr Liam Fox, but the trade White Paper ‘Preparing for our future UK Trade Policy’, which the UK Government published last autumn, is quite clear about this. It says,

‘The devolved administrations will have a direct interest in our future trade agreements. We will work closely with them to deliver an approach that works for the whole of the UK, reflecting the needs and individual circumstances of England, Scotland, Wales and Northern Ireland, and drawing on their essential knowledge and expertise’.

For our part, we have called for the establishment of a United Kingdom council of Ministers, which brings together devolved Ministers with UK Ministers, who should be fully engaged at all stages of the development and implementation of our future trade policy. In the shorter term, a new joint ministerial committee on international trade should be established to agree joint approaches on trade.

I commend, then, this paper to the Assembly and welcome any questions.

Yesterday, EU negotiator Michel Barnier said he respected the UK's decision to rule out any form of long-term customs union, but he did add—and I'm sure the First Minister will be alluding to this—that, without a customs union and outside the single market, 

'barriers to trade in goods and services are unavoidable',

which, of course, is exactly the position we would expect at the start of negotiations towards an agreed deal and just as apparently uncompromising as the position taken at the start of negotiations on the stage 1 discussions [Correction: 'deal'], which were successfully concluded with compromise on both sides before Christmas.

In response, the Secretary of State for Exiting the European Union in the UK Government, David Davis, yesterday said that he wanted a free trade deal with the EU, but also the freedom to strike deals with other countries where trade opportunities are growing. Well, given that the First Minister has repeatedly stated that he accepts the outcome of the referendum and believes this was more a protest vote than about control of borders, laws, trade and money, will he confirm to the people of Wales that continued membership of the single market and customs union would mean that the UK could not strike trade deals with countries outside the EU, other than through the EU?

According to both Her Majesty's Revenue and Customs and the Office for National Statistics figures and subject to small adjustments for finance, travel and transport, some 90 per cent of the UK economy and 85 per cent of the Welsh economy is not involved in exporting to the EU. The UK does more trade with the rest of the world than the EU. I know that, in Wales, the position is fractionally different, but we're talking about negotiations into the UK single market, which Wales is key to. That trade with the rest of the world is growing faster than UK trade with the EU, and because the EU sells some £80 billion more to the UK than the UK to the EU, clearly, it would not be in their interests to stop that trading.

When the External Affairs and Additional Legislation Committee met the Flemish Government, they told us that they were reliant on access to the UK and Welsh markets and were working with similar regions and sectors across the EU that needed a deal that enabled them to continue frictionless access to the UK market. So, what engagement have you had with regions and sectors across the EU that need a deal that enables them to continue to have free trade with Wales and the UK?

Of course, HMRC published details of changes to how regional trade statistics are calculated in May 2016, the result of which, under the old methodology, were that Welsh EU exports accounted for 39.2 per cent of all exports in the four quarters ending in June 2016, but, at the stroke of a pen, that rose to 67.4 per cent of all Welsh exports. So, in practice, not a lot had changed. Now, in his statement today and in the document published last Friday, the First Minister talks about 61 per cent of identifiable Welsh goods exports being traded with the EU single market. Why has that figure, therefore, already apparently fallen from 67 per cent to 61 per cent?

He talks about his belief that continued full and unfettered access to Europe’s single market is vital to Wales's forward economic interests, and says,

'We remain to be convinced that leaving a customs union with the EU is in our interests, at least for the foreseeable future.'

What do you mean by 'at least for the foreseeable future'? I'd be grateful if you could clarify. Is that simply a transition period, or do you have something else in mind? As you indicate, you,

'welcome the UK Government’s recognition in their White Paper, Preparing for our Future UK Trade policy, that Devolved Governments (and...legislatures) have an important role in shaping future trade policy'.

But, in evidence, as we heard earlier from the leader of Plaid Cymru, yesterday from you to the House of Commons Public Administration and Constitutional Affairs Committee, you said you 'don't think we should have a veto—it's hugely important that we have consultation'. And, of course, in your seven years in office, you have fostered the least diverse export economy in the UK, leaving Wales more reliant than any other nation on EU trade. So, what discussions is the Welsh Government, official to official, having with the UK Government, which I know are going on in detail, regarding frameworks, regarding a UK single market with agreed approaches on a range of matters, of course, including trade? Perhaps you could provide us with a progress report on discussions that are clearly already happening. Thank you.

Time is running out, and we still have no idea what UK Government's endgame is. We don't know in what position they want to be. We have, on the one hand, the Jacob Rees-Moggs of this world saying it doesn't matter about tariffs, it doesn't matter if we lose manufacturing jobs, because they'll be made up for in some unspecified way, and then we have another branch of the Conservative Party demanding that Jacob Rees-Mogg should be expelled. This gives you some idea of the chaos that sits at the heart of the UK Government.

If he talks about a free trade agreement with the EU, the EU will look to have alignment with a market that it has a free trade agreement with. What's the difference in terms of where we are now compared to a free trade agreement? Some will say free trade agreements give us the opportunity to have free trade agreements with other countries. Which ones? Which ones? Everyone talks about New Zealand—what for? Countries such as China—goodbye, steel industry. We need to be very, very careful in terms of what kinds of free trade agreements we should have, and this is a false promise. If we cannot come to an agreement with our closest, biggest, most aligned market, we have no hope of free trade agreements that take six or seven years to negotiate, on average, with any other economy, and why would we want to? One of the things I hear from Brexiteers is this suggestion that, somehow, Europe is not important, 'Forget about that, look at other economies instead'. I disagree; Europe is our most important market. It's bigger than the US, it's on our doorstep, it's not 3,500 miles away. To ignore our single most important market, I think, is folly.

Now, Mark Isherwood talks about gaining control of money. I wasn't aware that the UK was in the euro, and so I don't understand what he means by control of money. In terms of laws, well, that must apply, of course, to this place as well as to the UK Parliament. In terms of trade, well, one of the things he said later on was that our economy was weak because it relied on EU trade. What on earth is wrong with relying on trade with Europe? We're not an autarky, and it's hugely important that we trade with other countries and other economies like Europe.

Finally, on borders, let's nail this myth once again. The UK will not and cannot control its own borders. It just isn't going to happen. Why? Because the UK has a land border with the Republic of Ireland that will be an open border. So, let's nail this now: this idea that the UK will control its borders in some way with controls on borders is just simply untrue, and that is something that needs to be emphasised over and over again.

In terms of what he said about trade deals, yes, of course we want to see the best trading relationships possible with other economies. We do look at other countries. If we look at Welsh lamb, for example, that is sold in the United Arab Emirates, but we cannot ignore the fact that we have a large economy and a large market on our doorstep. There is no market—there is no market—that will replace the market for Welsh sheep meat exports in the European single market. It does not exist. It does not exist. And when I hear Brexiteers, like Jacob Rees-Mogg and others, say, 'It'll mean we have cheaper food,' what they mean is, that food will be imported and our farmers will be shafted. That's what they mean. So, let's be quite clear about it: they are willing to sell the agriculture industry down the river in order for there to be cheap imports, and they will do the same for other industries. Why? Why? Because it doesn't matter to them. If you listen to some economists, it doesn't matter: 'So what if we lose manufacturing jobs, because they'll be made up for in some way in service industries?' So, goodbye, steel industry; you don't count. Aeronautics, automobile—don't count. 'Economics without human beings', I call that, but that's what is advocated by the hard Brexiteers. If we look, for example, at—[Interruption.]

No, no, no, this is a statement.

He talks about the Flemish Government. Of course the UK is an important market, but the integrity of the European single market is far more important to any country or any manufacturer than anything else. We were told that the German car manufacturers would drive—they would probably drive—to our rescue. They've said quite clearly that, 'The UK is an important market, but the integrity of the European single market is far more important to us, and we're not going to do anything to disrupt that.' So, that was untrue, and that is something that was found to be wrong.

In terms of our exports, the figure varies, in terms of the 60s—sometimes up, sometimes down. But what is absolutely clear is that the vast majority of our exports go to the single market. Does that mean we can't sell there in the future? No, of course it doesn't. It doesn't mean we can't trade and sell in the European single market. All it means is that what we produce will be subject to barriers that don't currently exist, whether they are financial barriers or non-tariff barriers—paperwork, bureaucracy. People say about reducing bureaucracy; this is a vast raft of bureaucracy that's going to be imposed on business as a result of Brexit, and those barriers are important, because it would mean that we are less competitive in those markets. We already know that some countries in Europe are looking at producing light hill lambs, because they think that our products will be more expensive on the European market and they will be able to compete against us. And we must be absolutely clear about that.

He mentioned how long membership of the customs union should be. Well, until there are better alternatives, frankly. A transitional period, yes, but I'm not wedded to the idea that the transitional period should be for a specified amount of time. Surely the transitional period should be for as long as is good for the UK and is good for Wales.

And then, finally, in terms of frameworks—he asked about frameworks. Progress is being made on frameworks. Discussions are happening. They are without prejudice, of course, to an agreement being reached on clause 11, and the other clauses of the withdrawal Bill that impinge on the devolution settlement, but those discussions are ongoing. And I can see from the Conservative front bench that the hard Brexiters have already been expelled. [Laughter.]

I do welcome this important statement and if I may also say, I also welcome the apology that I received from the First Minister earlier this afternoon.

You mentioned in your statement the evidence base for the Government’s policy, and I agree entirely with that, and the research that you’ve commissioned from Cardiff Business School is useful and interesting. What we don’t have so far, though, is a full impact assessment showing the difference between the various different scenarios. That’s the kind of study that the Scottish Government has published, as has the mayor of London, and of course it’s now been revealed that the UK Government had such an assessment, and you referred to that and other studies across the UK too. Wouldn’t it be useful for us in Wales to have such a study, so that we can put a figure on this gulf in terms of the impact of the various scenarios, so that we can make the case even more strongly?

The Wales Centre for Public Policy published, last week, I believe, a paper that deals with this question of the role of sub-state Governments in terms of trade policy. The report made a number of recommendations to the Welsh Government in terms of recruiting negotiators, a team of influential negotiators, and also developing almost a para-diplomatic service, if you would like to describe it in that way, in terms of Wales having influence at various levels internationally, both pre Brexit and post Brexit. So, do you intend to implement some of these recommendations?

Finally, in providing evidence yesterday to the Public Administration and Constitutional Affairs Committee, you said that it wasn't possible to be entirely clear as to what sort of Brexit people had voted for. Isn't there an opportunity here for us in Wales to use the powers that we have as a Parliament to hold an advisory referendum, and to ask the people of Wales what kind of Brexit they want to see? Do they agree with us that the best option for the Welsh economy is membership of the single market and the customs union?

Work has been done by Cardiff Business School, looking at the impact on businesses, and we are, of course, considering evidence that has come before us from other assessments about different scenarios. We know what's going to happen with a hard Brexit. That's clear from what Cardiff Business School have said and, of course, it's not a story that provides any sort of assistance to us.

One of the things that we have done as a Government is to ensure that a few White Papers have been published. We have been completely clear about the kind of direction that Brexit should take, as a Government. He asked a question about para-diplomatic powers and whether those are important. Yes, they are. I have met with Michel Barnier already, I have been meeting with other leaders and, of course, we have an office in Brussels that will remain whatever happens—that's going to be vital—and, of course, we have opened offices, or are preparing to open offices, in a number of cities, not only in Europe but across the world. Why? It's vital that we ensure that we have a presence in many new cities so that we can secure investment and are able to export to those markets. It was clear to me, after Brexit, that it was vital to ensure that we had offices, for example, in Germany and in those economies that are vital to the Welsh economy. So, that is important to ensure that we know the views of Wales. Every time I have been in Brussels, they had a White Paper before them, and they knew what the view of the Government of Wales was, and they could see sensibly what was in the paper itself.

Referendum—interesting. One of the things, of course, that we would have to consider—. First of all, there is a cost, but without that, with any sort of advisory referendum, are we talking about something that has many questions? In what way then can you know what exactly people's views are if there's a split in terms of answers? So, there are things such as those to consider. For me, what I think is vital—and I've said this on many an occasion—is that this Parliament should have the power to permit, or not permit, the Brexit settlement that we will have at the end of the day. It's vital to me that there is permission from, or at least the blessing of, every Parliament in the UK before Brexit moves forward.

Well, this is quite an interesting document that's been produced by the Welsh Government, but only for the statistics it includes. There seems to be very little, if anything, that is new in terms of policy development. It's very disappointing, I think, that the same kind of pessimistic refrain that we've heard at any time in the last two years nearly, now, since the referendum, is coming from the mouth of the First Minister. Oscar Wilde once said,

'The optimist sees the doughnut, the pessimist sees the hole.'

I'm afraid that the First Minister is the man who is constantly looking into a hole. He sees a difficulty in every opportunity whereas the alternative view is to look at the opportunities that are in every difficulty, and that's what business people do.

Anybody who has ever run a business knows that the world is constantly changing and you adapt to it. If you constantly pretend that there are no alternatives to what we currently know, then you will never keep up with what's happening in the real world. All the academic studies in the world are merely projections of assumptions that are plugged into a computer. If those assumptions don't turn out to be consistent with what happens in due course, then those forecasts are always wrong, which is why most economic forecasts are wrong, and most specifically those that have come out of Her Majesty's Treasury in Whitehall. So, I wouldn't advise the First Minister to pay too great attention to academic studies of any kind, whether they suit his view of the world, or indeed mine.

The point about a second referendum, which has been raised by Adam Price, is that in the referendum—the real referendum that we had nearly two years ago—people were only asked one simple question: do you want to leave the EU or stay in the EU? There were no ifs or buts. It's not about, you know, 'What sort of trade deal do you want to see as a result of leaving the EU?' We could have a referendum on different kinds of trade deal, no doubt, but that wouldn't affect the real question, which is the right to recover control of our own borders, and the right to make our own laws in parliamentary institutions such as this. Staying inside the single market and customs union is not consistent with leaving the European Union because we would then actually be in a worse legislative position than we were before: outside the EU, but subject to the rules that they make and we would have no formal role in the development of policy and the laws that we would have to obey.

I do counsel the First Minister to keep things in perspective. Yes, as a result of leaving the EU, even if it's not possible to do a deal with the EU because they are too intransigent and they see—. They are the ideological zealots in this, as the First Minister pointed out. In relation to the spokesman for the German car industry, he said that they are much more interested in keeping the single market together as a political unit than in the economic damage that would be done to Germany if we were to leave the EU without a trade deal. One in five of all passenger cars that are made in Germany—that's 820,000 vehicles—is exported to the United Kingdom every year. They have a £20 billion a year deficit on trading account in cars alone. The United Kingdom has a trade deficit with the EU of over £60 billion. There is enormous opportunity here for import substitution, for example.

The First Minister concentrated very heavily on lamb. The document itself shows how small the market is that we are talking about there: £402 million a year are our exports of lamb—or agricultural products, rather. But, we import £600 million-worth of agricultural products, so 60 per cent of all the food that is eaten in Wales every year is imported. So there is—[Interruption.] I'm going on the figure that appears in the document. [Interruption.] In the document. I'm sorry, Llywydd, I thought that was you.

No, it wasn't me, but it is me now, and you do need to ask questions. This is your opportunity to question the First Minister.

Yes, exactly. I'm asking the First Minister if he will not keep this matter in perspective. As 90 per cent of the growth in trade in the next 15 years is forecast by the European Commission itself to be outside the European Union, the global market for what we produce in Wales is going to grow, whereas the market in Europe is stagnant. That's why, as Mark Isherwood pointed out earlier on, the proportion of our trade that we are doing with the EU is now declining, not least because of problems with the eurozone.

So, what I'm saying to the First Minister is that he should be doing far more—and going back to what I said in First Minister's questions this afternoon—he should be doing far more to help Welsh business cope with the inevitable changes that are going to be necessary in the transitional period that will follow immediately upon our leaving the European Union. There's no point in carrying on banging your head against a brick wall. The United Kingdom Government is resolved to leave the European Union, leave the single market, leave the customs union. Let us now work together to produce a practical set of proposals on how to make that process much more palatable, even to those who are against leaving the European Union, and a practical way forward for the businesses that will have to cope with extra changes. Nobody denies that there are extra changes that are going to come about, but they're all easily manageable.

Wishful thinking again. Can I remind him, I have actually run a business?Successfully, thanks, so I do know how it operates. Secondly, can I remind him that the European economy is growing faster than the UK economy? So, it's hardly hidebound in some way by the euro or by anything else. Can I express surprise at his wilful dismissal of evidence—something that is, of course, highly inconvenient to those who love to see wishful thinking? He says, 'Well, you know, people voted to leave the EU. That much is true.' Actually, we don't know what they voted for beyond that. There are some people who have a more extreme interpretation than others. Norway is not in the EU. The Norwegian model was offered by members of his own party, and now we are told it is not properly leaving the EU. Norway isn't in the EU, and yet it has the kind of beneficial trade arrangements that it wants with the European single market. If Norway can do it, then why can't the UK? Again, he repeats this mantra, and I invite the Brexiteers in this Chamber to answer this question at some point: the UK will not control its borders. It will not control its borders; it will have an open border with the European Union in Ireland. So, this idea that the UK will control its borders is simply a myth and never was true, and it was something upon which people were misled, bluntly, in the European referendum. So, forget about that; the UK cannot control its own borders in that way.

He mentions the irrational foreigners—the irrational foreigners that exist in Europe who are so irrational they will not bend to the will of the UK. How awful that is that they will simply not agree with what the UK is actually saying. Well, of course they’re not going to do that; they have their own corners to fight.

And he mentions the German car industry. The German car industry sees the single market is more important than anything else, more important than the UK market. And why? Well, they’ve calculated that people will still buy BMWs, they'll still buy Mercedes-Benz, they’ll still buy Audis, and pay the extra, but it's not the same for other car manufacturers when they try to export cars that don’t have the same sort of premium marque in the future.

He talks of lamb. Lamb is a tiny market. It doesn’t matter about lamb—something we can sacrifice. It’s only a few hundred million pounds. The reality is that the Welsh lamb industry needs exports to survive, because the UK consumer does not tend to buy it in the numbers that are required.

Then he says that we import £600 million; we need to have import substitution. We tried that in the war, and we had rationing. Is that what he’s suggesting? Because what he’s suggesting is this: it is a bad thing that the UK imports food. So, in other words, if you want to buy apples in January, tough. If you want to buy leeks in December, tough. If you want to buy strawberries out of season, in May, tough. So, what he’s saying to the consumer is: actually, what we want is to stop those imports coming in, so you can’t buy what you want to buy. Well, try that one to get past consumers in the future.

So, my advice to him is this: open your eyes and look at the evidence, don’t be blinded by ideology or nationalism, and start saying that we can have a Brexit that actually is sensible to the UK, not one that is costly in terms of bureaucracy, not one that destroys our farming industry, not one that destroys our steel industry, not one that makes it more difficult for us to attract investment from other countries because we're not part of the single market, and let’s have common sense, a commonsense Brexit, and not one driven by sheer zealotry.

First Minister, I welcome your statement. I'll try and keep my contribution to the questions and to the topic, which is the trade policy, and not repeat referendum discussions, as we seem to be hearing elsewhere.

First Minister, the trade policy, which I very much welcome, also reflects upon something that was raised earlier, because I was very pleased to see, on page 15, the reference to a 'no deal' situation, because at least we're starting to see now recognition that 'no deal' needs to be addressed, and it does refer to that. So, I'm very pleased at that.

But the paper that it builds upon, which is the work of the business school at Cardiff University, also discusses sectors that were very much at risk, mainly being those sectors that were deemed to be branches of global organisations, and, consequently, their supply chains as well. But what I want to know in relation to that is: what preparations are being made to develop support plans for those types of businesses and their supply chains? And it highlights that you shouldn’t focus on sectors; you should focus upon the businesses themselves, because they have different needs within it, and it’s very important that we look at that and identify those that are priorities for the Welsh economy, because—that means perhaps the ones that add value to Wales, not just simply coming in and going out again, where it doesn’t add much value to the product and, therefore, the economy doesn’t grow by much. So, can you tell me what you’re doing to look at those sectors, those businesses, and are preparing to help them in a situation where we may now end up in a 'no deal'?

Also, we talk about the transition period in your paper. Now, Dr Tobias Lock from Edinburgh University has given talks and written a paper on the legal challenges that arise during the transition period. Can you tell me what analysis the Welsh Government has done on the legalities that may be changing during transition and what you’re going to do to ensure that Welsh businesses and the Welsh economy do not have to face additional challenges because no-one’s thought of them in this legal situation?

Also, you talked about, in the paper, divergence of regulations. Now, yesterday, we attended a roundtable session as a committee, and one of the issues that came up was certification beyond the EU. What they didn’t want was a duplication of certification in the UK, where they have to get UK certification and EU certification because discussions haven’t taken place between the UK and EU on how they can actually represent one another and accept each other’s certification. So, can you tell me what discussions the Welsh Government's having with the UK Government to ensure that our businesses don't face increased bureaucracy and duplication of certification because no-one has got together to say, 'Let's ensure that this is equal across the EU'? They actually want it across the world, equal certification, but at least what we've got now is an EU certification. We want to ensure that we don't increase and have to duplicate that as a consequence.

Finally, First Minister, the Trade Bill. It wasn't mentioned, really, in your paper. We do know the Trade Bill refers to changes to existing EU trade rules and how that's put into place, including the Trade Remedies Authority. Can you actually give us a little detail as to how you see the Trade Remedies Authority coming in? Because you mentioned in your own statement the issue of steel; we do know that the EU has now put trade remedies in against steel from China in particular. Obviously, it affects my constituency very much. But how are we actually going to address trade remedies post Brexit to ensure that our industries do not suffer as a consequence of a trade deal done by the UK Government with, particularly, China, that allows imported steel getting in cheap? That's just one example, let alone what goes on in America and everywhere else. So, it's important that we look at that and ensure that we have a say in trade remedies.

Can I thank my colleague David Rees for those questions? If you look at the work that's been done by Cardiff Business School, it does look at what a 'no deal' scenario would be. It is right to say that it identifies some sectors as being more at risk, for example, from tariff barriers, and others from non-tariff barriers, and we're working with those sectors to make sure that we can understand their difficulties.

There is one thing that I hear time and time and time again—I heard it again yesterday—and that is the impact on recruitment, from businesses who are saying to me, 'We recruit from other countries. What happens now if we can't recruit? We are an international organisation, we need the best people from wherever they are. What happens how?' We're not sure how that's going to work in the post-Brexit future.

In terms of the legal challenges that he—. The other thing I should've mentioned is of course we are opening offices around the world, working with the UK Government to make sure that we identify new markets to try and mitigate what a hard Brexit would look like, but let's not pretend we can actually overcome the challenges that that would create.

In terms of legal challenges, much of it depends on what happens in the transitional period. If the UK is willing to accept that the European Court of Justice would still have jurisdiction and EU laws would apply in that transitional period then there's no difficulty. But of course the difficulty arises in terms of the UK saying, 'We're not going to do that'. Who then acts as the trade court? What scope will there be for divergence? All these things are unaddressed.

There is no reason, of course, in devolved areas that a devolved Parliament and Government couldn't just accept new EU regulation and incorporate it into domestic law. There's nothing to stop us doing it, but of course that would be a matter for this Parliament. If we look, for example, at the regulatory bodies: I've mentioned the European Medicines Agency already this afternoon, Euratom, if we look at the regulation of the air industry—none of these things have been addressed. No-one knows yet, and we're only a year away. No-one knows yet how these issues will be resolved in the future, and the Member's quite right to say that nobody wants to see duplication in terms of certification. I've heard some in the UK Government say, 'Well, you see, what Brexit is all about is basically keeping the same rules as the European Union, but it's our choice as to whether we keep them or not'. I've heard some say that. I've heard others talk about a bonfire of regulation. They want a low regulation economy, one where wages are suppressed, where environmental standards are depressed, and that is the classic right-wing ideology when it comes to what Britain should look like beyond Brexit.

In terms of trade remedies, it's hugely important, of course, that we have a role in shaping what that might look like in the future. We know it's a powerful tool. We've seen it in the United States in the last few weeks, and how important that can be, and the effect it can have on economies outside of the USA. That will be an important factor in terms of the discussions that we have with the UK Government as to what the trade relationships and the trade structure within the UK should be in years to come.

First Minister, I've only got a few, relatively minor points. You know my constituency well, and over the past couple of decades you'll have been aware of the impact of the closure of the mines, the closure of heavy industry. Yet over the last five years there has been significant growth and formation of new companies. A lot of that is due to a number of the projects of Welsh Government, the partnership with local government. In the last five years there have been 1,015 new businesses set up in the Pontypridd constituency, a 53 per cent increase.

I'm glad that you commented a little bit about some of the issues of regulatory frameworks in conjunction with the EU, because one of the concerns that's raised by a number of these companies that export to the European Union is that, 'We can cope with the tariffs, we can manage the tariffs; the problem is there must be no delay on the transit of goods.' The transit of goods is the fundamental point. If they cannot deliver on time then they will lose that particular market and that is their biggest concern and obstacle. And if we are not in the customs union, or something very similar to the customs union, if there is a divergence of regulatory frameworks, we will not be able to trade at all. What can the Welsh Government do in order to ensure that there's some assurance to those small companies that have set up, that have grown in difficult times, that are now facing yet another obstacle from the UK Government because of its approach, its ideological approach and obsession with the customs union?  

There is no doubt in my mind that staying in the customs union is the best way forward. I've seen no evidence of any alternative arrangement that delivers anything that is as good as the arrangements that we have now or anything that would be better in the future. If you're a business at the moment and you export to the European Union or, indeed, you supply a business that exports to the European Union, you are reliant on the free flow of trade. What Brexit has the capacity to do, although it doesn't have to do it this way, is to impose a vast bureaucracy on businesses—more form-filling, more red tape, more delay. This is particularly true and particularly acute in, for example, the fishing industry, where, of course, goods are highly perishable, they need to be moved very quickly, the industry's highly dependent on exports—sending goods to markets where people will pay the most and put more money into those who work in the fishing industry's pockets. The last thing they want is to have to fill in forms before they go, to find queues in ports such as Dover because the physical infrastructure isn't there—and no steps have been taken, to my mind, to address the issue of infrastructure. Checks at the ports—where will they be carried out? That's not been done; the work for that hasn't happened yet. All these things are barriers, let alone potential tariffs, but all those barriers will be put in place for business. The Member asked the question: what comfort can I give him? The comfort that I can give him is this, that we will continue to fight to ensure that businesses have access to our biggest single market, free of bureaucracy and part of the customs union.  

I’m grateful to the First Minister for his statement today and for the paper published. The fact is that this paper, as well as the analysis that was released behind closed doors in Westminster, reveals that there is a cost of Brexit to the Welsh economy, whatever the scenario you follow. There is a particular cost, as has been outlined in this paper, for the sheep sector, in terms of agriculture, and that’s very grave. We must also bear in mind that, behind that sector, there is an economy, but there are also people, communities, a landscape, water management, land management, the Welsh language, and a way of life that has been on the land of Wales for over two millennia, and it’s important that we keep a focus on what is supremely important for us as a nation, as well as important to us as an economy. That is something that we should bear in mind in all of this.

Could I just ask the First Minister how he intends to proceed with this work now? Adam Price asked you about dealing with other regions and other Governments. I’m sure you will have seen that the Labour Prime Minister of Gibraltar has said the constitution of Gibraltar, in his view, gives a right for the business of tariffs to be decided by Gibraltar, within the constitution approved in a 2006 referendum. You visited Gibraltar in June of last year, I believe. Have you discussed this with the Prime Minister of Gibraltar? Secondly, are you of the view that there should be a vote in this Assembly, this Parliament, in terms of any trade deal that is done? I know that we will have a vote on the legislative consent motion as far as the European withdrawal Bill is concerned, but this is a specific question on any trade deal. Despite us perhaps having an advisory referendum or not, as Adam Price suggested, we should have a meaningful vote in the Parliament on these issues.

And, finally, I must ask you, because you’ve set out something today, as you know, there is a great deal of agreement between Plaid Cymru and the Labour Party on this issue, but you are led by a leader in Westminster, Jeremy Corbyn, who doesn’t believe in remaining in the single market, who doesn’t believe in remaining in the customs union and is doing everything within his power to stop that happening at the Westminster level. I have to say: what are you going to do as the First Minister of Wales to put the interests of Wales before the interests of your own party in these issues? Because if we continue on the current route, then it’s very possible that we will have a very hard Brexit led by the right wing of the Conservative party with some silent consent from your own party in Westminster.

Our view as a party and as a Government is completely clear, and I’ve made that clear of course to our neighbours in London. On what you said about the sheep industry, it’s completely true that farming is part of life in rural Wales and farming of course can affect so many things such as the environment, and to ensure that rural Wales is kept in a way that we want. The fear that I have is that it’s possible of course to give more money to farmers, but because of the fact that they would lose so many of their markets, they wouldn’t be farmers anymore and farming is not what they would do. We’d lose that tradition. There’d be fewer in number, we’d lose that tradition and the nature of the livelihoods of those living in rural areas would change and farming would not be part of their lives.

In terms of the frameworks, work is proceeding well. A lot of discussion has been taking place between governments. We’re not in a situation yet where there is agreement, but of course, as I said, this is something that has to be considered in looking at the situation with the Bill itself.

In terms of Gibraltar, it is different. We have to remember that Gibraltar is outside the customs union and therefore there is a very hard border with Gibraltar. I wouldn’t want that to happen in Wales. That of course shows what happens if you’re outside the customs union, because if anyone wants to see what exactly happens if one landscape is within the customs union and one is outside, go to Gibraltar. That is what people want to avoid with Ireland. If that happens in Gibraltar, how do you avoid that in Ireland? Of course, that’s a question that hasn’t been answered yet.

In terms of some sort of vote on the trade Bill, there’s no problem at all with that. I’ve said many a time that it’s vital that the Assembly gives its consent on what the frameworks are at the end of the day, what Brexit looks like, and of course it’s vital that the Assembly gives a view on whatever happens on any sort of trade agreement.

First Minister, can I welcome your statement and the Welsh Government's trade policy paper? Of course, that paper shows that the Welsh economy would be disproportionately impacted by a hard Brexit, and identifies the sectors most at risk from tariffs—automotive, chemicals, steel and electrical engineering—while the aerospace industry is more at risk from non-tariff barriers. These are the sectors that are amongst the most productive in Wales and provide a large number of highly skilled, well-paid jobs. I know the First Minister would agree that it's vital that the voice of these key businesses in Wales, and in these sectors, is heard.

Yesterday, in fact, as David Rees said, the External Affairs and Additional Legislation Committee, for a round-table discussion, visited Aston Martin in my constituency and, last week, I spoke to engineering graduates at the Aston Martin careers fair at Cardiff and Vale College. That attracted young engineering students and graduates keen to hear about the opportunities at the Aston Martin St Athan plant, amongst the 750 new jobs coming to Wales.

The Aston Martin investment, with Welsh Government support, provides new hope and prospects, but can the First Minister clarify what the Welsh Government can do, what influence it can have on the negotiations in phase 2, to provide certainty and continuity for businesses like Aston Martin, not just as David Rees said in relation to issues like certification, which is key for the automotive sector, but also for environmental standards and skills?

Can I thank the Member, my friend and colleague, for that comment? Yes, of course, these are uncertain times for Aston Martin and, indeed, other businesses, as they seek to try to guess what kind of framework the UK Government wants to put in place following Brexit. Indeed, those negotiations will continue, and we've said to the UK Government that we wish to be part of those negotiations, not in the room, as it were, but close at hand in order to offer advice and to point out what pitfalls there might be. Now, this is not as strange as it might appear, because this is exactly the model that existed when I was rural affairs Minister way back between 2000 and 2002. We would meet every month, the Ministers from across the UK, and we would agree a common line at the European Council of Ministers. I would attend the European Council of Ministers when there was relevant business as far as Wales was concerned. I was in Luxembourg when the deal was done in Luxembourg for the future of the common agricultural policy. And it was the practice of the UK Secretary of State to come out of the room with proposals, and ask our view on them, and ask us whether we were comfortable with them, and that worked exceptionally well. We were never in a position, as a result of that system, where we felt that we'd been cut out in some way, or indeed that we could not support the deal that the UK finally came to. That's a model that we've urged once again for the UK Government to adopt.

Thank you, First Minister. 

The next item is the statement by the Minister for Housing and Regeneration on tackling rough-sleeping and homelessness. I call on the Minister to make her statement—Rebecca Evans.

We all need a decent home if we are to realise our potential and enjoy basic well-being. Thousands of households have avoided homelessness through the preventative approach required under our Housing (Wales) Act 2014 legislation, which is the envy of other countries. But we still have much to do. We have all seen people living on the streets, and, clearly, the numbers have grown. Talking to people I meet, I hear distressing accounts of family breakdown, domestic violence, mental ill health, financial problems, substance misuse and bereavement. These issues lead to people losing their homes, but then they can then create a vicious cycle, leading to rough-sleeping. All too often, people become trapped in this situation, and their trust in services may be undermined, and their lives become more chaotic. The rough-sleeper national statistical release was published last week, showing the results of the November 2017 count. The figures show that the two-week estimate is up 10 per cent compared to 2016, and the one-night snapshot shows a 33 per cent increase. This is disappointing in the face of our efforts and investment, but not unexpected, and I believe it largely reflects the increasing effects of continued austerity, increased in-work poverty, and welfare reform.

The £2.6 million announced last summer is funding a range of innovative projects, supporting the needs of rough-sleepers. The PATH programme, designed in partnership with Public Health Wales, Cymorth Cymru and the Welsh Local Government Association, seeks to establish a psychologically informed approach to housing advice and support services. There has been an overwhelmingly positive response to this training programme, to help professionals in the sector enhance their ability to engage meaningfully with people with the most complex needs. By the end of April, we will have provided training to 1,000 support staff across Wales.

We are funding 10 housing first pilot projects. The evidence of success from housing first approaches is well documented, but it's not a solution for everyone. However, it can be the route to stable housing and getting lives back on track. The Wallich, for example, has been providing a housing first service in Ynys Môn for some years, supporting people with complex needs to access and sustain their tenancy. We have funded research, which will report over the next few months, evaluating the impact of Part 2 of the housing Act, and the impact of legislation on former prisoners. Shelter Cymru will be reporting on the experiences of rough-sleepers in our cities, and this evidence will add to the body of knowledge such as the recent Crisis report on what works in their homelessness monitor.

We have a firm foundation for our next steps, working with stakeholders to develop policy, practice and guidance, drawing on the best international evidence, backed up by our own action research. We have the funding in place to invest in programmes and approaches that make a difference. Local authorities will have an additional £6 million in their revenue settlements. I will work with local government to ensure this delivers the secure long-term funding for which the Wales Audit Office recently called. A further £2.8 million is being channelled to local authorities to build on statutory prevention work, with a focus on improving access to the private rented sector, application of trauma-informed practice, strengthening services to people with mental ill health and/or substance misuse problems—including improved joint working between housing and mental health and substance misuse services—and action to prevent youth homelessness and reduce rough-sleeping. Talking to front-line workers, I repeatedly hear the message that the roof is the easy bit. People need help to overcome debt, deal with the effects of domestic abuse, poor mental health and substance misuse. And these issues, if not resolved, result in repeat homelessness.

Today, I am pleased to be launching two new policy documents. The first sets out principles for taking housing first forward across Wales. The second is an action plan to reduce rough-sleeping. And these are living documents. They will form the basis of dialogue and action across the sector. They will change as we acquire more evidence of what works, and they can build on successes. We have developed our housing first principles working with stakeholders, including the Wallich and local authorities. There is strong evidence that housing first works, but it works best where the core principles are adhered to: housing with no strings attached, ready and available support services, and a small fund to help meet individual needs. The principles document sets these principles out, and my officials and I will work with key partners over the coming months to explore how we can best use existing resources to support delivery of programmes based on these principles.

The action plan reflects my determination, and that of our partners, to significantly reduce the number of people forced to sleep on the streets. This plan has been developed in partnership with stakeholders such as Shelter Cymru and members of Rough Sleepers Cymru. It is a dynamic working document, subject to continuous review and change as necessary. The document covers a spectrum of activity, supporting people to engage with services and get off the streets as quickly as possible. It also addresses wider issues such as a review of priority need and our guidance on cold weather plans.

Rough-sleeping is one aspect of homelessness, and we can only truly address the issue if we have a system that offers secure housing for all. Building market homes and expanding social housing stock can only go so far to achieving this objective. I will work with the private rented sector to find innovative ways to harness their supply and meet demand. I will also be looking at how we continue to reduce the number of homes lying empty. The funding announced in the budget is welcome, but we must spend it carefully. I have deliberately not laid out how every penny will be spent. I intend to review progress and the evidence from the pilots alongside the research reports due in the spring and summer. I will also work with partners to consider what is needed most to develop our approach to rough-sleeping.

We all recognise the challenges in delivering collaborative services. It will require new ways of working and significant cultural change. I believe we have a good track record of delivery on homelessness prevention. This Government will continue to provide the leadership to ensure we deliver a reduction in rough-sleeping and end the need for people to sleep rough. Thank you.

Can I welcome the fact that the Welsh Government is now moving to adopt a housing first policy, or at least to extensively pilot it? It's something the Welsh Conservatives have been urging for some time, and I'm pleased to see it.

I do have some specific questions, however. First of all, how many of the pilots will be on a county basis, or are they on a smaller scale? I think we need to know how comprehensive the pilots will be in the areas where they are applied. I would urge us looking at a county level to really see whether this type of policy is going to work if we roll it out across Wales. I would like more detail on when the pilots will be evaluated so that we can make that determination, because many of us believe, from the evidence that we've observed, that this offers the best hope for the future.

Surely the Government now needs to review its attitude to the Supporting People fund. It's at the heart of the housing first approach, the support services that people receive, and you will know that those in the sector, like the Wallich, have been urging an urgent review and a reversal of Government policy in this area. I must commend the Minister. You did say in touching on this subject that putting a roof over someone's head is the first vital step but it's not the most challenging thing. In sustaining that improvement, it's the support that people get. So, I just want to know how coherent the Government's approach is. Obviously, if you're going to re-badge it and call it something else, I'm not particularly bothered, but at the moment there's been a reversal out of this type of approach by the Welsh Government.

Can I say, Deputy Presiding Officer, that I think we do need a target date for ending rough-sleeping? We know that, in Manchester, they've set a highly ambitious target of 2020. The UK Government target is for mid-2020s—2027, I think. I would like to see a more ambitious target than that, but it's perhaps somewhere in between—maybe an interim target that we could initially establish. And if we do see successful policy development here—and you will get widespread support, I think, for the innovations that are seen to be working—then we could, perhaps, advance that target and really be a leader in this sector, as Manchester at the moment are hoping to be.

Regarding the independent private sectors, I will give you credit for at least, in the statement, mentioning this because it is an important part of the solution, and I would like to know if you've been having any direct discussions, particularly with the private sector, because you do refer to the Wallich and other charities like Shelter, but I do think that private providers are going to be part of the solution as well, and I'd like to know what sort of discussions you're having. And I'm not quite sure of the rationale behind what you're saying in terms of you not intending to spell out the budget in great detail. I mean, the one advantage of being more candid on your spending commitments is that you will give much more information to the independent private sectors, so that they can then plan their services in terms of expansion for the future.

Finally, on house building, I'm not going to rehearse the whole argument. Of course, we need more supply, and for that, given that we're talking about medium and longer term targets here—well into the 2020s and even beyond—you do need to return to the assessment of housing need, and I think the Holmans projection is the one we should be adopting and working towards fulfilling, and I'd urge you to do that as soon as possible.

I thank you very much for those questions and for your welcome of the housing first approach. I certainly recall it was the first question that you asked me about when I came into this portfolio, so I'm glad to be able to be making some progress on this, I think, very much shared agenda of promotion of housing first.

We've approved funding for a number of projects and they are with local authorities. So, Bridgend, Blaenau Gwent, Merthyr Tydfil, Cardiff, Conwy and Swansea have already recruited staff teams and are already moving tenants into accommodation using that housing first model. But as a condition of that funding, local authorities do have to provide us with feedback on the development and the impact of each of those schemes, and we'll be using that information to update and take forward the principles as we seek to move things out further across Wales, because both of the documents launched today are very much living documents and they'll be changing and responding to the evidence that comes forward to us and to the things that we're hearing as the housing first principles are rolled out. We know it's worked well in areas of America, and we know it's worked well in Finland, but there might be specific issues that we need to look at addressing in Wales, which is why we've got the principles, which are very much embedded in our policy and in our legislation that we have already—our Housing (Wales) Act 2014, for example, and our approach through the Social Services and Well-being (Wales) Act 2014 to have all policy with the individual at the centre and always giving the individual the opportunity to have that voice and that control in the decisions that are made about them and ensuring that those decisions are made with them as well.

With regard to the Supporting People funding, I've been really clear that I am in listening mode at the moment. No decisions have been taken with regard to the funding for the second year. We're looking closely at the pathfinder projects that are taking place in seven of those local authorities that have the full flexibility across those 10 grants, and also the other local authorities with a 15 per cent flexibility as well, to see if it does give us the improved services for people who are experiencing or who do need support in order to maintain their home.

As I say, no decisions have been made. I've been listening carefully to individuals in receipt of Supporting People. Cymorth Cymru recently held a series of round-tables across Wales. I was pleased to attend the one in Carmarthen where I heard from people who spoke about the impact that Supporting People's had on their lives, and talked quite powerfully, really, about where they thought their lives would be if they hadn't had the support of Supporting People. So, there's no doubt at all that Supporting People is an important initiative that does have a huge impact on the lives of some of our most vulnerable people. I've also met with and had visits with a variety of organisations, from the Wallich, Shelter, Caer Las and others in order to try and understand the different projects that are taking place locally, because, obviously, the breadth of people and the breadth of vulnerabilities that are supported is quite something.

With regard to a target date for ending rough-sleeping, I think there's an inherent problem, really, in the data that we have for rough-sleeping. In my introduction I talked about how the two-week figures showed an increase of 10 per cent, whereas the one-night snapshot showed an increase of 33 per cent. It's extremely difficult to measure rough-sleeping, which is why I'm really pleased that the Wallich is undertaking some work to have a much more comprehensive look at the individuals who are rough-sleeping to take forward more of an individual casework approach, so that we do understand the lives of those individuals, because there are only a relatively small number of people rough-sleeping in Wales. It's too many, but there's no reason why we shouldn't have a better understanding of each of those individuals and understand better how to support them off the streets and into housing, and deal with all of those other issues that we've talked about: mental health, substance misuse, domestic violence and so on as well.

I'm really keen to see what we can do to encourage the private rented sector to take more individuals who are coming straight off the streets. There's some really good work being done again by the Wallich in Bridgend in this regard. I've spoken to the National Landlords Association and other organisations representing the private rented sector and I've been really clear that I am keen to hear their ideas. I'm keen to hear from the private rented sector and from landlords themselves what they see as the barriers to taking people who are more vulnerable. Sometimes it is a case of bonds, and we've had very successful bond schemes for many years now, in which Welsh Government provides the bond for the individual, so lessening some of that risk for the landlords themselves.

In terms of where do we take funding next? I would expect some of the future funding priorities to be around access to the private rented sector, but also application of those trauma-informed practice and psychologically informed environment ways of working, and strengthening the delivery of services to people with mental ill health and substance misuse problems, alongside improving the implementation of the national pathway for homelessness services for children, young people and adults in the secure estate, because we know that homelessness amongst those groups of people can be particularly acute as well.

I hope I've addressed as many of those questions as possible.

Thank you for the statements today. I'm pleased that there is extra funding over coming years for homelessness prevention and reaction. In the past, there has been focus on preventative measures, but perhaps there has been an eye taken off the ball to the growing extent of the crisis, with those slipping through the gaps of the services that are meant to be preventative.

However, reading through the action plan outlined today, I've immediately noticed one glaring problem, which is a major contributory factor to people falling through the gaps of preventative services, and that is that there's no clear commitment to remove priority need. As I've said in this Chamber before, we won't properly tackle the problem of street-sleeping while perceptions and, in fact, procedures remain that deter and deny permanent housing and accommodation to those who need it.

I understand there is a commitment to consider modifying legislation in 2020, but I think this is too far away and we need to have that consideration sooner so that we can legislate sooner still. And that is something that we need to look at because it is a huge contributory factor to rough-sleeping. People from across the sector—I've also done the visits you've done—are saying that removing priority need is something that would really help them. When I asked them what their wish list is, that is at the top of their wish list. 

I do welcome the plans for pilot projects throughout Wales for housing first, and I've also heard some of the successes via our committee visit to the Salvation Army recently. But I will say, and I hope it's just the guiding principles that are coming here—and I hope that's what you'll confirm because I do think it's quite vague in relation to funding. I hope the statutory element that you're going to release afterwards will come up with more meat on the bones because I'd like to know, for example, how it's going to be funded. It says you would expect local authorities to make the decision. Is it more or less an opt-in, opt-out-type agenda? And you say that it won't suit some people. From looking at research, if you do housing first properly, it could be rolled out as a flagship policy, not just as an option for housing associations, or for whoever is providing. I do think that it could be that effective if we put out a bold statement to that aim. 

But I'd like to be confident, for example, that the numbers of new homes outlined in the affordable homes strategy will be enough to be effective. If housing first needs, for example, more housing—how will you be able to accommodate that if the numbers are not high enough within the strategy already announced?

I'd also like to touch on some of the extra money announced, and again, as I've said before, there is a lack of detail here, but I hear what you're saying—that you want to keep some of the money back to be flexible, but I think, in particular, it's relating to the youth homelessness announcement by the First Minister before Christmas. I've already pointed out, but I think it's worth saying again that I don't think it's appropriate to put these statements out in the public arena before they come here. I understand that that money is for 2019-20, so I'm really confused as to why a statement was made last December for money that will be made available later on down the road.

I've also had housing associations and others telling me that they want to get involved in the youth homelessness partnership. There was a photo of you and the First Minister alongside Llamau and the future generations commissioner, but other people didn't know much about it, and when I clicked on the link, it clicked over to Llamau as opposed to the Welsh Government's website. And when I've gone on today, again, there's not any information as to who is part of it, how you can be part of it, or how people can shape that. So, I'm getting those requests from the third sector, so I would love it if you could explain to me fully, today, how people can get involved in that youth homelessness partnership. 

My final question is: you've referred twice to mental health and substance misuse—again, fundamentals to this whole agenda—how are you going to improve mental health provision? Because, again, when we went to the Salvation Army a few weeks ago, they were saying that they had to wait and wait and wait, and by that time, their health had deteriorated. So, how can we make sure that when people in these quite intense situations want mental health support, they can get it?

I thank you for those questions. I do think it's important that we keep our eye, both on the preventative side of things but also on the sharp end of homelessness, if you like, in terms of tackling rough-sleeping.

Our preventative approach has been very successful. Since the housing Act came into force fewer than two years ago, 13,000 families or 13,000 households have avoided homelessness as a result of the actions taken in response to the legislative requirements under the Act. So, I think that demonstrates that the Act has been very successful in terms of preventing people losing their homes or becoming homeless. But, obviously, there is still much more work to do as well.

In terms of priority need, you'll recall that, in the debate that we had, which enveloped this subject, over the last month or so, I did indicate that I am prepared to review the legislation on priority need and how it works for rough-sleepers and some vulnerable groups in particular. I think we need to ensure that any action and any decision taken, though, has to be evidence based, which is why I'm looking forward to the independent evaluation of the implementation of the Housing (Wales) Act, and that's been commissioned from the University of Salford. 

We have another piece of work, which is due early this year, from Wrexham Glyndŵr University on looking specifically at the impact of the legislation on prisoners and those leaving custody. And also, Shelter Cymru are undertaking some research in Wrexham, Swansea, Cardiff and Newport, reviewing the experiences of rough-sleepers, so talking to people on the streets, giving us some insight into what's led them to rough-sleeping, and how their situation could've been avoided. I think all of these pieces of research are going to be really important in terms of how we take forward the agenda in terms of priority need.

I'm really keen that it has to be evidence based, because we know that the situation in Scotland, for example, where there has been a blanket removal of the remaining concept of priority need, has had some unintended consequences, for example pushing increasing numbers of households into inappropriate accommodation for extended periods of time. So, I would be keen to avoid that, so any action that we do take with regard to the removal of priority need does have to be evidence based. That said, I'm very sympathetic to the concept of it, because I see things through the lens of the social services and well-being Act, which is about looking at the individual and their needs; it's not about looking at the individual as a category or as a box that they might fall into. So, I'm sympathetic to it, and it's something I very much want to explore further.

The funding for housing first has come through a funding stream of £2.6 million, and that was essentially to provide, I suppose, the opportunity to kick-start some of this, but I want to see housing first as very much a part of the normal way in which we would be dealing with people who are experiencing rough-sleeping. So, it really is a move to see how we can make this part and parcel of the package that we offer to people who are rough-sleeping, rather than specific pilot projects. I think we're at the start of a journey, rather than at the end of a journey on this at the moment.

We're all on the same page, as well, on the need to be building more houses more quickly. I'm very keen, as I've spoken about before, to see how we can unlock the potential of the small and medium-sized enterprises sector, which has been hard hit in recent years. I've had meetings with the Federation of Small Businesses and others to explore the barriers to building amongst SMEs. It's not the complete answer, because they're not going to be building at the kind of scale that we need, but I do think they are important players in this as well.

I'm looking, as well, to see what we can do to unlock some of the stalled sites that we have across Wales in terms of bringing forward land for housing, looking at Welsh Government land—what land can we be bringing forward from the Welsh Government to support house building as well? So, there's a lot of work going on within that particular area, as well.

The youth homelessness agenda and the £10 million—you're right that that funding does relate to 2019-20. As I've said before, I'm keen to hear all ideas as to what we really need to be doing to tackle youth homelessness. I was there at the launch of the End Youth Homelessness campaign, the launch of the coalition, over in the Wales Millennium Centre. It was very clear at that launch that this wasn't just about Government, it's not about one or two organisations, actually, it's much wider than that. It's about the housing sector as a whole. But, at the launch, it was very clear that this coalition needs to be involving local businesses, it needs to be involving charities beyond the housing sector, so I'm very keen to be involving as many people as possible, because youth homelessness is something that we should all be concerned about. So, if there are organisations and individuals who've expressed their concerns to you that, perhaps, they're not being as involved and that their enthusiasm and their offer isn't being used, then I'd certainly be keen to be approaching them to see how we can work together as well.

You also mentioned the issue of mental ill health as well, and we know there is a strong correlation between mental ill health and homelessness. I think around 40 per cent of homeless people are likely to be using accident and emergency services as their first point of accessing the health service, which tells us that, actually, a huge number of people don't have any kind of ongoing, long-term support from the health system. So, we clearly need to be taking forward work on that, and it is an objective within our mental health delivery plan to enable people with mental ill health to have fair access to housing and related support, and to promote access to mental health services amongst people who are homeless or vulnerably housed. So, that's a piece of work that we obviously need to be putting a great deal of effort into, and it is a piece of work, also, that housing first obviously dovetails very well with, in the sense that it is about getting the roof over somebody's head first and then build around them that package of support, in order to help them move on with their lives and deal with the many issues that, as we know, people on the streets often face.

Of course, it's not only rough-sleepers who are homeless. There's a number of people, probably not many miles from here today, who will be sofa surfing tonight—moving from friend's house to friend's house, and many of them end up on the streets when they run out of friends. I don't mean that unkindly, but that's what actually happens. They use the good wishes and goodwill of their friends for a certain period of time, that runs out, and then their ability to have a roof over their head runs out.

There's also a number of people who are inadequately housed, living in cold, damp and unhealthy conditions, and all these things have a huge effect on health. The 1945-51 Labour Government put health and housing together, because they knew how important housing was for people's health.

There are a lot of voluntary organisations involved. In Swansea, we have the Sisters of Mercy, the Wallich and Caer Las, all being involved, all doing a phenomenally good job, but we still have people who will be sleeping on the streets of Swansea tonight.

What causes homelessness? Debt, and universal credit can only make this worse, but also people on flexible contracts—or what I call exploitative contracts—where they're okay when they're working the hours they've worked regularly, but when they go back to their basic hours, which are somewhere between nought and six, all of a sudden they find themselves unable to pay their rent. Many of them, if they are unwell, will obviously go back to having no income at all, and trying to find their way through the benefits system, having been working irregular hours, means that eventually their landlord will evict them.

There's a drug and alcohol problem that is having an effect, and a number of people on the streets have drug and alcohol addiction. I think, in some ways, that's what the user needs to kill the pain of sleeping rough. I think that we can judge people for doing these things, but if we were actually sleeping rough at night, something to kill the pain may well be an advantage to us. Because we'll all go back to nice, warm houses with central heating, then perhaps thinking about those who don't have those advantages really is something we need to do. 

No-one should be sleeping rough. There's no reason why anybody should be sleeping out on the streets. There is, of course, a shortage of social housing, and this is where I disagree with Bethan Jenkins: increasing the demand side does not increase the supply side in housing. Giving more people a right to a house doesn't create one extra house. There's a desperate need for more council housing, and that is the answer to the housing crisis: council housing. Now we've done away with the right to buy, councils then don't have that sword of Damocles over their heads, that they build 10 houses, five get sold at a discount, and they end up making a loss on those houses. They can now build, and we need to be encouraging councils to build.

I've got two questions for the Minister. The first one is: what support is the Welsh Government giving to councils to build council houses, which I believe is the route out of dealing with homelessness? The second is a much more short-term problem: what financial support is the Welsh Government giving to build more night shelters, which should improve the lot, if not make right the problem, for people who are sleeping rough? These are capital rather than revenue costs, and we perhaps ought to be looking at using capital, even some of that loan capital we've had, in order to do some of these things, which will be of benefit and may actually raise money in order to pay it back.

Thank you very much for those questions. Mike Hedges is completely right to point out to us that, actually, when we're talking about homelessness, we're not talking only about rough-sleeping, although that is the most visible part of it. Estimates suggest that there might be 30 people sofa surfing or in other kinds of temporary accommodation for every person who we see sleeping on the streets. When we ask people what the reasons are that they became homeless, actually, a lot of the time, it is because a parent or a friend or a relative was no longer willing to accommodate them. So, for many people, although they might have a roof over their head tonight, it is a precarious one, and their situation could change at any time.

I also was pleased that Mike mentioned that we shouldn't be judgmental about people who are rough-sleepers and people who we see on the streets, because I'm very keen that we do take a trauma-informed approach, and that we consider adverse childhood experiences. Any person I've spoken to who has been in a homeless situation, or who's experiencing substance misuse, actually the kind of story that has led up to them being in the situation they're in now is something that very few of us would be able to cope with, so I think that it's quite right to highlight the seriousness of the issues that do lead to rough-sleeping and drug and alcohol abuse as well.

I completely agree that we do need to be building more council houses. I'm keen, also, that we ensure that those councils that are ready to build, able to build and ready to go can do so. I know that some of our local authorities are at the top of their borrowing cap now, and the borrowing cap is set by the Treasury. So, there are two pieces of work going on there: one around seeing what we could do, in partnership and in agreement with local authorities, to move some of the borrowing that hasn't been used by some local authorities over to local authorities that are at the top of their borrowing cap but can still do more and are still wanting to do more. And, also, seeing what we can do in order to ensure that the borrowing cap, which was raised in England—that we also get a similar relative rise to our borrowing cap as well. Those discussions are going on at the moment.

In terms of night shelters, we have provided funding for an additional 40 bed spaces across Newport, Wrexham, Swansea and Cardiff, and they'll be coming online over the coming weeks and months. However, we also know that, on any night, there are empty bed spaces in night shelters, and this is a particular concern to me: that there are people who would choose to sleep rough rather than use a night shelter. The reasons for that are diverse. For example, some people don't want to abide by some of the stricter conditions that might be laid down in some of the night shelters. There will be other people who have been banned from night shelters on the basis of previous behaviour. Others don't want to go to night shelters because they see them as areas where there is substance misuse of various sorts, and they want to stay away from all of that. In other cases, there might not be opportunities for couples to stay together or for people to take pets, for example. So, there is a wide range of reasons why people don't engage with night shelters. I do think there's a piece of work for us to be doing there, with the sector as well. I hope that that work that Shelter is doing, talking directly to rough-sleepers, will give us some of the answers as to what can make night shelters more attractive, especially on the coldest of nights.

Thanks to the Minister for today's statement. We've been having an inquiry into homelessness on the Equality, Local Government and Communities Committee. As Bethan Jenkins mentioned earlier, we did have a site visit to the Salvation Army hostel just down the road from here, in Bute Street, which was a very instructive visit as we did get to speak not only to the staff, but also to several of the residents, many of whom are former rough-sleepers. Of course, it was only a small group, but I think common themes emerged fairly strongly. These seemed to tell a tale of early family problems, in many cases, which lead to early abuse of alcohol and drugs. When the residents begin to go on programmes where they are able to detox, several of them began to realise that the substance abuse was actually masking mental health issues.

I know this has been mentioned several times today—the mental health issue. Mike Hedges mentioned the possibility that some people start to abuse drugs and alcohol once they become homeless, and indeed this may be the case in some instances, but certainly, I think the experience that I took on board from the site visit was that it's probably more likely that the substance abuse and alcohol abuse led to the homelessness. That probably comes first.

I think the crucial thing, which you have tackled in your statement today, is that there are these intimate links between mental health, substance abuse and homelessness. So, a persistent problem that you are going to have in dealing with the homeless issue is that you will have to work alongside the health ministry in getting resources directed towards mental health provision so that the homeless can access them. I know you've acknowledged that. So, to move to questions, how closely are you working with the health Minister in this regard? And in terms of the new funding that you're announcing, can you be more precise on how much is actually going towards mental health provision?

I think that, in many respects, tackling the homelessness problem means crossing portfolios for you, Minister, in some important respects, not only with the health Minister. There's also possibly the training aspect, which you've touched on a few times today. Because when we went to the hostel, other issues that were raised by the staff at the hostel included the need for continued resources so that more staff could be trained to deal with the complex needs of homeless people. As well as the detox programmes, there are also programmes being run dealing with teaching the residents basic skills that could eventually lead them into employment. I think it's good that you have mentioned several times in your statement the training aspect. Do you see any benefit in interacting more closely with the skills Minister over issues like this in terms, for instance, of accessing resources?

Finally, there have been comments—not today, but comments in general—that the homeless issue is really only discussed in politics once a year, and that is in the run-up to Christmas. There is some extra funding provision at that time of year, it becomes a media issue and, of course, we do have a lot of volunteers active at that time of year. But now, we are in February and we're in the midst of another cold snap. I note that you mentioned cold weather plans in your statement, so could you expand a little on how these cold weather plans will work? Diolch yn fawr.

I thank you for those questions, and I'm really encouraged that the committee is undertaking a piece of work into rough-sleeping in particular, and looking at homelessness more widely. That's really important because I hope I've been clear that both of the documents that have been published today are live documents. So, I'll be keen to be looking at the recommendations that the committee might be coming forward with, in terms of reviewing and adapting those documents to the best evidence and the best ideas that are coming forward throughout.

It is a complex picture in terms of which comes first, in terms of substance misuse and mental ill health. But I think that what's important is that we do ensure that all of our services that are there for people who are rough-sleepers do come from a trauma-informed approach. That's why the PATH project, which Public Health Wales has been leading on, is so important, because that's been offering training to front-line professionals—over 1,000 of them now—in terms of how to take that trauma-informed approach and to consider the story of the individual and what got them to that place and what can be done to assist them.

Some of the projects that are being funded by the additional £2.6 million of funding that was announced this financial year are specifically to support people with mental health needs who are experiencing homelessness. So, that includes training for outreach workers in Wrexham, for example, so that they're able to support and assist people with a mental health support need, and funding for a link worker between health and homelessness services in the Vale of Glamorgan as well. So, there are some specific posts that are being funded as a result of that.

More generally, in Welsh Government, I've been keen to make that link—coming, as I have done, from the social services portfolio into the housing one—between my former responsibilities and my current ones. So, we now have a member of staff within Welsh Government who is specifically looking at housing and health—so, looking across the piece, really, in terms of what we can be doing with our capital funding through the intermediate care fund, for example, and in terms of policy as well to ensure that we are fully linked up and using all of the potential, really, that good housing has for the promotion of good health as well.

My former responsibilities also included substance misuse, so I'm keen to highlight the fact that, within our substance misuse delivery plan, we do have specific actions there in order to develop support for people who are rough-sleeping and people who are homeless. Welsh Government invest almost £50 million a year in this agenda, and our area planning boards will have a specifically important role in terms of tackling substance misuse locally, and that will extend to people who are homeless and rough-sleeping as well. Many of the projects, such as the Huggard centre, which the committee visited, are very much fully linked in with substance misuse services.

I'd also point out that we've commissioned a review of the substance misuse treatment framework good practice framework for the provision of substance misuse services to homeless people and those with accommodation problems. That will be completed in the spring in order to, again, make sure that we are linking up with all the best and latest evidence in terms of substance misuse and homelessness.

Thank you. I have three more speakers, so I will extend this session. But that's not an invitation for the three speakers to go on at length. So, it is a question and a—well, a relatively short question and a relatively short answer from the Minister, and we'll get the three in. John Griffiths.

Diolch yn fawr, Dirprwy Lywydd. I welcome the Government statement and action plan. As we've heard, rough-sleeper numbers do appear to be increasing in terms of the counts that are taking place. That's why I'm very pleased that the committee that I chair, the Equality, Local Government and Communities Committee, is doing a piece of work on rough-sleepers. We've already made visits to Solas in Newport and the Salvation Army in Cardiff to hear from staff and service users. I think it's clear that there are complex issues involved, as we all know, and there is a great deal of vulnerability and danger faced by those sleeping on our streets. So, it's absolutely right that we have more focus and priority for these issues.

The committee inquiry will look at the effectiveness of the legislation and the causes, the services provided, including emergency accommodation, the scale and adequacy of data—and I think there are quite a lot of questions around that—and of course the steps required to deal with the issues. We will also look at the action plan with the input of stakeholders and, of course, question the Minister in due course on the detail and on how she intends to take the action plan forward.

So, I guess, really, what I’m really looking for today, Minister, is just confirmation of what you’ve already said, really, that you will be keen to work with the committee, that the action plan is an evolving and developing document, as new evidence, new circumstances, emerge, and that the work of the committee will be one part of informing future policy and strategy on these crucial issues.

I thank you very much for that. I am very, very pleased that the committee is taking a good look at this particular issue, and it is important, because, as we've probably seen through the statement, there are questions, and some of the questions we don't have the answers to yet. For example, that question as to why, even on the coldest of nights, there are empty bed spaces in some of our hostels and other provisions.

I was at a local surgery, one of my surgeries in Gower, on the weekend, and a lady came in and said that last year her church had provided 10 beds during a cold period for homeless people and they were full, but, this year, those 10 beds, not one person turned up for them, and, even though we understand that the scale of homelessness has grown and it’s been very cold, equally, there seems to be a mismatch in terms of people’s willingness now, I suppose, to engage with some of those services that are being provided. So, I think that the fact that the committee is looking at this particular issue, alongside others, will be very useful in terms of helping us map out the way forward.

You referred to the borrowing cap. Would you agree that when the borrowing caps were first introduced, following exit from the housing revenue account by agreement with local authorities, it was expected that those would be devoted primarily to helping the stock transfers that had not met the Welsh housing quality standard to achieve the Welsh housing quality standard? How, therefore, are you ensuring (a) that the Welsh housing quality standard is not given a lower priority to delivering some much-needed new social homes, and (b) that local authorities are all working in accordance with the agreement made with registered social landlords through the Welsh Government late in 2016 to ensure they work together with their combined resource to maximise the number of new social homes they can provide?

Thank you very much for that question. It’s good to hear the Welsh housing quality standard mentioned. All local authorities are working towards meeting the Welsh housing quality standard by 2020. All of them have confirmed that they are on track to do that, so I think that’s really positive. I suppose the challenge for Government will be to say, 'Well, what next?' You know, what will be the next step in terms of what we are requiring from local authorities and RSLs in terms of raising the game of the standard of accommodation that we do have in Wales.

One thing that I am considering in terms of the way forward has to be about retrofitting in terms of our decarbonisation agenda and the role that housing can play in that. If we are to meet some of our very stretching targets in terms of decarbonisation then housing and dealing with some of that has to be right at the centre of that agenda as well.

But, in terms of Welsh Government investment in housing, it has to be housing that is of a good quality, which helps us deal with decarbonisation but also provides people with a decent, warm, affordable home.

Thank you very much.

The next item is a statement by the Cabinet Secretary for Health and Social Services: 'The Chief Medical Officer's Annual Report 2016-17'. I call on the Cabinet Secretary to make the statement—Vaughan Gething.

Thank you, Deputy Presiding Officer. I welcome the publication of the second annual report by Dr Frank Atherton, the Chief Medical Officer for Wales, covering the period 2016-17. I'd like to thank Dr Atherton for his assessment of our progress in improving and protecting the health of the nation, his insights into emerging threats to public health, and his considered thoughts on actions needed to deal with them effectively. 

It is reassuring to read of the consolidation of a number of public health gains and ongoing improvements in a number of areas. At a time when outside commentators too easily make sweeping and ill-informed statements about the quality of our NHS, it's helpful to remind ourselves in an authoritative CMO report of some of some of the concrete facts about the state of health and healthcare here in Wales. 

The report outlines that overall life expectancy in Wales continues to rise, up to 78.4 for males and 82.3 years for women. Most adults report good general health, with over 72 per cent of over-16s reportedly in 'good' or 'very good' health. And our infant mortality rate, at 3.7 per 1,000, remains low in historical terms.

As we have rehearsed many times on the floor of this Chamber, there are many factors impacting on the health of the nation. High-quality healthcare is of course one of them, but there are a broad range of social determinants, such as housing, education, quality employment and the environment, that play an even bigger part. There are also a significant number of public health threats each year, and Dr Atherton's report highlights significant achievements in dealing with these. One of the examples it cites includes the impact of the introduction of the all-Wales hepatitis C treatment roll-out programme. The success of this programme has meant that, in Wales, we have now treated, or are giving treatment to, all of the patients that are known to, and have accepted referral to, hepatology services and are still accessing care, or, to put it more simply, we are ahead of every other UK nation in the treatment and the hopeful elimination of hepatitis C. That is a cause for recognition and thanks to that group of clinicians leading that work. 

It also refers to individuals infected with HIV benefitting from anti-retroviral therapies so that they lead the most healthy of lives. It notes the number of new diagnoses of HIV in any one year now being on a downward trend, and the number of individuals testing annually increasing. The importance of testing is crucial now that pre-exposure prophylaxis or PREP is available to all those for whom it is clinically indicated. I do look forward to the results of that PREP trial in due course as we roll through a genuinely nationwide trial.

The report also sets out priority actions for our seasonal flu and childhood immunisation programmes, which will be necessary to deliver to ensure that those programmes remain the envy of the world.

While communicable disease may be regarded a traditional public health threat, Dr Atherton also uses his report to shine a spotlight on the emerging public health risk of problem gambling. He focuses on the harm that can be caused by gambling, not just to individual gamblers but also family, friends and to society as a whole; harm that can include financial hardship, psychological distress, and the breakdown of personal relationships.   

The report sets out the prevalence of gambling. The UK has the tenth highest gambling spend per capita in the world. In Wales, 61 per cent of adults have gambled in the past 12 months: 63 per cent of men and 59 per cent of women. It is estimated that, each week across England and Wales, 450,000 children aged between 11 and 15 are involved in some form of gambling. That equates to 16 per cent of that age group; 1.1 per cent of our population self-report as having a problem with gambling and a further 3.8 per cent of people in Wales are estimated to be at risk of problem gambling. The report also highlights that the harm caused by gambling is unequal in its distribution. People who are economically inactive and live in deprived areas are more likely to suffer most harm.

Dr Atherton comments on the evolving nature of the gambling industry, its marketing and its products. Gambling is no longer solely taking place within traditional physical premises like arcades, bingo halls or racing tracks. The fastest growing method of gambling is of course online betting, with 24-hour availability, accessed through computers, mobiles or tablets. In the UK, nearly 9 million adults have gambled online in the last four weeks. In Wales, 9.2 per cent of online gamblers surveyed were identified as being problem gamblers. 

Dr Atherton sets out the case for a public health approach to deal with gambling—an approach that seeks to address the inequity of harm. He calls for a range of actions to reduce harm that do not just focus on individuals but also a wide range of measures, including advocacy, information, regulation and appropriate prohibition in a co-ordinated way. In doing so, Dr Atherton recognises that gambling is primarily regulated at a UK Government level, with a number of UK bodies having responsibility for different aspects of gambling. An effective response to the harms caused by gambling will require a co-ordinated response.

I know that a number of Members in this place have taken a very active interest in the issue of problem gambling and the need to both support problem gamblers, as well as to deal with the prevalence and the ease of gambling. You will no doubt join with me in welcoming this thoughtful report drawing attention to the risks and making recommendations for action. I'll certainly be joining Dr Atherton and relevant stakeholders to consider how we best take forward those recommendations, not only through our calls for effective action at a UK level; in addition, we will look to use any new powers in Wales in a sensible and proportionate way to reduce the harms caused by problem gambling. I look forward to answering Members' questions. Thank you. 

Cabinet Secretary, thank you very much for bringing forward this statement about the chief medical officer's report. I do welcome this report today. I believe it clearly lays bare the challenges of ensuring that we all age well. It's great news to see the increases in longevity—I, for one, am very grateful to see that—but we must also recognise that over a quarter of the Welsh population will be over 65 in 20 years' time; that's a quarter of our population. And I would like to ensure that today's plans recognise that, so, Cabinet Secretary, I wonder how will you ensure that health and social care services will be delivered fit for a quarter of our population going further forward, especially when we hear things such as the Welsh Local Government Association and the Association of Directors of Social Services saying that the key determinants of health are largely outside the control of health services, and so the quality of and spending on social care has to have one of the greatest demands on healthcare.

It's also very good news to see the improvements in cardiovascular diseases and neonatal disorders, and I also recognise the very good work that's been done on hepatitis C. But Welsh Government does need to get to grips, according to the CMO's report, with the stasis that we see in cancer outcomes. And so, Cabinet Secretary, I ask what you might have up your sleeve to help us improve that, because those figures—the dailies on cancer outcomes—have not changed significantly for over a decade. 

The points made by the chief medical officer on gambling are pertinent and, I believe, well made, and I for one cannot understand why we are allowing this canker to develop. In fact, I'd like to pay tribute to Darren Millar because he raised a short debate on this issue back in July 2017, which called for greater restrictions on gambling advertising and fixed-term betting terminals, and I know that this has cross-party support. The then Minister for public health, Rebecca Evans, stated that Public Health Wales were commissioning research to map out all the gambling venues in Wales. An update on progress in this regard would be most welcome, and I wonder if perhaps you might be able to address your intention in that area. 

Although there are other issues and comments, I'd like to finish with the CMO's commentary on protecting the public from health threats and, indeed, staff from health threats. Seasonal influenza is one of the biggest winter pressure threats. It lays siege to GP surgeries and A&Es, and I've tried to get guidance from the British Medical Association as to what can be done to increase the numbers not just of doctors, nurses and healthcare workers, but other healthcare professionals, to take up flu vaccines. The public need galvanising but so, Cabinet Secretary, do the public sector workers. Is there any ability for Welsh Government to look at guidance, statutory or otherwise, for health and care workers to receive the flu vaccine? Because you yourself refer to our seasonal flu vaccination as being an envy of the world, and yet that is in direct contradiction to evidence we hear in the Health and Social Care Committee, and we do know that seasonal flu is one of those great winter pressures. If everybody in this Chamber, all our staff, the public and those who work in the public sector were to have the flu vaccine, it would help with that enormous pressure on our NHS, and I'd be very grateful for your thoughts on how we might increase the uptake. Thank you.        

I'll happily deal with that last point first. I welcome the fact that there's a recognition of the importance of the seasonal flu campaign, and part of the strength of that is that it is genuinely seen as cross-party. There are plenty of things that we argue about in this place between parties; this isn't one of them. We want to have more members of the public in at-risk groups taking up the opportunity to have the flu jab on the NHS, but also to think about those workers working with people who are by definition vulnerable, and in health and social care in particular. It's one of the things that I've concentrated on. Rebecca Evans, in her then role as Minister for public health, had a particular focus at the start of this flu season on trying to make sure that more public service workers who should have the flu jab actually take it up.

We have some challenges here, though, that we should honestly recognise. Part of that is that, actually, even though we think there should be some professional responsibility on people to do this and there is an interest for people in the social care sector from a business continuity point of view to ensure that their staff can come in to work as well as make sure that they don't impact on the people they're caring for, within social care and within the health service, it's quite difficult to say, 'You must' and in particular to say, 'You must have the flu jab.' 

There's still a conversation about how we have even more uptake. This year, I've been encouraged, comparing this year to last year—and I won't take credit for this year's campaign because, as I say, Rebecca Evans was the Minister at the start of this—we've had an increase in uptake amongst our staff. We still need to do more and more and more to try and make sure that staff realise that it's a good thing for them and the people they care for to continue not just to have the flu jab but to have it in greater numbers as well so that it becomes something that is accepted culturally rather than us having to fight to persuade people to actually have the flu jab. Some of the myths about this year's vaccine not being effective—that gets said almost every year, and yet we know it is the best front-line protection against the flu, which has serious consequences for a whole range of vulnerable people, from neonates to the very old and everyone in between.

On your point about an ageing population, again, the report highlights figures given in other reports, including the parliamentary review and the previous Nuffield and Health Foundation work about the rise in the age of our population, and in particular the proportion of our population who will be over 65 and over 75 and the increasing demand in health and in social care in particular. Part of our challenge is that, as we make budget choices—again, that we will debate, discuss and, no doubt disagree with—whatever the sum we have and whether or not it's through times of austerity when our overall budget is decreasing, we have to make a choice about what we put into each area. At the moment that means that we have a real challenge in matching the demand in health and in social care.

We've actually met the health challenge in the way that Nuffield and the Health Foundation suggested we needed to. So, we've met that particular part of it, but social care is part of our real concern, highlighted again by the parliamentary review. That's why I think it's particularly important that we're prepared to engage in—. The debate on austerity is difficult because we take entirely different views about it, but on the debate around what we do in the medium term, there should, I hope, be an opportunity within this place and outside it to try and engage in the conversation about the social care levy proposed by Gerry Holtham. I think it's well worth pursuing because, if we're going to have a long-term funding answer, 'as we are now' isn't going to get us there, and it will be every single constituency, every single community that will be affected. If we can't resolve the longer term funding challenge for social care, we will have lots and lots of our older citizens, who we all want to see cared for with dignity—we'll find ourselves in a completely compromised position. So, it's in all of our interests to reach there.

There's something here for each party to do on that and for us to demonstrate some leadership on, but also it's a conversation with the UK Government as well. It doesn't matter what shade the UK Government is. I hope it's a different colour in the near future, but in any event the UK Government have to be part of the conversation because what we cannot get into is that if we introduce a social care levy and people then receive money to pay for their social care out of, if it works, if all those things happen, if the Treasury then say, 'Actually, that's effectively income', that will then affect people's ability to have income from other benefits as well. That's a really serious point, so the work that Dilnot and others have done—we have to get back to that and we have to make sure that our colleagues in the UK Parliament are prepared to have, again, a sensible and grown-up conversation about this too, because this is an issue for Wales, but it's absolutely an issue across the United Kingdom too.

On cancer outcomes, actually, on survivorship, we have a good story to tell. We've had statistically significant and material increases in survivorship. One-year survival is now at 73 per cent; five-year survival is at 57 per cent. But our challenge is that when we look at ourselves and England, for example, we actually have statistically similar survivorship rates between Wales and England, and you would actually not expect that to be the case, because the English population is healthier and wealthier. You'd expect the cancer survivorship rates to be materially different, but they're not. And there's something there to celebrate, actually, from Wales's point of view—that we're not seeing a statistical difference in Wales's and England's survivorship rates. But actually the bigger challenge isn't to say, 'We're not any worse than England' or 'We're as good as England'; it's actually to say that, on an international basis, when you look at other countries across Europe, every single nation in the UK doesn't do well enough at all. So, we actually still have a significant step forward to make in any event, and that's our challenge. Otherwise, we'll just persuade ourselves to narrow down our ambition and where we should be.

So, that's why I'm interested in the single pathway. It'll change the way that cancer is measured. We've got further work being done on that. It's also about the point about early diagnosis. It's also why we have this conversation about drugs and effective medication being available. It's why some of the debate has been about a cancer drugs fund and why we have a new treatment fund that is evidence based. But, in particular, for curative options, you're talking about surgery and radiotherapy, and we hardly ever talk about those when we talk or have a debate about improving cancer outcomes; we almost always talk about diagnostics and medication. So, actually, we need to spend more time and focus on that.

And on the work about gambling, the CMO is leading work on gambling with a group of stakeholders, and I'll be more than happy—some Members have asked for a meeting with the CMO, and I'll be more than happy to provide an update in this place or in writing. And, of course, when the CMO comes to the health committee—I think he normally does; I'm just looking at the Chair—I'm sure that he'll be happy to set out more detail on the work that is already in train and proposals to use the powers that will come to Wales in April of this year.

Thank you to the Cabinet Secretary for his statement. I will also note my thanks to the chief medical officer, Dr Frank Atherton, for his second report. It’s important, despite that, that I draw attention to the fact that we’re having a statement here today on this report, while in the past, including last year, we had debates on the report of the chief medical officer. I would encourage the Government to return to that practice and not let the political balance here and the fragility of that balance to decide in what way important matters with regard to health in our nation are discussed here at the Assembly.

We could go into several different areas, almost any area with regard to health in Wales here, as a result of this report. I will keep to what has been mentioned in the statement itself by the Cabinet Secretary today.

The statement has noted there are many factors that influence public health. That has been discussed several time here. But possibly these reports and what we’ve heard from the Government in general could give greater clarity for us about the true effect that austerity and expenditure decisions in areas separate to health can have on health outcomes. Cuts to social care, housing and so on are cuts to the health service in general as well and I would ask for ways of having an evaluation to measure exactly what the effects of those cuts are on the health service in future.

I will move to the main body of the statement today, which is on gambling. The report does shed light on the problems that are caused by people becoming addicted to gambling and it notes the progress with regard to betting advertisements on television. We are aware of the hypocrisy of the football association in England banning players from gambling on games whilst drawing a great deal of sponsorship from gambling companies.

Your statement, Cabinet Secretary, says that you regret that gambling is being regulated at a British level. I would agree that, when something is regulated at a UK level, that should be the cause of regret because very often it means that regulation happens for the benefit of industry rather than the benefit of the public. I would hope that that’s something that we could look at in Wales in future. But, there are some things that the Government could do. The chief medical officer’s report notes that the Wales Act does give powers for Welsh Ministers with regard to fixed-odds betting terminals to decrease the highest stake from £100 to £10 in B2 categories. I would ask whether you will do that. Is that something that you would wish to do?

Also, there are powers available to local government with regard to giving planning consent for the change of use of shops to betting shops. Research here with regard to discussions on a potential Bill has found that several local authorities are very careful and are concerned about using the powers that they have to increase the number of betting shops, in case of legal steps that might be taken against them. Will you ask the Cabinet Secretary for local government to give greater clarity and certainty for local authorities who want to take steps to prevent the increase that there has been in the number of betting shops?

I will finish, if I may, by referring to what you said about hepatitis C. As one of the champions of the issues related to hepatitis C in the Chamber—I and many other Members—it’s good to see that Wales is in the vanguard in this area. Very often, the situation that we face is finding those people who have hepatitis C—finding enough patients to go through our system. It’s a good problem to have, but it is an issue that we need to solve. May I take this opportunity—and I often find, as do other Members, an opportunity to do this—to press you to make a statement today, perhaps, to be even more ambitious with regard to the need to move forward with getting rid of hepatitis C in Wales?

Thank you for the comments and the questions. I note everyone's preference to have a debate not a statement, although, actually, to be fair, statements provide more questions from Ministers to answer and more scrutiny in that sense, but these are choices that are made.

I broadly share your concern about the impact of austerity on health and health outcomes. I think both Dai Lloyd and Simon Thomas from your party have also indicated their concern and interest in reports and studies that have been done trying to look at the impact of different changes driven by austerity to welfare benefits, for example, and in physical and mental health outcomes as well. They're things that we should continue to be cognisant of—the evidence over and our ability and our choices in what we choose to do in running the health and care system here in Wales and recognising the different drivers of healthcare need in the country.

On your three substantive points about fixed-odds betting terminals and also, then, planning, public health, betting shops and hepatitis C—. On fixed-odds betting terminals, the UK Government are out to consultation on this issue, and one of the proposals is that they could actually reduce the maximum stake down to £2. Now, actually, we think that would be a good thing to do, and the chief medical officer has submitted evidence to that effect as part of that consultation. The odd thing is, we're about to get powers in April that will allow this place to reduce the maximum amount—you might want to give local authorities the power to reduce it to £10. So, if we got to the point where we reduce it to £10, there's a potential opportunity to reduce it to £2. Actually, if we're clear that the UK Government are going to act in that way, I think that would be preferable. It would be a consistent system across the UK, and we could indicate that in itself. If that isn't going to happen, then we will of course look to use our powers here in any event. We ought to be really clear about—. There's very clear advice from the chief medical officer about wanting to take a deliberately proactive approach in this area, and I'm sure that I—whether it's me or another Member of this Chamber who's in this particular role—will want to take this seriously and take appropriate action.

On betting shops and priority health impact, there's a broader context—not just about betting shops but a range of public health considerations in planning. I'm quite open-minded about how we could do that, but we need to have a conversation across the Government about the planning policy and governance that we currently have—from a national perspective as well as that in place in local authorities. But we should certainly be prepared to again be led by evidence on what we could and should do to deliver a greater public health benefit.

On hepatitis C, I know that you, Angela Burns, and Julie Morgan and others have raised the progress that is being made, and, again, I welcome the fact it's been highlighted in the CMO's report about what they're actually doing on hepatitis C. We have a genuine national approach that—. It was really interesting and I've actually—. I don't always read journals and medical publications, but there was real praise for the approach that's been taken here, in professions in England and in Scotland too. They like what we're doing and, in fact, people in England would rather like to have a generally nationally joined-up approach, where they're looking at the most effective medication and not always the most expensive, but it's delivering the real benefit. It's the next stage in eradication in terms of getting to those people who're the hardest to reach, and that, I think, is the point you're making: how do we get to those people who either don't present to healthcare services, present infrequently, or are living chaotic lives, and, actually, even if they may want to, how do you maintain a link with them to actually deal with the challenges that they have?

As I set out in a previous statement in this place, we think we're in a good place to carry on making further progress. The ambition remains, though, that we want to be a country that eradicates hepatitis C. We're now at the more difficult end, and it's the best problem to have, but I'm confident that we'll continue to make further progress, and, indeed, whatever progress we do make, we'll update this place and the committee as to the progress that is being made by staff within our national health service.

Cabinet Secretary, I do welcome the chief medical officer's annual report, and I welcome the focus on the adverse impact of gambling on public health.

Dr Atherton, our CMO for Wales points to the fact that gambling has great potential to cause harm to individuals, families and society and he calls for better research and monitoring of the impact of gambling on health and for greater regulatory control in Wales and the UK, and you've been answering questions on that point. But last year, I co-sponsored research undertaken by the University of South Wales for a report, 'An investigation of the social impact of problem gambling in Wales', with Jayne Bryant, Mick Antoniw, Ken Skates and Lesley Griffiths. Alongside this, do you welcome the research undertaken by Citizens Advice Cardiff and Vale on gambling disorders and gambling-related harm, and welcome the conference that they're holding on 23 March to consider the findings and the way forward? I would invite you, or, indeed, an official to attend that event, which I'm addressing.

I also welcome the case studies in the CMO's report taken from Citizens Advice. Do you agree that advice services are playing a vital role in supporting people who fall into debt and distress as a result of gambling? If you're minded to accept the recommendations in the CMO's report, will you draw on the expertise of third sector organisations like Citizens Advice in producing an action plan on this issue? And do you recognise that this needs to be tackled at all levels of Government, but also needs to involve those at the front line supporting people affected by what can be a drastically negative impact of gambling?

I thank you for those brief comments and points. I'm interested in the work being done by Citizens Advice here in Cardiff and Vale to understand the scale of the problem with gambling in this particular part of Wales. On the event on 23 March, I won't give a commitment without having checked my diary—I've been told off about that before, about giving commitments and then not understanding whether I can do them or not—but to look at the event on 23 March. I would be interested, if I'm not able to attend, in whether we can have someone there from Welsh Government to understand the nature of the report and the evidence that's been collected, and what that looks like.

So, that leads into your second point about advice services, not just Citizens Advice, but a range of other organisations, a number of which are mentioned in the report. They are really important in helping people to try and get through problem gambling and understanding where it gets picked up and how people are supported. That's not just about financial advice, but a whole range of other impacts that problem gambling can have. And that, absolutely, is part of the work that the CMO and stakeholders are considering in actually having a response to the problem of gambling and its public health impact. So, I think the points are well made, and in coming back to this place to have an update on that, I'm sure that'll be part of what we'll want to cover in doing so.

Thank you for your statement, Cabinet Secretary, and I would like to add my thanks to Dr Atherton for his second annual report as chief medical officer. I'm pleased that Dr Atherton has opted to use his annual reports to shine a spotlight on growing public health challenges. Last year, he singled out the health inequalities that exist between those living in our most and least deprived areas, and this year he has focused on gambling.

When you consider the major public health challenges facing our nation, such as obesity and drug, alcohol and tobacco addiction, these are well known and well understood. Problem gambling, or rather the public health implications of problem gambling, aren’t as well understood. Whilst there have always been problem gamblers, we are starting to see them in greater numbers. It is therefore welcome that Dr Atherton has drawn attention to this issue now.

In 2005, the Labour Government, under Tony Blair’s stewardship, undertook the biggest deregulation of gambling our nation has seen. This led to an explosion in online betting. With tv ads for gambling now permitted, you can’t escape prime-time adverts for online casinos and bingo.

It is now much easier than ever before for young people to gamble. A recent Gambling Commission survey found an increase in students who gamble, with two out of three gambling, many online. This finding led the Gambling Commission to produce advice to universities, encouraging them to provide information and support about potential gambling-related harm to their students—much as they do for drugs, alcohol, and safer sex.

As Dr Atherton highlights, 1.5 million of us gambled in the past 12 months. Whilst there is nothing wrong with the occasional flutter on the grand national, or buying a lottery ticket once in a while, the sheer ease of access makes it easier for gambling to become problem gambling.

I welcome Dr Atherton’s recommendations for the need to conduct further research. We need to fully understand the risks and the harms, and develop evidence-based policy that balances the social benefits of gambling against the harms related to problem gambling. Cabinet Secretary, could you outline what action you are taking to implement Dr Atherton’s recommendation for further research into the impact of problem gambling? How do you intend to balance the need to take action to target problem gambling without impacting on an adult’s ability to gamble responsibly? Finally, Cabinet Secretary, how will you involve the Assembly in the development of an evidence-based policy approach on tackling problem gambling?

Thank you once again for your statement and to Dr Atherton for his latest report. I look forward to working with you to develop a balanced approach to this and other emerging public health issues. Diolch yn fawr. Thank you.

Thank you for the comments and questions. On the overall point—the liberalisation of gambling—that's something that we have all recognised: that, actually, the growth in online gambling, in particular, is causing real challenges for us. For all the exhortation encouraging people to be responsible gamblers and encouraging the industry to be more responsible, actually, it hasn't led to the sort of shifts in behaviour that we'd want to see, and that's why I think, even within the UK Government, which instinctively wants to encourage people to act in industry, as opposed to having, if you like, a regulatory approach, they are shifting their own views. Certainly, the fixed-odds betting terminal issue is a good example of where they are now consulting and, actually, regulating a very different approach, because they recognise the harm that's being done. This is a completely liberalised area, with very significant harms that can be done in a very quick period of time. So, there is some awareness, but we will need to think about how we can actively use our powers here in Wales.

That's why, as I've indicated earlier, the chief medical officer is leading work with stakeholders to look at what we can do, what we should do, both in the here and now, and also looking ahead to the powers that we'll acquire in April of this year. Indeed, you've heard in the statement and the questions already today about the research Jane Hutt referred to that Citizens Advice are doing in Cardiff and Vale. There's a range of other people who are undertaking their own research, anecdotally and more generally, about the problems they're seeing coming through their doors—some of those are mentioned in the report as well—in addition to the research that was undertaken by five Members in this place. Jane Hutt was one of them, and Mick Antoniw and Jayne Bryant—the three that are in the Chamber now. That research matters, highlighting the challenge that we have, the scale of it, and the need for not just a policy response, but a practical one too. So, as I've said on a number of occasions, I actually expect to come back to this place to update Members on the work of that group and the concrete action that we expect to be able to take here in Wales.

Cabinet Secretary, I won't go over many of the points that have been covered on the gambling issue. Can I just say, first of all, you'll remember the individual Members' debate we had here in 2013—I think this Assembly is one of the first of the Parliaments to actually have a detailed, thorough debate on the issue of the emerging problem of growing gambling? In fact, it was that debate—when people say, 'Well, what do these debates mean?'—that actually led, in the Wales Act, to at least some devolution of powers in respect of fixed-odd betting machines. Unfortunately, it didn't attract the sort of attention that occurred later on, but I think it's fair to say that this Assembly has led the way, actually, in identifying and looking at ways in which gambling could be dealt with as a public health issue. 

What's important about this report as well is that almost half of it—17 pages of it —deals with what is identified as an emerging public health challenge, and this is the thing that we've had in the various debates in this particular Assembly. And it's a very good report, because it also, in terms of establishing a task and finish group in terms of the need for more research—. You'll recall that all that research was stopped in 2010, so that the actual data we have has been limited until the work that was done in terms of the report that Jane Hutt and myself and others funded. But this gives us an opportunity now to do proper analysis, proper investigation, into the actual scale of the problem. Very importantly, what is identified is that whatever work is done has to be free of the influence of the tobacco industry—I beg your pardon, the gambling industry; that's another issue—an industry that has ploughed money into research, but has a stranglehold over that research, the direction it has, and research that seems to go around in circles for decades. So, it's very important that we are independent of that.

Can I also say one other thing? Of course, many of us have been watching some of the recent sporting successes of Welsh soccer teams, and of course Spurs are playing Newport tomorrow night. There may even be Assembly Members who will be at that very game. But I raise the point not to diminish anyone's enthusiasm for their local team, but because of the stranglehold that gambling now has over sport: the identification in people's minds of sport, of soccer, of whole varieties of sports, with gambling. Those of us who will watch that game that night will see, around all the ground now, all the gambling adverts. We will see the texts that come on the phones, the stuff that comes onto online and so on. And whatever capacity we have—we can do some things on fixed-odd betting machines, we can do stuff in terms of our planning powers—I think we also have to look at our association with sport within Wales in terms of how we actually tackle and ensure that there isn't that growth of gambling advertising taking place, and that we also engage with Westminster over the fact that, having identified a public health issue, we actually need the powers to be able to deal with it. One of the problems, of course, with the Wales Act is it limits the capacity we might have had in certain areas of gambling as a public health issue—

Are you coming to a question?

—but we have to ensure that we do have the ability to deal with those issues.

Thank you, and I want to start by recognising the consistent concern that Mick Antoniw has expressed in this particular area, as well as generally across parties. The evidence on the scale of the problem and what our most effective response is is really important. I recognise we have some evidence and a building picture, but to move beyond anecdote to understand not just the survey evidence, but then to that point about the challenge and what is the most effective response if you would like a treatment response if someone presents as being a problem gambler, and the report recognises that we don't yet, in this area, have an effective consensus on what the right response is, because, actually, it's unlikely to be a pharmaceutical intervention.

This is more about the field of talking and supporting people, and that in itself is challenging, about understanding what is the right sort of intervention. The report looks at brief interventions, it looks at work that we're doing. We want to get involved with the National Institute for Health and Care Excellence, for example, on work that they recognise they need to develop in this area to support health and care services for people who do have problems with gambling. But in particular, I do recognise your particular point at the end, not just about—. Almost all of us in this place, I'm sure, will wish Newport well against Spurs. I recognise the Member's longstanding loyalty is in a different direction.

But this point about advertising, and the ubiquitous nature of advertising—so many different events. It is hard to ignore. If you think back about where we are now with sport, it wasn't that long ago that alcohol was advertised in sport in a way that was—. It was odd, wasn't it? Almost as if you were being encouraged to drink lots, whilst you were at a sporting game, and to look at the physical activity and prowess of people on the pitch. And before that, tobacco was regularly associated with advertising all sorts of sporting events. Fast food still is. Even fast food, they are looking to change it. There is still a challenge about all these different areas of activity and their willingness to be associated with sport, because they recognise the power of sport and advertising and what it can do for their products. So, as the report recognises at point 6.4 in the chief medical officer's report, there is a need to look at controls on advertising of gambling. That is something we do need to continue to have conversations with the UK Government about.

I also welcome this report, particularly the section dealing with gambling. Without rehearsing what's already been said, I do note that the report states that the cost of addictive gambling to public services in Wales is around the £40 million to £70 million mark per annum, because of the impact on the health service and care services particularly. I share the concerns clearly expressed by many Members on the way that gambling and gambling advertising have permeated into the normality of everyday life, so that it's appeared recently on children's sports shirts, emulating some well-known football teams.

One thing I particularly wanted to ask the Government on is the comment made that research into this area is done, to all intents and purposes, by the industry itself, by GambleAware. But, GambleAware has been under the influence of the industry. They have tried, I think, to re-establish themselves to be more independent, but it strikes me that what we need is something similar to a levy on the industry, where you could have complete independence and funding could be provided, not only for research into gambling, but also to mitigate some of the unfortunate and detrimental impacts of gambling. That's not a power in the hands of the Cabinet Secretary, but I wanted to ask, is that the view of the Welsh Government: that they would want to see a levy of that kind, and that they would work and put pressure on the Westminster Government to introduce such a levy.

And the second element of the report, which I believe is important, is the fact that, once again, the chief medical officer has outlined the impact of air pollution on society and the impacts of that—2,700 premature deaths because of air pollution. I would like to know exactly where air pollution sits now within the range of causes of premature deaths in Wales. It's around third, or even second, in terms of the reasons now. I know that the Government is doing some things to tackle the issue, but the problem is that this is disseminated between Government and local authorities. The local authorities are specifically responsible for monitoring and tracking and then putting particular zones in place, and this Government is facing a court case because some of those steps have failed recently. So, specifically, and in looking at the costs and health impacts of air pollution, will the Welsh Government be taking a further step on a national level now to ensure that all schools have an air pollution monitoring unit outside the school, so that we have a better understanding of the true impact of air pollution, and that we have a national strategy to tackle the health problems emerging from air pollution?

Thank you for those comments and points. I'll deal with your points about air pollution first, if I may. As you know, air pollution, the lead for this across Government is Hannah Blythyn, the environment Minister, but the points that you raise recognise that it's an issue that has an impact right across a range of departments. There is clearly a public health impact. If you're talking about monitoring in and around schools, then I'm sure that the education Secretary will want to be involved and engaged in that as well. So, I won't give you an off-the-cuff answer about a national strategy and about the work that's being done, and I will certainly talk to colleagues across Government, not just to answer your question but more broadly the continuing conversations that we are having across the Government about a Welsh Government strategy on improving air quality and recognising the significant benefits to all of us in doing so across a wide range of policy areas.

When we talk about gambling and the significant financial cost on health and care services that's recognised, the report does also recognise that, for lots of people, it's a mild and modest activity. Most people in this room have gambled and probably gamble regularly, if you think about it. The amount of times that we are invited to either take place in local lotteries or raffles at the different events that we attend, then actually, if you're the serving politician in the room, it's very hard for you not to buy raffle tickets when the jar goes around. So, we're really talking about problem gambling where people are betting more than they can afford. 

Interestingly, in the report, it sets out the particular points that others have made about the difference in problem gambling between different income quartiles. It does show that the lowest income quartiles are most likely to have the largest problem with gambling itself. That's the concern that the chief medical officer, in particular, is highlighting for us. Interestingly, your point about the levy is mentioned in the report. It's the example in New Zealand, on page 21 in the report, which looks at the levy they've had there and the way they designed that. I'm open and interested in what we could do, both with our current powers and in that continuing conversation with the United Kingdom Government about a real clear and present challenge that will only get bigger, if we don't act now, in the future.

I just need to declare that I am a director and trustee of The Living Room, which has pioneered the focus on gambling as just as harmful an addiction as alcohol or tobacco or any other addiction. So, of course, I welcome this focus on it, because I have many constituents who have lost their home, lost their business as a result of their gambling addiction. We need to ensure that we are getting large organisations, like the football industry, to use their excessive wealth and dominance of the television schedules not to promote gambling, which is what they're doing at the moment, and that is a very worrying concern.

I think we should also worry that video games are being used to target children and promote a form of gambling in order to prepare them for the future. I know that the Advertising Standards Authority is on to this and endeavours to be vigilant, but I think that it's something that we all ought to worry about. I completely agree that we need to reduce our stake to £2, so I do hope that you're successful in persuading the UK Government to take the plunge on that one.

Probably the only thing I agreed with Mrs Thatcher on was that she was worried about the lottery being located in our post offices. The poorest people in our communities collect their benefits from the post office still today, despite the electronic transfers of money, and then they are invited to spend some of it immediately on gambling. That is quite an uncomfortable situation, and we all see it every time we go into a post office. So, I think it's a major concern, and I very much welcome the emphasis in this report.

I just wanted to focus on something that's not in the report, which is the issue of breastfeeding, which wasn't in last year's report either. It is confined to two lines in Dr Atherton's report. We are told that children in the most deprived areas are half as likely to be breast-fed, and that, obviously, is combined with the fact that they are twice as likely to have decayed, missing or filled teeth. There is a link in all this. When I asked you about this subject back in November, you did say that this remains a priority for Public Health Wales, and that you have asked your officials and the Royal College of Midwives to explore ways to further improve uptake and support and provide better support to families. So, I'd be keen to understand, if this information isn't available in our public health report, where we are going to find out what our strategy is on this really important subject. Because it does actually follow babies right through their lives; if they are not breast-fed, there are serious consequences to all this. It is particularly concerning that it is in the lowest income households where people are least likely to breastfeed and therefore need more support to do so. So, I'd be keen to hear what you can offer on that.

Thank you. I'd like to recognise Jenny's role in being a director of The Living Room, which is actually mentioned on page 24 of the report as part of section 7, about how people are helped to access support for people who suffer gambling-related harm—one of a number of positive initiatives. Again, I recognise what you have to say about the power of sport and gaming, either to impart positive messages or, indeed, to be used to advertise things where you think potential harm is caused as well.

On your point about breastfeeding—to finish, Llywydd—in last week's debate on the committee report into perinatal mental health, there was a section in that report and in my response that dealt with breastfeeding, not just in one specific area but more generally about our breastfeeding strategy in Wales, because we do recognise that, across all groups, we would like to see more people take up breastfeeding—well-recognised health benefits for the mother and the child. There's something there about having supportive partners as part of that as well, and a supportive society that recognises that it is an entirely natural thing that we want to encourage more of. And, within that, we recognise that, sadly, there is definitely a relation between income and likelihood of breastfeeding. So, that is part of the work that is being done now to understand where we have been successful and not, and, in both committees, in both the health committee and, indeed, in the Children, Young People and Education Committee, I expect to report back on when that strategy is ready. I expect I'll be scrutinised on that—every time I go before the children's committee, I know I can expect to have questions on breastfeeding. Until we see sustained improvement, I expect those questions will be there. So, I don’t shy away from it; it is an area of work that is being developed and led by Public Health Wales, and I will of course report back, not just to the committees, but to this place as well, as we do make progress—certainly as we reformulate where we wish to be on promoting breastfeeding right across Wales in every particular income group, but in particular those with the lowest take-up at present.

I thank the Cabinet Secretary.

The next item is the statement by the leader of the house on the centenary of women's suffrage. I call on the leader of the house to make the statement—Julie James.

Diolch, Llywydd. Today marks the significant, 100-year anniversary of the Representation of the People Act 1918, which was passed on 6 February 1918. This Act enabled all men and some women over the age of 30 to vote for the first time. It is worth noting, however, that it wasn’t until 10 years later, with the passing of the Equal Franchise Act 1928, giving women the right to vote at age 21, that women could vote on the same terms as men. So, on 2 July this year, we can mark the ninetieth anniversary of that Act. I am also mindful that this centenary overlaps with the Welsh Government's Cymru'n Cofio: Wales Remembers 1914–1918 programme, which marks the centenary commemoration of the first world war in Wales. The contribution of women at the time to the war effort was paramount and part of the impetus in establishing the Representation of the People Act in 1918.

A number of other significant, related anniversaries will take place during 2018, providing the basis for a year of celebration. As well as today’s anniversary, Members may want to note some other key dates this year: 30 April marks the sixtieth anniversary of the Life Peerages Act 1958, which allowed women to sit in the House of Lords; 21 November will be the hundredth anniversary of the Parliament (Qualification of Women) Act 1918, allowing women to stand for election to the House of Commons; and, finally, 14 December 2018 is the hundredth anniversary of women voting for the first time, in the general election of December 1918. These and other notable anniversaries will make this truly a year of celebration. In addition, International Women’s Day on 8 March will be closely linked to the centenary, as well as to the very appropriate international theme of 'press for progress'.

The Welsh Government has committed nearly £300,000 to mark the centenary of women’s suffrage with a range of activities focused around the themes of 'celebrate, educate and participate'. I would like to set out our plans and I will provide Members with a link to a website where further details of these and other activities across the UK can be found.

The Welsh Government has sponsored Women’s Equality Network Wales to deliver a project to celebrate the top 100 Welsh women. The list will span education, science, sport, the arts, business and politics and will cover both historical and contemporary women. Welsh women are almost invisible in our history and this positive campaign aims to change that. In the autumn, the public will be able to vote to choose the Welsh women who they believe have been most inspirational. Two statues will be commissioned as a result of this project. We hope this will lead to more statues and other permanent memorials of real women throughout Wales. We will encourage community involvement to facilitate this. 

We will also fund the commissioning of purple plaques for as many of the original 100 nominees as possible. On International Women’s Day last year, I was proud to be part of the Assembly Labour women's group, which launched the purple plaque campaign. Our aim is to give remarkable Welsh women the recognition they deserve by installing a purple plaque at their former home or workplace. There are currently 216 blue plaques in Wales commemorating notable figures and historic events and organisations, and just 11 of those are for women. Purple plaques were chosen to reflect the suffragette movement and I believe it's time we recognised the impact women have had on our cultural, political and scientific life here in Wales. 

Today, I'm also launching a one-off grant scheme for third sector and community organisations to undertake innovative activity relating to the three key themes of 'celebrate, educate and participate' to mark the centenary. The scheme will enable local communities to get involved with the centenary celebrations, highlighting local contributions from around Wales to mark the history of women’s suffrage. I’d also like to encourage activity that celebrates and encourages women from other under-represented groups, including BAME women, disabled women and LGBT+ women. I want to emphasise the importance of empowering women from these communities, who may face higher levels of discrimination and lower levels of opportunity. Applications for grants of between £500 and £20,000 will be invited. We have more information about the grant scheme and the application process on the Welsh Government website, and I'll be supplying Members with the link. 

More will be happening throughout the year, including our participation in activities being organised across the UK. For example, a suffrage banner relay is being organised with all the devolved administrations. The banner will be coming to Wales in May and we will be arranging a programme of events around that. I encourage Members to support both the national programme and local events in your own constituencies as the year goes on.

The centenary and the activities related to it will look forwards as well as back. Our aim in highlighting notable Welsh women both past and present is to raise awareness of their achievements and provide lasting memorials for a significant number of them, telling their stories in the context of their local communities. They provide powerful role models for the women and girls of today, for whom there are different challenges, as well as new opportunities.

It is right to celebrate the progress we have made in the past 100 years. It's also right to remember the struggle and sacrifice that has been the price of this progress. We need to maintain our momentum to strengthen democracy further, increase the number of women in decision-making roles, and continue to challenge inequality and unfair discrimination. Diolch.

Could I thank the leader of the house for her statement, please? There's a lot in that to welcome and to celebrate. But I think it is worth mentioning that, while we're celebrating this, we are actually marking a milestone rather than the end of the journey. It took another 10 years for the Baldwin Government to introduce equal suffrage, after all, but we've got a long way to go, I think, on equal participation. 

The arrival of Nancy Astor—I've got to mention her—in Parliament was of course one of those milestones, and Conservatives have been happy that some of our women representatives have been amongst the first to achieve high office: our two Prime Ministers—I think everybody knows about them, but, of course, they were no strangers to prejudice on their journey—but we've also got people like Betty Harvie Anderson, who was the first woman Deputy Speaker, Janet Young, who was the first Leader of the House who was a woman, Cheryl Gillan, the first woman Secretary of State for Wales, Liz Truss, first woman Lord Chancellor, and, of course, Nusrat Ghani—I'm sure all of us will welcome this—the first woman Muslim Minister to speak at the despatch box in Westminster. They're all role models to women of all political persuasions, just as women of other political persuasions have been a role model to me.

Now, we're all doing better at getting women to stand at all levels here in Wales, and while perhaps getting our first Welsh Conservative woman MP may not be your priority, leader of the house—it'll be a great purple plaque when it happens—I'm sure we do share this aim, which is that universal suffrage doesn't mean as much as it should unless we move towards more universal interest in politics, and this is what my questions are about.

We need more women taking an interest and then believing it's worthwhile voting in the first place, but then of course standing and reflecting back to communities that politics is a serious purpose and it needs an active and diverse—and you referred to the diversity plans in your statement—citizenry to participate and help prioritise what we should be voting about in the first place. So, alongside the action on barriers that we often discuss—caring responsibilities, poverty and so on—I think we need to work on societal attitude and placing greater value on the strengths and interests still primarily associated with women, but which benefit us all. In acknowledging the money made by all Governments in the UK today, especially Welsh Government, could I ask you, in working through the three themes that you mentioned, whether Welsh Government will be offering active support to the Ask Her to Stand cross-party campaign? Because there's plenty of research, I think, now to show that, in the workplace and in candidate applications across party, men are more willing than women to put themselves forward for consideration when they don't fulfil all elements of a job spec or even a candidacy requirement. Occasionally, maybe all you need is someone just to plant that seed and to ask. So, will you be restricting the support you're offering to Wales-only projects, or are you happy for that money to be used for leverage for cross-border projects, or even cross-country projects, really, because what we're celebrating today here is being watched elsewhere?

Will you also be looking to support work that supports that societal change of attitude about what constitutes a strength in our politicians? RECLAIM in my region, for example, has been doing some wonderful work with year 7 and 8 girls—they're not even teenagers—about confidence and leadership; David Rees will know about them as well. Because I would say that a more diverse political class with a range of strengths will give life to new ideas, and I hope that you will be able to help support the removal of intimidation and aggression that's corrupting public discourse at the moment—political discourse—and there is quite a lot of work out there starting. 

And then, finally, women's suffrage, of course, is not universal. There's one canton in Switzerland that didn't allow women to vote in local elections until 1991—1991—but that's actually not—. [Interruption.] I'm talking about countries where having the vote is not the same as having power to make a real difference to women's lives. Just a few examples here, if you will permit me, Llywydd: so, we've got Iraq, a constitution that states that a quarter of parliamentary seats and Government positions must go to women, but as of 2015 had no domestic violence laws. Malaysia: you've got YouGov research finding that the majority of people in that country agree that it is still likely to cause problems if a woman earns more money than her husband. Algeria: 32 per cent of the seats are held by women in national Parliaments, but the same study that reaffirmed that reported that Algeria is still more likely to say it's unattractive for women to express strong opinions in public. 

I just want to be sure that, as we work to encourage more people in Wales to take part in democracy, participate in it, particularly women, obviously we need to make sure we don't allow claims of women's suffrage to disguise the problems that sometimes it should be helping to solve. Thank you.  

I completely agree with everything the Member has said, which I don't often do across the party, but in this instance I do completely agree. We don't have any preconceived ideas, really, of what we're expecting to come forward, and any project that comes forward and asks for support will be looked at on its merits and sustainability and so on. And it's not just about—. It is the three aims of this, so it is the 'celebrate, educate, participate' bits. And the participation, I hope I made clear, is not just political participation; it's participation in all walks of life across everything in our country and beyond. 

I completely agree with the Member around all of the things about encouraging people to come forward and giving them support around some of the things that happen in public life, particularly to women, and this whole issue around how people look and so on being more important than what you say or what your intellectual ability is, or whatever, is a matter dear to my heart. 

We've also been, today, celebrating, actually, Internet Safety Day, for example, and there's a huge issue with social media around getting young women to stand and some of the abuse that many women in public life have to face. So, it's very important that, as part of this celebration, we actually set forward—and I think I said right at the end of my statement—some of the difficulties that today's women face that perhaps they didn't face in the past that we also need to support them to do. 

So, I completely agree with everything you said. We do want to support as many women to come forward into these roles from as diverse a range of backgrounds and positions as possible, because the whole point of this is to get equality across the piece, and you can't do that unless you have the whole range. But I do think that the thing I would like to emphasise very much is this: what we actually want are people to believe that they can do it, and in order to do that you have to have appropriate role models for your own particular sets of beliefs, for your own communities, for your own—. You have to be able to recognise yourself in what you aim to be, so it's very important that we do get that cross-bench support, if you like, for this going forward.  

Thank you very much for the statement, and I too am very pleased to mark today as an important day on the journey towards equality for women. The journey continues. It continues in trying to arrive at full equality in all aspects of life. It's a journey that’s seen loss of life, and it continues to be a long and tiring journey. But I do believe that my generation of women is determined to give all support to the young female voices that are increasingly angry about the way that they’re treated in modern Wales. This makes us as determined as ever to prioritise the need to achieve full gender equality, determined to take urgent action, and the need to place gender equality at the heart of the political agenda here in Wales.

To turn to some specific issues in your statement, you mentioned a project to celebrate 100 prominent women in Wales in all aspects of public life. What exactly will the criteria be in compiling this list? And then what will the criteria be when commissioning the two statues? Will they depend entirely on who is most popular with the public in Wales or will there be other considerations as well? I'm slightly concerned that if popularity alone is going to be at the heart of this, that might cause some concerns. Then you talked about having two statues located in two different areas of Wales. I take it that those will be geographically separate areas and that the north and the north-west, for once, will be included in that.

Turning to your grant scheme, I'm slightly concerned that there's a very tight timescale for applications for this grant pot, and it's not clear whether these grants can be used to eradicate some of the barriers facing women today. As well as remembering the past, we obviously still need to move things forward as well. As you know, getting more women to participate in public life in Wales at the level where important decisions are made is something that some of us here continue to campaign for.

If we look at local government, we see that we are at a standstill, almost. There was almost no increase in the number of women elected in 2016, as compared to the previous election, and 28 per cent of councillors are women. It will take 82 years to achieve gender equality in councils in Wales at the present rate, and we can't wait that long. I believe, and I believe that you agree, that we must use a specific mechanism for this. Evidence worldwide shows that quotas are an effective way of getting more women into positions of influence. I know that I'm wandering into a debate that is going to happen tomorrow, but I do believe that we need to look seriously at this now. Eighty per cent of nations that have more than 30 per cent of women in Government use a quota of some kind, so clearly it does work.

But, of course, quotas alone won't change the culture that's been dominated by men's needs for so long. Quotas won't eradicate sexual harassment, they won't get rid of daily belittlement and bullying on the basis of gender, they won't stop women from having to juggle caring duties and work, and they won't close the gender pay gap, and nor will they prevent domestic abuse and power-based violence. But quotas can lead to the structural changes needed in Wales to take us closer to equality.

So, to come to a question, will the grants that you've announced today be able to be used to promote the cultural and structural change needed in Wales, so that we use this initial victory that we celebrate today by the suffragettes 100 years ago—so we use that victory deliberately for achieving full equality in modern Wales, so that it genuinely accelerates this process? So, can these grants be used for that purpose?

Yes. The short answer to that is, 'Yes, they can.' We've got the three themes; so as long as you fit into the three themes, the grant will be applicable, and it's very plain that promoting change in order to encourage all three of the themes is a very simple thing to do. So, absolutely, and I would expect to be using the grant money. We've put a range of available moneys in because we want to encourage very small local schemes as well as the bigger schemes, hence the wide range of grant aid available, for exactly that reason—so we can encourage hyperlocal things that might make a difference locally to the ability to change a particular thing that might be seen as a barrier or to celebrate something or whatever, and indeed you might have a much bigger scheme to look at perhaps a nationwide effort to pick up particular barriers and changes. I spoke a little bit in the statement about trying to encourage a wide range of women to come forward as well to celebrate the diversity of women in Welsh life, and it's very important to us that we do encourage that, because we know that women who also have other characteristics, protected characteristics, face even more of a barrier than many of us who don't have some of those characteristics.

On the quota thing, I'm having long discussions with my colleague the Cabinet Secretary for public services about some of the things we might be promoting in local councils. I have no problem with quotas myself; I'm not in a position to commit the Government to it at the moment, but it's certainly an ongoing and active discussion that we're having in the Government and, indeed, I'd encourage us to have it across the Chamber as well about the various mechanisms that are available. I concur with the very many women who've been saying all over the UK today that we celebrate the 100 years, but that progress has been too slow, and that I'm not prepared for my daughters and granddaughters to be having this conversation in another 50 or 100 years. And so, we do need to find a way to accelerate this change, to celebrate the successes and the sacrifices of the past, but also to make sure that we don't need to be having a similar conversation again in 100 years.

Can I just also very much welcome the statement by the leader of the house on the centenary of women's suffrage? We do, as you say, leader of the house, celebrate today the Representation of the People Act passed on 6 February 1918. It gave women the right to vote whilst also noting that women had to be over 30, and they, or their husband, had to meet a property qualification in order to vote. So, it was very much partial suffrage. But, also, in 1918, an Act was passed allowing women to stand for electoral office.

So, will you join me in welcoming the Barry and District News feature this week on Barry's first female politician, Councillor Beatrice Alice Lewis? Beatrice Alice Lewis was born in Ely, Cardiff, and was married to a coal trimmer in Barry. She topped the ballot in the 1919 local elections for the Castleland ward in Barry. She served for nine years and was noted for her campaign for a Barry maternity clinic. Will you also welcome the women's right to vote exhibition that's staged in Vale of Glamorgan libraries by the Vale Labour women's forum? That features Dame Dorothy Rees, the first female MP to represent Barry.

I think the statements that have been made by colleagues across the Chamber are important today: Suzy Davies talking about meaningful suffrage, the lack of suffrage, and the exclusion of women in many parts of the world, and also Siân Gwenllian who spoke about recognising the initial victory, which we celebrate today, 100 years on, but recognising that we have to achieve full equality in modern Wales, particularly for young women. This is a time when we must recognise what we have in common. There's more that unites us than divides us on these issues.

So, do you agree that we have a responsibility to encourage women to stand for local government, the Assembly and Westminster, and do you welcome the Chwarae Teg women's LeadHerShip campaign? I'm sure many of you will know about the LeadHerShip campaign at Chwarae Teg because it's enabling women to shadow Assembly Members—and I think many of you have agreed to sign up to this, men and women—to encourage greater political participation given the unacceptably low level of representation, particularly of women in local government. Indeed, only 20 per cent of councillors and MPs are women, but, of course, we do have an opportunity to seek gender equality in this Assembly. We've seen how fragile it is when we did have that equality in 2003: 50 per cent down to 42 per cent. We've got to make that gender parity stick. So, will you welcome the Chwarae Teg LeadHerShip campaign, and also, again, confirm that you are announcing today this all-important Welsh Government's women's suffrage centenary grant, and that we want all those organisations to engage with it locally and nationally?

Indeed. I'm very happy to welcome all of the contributions that Jane Hutt has highlighted, particularly in Barry and the Vale; they're excellent. There are a number, of course, right across Wales, of excellent exhibitions of this sort. The grant scheme I'm announcing today is, indeed, to assist people to continue those exhibitions into the future or to develop them in any way that they see fit. I should have answered in response to Siân Gwenllian, but I'll say it now: we are not looking at a short timescale to come back. We're imagining that a lot of these schemes will be towards the end of the year when some of the other centenaries are coming forward. The centenary, for example, of the first actual vote is in December, and so on. So, this is a whole year of celebration. There are some UK schemes that are active at the moment and we're encouraging them to go forward. So, I'm not looking for a short period of time; we'll be giving people a reasonable length of time to get the grants together and some assistance in doing so.

This is about addressing a large number of the issues that have just been raised around making sure that the contribution of women is recognised and the role models are recognised, with all of the schemes that are there to encourage young women in particular to come forward and be seen in public life. It's not just as an elected politician, it's to be seen in public life. So, the councillors are very important, but actually, it's very important to be seen to be on public boards and prominent on the boards of charities and all the rest of it, so that women take their proper place in public life. We know that once we get that representation to start, then things such as the maternity hospital and so on suddenly accelerate up the agenda, and rightly so. That's part of what it's about; it's to make better decision-making processes come about and to have less restrictive employment practices and more supportive arrangements in place not just for women, but for many people with other protected characteristics that are so important to get diversity in public life into the prominence that it ought to have in Wales.

Thank you for your statement, leader of the house. One hundred years ago today, the right that so many women had fought and sacrificed so much for became law; women finally got the right to vote after so many years of struggle. That women won the right to vote is testament to the hard work and sacrifice of the suffragettes and their allies, both inside and outside Parliament. When those 8.5 million women voted in the general election of December 1918, they exercised the right to decide who would govern the country and them. My great-grandmother's vote and those of her generation could decide who would govern future trade policy, agricultural and fishery policy, economic policy, competition laws, company laws and every other area of governance. That is what the suffragettes fought for. But little more than 50 years after women voted in this country for the very first time, our Government started diluting our vote and giving it away, piece by piece, along with the governance of our country, to unelected bureaucrats.

The vote exercised by my generation of women is now subject to qualifications. It affects only those laws and policies that aren't decided by the European Union. We can change the person who decides how our NHS provide services, but not whether VAT is charged on tampons. No-one asked women of my generation whether it was what we wanted. I'm sure there will be a lot of Members speaking in glowing terms of the glorious step forward taken 100 years ago today, which, of course, it was. Schoolchildren are often surprised when they learn that women did not always have the vote. They cannot fathom why anyone would ever think it acceptable for decision making to be the preserve of the select few. But in this place, and in Westminster, we have politicians who are happy for our hard-won voting rights to be ignored so that decisions can be made by unelected, unreachable, untouchable bureaucrats. [Interruption.]

So, while, of course, I'm celebrating the 100 years of women having the vote, I'm also celebrating the wonderful Brexit vote where Welsh women and men voted to regain the power of their vote. If we don't want to allow the fight, the injuries, deaths and other immense sacrifices the suffrage movement made for us to go to waste, and if we don't want women, and men too, to lose the power of their vote, you must ensure a proper Brexit and the full repatriation of our governance. Regaining the power of our vote is a continuation of the suffragette struggle 100 years ago. So, my one big question is this—[Interruption.] You knew I'd get to it. Putting up plaques, celebrating notable women and giving grants is all well and good, but how are you going to re-empower women in Wales? And how are you going to ensure in the future that their vote will mean as much post Brexit as it did 100 years ago? Thank you.

Well, I'm afraid I couldn't disagree with the Member more about almost everything she said, which is a shame, as part of this. I personally exercised my vote in the European elections and many of the women in my family did so as well. It was always open to people to exercise their vote in the democratic elections for the Members of the European Parliament, and, indeed, we have a previous Member of the European Parliament as part of the Labour benches in this Assembly. So, I disagree entirely with what Michelle Brown said, but I will make a couple of other remarks. No relative of mine voted in the general election in December 1918 because they were working class and owned nothing. So, actually, the celebration of universal suffrage is the one that I would be looking forward to. I'm also looking forward to taking forward the debate about votes at 16, so that we lower the voting age so that everybody in this country who is eligible to pay taxes has proper representation in the places that represent them.

We had the Brexit vote, and of course the Government will honour it, but what we didn't do is have a vote about the terms of that Brexit. We've had that debate elsewhere, we don't need to have it now. But the three themes of the centenary celebration are very important here. The educate one is very important. It is very important indeed that people thoroughly understand all of the circumstances of their democracy so that they continue to make the right decision when they exercise their vote responsibly.

Can I thank the leader of the house for her statement, which, I was pleased to note, acknowledges the sacrifices of those who went before us and those who spoke up for women's right to vote, and, indeed, women's right to stand for election? In the case of the Merthyr Tydfil and Rhymney constituency, it's a matter of pride to me that such support came from Keir Hardie, who was their MP at the time. In 1905, Keir Hardie wrote a plea for women's suffrage, about attitudes to the franchise, and he said, 

'We do not now speak of women as being in the same category as "idiots" and "lunatics," but for political purposes we treat them as if they were.'

So, it's perhaps a matter of reflection that, since Keir Hardie spoke of his support for women's votes, it wasn't until I was elected in May 2016—over 100 years later—that his constituency finally had a woman representative, either in Parliament or in the National Assembly for Wales. So, I'm also delighted to be involved with the Chwarae Teg LeadHerShip campaign, which is going to help to encourage women into politics, and if I can play some small part in encouraging that, I'm happy to do so.

But I'm sure, leader of the house, that you'll agree with me that the impact of the Labour Party policy on all-women shortlists has seen Labour as the party that has delivered more women representatives, in both Westminster and here in Cardiff Bay, than any other party put together. And that is a very proud achievement, but one that demonstrates the need for us to be proactive in our support for equality of representation.

Now, I've spoken briefly about the support that came from Keir Hardie, but I do want to mention briefly as well the support for women's suffrage that came from other quarters in Merthyr Tydfil, and you may be aware of the Crawshay family who were renowned as ironmasters, but it's also true that Rose Mary Crawshay, who was the wife of the last ironmaster, Robert Thompson Crawshay, was a staunch feminist of her time, and signed the first woman's suffrage petition in the nineteenth century. Indeed, such was her support that she was accused in the media of disturbing the peace and leading Welsh women astray. So, can I ask the leader of the house if she agrees with me that as the debate about further changes to our National Assembly unfolds, we should ensure that our democratic institutions give a real voice to the women of Wales? And would she further agree that, like Rose Mary Crawshay, we should continue to disturb the peace for as long as the fight for equality continues?

I'm extremely happy to agree with both of those sentiments—absolutely. One of the biggest compliments I was ever paid during my long career in the law was that I was a bloody mouthy woman—[Laughter.]—which I think I was going to have put as an epitaph on my grave, actually. So, I completely agree with that. As everybody in this Chamber will know—I've said it many times—I'm extremely proud that I, myself, was elected off an all-women shortlist. I was the first woman in my family to go to university and I'm extremely proud to be the first woman in my family who has achieved elected office, but I'm absolutely determined that the ladder I climbed will be available for all the young women in Wales to climb in my stead.

I will be taking part in the scheme from Chwarae Teg. There's also a mentoring scheme from the Women's Equality Network Wales that I want to mention, which I would encourage everybody to also take part in. It's really important to get the diverse range of Assembly Members to take part in those schemes so that everybody can have an opportunity to take part, and in this way, we can make sure that our voices continue to be heard. And in the words of Welsh Women's Aid, assuredly, still we rise.

I think today, whilst we look back, has to be an opportunity for us to pay tribute, not only to those women who delivered the vote, albeit restricted, 100 years ago, but for the struggles that went on and those women who delivered us here to the Assembly. I'm particularly thinking here that it was in 1918 that we had the vote, albeit limited, but it was 1999, 81 years later, that women took their rightful place to represent their constituencies in this Assembly, and that didn't happen by accident, those numbers. Those numbers came about by a vision and determination by Baroness Anita Gale—commonly known as 'Anita' to all of us, as she would say—the then general secretary of the Labour Party in Wales. And she seized on an opportunity, where there was an absolute blank sheet of people representing 40 constituencies and the regions, and she persuaded and cajoled people to support her vision, and that vision was to select 20 men and 20 women on behalf of the Labour Party to go forward and do their best. And I say she persuaded and cajoled; actually, there were—and there are many of us here who know—hugely heated and highly contested discussions that went on across Wales. And eventually, through those, we arrived at the trade unions and the membership to support that move. There are many of us here who still bear the scars as a consequence, but it was a good move, and it did deliver what we have now. Now, does that make a difference? Not by itself. It will never make a difference in and of itself.

So, again, we need to pay tribute to those women who came here very, very early on, and inserted protection for women within the legislative format that is Wales. We had, in the very first constitutional arrangement, an absolute duty to equality that was put in. We also had legislation—well, not legislation, because we wouldn't make it, but statements that we would look after women and girls fleeing domestic abuse and make sure that they were safe. So, it isn't simply about getting women into an institution. It's about getting the right women, with a vision, into this place. And I thank Anita, and I'm sure that you will also, for that. But on Friday, I took part in the Commonwealth Women Parliamentarians event in Jersey, and I went to speak to women and girls as part of a programme—a wide programme—that is to encourage women to stand for or take part in politics, at whatever level that might be. So, it is really being part of a wider movement, and I'm really pleased that we've got some money for areas like mine, rural areas and all areas of Wales, to actually think about what it is they need to do in their own communities. And I suppose my question on that is: how are those communities going to know that that money is available to them, because we want as many organisations to apply for it as is possible? Thank you.

Well, I'm more than happy to pay tribute to great Anita Gale. I don't know if it's a mystery to people on the other benches why we all started to smile when Joyce said 'persuasive' and 'influential', but we all remember Anita's persuasion and influence—in my case, fondly. In other cases, perhaps people might still be twitching a little. But it shows the power of somebody with a determined vision and the strength of character to pull it through. So, she was absolutely determined that we were going to have gender equality in our constituency representation for this place, and her determination shone through and won the day. That's the real message of Anita. Two things: have your vision, pursue it formidably—I think that's the right word—and actually, to this minute, persist in your struggle to make sure that the vision that you have for gender equality stays firmly on the agenda.

Joyce is right also to pay tribute to the many women who came to this place right at the beginning and set some of those standards, and I want to mention one as well, which is Val Feld, who everybody will know was extremely determined to get equality onto the agenda of this place, and I think we'll all agree that she did a very good job in that. But I also want to pay tribute to my colleague Jane Hutt, who is, of course, the longest-serving Minister in any administration in the UK, and was one of the original women here, and I think also herself played a very large role in making sure that this place treats equality with the seriousness that it deserves, and with the prominence that it deserves in our national policy making.

In terms of the availability of the grants, though, we will be making that available. I'll be making sure that every Assembly Member gets a letter explaining how it works. We will be writing out to all of the community organisations that we support already, but if any Assembly Members want us to do anything specific in their area or highlight it in a particular place, I'm more than happy to do that as well.

I realise now that I'm probably speaker No. 3 from the back benches, so I shall practice what I preach to you all and be very brief in just asking you a question.

Can I welcome the statement, leader of the house, and also today recognise that it was the brave women in 1908 who set the second suffragette branch up in Rhyl, who went forward and helped those women on their way? As many have noted, it's a partial franchise for women today, and we move on and we will all celebrate.

There are a number of things that you've mentioned, and there are a number of things that the Assembly are doing. Particularly the one I wanted to mention is the women's suffrage in Wales exhibition, which starts on 5 March and runs through to 18 March. It takes in International Women's Day, which this year the Assembly have dedicated over to the women's suffrage movement. I just wanted to say to you, or ask you, and ask the Government—part of the work stream that I'm concentrating on is women in public life, and a lot of what you've mentioned are things that I will be involved in, but can the Welsh Government and the Assembly Commission work very closely together so that we don't duplicate events, that we get the maximum window dressing, as I've heard it being said today—I don't care how many windows we dress in purple, white and green because I think that's what we need to celebrate—and that we move forward together, as an Assembly Commission, as a Welsh Government, as the people of Wales, the representation of Wales, to celebrate the work of women? I just wonder whether you will agree that that is the best way forward.

Of course I agree that that's the best way forward, and I look forward to working with the Commission, actually, to make sure that we get the celebrations sorted out for the year ahead, and that we get the maximum value out of both the Government grants and what the Assembly can do to highlight the good work that's been put forward together. I understand—and I hope this is right—that the Assembly Commission has agreed to be a Chwarae Teg FairPlay Employer, so I look forward to hearing about that, and to encouraging the Welsh Government to join in with that scheme as well.

Women demanded the vote as much in the interests of men as of women. They wanted it for the good of the whole community, so said my great-aunt, Eleanor Rathbone, who was the ninth woman elected to the UK Parliament. She firmly believed that it was entirely necessary to take the whole community with her, which is why she spoke at hundreds of public meetings across north Wales, Liverpool, Cheshire and Lancashire. Because we have to remember that people in those days, ordinary people, couldn't afford to buy a newspaper, and they certainly couldn't afford to buy a radio, so how else were they going to get information about the importance of the fight for the suffrage of all women and all men, because most men were also excluded at that point? We have to remember that in 1918, only 17 women managed to become candidates in the general election, and only one of them was elected, Countess Markievicz—and because she was a Sinn Feiner, she never took her seat. So, it took an awful lot more struggle to ensure that women really became part of the political fabric.

Indeed, Eleanor's view, having spent 40 years campaigning for family allowances, based on her observation of how women and children were treated during the first world war—when their men all went off to war, they were all left destitute. She spent the rest of the war dishing out welfare to all these families as the only woman on Liverpool City Council. That really did focus her mind on the importance of the role of the family as the producer and reproducer of the future labour force. She firmly believed that family allowances had to be society's contribution to all children, because whether we have children or not, it is everybody's duty to support the well-being of children. The family allowance became child benefit under Barbara Castle, but now it is being seen as withering on the vine. Child benefit has reduced in value since 2010—by 20 per cent since the Conservative Government came in. As well as that, we've got in-work benefits also being reduced at less than the rate of inflation, and children are suffering the brunt of this austerity campaign. We need to remind ourselves that it is children and their well-being that have to be at the forefront of our minds in ensuring the well-being of our whole community. So, we won a battle, but we certainly haven't won the war.

Well, absolutely. We won the battle, and the war is by no means over, and there are a number of fronts on which that war—if that's the word that you want to use—needs to be conducted. There are some interesting things about the suffrage, as it was first instituted. If all women had been allowed to vote at 18 just after the first world war, there would have been far more of them than there were men, of course, because of the tragedy of the great war. One can't help but feel that the policy makers, who might have been all men, might have had that in mind when they considered the suffrage. It's a really good example of why you need a diverse range of decision makers to take all of these things into account when you are going forward. So, you are absolutely right, and you are absolutely right to highlight the fact that there are campaigns that affect the whole of society that women tend to bring forward because they are the carriers of the burden, quite often. As society changes, we hope that we will not be able to say that in the future. But, as we speak, it is still the case that the majority of women carry the burden of the family alongside them in public life.

So, part of this campaign will be about gender equality. I started a campaign called 'THIS IS ME' last Monday in Gower College, about making sure that everybody can be the person that they want to be, regardless of their gender or their sexuality or their race or their creed or disability or any other characteristic. Until we accept that human beings are human beings, and that they should be able to be the best person they can be and make the best contribution that they can make, we will still have this struggle. So, it is very much, Llywydd—it's a good place to end this debate—it is very much the case that what we are actually talking about with gender equality is the right of every individual human being to be the best person they can be and to make the best of their own selves and take their rightful place in the world, whatever that rightful place is—in public life, in private life, in economic life, in cultural life, in every other aspect of our society. Only when we've achieved that will we have achieved equality.

I thank the leader of the house.

The next item, therefore, is a statement by the Cabinet Secretary for Health and Social Services on how digital technology is improving primary care. I call on the Cabinet Secretary to make the statement—Vaughan Gething.

Thank you, Presiding Officer. The way that we deliver primary care services is, of course, changing. Digital technology is transforming the way that citizens access their local healthcare. Greater use of digital technology is a key aspect of our vision to deliver the right care, at the right time, and in the right place, as close to home as possible.

One of the ways that we are achieving this is through the introduction of the Welsh patient referral service system. This service has been in place since 2015, so GPs can now send referrals to secondary care electronically, enabling the referral to be processed in under an hour. This is in contrast to the days or weeks that it takes for paper-based processed referrals, meaning that patients receive faster specialist care. GPs are using this digital technology to ensure that nearly 20,000 referrals are prioritised every month. The service also enables the consultant to request additional information from the GP referrer. In the future,  this will be further developed to allow dialogue to take place, empowering GPs to manage their cases locally and, of course, to avoid unnecessary referrals.

Of course, the local healthcare team is more than our hardworking GPs. For example, community pharmacists play a vital role in meeting people’s needs locally. The Welsh Government has, of course, invested substantially in the Choose Pharmacy IT platform to support community pharmacists to deliver services that would traditionally be accessed through GPs. This avoids the need for patients to wait for a GP appointment, and it includes the common ailment service, the seasonal flu vaccination and the discharge medicines review service. Working digitally allows community pharmacists to access a patient’s GP summary record, including information on allergies, and ensuring that medications are prescribed safely and appropriately. Since this service started in September 2013, our community pharmacists have undertaken over 22,000 common ailments consultations and have delivered 30,000 flu vaccinations in this season alone.

The Choose Pharmacy platform also supports the electronic transfer of hospital discharge information to ensure that relevant information about an individual’s medication is shared appropriately between primary and secondary care, and I expect us to do more on making the very best use of the Choose Pharmacy platform. This, combined with access to the patient’s summary record, ensures that community pharmacists can provide their service with the full knowledge of an individual’s medication regime, to ensure that that patient receives the correct medication and to help them to understand their medication regime—not simply using a pharmacy to dispense a volume of medication, but to actually improve the quality of the care and that ease of access.

And digital technology is also improving how we deliver community care. The Welsh community care information system that you may have heard referred to as WCCIS in visits around the country or locality has been live since April 2016. And that’s driving joint working between NHS Wales organisations and our local authorities. It’s an excellent example of that joint working. It supports the safe sharing of information between health and social care with a system that is helping to deliver improved care and support for people across Wales. This is being achieved by allowing health and care staff, including community nurses, mental health teams, social workers and therapists to use a single system, to have access to a shared electronic record of care for the patient. And, for the patient, that should ensure that the health and care system is more joined up. It will avoid them having to repeat information, and it will give them confidence that the professionals they meet will understand their treatment and care needs.

Nine local authorities in Wales are currently live with the Welsh community care information system, along with Powys Teaching Local Health Board. A number of our early implementer local authorities include front-line health professionals who work within locally integrated care teams To support this, the provision of mobile devices for community nurses across Wales is being funded through the integrated care fund.

While there is clear evidence of the growing use of digital technology to provide care locally, it is still not yet at the scale that I would expect. So, it’s important that people are able to find up-to-date, trusted information and advice and assistance on the right care at the right place, and at the right time, and a proposed online platform for health and well-being, and the development of the integrated directory of services for health, social services and the third sector, will enable individual citizens to easily find this information online in a single place. And that directory of services has already been developed and used to support the 111 service where it’s already been rolled out in Wales.

The use of point-of-care testing, where diagnostic testing is undertaken outside a laboratory, will increase, and that will mean that more testing will be carried out close to, or within, a patient’s home. We're funding two studies that include provision of specialist devices to 100 GP practices and recruitment of patients to undertake self-testing and management at home. 

I've already explained some of the benefits that digital technology is bringing to the GP referral process. In this next year, from April onwards, the Welsh Government aims to introduce a similar electronic referral system within both dentistry and optometry. Ultimately, this should enable more people to be treated and cared for locally. That should reduce demand in secondary care and provide a better experience for the person themselves.

But we shouldn’t underestimate the challenges that we face in achieving our digital vision for local healthcare. We need to ensure the workforce has the skills and capability to use digital technology successfully. The way in which local healthcare and support is delivered is changing, and communication with the public is critical to this. The NHS and social care across Wales already gather a wide range of data and information. The more digitally we work, the more essential it becomes to use that data to improve the public’s participation in, and experience of, health and care services. This is why, last October, I set out plans to develop a clear policy framework to support effective, efficient and safe sharing and use of health and care data. Alongside this, we need to have a national conversation with the public to ensure that they better understand the way we use and share data, and explain how we protect and use that data responsibly to enhance and improve their own experience of care and treatment.

Effective engagement, of course, with our health and care professionals is essential to this. We need to create an environment where they're given time to inform and champion future developments. Our plans to exploit the potential of digital technology to improve care with local health and care professionals routinely communicating with specialists to diagnose, treat and care for people at or close to home are wide-ranging and ambitious. But, as the parliamentary review recognised, we have more to do, and more gain to be made. Greater and better use of digital technology is an essential part of the future of our health and care system, and I look forward to reporting on further progress to be made.

Can I thank the Cabinet Secretary for bringing the statement forward today? I think that repeating information is the bane of a patient's life and a common cause for complaint, and I do believe that digital technology, used in the right way, will certainly help to take our health service into the twenty-first century. I believe that more and more people want to take ownership of their own healthcare data, and I was very pleased, Cabinet Secretary, to read in your statement of the success of the Welsh patient referral system to help GPs. However, you also refer in your statement—you make the comment that,

'there is clear evidence of the growing use of digital to provide care locally, it is not yet at the scale I expect'.

Could you please go into more detail as to what you expect, what the hold-ups are, what hasn't happened and what the lessons are that have been learnt so far in the progression of that?

I note with interest the desire to roll a similar referral scheme out to dentistry and optometry, and I look forward to seeing how that works. I would like to understand what controls might be in place to ensure that health boards across Wales are training their staff appropriately and well, because the weakest link in a data trail is actually, indeed, literally the weakest link, and can cause that data to be corrupted, to be inadvertently misused, and we need to make sure people understand the responsibility that they have towards ensuring patient data is absolutely correct. Could you please perhaps give us an overview about how you're going to protect all of this data that we are collecting, and ensure that there is adequate data protection?

I do note that the parliamentary review flagged this up as being incredibly important, and I do think it will make healthcare provision far more efficient, and we will no longer, perhaps, as Assembly Members, have to listen to patients who have written to us with stories of turning up to see a consultant after waiting for x months only to find that their notes haven't followed through, or the x-rays haven't followed through, or the blood test results haven't followed through, because it's such a colossal waste of their time and the NHS's time.

I would like to understand how radical you intend to be, Cabinet Secretary. I have floated before the idea of patients being in control of their data. I would like to see every patient in Wales have a credit card with all their NHS data on it. As somebody who inadvertently, for a gruesome 18 months, became an NHS frequent flyer, I can tell you that it would absolutely have helped me to have been able to access my data, understand what the issues were, understand what had happened, understand what hadn't happened, and, more importantly, be able to take that data to all the other people who were involved in the care that I so excellently received from the NHS. How are you going to make sure that people are empowered so they no longer have to write in and ask for their NHS information and that we understand that it's their information and they have that absolute right to it?

Finally, I'd like to just touch on how bold you intend to be in terms of the true digitisation of the NHS. If you look to Europe, many European countries—Germany and France, for example—do not have a paper trail in their hospitals. Everything just goes straight onto laptops, into tablets, and, of course, the great advantage of that is that, when somebody picks it up to put somebody's observations in, they can immediately see if that patient's supposed to have a particular medicine at a certain time, or needs key information.

I will just end, if I may, Deputy Presiding Officer, with a rather vaguely amusing, although perhaps not quite so amusing at the time, story of when I was lying there in hospital, and this rather important doctor came bustling in on a Sunday to do the ward round, and he picked up my admittedly not inconsiderable file that was sitting at the end of my bed and rattled through it, and then he said, 'Oh, Mrs Burns, so how did the operation go?', to which I replied, 'I haven't had an operation; I'm in here recovering from sepsis.' You know, it was just a game: 'Let's look at it', no real use of it. Let's make this data really useful and make sure that mistakes aren't made, that information gets to the right place at the right time, and I would support you, Cabinet Secretary, in being as ambitious as you possibly can be to make sure that we use this as a way of making our NHS and our social care system as effective as it possibly can be. 

Thank you. I broadly agree with where you want to be, in that I don't think  there's going to be much party difference on where we want to get to in terms of a vision of having a genuinely electronic patient record and having proper access between different parts of healthcare, because within primary care, which this statement is largely focused on, you have GPs, you have a range of community staff, you have the community pharmacy sector, you have optometry and dentistry, you have a range of areas where we all recognise that services are provided, and wanting to make sure that we reduce the room for error, which is one of the points you made, which a patient-based record always has and for loss, but also that should be seen as an opportunity to improve treatment and care as well. 

So, I'm interested in the Wales Audit Office report, which I'm sure we'll hear more of later—I'm looking at my colleague the Member for Llanelli. They recognise that there's a vision that they think is clear about having access to that record and having it available and having access to it consistently, but we haven't moved as quickly as we want to. Some of it has been about some of our challenges in actually getting different partners to point in the same direction at the same place in time, so it's about some of our staff groups and it's also about some of our organisational barriers as well. That's when I talk about not having moved at the pace that I want to see. I would have wanted us to have been in a position where the sharing of the record has made greater pace and progress than it has done to date. I'd want it to be where people are already able to access their own information more readily—one of the points you made several times in your comments. 

There is something about that there are some people who want to take greater ownership of their own health information, and that would help them to make further improvements in managing and sustaining their own healthcare. That's also why the investment, we're not just making it in the IT platform in pharmacies, but actually it's about the advice that should be given. Actually, we're paying for the quality of care that is provided in the pharmacy, and it's not simply about dispensing. It should also mean, actually, that we're able to process people more quickly through our system. So, part of the challenge we have in a hospital discharge service is whether people are waiting in a pharmacy there, when they could actually be seen, with electronic transfer, to actually go to their own pharmacy or to have that medication delivered to someone's home as well. So, there is lots of gain to be made, and a number of examples of why I'd want us to move more quickly than we have done. 

And, interestingly, when you think about your challenge about, 'What do you want to do more quickly?', optometry is a really good example. We need to have agreement on a system to use and to make sure that we have a once-for-Wales system, so that we don't have different health boards, as has happened in the past, having different products that clinicians are used to using, and then when you try to have a consistent system across our national health service, let alone to a join-on with social care, you have different systems that aren't necessarily compatible with each other, and you've got to transfer people to move onto a different system. That's taken time, energy and effort, and I wish it had not done. 

Interestingly my colleague Julie James is now in the room, because we do have a national informatics board that meets, and thinking about the way we have a more consistent approach across Government. So, Julie James will now be spending some of her time with that informatics board to try and make sure there's a consistent digital vision, and that health and care are very much part of that.

And, you know, your point about record provision across our system, it isn't just about the GP record; it's actually things like images as well. We've actually done quite a lot in eye care where you can actually transfer records from high street optometrists to the hospital sector as well, and that's a good example of where you can improve care as well. So, really good examples, but the consistency, the pace and the scale are not where we need them to be, but we have made real progress. The next stage is to do much more, because otherwise we won't meet the challenge the parliamentary review sets us on really realising the potential of digital for all the health gain that has yet to be made, and the way that, frankly, citizens are already used to living their lives.

I think you're entirely right, Cabinet Secretary—there should be very little difference between anyone in this Chamber in terms of our aspiration to move towards a position where our health service is entirely digital, where systems work together for the benefit of patients. And yet, in the context of Brexit, people’s willingness to turn the clock back does make one think that some people might prefer to go back to doctors keeping their records on slate, but I hope that it would be a minority who would be of that view.

You’ve taken us through a number of elements of the technology that is being and has been introduced into our health service—the Welsh patient referral service system. It’s very important that we get this right, and the telecommunications platform for Choose Pharmacy is also extremely important. You say that digital technology is transforming the way in which people access healthcare, and certainly it should be. My concern is that we are still failing to make ground in some of the most crucial areas.

We’ve recently had an informal discussion on a digital system that should assist nurses in carrying out their duties on wards, and some delays in the system and in ensuring that that is being rolled out across Wales. In the context of pharmacy, I very often discuss the frustration of pharmacists that there isn’t a read-write system in place that allows real communication between pharmacists and GPs, so that the primary care system truly can work in a united way. There are still too many patients leaving hospital with a piece of paper scrunched up in their pocket that they’re supposed to pass on to their GP once they’ve left hospital, and they lose that paper and the systems break down. One would hope that we could move to far more stable streamlined systems within our health service.

I’d like to focus my questions, however, on one change that’s been announced by the Government within the past few days. This gives us a clear warning on the importance of getting things right in introducing systems that have a strong element of futureproofing, so that we avoid problems further on down the line. I’m talking about the decision, following a procurement process, to change the clinical system that is used by GP surgeries across Wales. A number of surgeries have contacted me, not so much expressing disappointment, but almost in a panic at the decision to take the EMIS Web contract, or rather not to allow EMIS Web to be the system that is used in primary care in future. This system has only been in place for three or four years. There has been substantial investment in introducing this system in surgeries across Wales, and now those surgeries are hearing that the system is to be scrapped, and that a new system will have to be put in place. Eighty-nine of the 118 surgeries that are affected in this case are in north Wales, so there’s a particularly acute issue in the part of Wales where I live. Surgeries have had to invest in hardware and software to work with EMIS Web. They’ve had to have new ECG machines, new blood monitoring machines for patients on warfarin, and other equipment so that they have equipment that interacts with the EMIS system. I will read to you what another surgery told me:

'Half of practices in Wales will be forced into changing their clinical system. Practices have not been consulted. Practices have not been given a reason. We're told that EMIS have failed to reach standards. What is apparent is that whoever made this decision has absolutely no idea of the upheaval this will cause practices who are already under pressure.'

Now, I am very concerned about the effect of this change. Can I ask, in the context of your statement today on the need to get digital right in primary care, what support Welsh Government will give to surgeries to get them through this change, including financial support? Because investment has been made in hardware to go along with a system that has only been introduced in the past three or four years. What does that tell you, Cabinet Secretary, about the need, as we roll out new digital right across the NHS, for getting it right and futureproofing because we can't operate in a way that is not strategic? It is costly and it means that we cannot get a system that works both for NHS staff and for patients.

Thank you for the comments and the substantial question at the end about the IT system in general practice. I recognise what you said about the nurse rostering and organisation system in Wrexham. I still maintain an interest in that and want to see that properly developed in the hospital service. I guess for the hospital discharge part, that's about the discharge between secondary care back into primary care. There is certainly more that we could and should do, and I will have more to say as we're looking for more pilot work to be done in that area.

But as the substantial questions were about what's happened with the IT system in general practice, and in particular with EMIS, who have not been successful in the recent tendering exercise, I am, as I said last week, still limited in what I can say. Today is the last day of a potential 10-day legal challenge period, so if that challenge is not made, then there's more that we can say, but I am restricted in what I can say. But I recognise the very practical nature of the challenge for those practices who have taken up EMIS as a system.

It was raised with me on my recent visit to north Wales when I met doctors at the Bethesda practice. They are an EMIS practice and they were talking about—they were concerned about the practical reality of having to migrate to a new system, even if, to be fair, they did recognise that we'd indicated there would be support provided through the NHS Wales Informatics Service for them. In meeting that group of doctors, I think they see that there's a long enough future in the profession for them that they would go through that. They don't particularly welcome the change, but part of my real concern and recognition is that, if you are within a few years of retiring in any event, then this is the sort of change where some people may seriously consider actually not coming back, or actually accelerating their plans to retire. I recognise there is a real risk of that, and that's something that has been raised both by the Royal College of General Practitioners and by the British Medical Association as well. They're practical things they want people to talk through to try and make the transition as easy as possible for their members, and I expect to be meeting—if I'm not meeting them directly, an official will be meeting with them in the near future to talk through where we are as we get through the period of challenge. It is worth highlighting again, though, that I expect there to be a robust process to try and deliver proper value for the public purse and the actual service that that then procures and provides, and the general practice committee of the BMA were engaged as part of the decision-making architecture around this and they supported the choice, even though they recognised it would cause real difficulty for their members. They still think it was the right choice to make.

In the coming days, as I said, once we get past today, I may well be in a position where I can say more and provide a fuller explanation, not just to yourself but to general practitioners themselves. I'm keen that we can do that so that people can see the context in which that choice has been made, and then to actually deal with the practical challenge that we are nevertheless left with, regardless of the propriety of the choice that has been made.

Cabinet Secretary, I've seen the future, and it works. Last night, I had my first online GP consultation. I downloaded an app. I subscribed for a service at £5 a month. I was able to get an appointment within an hour. I sent the GP my notes and some pictures. I had a very good consultation, and within minutes a prescription had been e-mailed to a chemist of my choice.

The pace of change outside the NHS is extraordinary, and as a Labour and Co-operative Assembly Member, I don't want to be using the private sector. But given the frustrations people have in accessing a GP, and given the ponderous pace of digital change within the NHS, there are revolutionary changes happening around us, and the NHS simply isn't keeping pace. The debate this afternoon has primarily been about back-of-office functions, record access, not about patient care, not about diagnostics, not about the potential in digital and artificial intelligence that revolutionised the way that people access healthcare services. And I really worry that the approach we have, the approach to procurement in particular—the rather bureaucratic, longwinded culture we have in the NHS in Wales, in particular—is really holding us back. The Public Accounts Committee has been hearing of the 10 years it's going to take for an IT system on hospital catering to appear after it was first recommended; seven years is a typical time lag. Given what we know of the changes in digital and AI, seven years is more than a lifetime. It simply isn't good enough.

So, I could ask you, Cabinet Secretary, you've had now very critical reports from the Wales Audit Office on the NHS Wales Informatics Service, and bear in mind Wales Audit Office reports are agreed reports, they're negotiated reports with the host bodies, they generally are fairly calm in their criticism—this report was very firm and damning. We've also had the parliamentary review, which gives chapter and verse on how change needs to happen, and I simply fear that our cultural approach up to now is no longer fit for purpose and we need some radical change rather than continuing in the rather ponderous way we have to date. 

And I recognise that we have real challenges in moving the health service we have today that people are used to into a different way of communicating, because there are lots of people that will expect to be able to communicate in the remote way that you have done in having an online consultation. So, a number of GPs are already able to and are investing in Skype for Business, which will allow that contact to be delivered in a different way. And I think more and more people will want to do that; there are others who will still want the rather more traditional face-to-face. So, we're asking GPs to be agile with their local healthcare team in the way in which they interact with patients and provide that care advice, treatment and support. So, investing in the architecture matters, and within that we have to make priorities and choices. So, is the investment in a hospital catering system the first priority we'd choose? I don't think it would be; I think there are other points where there is a larger impact on patient care and patient experience we would choose to invest in first. 

It comes back to the comments that I made honestly in this place and outside before about understanding our capacity to deliver some of that change, understanding the need to catch up with the way the public make choices about how they live their life already, and choosing to invest that time, energy and effort in areas that will make the biggest difference and the biggest return for the service and for the citizen as well, because the experience of people's care very much reflects on how people feel and their confidence about the quality of care they then receive as well. 

So, I recognise the challenges that you set out, and I recognise what the future could well look like in making greater use of digital. So, I don't apologise for, myself, having some restlessness over where we are, because I think it's really important to drive into our system to make clear that we can't say, actually, we can take lots and lots of time thinking and reconsidering what we're doing. But the statement today is to point out that we've made some real progress in the last three to four years. Actually, we need to make even faster progress in the next three to four years if we're going to catch up and deliver the sorts of services that people will, I think, more and more demand.

And you'll see some of that in the response to the Wales Audit Office report. The response will be provided—a full response—by the start of March I think is the timescale, but there will always be more for us to do. But today is a genuine attempt to set out progress made and to give people an assurance that we recognise there's much, much more that we need to do at a faster pace.  

Finally, Caroline Jones. 

Finally, thank you. Diolch, Dirprwy Llywydd. 

Thank you for your statement, Cabinet Secretary. Digital technology is transforming our health service. The use of information technology is vital to a modern NHS. We can’t go back to the days of paper records or a time when test results took weeks to arrive with our Royal Mail service.

I welcome the introduction of the Welsh patient referral system, which is speeding up the referral process and making it much more reliable. Cabinet Secretary how do you plan to expand upon this system? Aneurin Bevan Local Health Board has partnered with DrDoctor, which has digitised communications between patients and appointments management. The local health board have said that this system has already saved them £1 million from better clinic utilisation. Do you have any plans to encourage other local health boards to adopt similar systems?

I also welcome the investment in the Choose Pharmacy platform, and the benefits this is delivering to patient care. Cabinet Secretary, how will you be building upon the Choose Pharmacy IT system to ensure that everyone in Wales has access to online prescription ordering, regardless of where they live?

Digital technology is transforming healthcare for the better, but we have to ensure that it is properly implemented. We learnt yesterday that the majority of trusts in England who fell foul of last year’s cyber attack have still not secured their systems. Can you outline the steps we are taking in Wales to prevent such attacks on our primary care IT infrastructure?

Data scientists, information security specialists and software engineers are as vital to our NHS as the clinicians, pharmacists and allied health professionals who staff hospitals and GP surgeries. Can you outline how the Welsh Government plans to increase the IT workforce within the NHS?

And, finally, Cabinet Secretary, I would like to return to the issue of the GP IT systems. Many GP practices have undertaken significant investment in systems that integrate with EMIS. Can you outline what assistance the Welsh Government will be giving to those practices to ensure that their systems will work with replacement systems and how you will help to train staff on the EMIS replacement?

Thank you once again for your statement. I look forward to the further improvements digital technologies will bring to our NHS. Diolch yn fawr.

Thank you for those questions. On your final point, I think I've answered most of those points in response to Rhun ap Iorwerth, but, as I say, I expect all my officials—if not me, then my officials will be meeting with both the Royal College of General Practitioners and the BMA general practice committee to understand the practical steps that we'll need to take in rolling out a new system, in addition to providing a fuller explanation when we're able to about the reasons for the choice that has been made following the procurement.

On your point about workforce—how we develop and maintain a workforce—there's something here about exactly that: what will the workforce do? How much of our workforce will be needed to maintain our current systems and to sustain them and how much will we have to do to develop new products as well and then how will we then assess the product development that takes place outside the health service? We have lots of examples of different Welsh companies that are able to develop products that could and should help the service. There's a challenge about how quickly we assess that. So, Health Technology Wales should be able to help us assess the efficacy of some of this. We then need to get, at a much faster pace, into how we then adopt that technology and make choices across the country as well.

We invested about £10.5 million recently, in this financial year. I've approved that to accelerate some of our national systems. That should provide us with greater robustness in dealing with cyber attacks. The recent outage wasn't actually an issue about cyber attacks, but it does actually highlight the need to continue to improve our systems as well rather than simply assuming that if it hasn't fallen over it will all be okay. There's something there about the more general message for our healthcare systems as well about not waiting for something to go wrong before we look to improve it. Again, that's part of what this statement is supposed to set out.

In terms of people's ability to order prescriptions online, I don't think that's really about Choose Pharmacy. That's really about a proper use of myhealthonline or a successor product, and thinking about how easy it is to use for the individual citizen and also for the practice as well. We had about 220,000-odd people sign up to use myhealthonline but, actually, in a country of 3.1 million people, that's not enough. It's not a great enough proportion who are able to use it and access it and equally then to make sure that our general practices are able then and willing to properly use the whole system. There's also something about, for example, the greater use of texts and other things, about simple things that have actually improved people's awareness of what's going on and actually are just making sure that we don't lose time in the way that our appointments and infrastructure work as well. There's great waste and inefficiency in that, and digital technology will help to be part of the answer to try and reduce that. That should mean a better use of the healthcare professionals' time.

We talked previously about the use of telemedicine and telecare, and it's an issue both for hospital-based care but also in local healthcare as well—not just the comments that Lee Waters has made, but thinking about the opportunity to provide advice, guidance, care and treatment with a healthcare professional as well as to make sure we move information around our system to make sure it's getting to the right healthcare professionals to help make a choice, to have an informed conversation with the individual citizen. I think this goes back to Angela Burns's points at the start as well about the safe sharing of data and the effective use of data. The encouragement is that we have actually set ourselves on a path where we are looking to make that easier to do, to make it easier to share that data across our health and care system, and the other encouragement in that is I think we've turned the corner. A few years ago—well, certainly when I first became an Assembly Member, there was much greater reticence between health and care professional groups about sharing of data and information. I think we're in a different place now. Not only that but the public are ahead of where we are and ahead of where I think professionals are. They want and they expect us to be able to share that information, to help them to make choices, to make sure they don't have to repeat information to more than one person, and because they want us to be more joined up. That's where they want us to be. So, this isn't just an enabler, it's essential to delivering the vision for the future. Some of it happens now and we should celebrate and recognise that. The challenge as ever is how much more we could and should do to deliver better care, better outcomes and, actually, better value for all of us through our health and care system.

Thank you very much, Cabinet Secretary, and that brings today's proceedings to a close. Thank you.